Agenda and minutes

Venue: Council Chamber, County Offices, Newland, Lincoln LN1 1YL. View directions

Contact: Katrina Cope  Senior Democratic Services Officer

Media

Items
No. Item

68.

Apologies for Absence/Replacement Members

Minutes:

Apologies for absence were received from Councillors G Scalese (South Holland District Council) and R Wootten.

 

It was noted that the Chief Executive, having received notice under Regulation 13 of the Local Government (Committee and Political Groups) Regulations 1990, had appointed Councillor N Sear to replace Councillor R Wootten on the Committee for this meeting only.

 

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

69.

Declarations of Members' Interest

Minutes:

Councillor Mrs S Harrison (East Lindsey District Council) wished it to be noted that she was a member of the Lincolnshire Patient Group for the East Midlands Ambulance Service (EMAS).

70.

Minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 19 January 2022 pdf icon PDF 202 KB

Minutes:

RESOLVED

 

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 19 January 2022 be agreed and signed by the Chairman as a correct record.

71.

Chairman's Announcements pdf icon PDF 187 KB

Additional documents:

Minutes:

Further to the Chairman’s announcements circulated with the agenda, the Chairman brought to the Committees attention the supplementary announcements circulated on 15 February 2022.  The supplementary announcements referred to:

 

·       Care Quality Commission Report on United Lincolnshire Hospitals NHS Trust;

·       Covid-19 Update;

·       The Government’s Proposals for Health and Care Integration: Joining up Care for People, Places and Populations;

·       Intermediate Minor Oral Surgery – Response from NHS England (Midlands); and

·       NHS Support for Victims of Sexual Assault.

 

During a short discussion, some clarity was sought regarding the following:

 

·       How much money had been allocated from the East Midlands to Lincolnshire for Dental Services; and the time scale for spending the allocation.  The Committee noted that the amount would have to be spent within the existing financial year; and that confirmation would be sought regarding this, and the allocated amount for Lincolnshire;

·       Some questions were raised regarding mental health support.  The Committee was advised that an update would be received from Lincolnshire Partnership NHS Foundation Trust at the 13 April 2022 meeting; and

·       Findings of Care Quality Commission report for United Lincolnshire NHS Hospitals Trust.  It was highlighted that this item would be picked up later in the agenda when the Committee considered its work programme.

 

RESOLVED

 

That the Supplementary Chairman’s announcements circulated on 15 February 2022 and the Chairman announcements as detailed on pages 13 to 17 of the report pack be noted.

72.

East Midlands Ambulance Service Update

(To receive a report from the East Midlands Ambulance Service, which provides the Committee with an update on the various issues relating to the emergency ambulance service in Lincolnshire. Ben Holdaway, Director of Operations and Sue Cousland, Divisional Director for Lincolnshire will be in attendance for this item)

Additional documents:

Minutes:

The Chairman advised the Committee that this item had been circulated as part of the supplement issued on the 10 February 2022.

 

The Chairman invited the following presenters from East Midlands Ambulance Service (EMAS): Sue Cousland, Lincolnshire Divisional Director and Ben Holdaway, Director of Operations, to remotely present the report.

 

Note: Councillor S R Parkin joined the meeting at 10.20.am.

 

The presentation provided the Committee with an update on the EMAS, which made reference to:

 

·       The strategic vision, the strategy and supporting strategies; and the objectives of EMAS respond, develop and collaborate;

·       EMAS Performance 2021/22 – Quarter 1 to Quarter 3. 

·       Lincolnshire Performance 2021/22 – Quarter 1 to Quarter 3.  It was noted that the number of Lincolnshire incidents had continued to increase, and details of activity rates, conveyances, operational resources and pre-handovers were shared with the Committee.  It was noted that there had been a downward trend in conveyances;

·       Details relating to the reshaping of operations, service improvements were shared;

·       The importance of system relationships and that the positive benefits from the pandemic had been enhanced system working with all stakeholders;

·       In relation to system relationships strategically and with providers, particular reference was made to the relationship with United Lincolnshire Hospitals NHS Trust and Lincolnshire Community Health Services NHS Trust;

·       Lincolnshire Initiatives; and

·       Priorities for 2022/23.  It was highlighted that the top priority for EMAS was to provide safe and effective care delivery.  There was recognition that some responses to patients were delayed, but when crews arrived the service delivered was a quality service.  Reference was also made to empowering staff to reach their full potential; and improving efficiency and effectiveness of all resources.

 

During discussion, the Committee raised the following comments:-

 

·       Whether the times for Lincolnshire pre-handovers were averages.  Confirmation was given that the figures provided were mean averages and that the service recorded data on 90th percentile and 95th percentiles.  There was recognition that some people were waiting longer and, similarly some people were waiting less time.  Confirmation was also given that in circumstances where patients required care immediately, these were prioritised.  Reassurance was also given that processes were in place to ensure patients received the care they required as soon as possible;

·       Some concern was expressed, from personal experience to the questions asked by 999-call handlers regarding the condition of patients.  The Committee noted that the 999-call handlers used a script based on a series of algorithms to assess the information provided and initiate the most appropriate response.  There was recognition that it was sometimes difficult for a caller to communicate the exact nature of the problem, but call handlers were trained to get the best information they could to help identify the problem.  The Committee noted that all calls were prioritised and allocated to one of five categories, with category one being the top priority, and that EMAS aimed to get to these patients within seven minutes; with 99% of them being within 15 minutes.  Confirmation was also given that  ...  view the full minutes text for item 72.

73.

NHS Continuing Healthcare

(To receive a report from Lincolnshire Clinical Commissioning Group, which provides the Committee with an update on NHS Continuing Healthcare.  Wendy Martin, Associate Director of Nursing and Quality will be in attendance for this item)

Additional documents:

Minutes:

Consideration was given to a report from the NHS Lincolnshire Clinical Commissioning Group, which provided the Committee with an update on NHS Continuing Healthcare, a defined package of ongoing care arranged and funded solely by the NHS, where an individual had been assessed and found to have a ‘primary health need’

 

The Chairman invited the following representatives from the NHS Lincolnshire Clinical Commissioning Group: Wendy Martin, Associate Director of Nursing and Quality and Helen Sands, Continuing Healthcare Clinical Lead, to remotely, present the item to the Committee.

 

The Committee noted that this item and been circulated as part of the supplement on 10 February 2022.

 

The Committee was advised of the background to NHS Continuing Healthcare, primary health need, NHS-Funded Nursing Care and the roles of the NHS and Local Authorities.

 

It was reported that Lincolnshire Clinical Commissioning Group (CCG) had an in-house Continuing Healthcare team and that the team comprised of five main areas, details of which were shown within the report presented.

 

Details of the expenditure on Continuing Healthcare for 2020/21 was shown on the bottom of page 17 of the supplementary report pack for consideration by the Committee.

 

During consideration of the item, the Committee raised the following comments:

 

·       If a patient’s circumstances changed to the point that they were no longer eligible for continuing healthcare, but they still needed support, what measures were in place to ensure a smooth transition to another service.  It was reported that a package of care was not handed over until it was known that there was a subsequent package of care in place.  It was reported further that a 14 day notice period would be given to end continuing healthcare packages and that during that time an assessment would always be done with social care colleagues, and that ongoing discussion would continue with workers to see if any funding needed to be carried on until the package of care was in place;

·       What measures were in place to ensure that accessing the service was not too complicated, and how long, if a patient was not fast tracked, did the process take.  The Committee was informed that there was 28-day process, informed through a checklist of need via the health care worker or social care worker.  The Committee was advised that the process was a national process which could not be changed, and the starting point was receiving the checklist.  It was noted that so far, the 28-day process time had been met;

·       Whether there was an appeals process and what percentage were accepted for continuing healthcare.  The Committee noted that there was an appeals process for the checklist stage.  Unfortunately, the percentage accepted was not a figure available at the meeting;

·       Whether the access to NHS continuing healthcare was fair and equitable.  The Committee was advised that the CCG had reviewed their process over the last three years to ensure that the process was fair and equitable;

·       Whether the demand for NHS continuing healthcare was expected to increase over the  ...  view the full minutes text for item 73.

74.

Suicide Prevention in Lincolnshire pdf icon PDF 302 KB

(To receive a report from Lucy Gavens, Consultant in Public Health, Public Health Division, Lincolnshire County Council, which provides the Committee with information on recent suicides in Lincolnshire and the action being taken locally to reduce future suicide deaths)

Additional documents:

Minutes:

Consideration was given to a report from the Director of Public Health, which provided the Committee with information on recent suicides in Lincolnshire and the action being taken locally to reduce future suicide deaths.

 

The Chairman invited Lucy Gavens, Consultant in Public Health, Public Health Division, to remotely, present the item to the Committee.

 

In guiding the Committee through the report, reference was made to the number of suicide deaths (5,224) registered in England and Wales in 2020; the number of suicide deaths (90) in Lincolnshire in 2020.  It was noted that between 2018 and 2020 the male suicide rate in Lincolnshire was 20.3 per 100,000, which was significantly higher that the England average (15.0 per 100,000).  Figure 2, on page 21 of the report provided details of directly standardised mortality rates due to suicide in Lincolnshire, by gender. Figure 3, on page 23 of the report provided details of suicide rates by district.  It was highlighted that Lincoln had the highest suicide rates in the county since 2010/12, except for 2015/17 when rates were highest in East Lindsey.

 

The Committee was advised of the key factors that increased the risk of death by suicide; details relating to preventing suicide in Lincolnshire.  Appendix A to the report provided the Committee with a copy of the Authority’s suicide audit, and Appendix B provided a copy of the Lincolnshire Suicide Prevention Strategy for the Committee to consider.  The Committee noted the Lincolnshire Suicide Prevention Strategy five ‘Priorities for Action’; the key actions in 2020/21; and the key priorities for 2022.

 

During consideration of this item, the Committee raised the following comments:

 

·       Why people were waiting so long for treatment.  The Committee noted that work was ongoing with Lincolnshire Partnership NHS Foundation Trust (LPFT) around how to make sure that children and young people and adults could be identified before the point of crisis.  It was noted further that a group of senior stakeholders across the system were looking at this, to make sure that the support pathways were joined up, as it was anticipated that the impact of Covid-19 on mental health and wellbeing had been significant.  It was also reported that more needed to be done to support individuals, their families and communities to be able to have conversations and to be able to access the support needed for anyone at risk of suicide;

·       Concern was expressed to the Covid-19 and economic pressures and the impact this was having on families and communities, and that vulnerable people needed to know who to contact for help and support.  There was recognition that it was hard to reach individuals who were not already in contact with mental health services.  It was recognised that more need to be done to obtain more information about the impact of Covid-19 on suicide deaths and to gain an understanding on what the key risks were.  With regard to financial struggles, it was highlighted that officers were working with the Financial Inclusion Partnership to better understand the key  ...  view the full minutes text for item 74.

75.

United Lincolnshire Hospitals NHS Trust- Reconfiguration of Urology Services Update pdf icon PDF 776 KB

(To receive a report from United Lincolnshire Hospitals NHS Trust, which provides the Committee with an update of the implementation of the new model for urology in Lincolnshire’s hospitals.  Dr Colin Farquharson, Medical Director and Mr Andrew Simpson, Consultant Urologist will be in attendance for this item)

Minutes:

Consideration was given to a report from United Lincolnshire Hospitals NHS Trust (ULHT), which provided the Committee with an update of the implementation of the new model for urology in Lincolnshire’s hospitals.

 

The Chairman invited the following representatives from ULHT: Dr Colin Farquharson, Medical Director and Mr Andrew Simpson, Consultant Urologist, to remotely present the item to the Committee.

 

The Committee was reminded of the challenges facing urology services across Lincolnshire’s hospitals, the public engagement exercise to consult upon the proposed changes, and the subsequent approval by the ULHT Board on 2 August 2021 to the proposed changes.

 

The Committee were advised of the model of service; the case for change; the benefits of the reconfigured service to date; non-elective performance, it was noted that non-elective admissions were now significantly lower than they were Trust-wide before the re-configuration, and that this trend would be monitored; average length of stay on the urology non-elective pathway; the quality impact assessment; patient feedback, it was noted that to date although patient survey responses had been low, no negative feedback or formal complaints had been received; public/patient engagement in the process; staff engagement; finance; and key risks and issues.

 

In conclusion, the Committee was advised that the expected benefits of the model and its wider impact were continuing to be being monitored.

 

During discussion, the Committee raised the following points:

 

·       The reluctance of some patients to engage with services due to Covid-19.  Confirmation was given that Covid-19 had clearly affected the willingness and ability of some people to engage with services.  Confirmation was given that so far in February there had been no cancellations due to elective bed pressures, despite considerable emergency activity at hospital sites;

·       Level of response received from the consultation and the themes of concern had been highlighted.  It was reported that the level of response from patient feedback had been limited (3 responses).  Confirmation was given that there had not been any concerns raised apart from one isolated complaint.  There was recognition that further feedback from patients and staff was necessary.  It was highlighted that from 50 staff, 20 responses had been received.  The Committee was advised that the feedback exercise would be repeated;

·       When would there be evidence of reduced cancellations of elective appointments and improvements to cancer care.  The Committee was advised that there was an expectation to see reduced cancellations due to the split between emergency and elective care, which at present was not supported by the present data, and as a result this information would be reported to a future meeting of the Committee.  Regarding cancer care, the Committee was advised that there had been a reduction in the most urgent cases, but the service was still struggling with its cancer performance figures.  It was highlighted that the introduction of robotic surgery would reduce reliance from other providers to deliver the most complex cases; and

·       Whether the urology/trauma assessment hub had progressed any further and if not, when was it likely to be put in place.  ...  view the full minutes text for item 75.

76.

Health Scrutiny Committee for Lincolnshire - Work Programme pdf icon PDF 230 KB

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

Minutes:

The Chairman invited Simon Evans, Health Scrutiny Officer, to present the report, which invited the Committee to consider and comment on its work programme as detailed on pages 73 to 76 of the report pack.

 

The Committee noted that the item on Nuclear Medicine would be included on the work programme for the March meeting, and that the Lincolnshire Pharmaceutical Needs Assessment item would not be a substantive item, but a working group would need to be considered to respond to the draft document.

 

From the items considered earlier in the agenda, it was highlighted that a urology update would be received in either May/June; and that a report would be received concerning United Lincolnshire NHS Hospital Trusts progress on the response from the Care Quality Commission report; and that a working group would be set up to look into the issues relating to suicides in Lincolnshire.

 

During consideration of this item, the Committee raised the following suggestions:

 

·       North West Anglian NHS Foundation Trust (NWAFT) – Revised Estate Strategy; and

·       Recovery planning of the NHS;

 

RESOLVED

 

That the work programme presented be agreed subject to the inclusion of the items/suggestions highlighted.

 

 
 
dot

Original Text: