Agenda and minutes

Apologies for absence were received from Councillors S Barker-Milan (North Kesteven District Council), Mrs R Kayberry-Brown (South Kesteven District Council), C S Macey (Chairman – Lincolnshire County Council) and G Scalese (South Holland District Council).

The Committee noted that Councillor L Wootten (South Kesteven District Council) had replaced Councillor Mrs R Kayberry-Brown (South Kesteven District Council) for this meeting only.

An apology for absence was also received from Councillor S Woolley, (Executive Councillor for NHS Liaison and Community Engagement).

Councillor C J T H Brewis (Vice-Chairman) was in the chair.

There were no declarations of members' interest made at this stage of the meeting.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 22 July 2020 be agreed and signed by the Chairman as a correct record.

Further to the Chairman's announcements circulated with the agenda, the Vice-Chairman brought to the Committee's attention the supplementary announcements circulated prior to the meeting.

The supplementary announcements provided information on the following items:

·       Response of Edward Argar, MP, Minister of State for Health, to the Chairman's letter of 23 June 2020; and

·       Information on the Proposed Closure of the Woolsthorpe Surgery; and Annual Reports and Accounts 2019/20 and Annual Meetings.

Some members of the Committee expressed their concern and dismay to the response of Edward Argar, MP, Minister of State for Health to the Chairman's letter of 23 June 2020.

RESOLVED

That the Supplementary Chairman's announcements and the Chairman's announcements as detailed on pages 17 to 25 of the report be noted.

(To receive a report from United Lincolnshire Hospitals NHS Trust (ULHT), which enables the Committee to consider the progress made by the ULHT in its restoration and recovery following the acute phase of the Covid-19 pandemic.  Senior representatives from ULHT will be in attendance for this item)

The Committee was advised that item 5 could be found on pages 27 to 70 of the report pack.

The Vice-Chairman invited Mark Brassington, Director of Improvement and Integration and Deputy Chief Executive, United Lincolnshire Hospitals NHS Trust (ULHT) and Simon Evans, Chief Operating Officer, ULHT to present the report to the Committee.

At the 17 June 2020 meeting, the Committee had requested a further update from (ULHT) on the progress made on restoration and recovery following the acute phase of the Covid-19 pandemic.

Detailed at Appendix A to the report was a copy of a report to United Lincolnshire Hospitals Trust Board of Directors (1 September 2020) – ULHT Covid-19 recovery Phase Update – Progress Summary; and Appendix B provided a copy of a report to the United Lincolnshire Hospitals NHS Trust Board of Directors (7 July 2020) – ULHT Covid -19 Restore Phase Update – Progress Summary.

The Committee was advised that since 1 August 2020, the Trust was in Phase 3 - Recovery.  Details of targets set for the recovery of capacity levels were shown within the report.  The Committee noted Phase three planning had been split into 3 high levels, which were accelerating the return to near-normal levels of non-Covid health services; preparing for winter pressures, alongside continuing vigilance in light of further probable spikes; and taking into account lessons learnt from the first Covid peaks.

It was noted that the Trust's response to diagnostic recovery had been positive, with particular progress being made in endoscopy and radiology.  The Committee also noted that planned care waiting lists had continued to plateau after a period of decrease in the Restore Phase.

It was reported that cancer recovery had been positive.  It was noted that the Trust had met its objectives of reducing patients waiting times; the objective more than 62 days for treatment had been reduced by 20% by the 21 August 2020.  However, it was highlighted that patients waiting more than 103 days objective had not been met, but significant progress had been made in reducing the waiting list by more than 60%. 

It was highlighted that the Grantham 'green' site model continued to deliver an important part of the restoration of services as both cancer and planned care waiting lists had been reduced.  The Committee was advised that the Trust had conducted 680 operations for vulnerable patients to date.  It was also highlighted that some patients were still reluctant to return to access services, as they were not confident of their personal safety.

The Committee noted that the Trust had only had 14 days when there had been zero Covid-19 patients.

The Chief Operating Officer provided the Committee with an update on the progress made in restoring services to pre-Covid levels, full details of the Trusts Restore Phase response was contained within Appendix B to the report.

During discussion, the Committee raised the following points:

·         Congratulations were extended to the Trust and their team for all their hard work in reducing the  ...  view the full minutes text for item 18.

(To receive a report from the Sustainability and Transformation Partnership (STP), which enables the Committee to consider the final report on the Healthy Conversation 2019 engagement exercise and the next steps for the local NHS. Senior representatives from the STP and Lincolnshire Clinical Commissioning Group will be in attendance for this item)

The Vice-Chairman welcomed John Turner, Chief Executive, Lincolnshire Clinical Commissioning Group to the meeting and invited him to present the report to the Committee.

The item as detailed on pages 71-178 of the agenda report pack enabled the Committee to consider the final report on the Healthy Conversation 2019 engagement exercise; and to receive a progress update on the next steps to be taken by local NHS in developing plans for public consultation relating to elements of the Lincolnshire Acute Services Review.

It was reported that the Healthy Conversation 2019 engagement had identified some key messages from the people of Lincolnshire.  A copy of the final report was attached at Appendix B, together with five further supporting appendices:

·         B1 - Purpose and Activities;

·         B2 - Engagement Feedback;

·         B3 - Workshop Frequently Asked Questions;

·         B4 - Acute Services Review Survey Report;

·         B5 - The People’s Partnership Acute Services Review - Engagement with; and

·         Hidden and Hard to Reach Communities (Executive Summary).

A summary of the Committee's response relating to engagement was detailed on pages 73 and 74 of the report pack.

Also, detailed at Appendix A to report was a copy of the Health Scrutiny Committee for Lincolnshire – Responses to Specific Topics in the Healthy Conversation 2019 Engagement Exercise (pages 76 to 86 of the report pack).

The Committee was reminded that the Healthy Conversation 2019 engagement exercise had been launched in March 2019 and had concluded on 31 October 2019.  Healthy Conversation 2019 had enabled the NHS in Lincolnshire to have open engagement with residents of Lincolnshire to help shape how health care was taken forward in Lincolnshire.  The overarching campaign messages had been that the NHS needed to continue to change, improve quality and attract staff in order to be fit for purpose and for the future; and to review the way residents use its services.  

The Committee noted that all feedback received from the Healthy Conversation 2019 engagement exercise had helped shape the Long Term Plan (LTP) for the NHS in Lincolnshire.

Recognition was expressed that the whole process had taken a long time, but there had been external factors that had impacted on the process, not least the Covid-19 pandemic.  Confirmation was given that joint working was continuing with partners and the care home sector in light of Covid-19, and that it was hoped to refresh the Lincolnshire LTP over the next six months; and that it was hoped to publish the LTP in the spring of 2021.

The Committee was advised that consultation on the following four elements of the acute services review would take place first as they did not require significant capital funding:

·         Medical Services / Acute Medicine (Grantham and District Hospital);

·         Stroke Services;

·         Trauma and Orthopaedic Services (Centre of excellence); and

·         Urgent and Emergency Care Services.

The Committee noted that the remaining elements of the acute services review requiring significant capital funding, consultation would take place when funding was available:

·         Breast Services;

·         General Surgery Services;

·         Haematology and Oncology Services; and

·         Women’s and  ...  view the full minutes text for item 19.

(To receive a report from the Lincolnshire Clinical Commissioning Group, which provides the Committee with background on the establishment of the new Clinical Commissioning Group.  A senior representative from the Lincolnshire Clinical Commissioning Group will be in attendance for this item) 

The Chairman invited John Turner, Chief Executive, Lincolnshire Clinical Commissioning Group (LCCG) to provide the Committee with an update on the new Clinical Commissioning Group arrangements in Lincolnshire.

The Committee was advised that the new CCG for Lincolnshire had been established with effect from 1 April 2020.  It was noted that the merger of the four former CCGs into a new Lincolnshire CCG had not directly affected front line service provision.  It was noted further that CCGs were responsible for the commissioning of most health services, including mental health services, urgent and emergency care, elective hospital services and community care.

The Committee noted that the CCG Board (formally referred to as the governing body) comprised of:

·               The Chair

·               The Chief Executive

·               Director of Finance

·               Director of Nursing

·               Secondary Care Doctor

·               Seven Non-Executive Directors

·               Four Locality Clinical Leads; and

·               Two Primary Care Leads '

It was highlighted that the new organisation had a budget of £1.3 billion; and that as one CCG, its boundaries were consistent with those of the County Council.

The Committee was advised that the Lincolnshire CCG's goal was to ensure that everyone living in Lincolnshire had the best possible health and wellbeing they could, and that this would be achieved by working alongside other health care partners. 

The Committee was advised to do this, the vision was to deliver the ambitions identified in the NHS Long Term Plan, working with partners both in local and district councils, partners across the voluntary sector; and the people of Lincolnshire, to improve the quality and experience of services to enable the population of Lincolnshire to live happier and healthy lives; and to reduce the health inequalities that currently existed across the county.

Particular reference was made to the stronger working relationships that existed with partners in Lincolnshire, and that these had become more evident over the last few months.

During discussion, the Committee raised the following points:

·               Support was expressed for the new arrangement of four CCGs into one CCG.  The Committee was advised that the one CCG, with four localities, would recognise the different needs across Lincolnshire and that the differences played a major part when providing services.  It was felt that the current structure put Lincolnshire in the best place to do the best for the people it served.  The Committee also noted that one CCG was in a stronger position representing NHS in Lincolnshire, where previously, this had been more difficult.  The Committee noted further that the Chief Executive had a weekly conversation with the Midlands Regional Director, and that these conversations were constructive, as there was a will for the Lincolnshire NHS to succeed;

·               Budget – How much of the £1.3 billion budget went to Provider Trusts in the county and how much of the budget went out of county.  The Committee was advised that these figures were not to hand.  It was highlighted that lots of residents chose to go out of county for their treatment, and that there was virtually no flow into the  ...  view the full minutes text for item 20.

(To receive a report from Simon Evans, Health Scrutiny Officer,  which invites the Committee to consider its response to the consultation on the proposed NHS Rehabilitation Centre on the Stanford Estate, near Loughborough) 

The Vice-Chairman invited Simon Evans, Health Scrutiny Officer to present this item to the Committee.

On 19 February 2020, the Committee had agreed to engage in the consultation on the proposed NHS Rehabilitation Centre on the Stanford Hall estate, near Loughborough.

A draft response to the consultation had been circulated to all members of the Committee by email.  The Committee was advised that a further comment had been added for Q12 to the effect that 'The Committee would like to highlight the importance of mental health assessment at least three times a week, as stated in the consultation document'

The Committee extended their thanks to Simon Evans for his clear response document.

RESOLVED

That the draft response to the consultation with the added comment shown above be approved as the Health Scrutiny Committee for Lincolnshire's response to the consultation on NHS Rehabilitation Centre, Stanford Hall Estate, Near Loughborough. 

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider and comment on its work programme)

The Vice-Chairman invited Simon Evans, Health Scrutiny Officer to introduce the item to the Committee as detailed on pages 203 to 210 of the report pack.

The Committee noted that there was an addition to the work programme:

·               GP Appointments: Face to Face and Virtual.

The Committee also discussed items from the Chairman's Announcements item earlier in the agenda, these included:

·               Ash Villa – The Committee noted that Ash Villa was re-opening as acute inpatient unit for women;

·               Proposed Closure of the Woolsthorpe Surgery – The electoral division Councillor requested a copy of the consultation paper.  The Health Scrutiny Officer advised that there was going to be a public meeting via Teams and that he would forward on details to the said member;

·               Response from Edward Argar, MP, Minister of State for Health, dated 14 September 2020, to the Chairman's letter of the 23 June 2020.  The Committee agreed to record its dismay and request that the Chairman respond to Edward Argar, MP, Minister of State for Health, seeking clarification of the role of NHS England/Improvement in local decision making; and that copies of the said letter should also be sent to all local MP's.

RESOLVED

1.        That the work programme presented be received subject to the item listed above.

2.        That a response letter be sent on behalf the Committee to Edward Argar, MP, Secretary of State for Health, seeking clarification of the role of NHS England/Improvement in local NHS decision-making, and that a copy of the said letter should be sent to all local MP's.

3.        That details relating to the public meeting regarding the Woolsthorpe Surgery be passed on to the electoral division Councillor by the Health Scrutiny Officer.