Agenda and minutes

Apologies for absence were received from Councillors Mrs L Hagues (North Kesteven District Council), Mrs S Harrison (East Lindsey District Council), G P Scalese (South Holland District Council), Mark Whittington (South Kesteven District Council), S Woodliffe (Boston Borough Council) and B P Wookey (Healthwatch Lincolnshire).

Note: Councillor M Whittington observed the meeting remotely, via Teams.

Apologies for absence were also received from Councillors C Matthews (Executive Support Councillor for NHS Liaison, Community Engagement, Registration and Coroner’s Services) and Mrs S Woolley (Executive Councillor NHS Liaison, Community Engagement, Registration and Coroner’s Services).

Councillor M E Thompson wished it to be noted that he had an appointment scheduled with United Lincolnshire NHS Hospitals Trust.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 16 February 2022 be agreed and signed by the Chairman as a correct record.

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

·       Information requested from the last meeting of the Committee held on 16 February 2022;

·       Covid-19 update;

·       The reshaping of health services in Nottinghamshire;

·       The NHS proposed new standards for the treatment of cancer;

·       The Health and Care Bill; and

·       National trade media report in relation to United Lincolnshire Hospitals NHS Trust.

During discussion, some concern was expressed to the rising number of Covid-19 cases across Lincolnshire.

One member also enquired whether Ashley House, Grantham would be re-opening after being temporarily closed.   The Committee was advised that a request would be made for this to be included in the update from Lincolnshire Partnership NHS Foundation Trust which was due to be received at the 13 April 2022 meeting.

RESOLVED

That the Supplementary Chairman’s announcements circulated on 15 March 2022 and the Chairman’s announcements as detailed on pages 17 to 23 of the report pack be noted. 

(To receive a report from United Lincolnshire Hospitals NHS Trust, which invites the Committee to consider the information presented on the inspection report by the Care Quality Commission on United Lincolnshire Hospitals NHS Trust, and the Trust’s actions in response to the inspection report.  Andrew Morgan, Chief Executive and Karen Dunderdale, Deputy Chief Executive and Director of Nursing, at United Lincolnshire Hospitals NHS Trust will be in attendance for this item)   

Consideration was given to a report from United Lincolnshire Hospitals NHS Trust (ULHT), which invited the Committee to consider the information presented on the inspection report by the Care Quality Commission (CQC), and the Trust’s actions in response to the inspection report.

The Chairman invited the following representatives from United Lincolnshire Hospitals NHS Trust: Andrew Morgan, Chief Executive and Karen Dunderdale, Deputy Chief Executive and Director of Nursing, to remotely, present the item to the Committee.

In guiding the Committee through the report, mention was made to the unannounced core-service inspection and the announced ‘well-led’ inspection during the months of October and November 2021; the findings of the CQC report published on 8 February 2022, these were shown in Appendix A to the report; and Appendix B provided the Committee with details of the key findings of the report for their consideration.

It was reported that overall, the CQC had recognised the widespread improvements made by the Trust in the quality and safety of services since the last inspection in 2019.  Positive comments were also received about the Trust having a strong cohesive team with collective leadership at Board level.  The Committee was advised that the overall Trust CQC rating remained as being ‘Requires Improvement’.  It was highlighted that the overall rating of ULHT was not able to be changed, as the CQC had not inspected all services on all sites.

Comparison information with the previous 2019 ratings were set out on pages 27 to 30 of the report for the Committee’s consideration.

In conclusion, the Committee noted that the ULHT Board of Directors had considered the CQC report at their meeting on 1 March 2022, at which they had acknowledged the widespread improvements made and recognised that further improvements were required.  They had also endorsed the preparation of an action plan to be submitted to the CQC, as required, by 10 March 2022.

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

·       Some concern was expressed that Lincoln County Hospital still required improvement;

·       The good rating for Grantham and District Hospital and the excellent service provided by staff at the hospital.  The Committee noted that Grantham Hospital remained a key part of the Trust’s services; and confirmation was given that not all services could not be provided at all sites, as the Trust needed to ensure that services operated within safety standards and remained sustainable;

·       The need for the Committee to have access to the latest action plan;

·       The 2017 special measures.  The Committee was advised that the Trust was put into special measures because of quality, safety, and financial issues by NHS England (NHSE).  It was noted that the CQC had written to the NHSE concerning the recovery programme status, and it was hoped that the Trust would soon be exiting special measures and the recovery programme.  The Trust offered to share the action plan with the Committee at its May meeting;

·       Medicine Storage.  It was reported that significant work had been undertaken  ...  view the full minutes text for item 81.

(To receive a report from United Lincolnshire Hospitals NHS Trust, which invites the Committee to consider and comment on the service proposals and to formulate a formal response to the consultation.  Laura White, Head of Nuclear Medicine at United Lincolnshire Hospitals NHS Trust will be in attendance for this item)

Consideration was given to a report from United Lincolnshire Hospitals NHS Trust (ULHT), which invited the Committee to comment on the service proposals, and to formulate a formal response to the public consultation on Nuclear Medicine Services at ULHT, which was due to close on the 23 May 2022. 

Attached at Appendix A to the report was a copy of consultation document for the Committee’s consideration.

The Chairman invited Laura White, Head of Nuclear Medicine ULHT and Anna Richards, Associate Director of Communications and Engagement ULHT, to remotely, present the item to the Committee.

In guiding the Committee through the report reference was made to:

·       the background to the nuclear service at ULHT;

·       the challenges faced by nuclear medicine nationally;

·       the challenges faced by the nuclear medicine service in Lincolnshire with the shortage of clinical technologists.  Staffing information was provided on page 69 of the report pack for the three sites currently providing nuclear medicine services;

·       the case for change, it was noted that at present staff and services were spread so thinly across the three sites, and that low levels of staff absence impacted on the amount of work the service could perform; and

·       the options appraisal, this identified that the safest way to provide a sustainable, long-term service was to reduce the number of where sites nuclear medicine was provided, which would then reduce the redundancy of equipment and create a greater capacity to replace aged equipment and allow for better staff cover.  Details of all the options were shown on pages 72 to 80 of the report pack.

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

·       As there was a shortage of technologist nationally, how were other hospital trusts managing the service.  The Committee noted that all areas were in a similar position, as this was a national problem.  The problem was training and retaining staff whilst still providing a service.  It highlighted that Lincolnshire had converted one of its technologist posts to an apprentice post in a bid to grow their own technologists.  It was also highlighted that there was a shortage of radiologists in Lincolnshire who held an Administration of Radioactive Substances Advisory Committee (ARSAC) licence and trained Medical Physics Experts;

·       Some concern was expressed that equipment had not been replaced earlier and to the proposed reduction in the service at Grantham Hospital;

·       Whether the service had experienced any supply issues of radioactive materials.  Reassurance was given that cancer patients were prioritised, but it was not known what the longer-term effect would be;

·       Some members felt that the consultation appeared to be pre-determined;

·       It was highlighted that the NHS nationally should have confronted the issue of a shortage of specialist staff earlier and should have ensured that training was available to ensure continuity of the service.  The Committee was advised that ULHT was trying to run an efficient service and reducing the number of sites nuclear medicine was provided from was a sustainable option; and

·       Concern was expressed that centralising services  ...  view the full minutes text for item 82.

(To receive a report from the NHS Lincolnshire Clinical Commissioning Group, which provides the Committee with an update on the Community Pain Management Service (CPMS).  A senior representative from Lincolnshire Clinical Commissioning Group will be in attendance for this item)

The Committee considered a report from NHS Lincolnshire Clinical Commissioning Group (LCCG), which provided an update on the Community Pain Management Service (CPM).

The Chairman invited Tim Fowler, Associate Director of Contracting and Performance, to remotely, present the item to the Committee.

In guiding the Committee through the report reference was made to: the background behind the service; the LCCG commentary, which included a Covid-19 update, quality reporting and key performance indicator information.

In conclusion, the Committee was advised that the CPMS had made improvements in access and performance over the last six months, and it was expected that these would be sustained for future months.  It was also highlighted that the service continued to be commissioned and delivered in accordance with the National Institute of Health and Care Excellence (NICE) and British Pain Society guidance.

The Committee was also advised that no quality concerns had been identified, and that reported patient’s experiences, and outcomes were good.

Appendix A provided Key Performance Indicator summary details for the period April 2021 to January 2022 for consideration by the Committee.

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

·       The type of treatment offered to patients.  The Committee noted that the service was delivered in accordance with the National Institute of Health and Care Excellence (NICE) and British Pain Society guidance.  However, it was noted that in some circumstances patients did continue to receive injections;

·       The strain of chronic pain on an individual’s mental health.  One member enquired whether people were being referred to the service by GPs in a timely way.  The Committee was advised that GPs were all well aware of the service; but there was unfortunately no evidence that patients were being referred at the right time.   One member also highlighted that someone not being referred in a timely manner could also have an impact on their mental health and in some circumstances could lead to suicide. The Associate Director agreed to look into the matter further and report back if there were any concerns regarding referrals and whether there was a link to suicide rates;

·       Clarification was given that the data provided was point-in-time data;

·       What was the outcome from the CCG raising the issues found from the negative feedback with Connect Health and what lessons had been learnt.    The Committee noted that no issues had been raised;

·       Had the pandemic affected the level of demand for the service.  The Committee was advised that the demand for service had slightly reduced, but had now started to return to normal levels; and

·       Confirmation was given that the contract was due for renewal in April 2024.

RESOLVED

1.      That the Lincolnshire Clinical Commissioning Group be thanked for presenting information on the Community Pain Management Service.

2.      That the Committee’s consideration of regular updates on the Community Pain Management Service since October 2019 be noted and in view of the sustained improvement of the service and positive patient feedback, no further updates be received, unless a significant change in  ...  view the full minutes text for item 83.

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider its approach to the Quality Accounts for 2021-22 and to identify its preferred option for responding to the draft Quality Accounts for 2022)

Consideration was given to a report from the Simon Evans, Health Scrutiny Officer, which invited the Committee to consider its approach to the Quality Accounts for 2021/22 and to identify its preferred option for responding to the draft Quality Accounts, details of which shown on pages 91 and 92 of the report pack.

During consideration of this item, the Committee agreed to consider the following statements on the draft Quality Accounts for 2021/22 for the following providers: East Midlands Ambulance Service NHS Trust, United Lincolnshire Hospitals NHS Trust and North West Anglia NHS Foundation Trust.

The following Committee members volunteered to be part of a working group: Councillors R J Cleaver, C S Macey, S R Parkin, Mrs A White, M A Whittington, L Wootten and R Wootten.

RESOLVED

1.      That statements on the draft Quality Accounts for 2021/22 be made on the following local providers of NHS-funded services: East Midlands Ambulance Service NHS Trust; United Lincolnshire Hospitals Trust; and

North West Anglia NHS Foundation Trust.

2.      That the working groups include the following Councillors: R J Cleaver, C S Macey, S R Parkin, Mrs A White M A Whittington, L Wootten and R Wootten.

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

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 98 to 99 of the report pack.

The Committee was invited to consider setting up a working group to consider and respond to the consultation of the Lincolnshire Pharmaceutical Needs Assessment as detailed in section 4 of the report.

The Committee also considered the establishment of a working group to consider access to mental health services but agreed to wait until after its next meeting on 13 April 2022, as the Committee was due to receive a general update report from Lincolnshire Partnership NHS Foundation Trust. The suggestion for a working group had been made on 16 February 2022 following the Committee’s consideration of an item on Suicide Prevention.

It was confirmed that as GP Practices were NHS funded services, it was appropriate for the Committee to give consideration to them, in particular how they delivered their contractual obligations.

It was requested that the item from Lincolnshire Partnership NHS Foundation Trust on 13 April 2022 make reference to the Mental Health and Wellbeing Champions.

RESOLVED

1.     That the work programme presented be agreed subject to the inclusion of the items/suggestion raised above; and the inclusion of the United Lincolnshire Hospitals NHS Trust Recovery and Action Plan in response to the Care Quality Commission report, and the Committee’s draft response to the Nuclear Medicine Consultation for the 18 May 2022 meeting.

2.     That a working group be established to respond to the consultation draft of the Lincolnshire Pharmaceutical Needs Assessment.  The working group to include the following members: Councillors C S Macey, Mrs A White, L Wootten and R Wootten.