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) and R Wootten.

It was noted that Councillor T Boston (North Kesteven District Council) was the replacement member for Councillor Mrs L Hagues (North Kesteven District Council) 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).

The Chairman also welcomed Councillors K Chalmers and J Loffhagen to their first meeting.

No declaration of members’ interest were received at this stage of the proceedings.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 13 April 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 17 May 2022.  The supplementary announcements referred to:

·       Membership information following the recent District Council elections;

·       Covid-19 Update, Appendix A to the supplementary announcements provided weekly briefing information prepared by Lincolnshire County Council Public Health;

·       Healthwatch Lincolnshire – latest findings on Access to Dental Services;

·       Draft guidance from NHS England and NHS Improvement entitled: Working in Partnership with People and Communities Draft Guidance; and

·       Extension of the United Lincolnshire Hospitals NHS Trust – Nuclear Medicine consultation period from 23 May to 6 June 2022.

A short discussion ensued, from which reference was made to the problems encountered when trying to access dental services; the welcomed opening of the Grantham Community Diagnostic Centre; and problems encountered by some patients regarding pharmacy provision, following the recent transfer of the Stackyard Surgery to the East Leicestershire and Rutland Clinical Commissioning Group.  The Chairman advised that this matter would be taken up with the Lincolnshire Clinical Commissioning Group.

RESOLVED

That the Supplementary announcements circulated on 17 May 2022 and the Chairman’s announcements as detailed on pages 17 to 26 of the report pack be noted.

(To receive a report from United Lincolnshire Hospitals NHS Trust (ULHT), which invites the Committee to consider the Lincolnshire Elective Recovery Plan 2022/23 and the response of ULHT to the inspection report by the Care Quality Commission.  Simon Evans, Chief Operating Officer ULHT and Sarah Brinkworth, Planned Programme Lead, Lincolnshire Clinical Commissioning Group 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 Lincolnshire Elective Recovery Plan 2022/23 and the response of ULHT to the inspection report by the Care Quality Commission (CQC).

The Chairman invited the following representatives from United Lincolnshire Hospitals NHS Trust: Simon Evans Chief Operating Officer, Karen Dunderdale, Director of Nursing and Sarah Brinkworth, Planned Programme Lead, Lincolnshire Clinical Commissioning to present the item to the Committee.

The following appendices were attached to the report for the Committee to consider:

·       Appendix A – provided a copy of the Lincolnshire Elective Recovery Plan 2022/23;

·       Appendix B – provided a copy of the Response to the Care Quality Commission Report;

·       Appendix C – provided a list of CQC ‘Must do’s’ & ‘Should do’s’; and

·       Appendix D –provided a copy of the CQC Improvement Action Plan.

In guiding the Committee through the report, reference was made to: the response to the Care Quality Commission Inspection report, the CQC’s required actions following the inspection which were detailed at Appendix C; the five ‘Must-do’ actions that the Trust had to take action on in order to comply with its legal obligations, these were shown on pages 29 to 30 of the report; the Trust’s CQC Improvement Action Plan, a copy of which was shown at Appendix D to the report; and Lincolnshire’s Elective Recovery Plan for 2022/23, which was detailed on pages 34 to 30 of the report.

It was highlighted that the Trust Board would receive regular progress updates and that progress would be monitored using the Trust’s established Blue, Red, Amber and Green (BRAG) ratings and that any identified risks would be escalated to the Trust’s performance review meetings and reporting through Executive and Trust Leadership team meetings.  It was highlighted that a revised approach to obtaining assurance linked to the CQC had recently been approved and would be implemented for all elements of the Trust’s monitoring and management of actions in response to the 2022 inspection report.  Details of the approved process were shown on page 32 of the report pack.

During discussion, the Committee raised some of the following comments:

·       Recruitment measures - The Committee was advised that since the Trust had left special measures, there had been an increase in the number of candidates applying for specialist positions in Lincolnshire, and that the Trust was marketing Lincolnshire, building on that positive news and to the fact that Lincolnshire was already managing to reduce its waiting lists.  It was highlighted that the Trust was also working with the University of Lincoln in respect of rotational posts and allied care worker positions, as well as looking into new emerging roles.  The Committee noted that the Trust had been successful in recruiting 220 health care support workers, some of whom were new to the care profession.  The Committee was advised that the number of student nurse placements had increased, and the benefit of these places would be seen in three years’ time.  The  ...  view the full minutes text for item 99.

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

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 Andrew Simpson, Consultant Urologist to present the item to the Committee.  Simon Evans, Chief Operating Officer ULHT, was also in attendance for this item.

Whilst guiding the Committee through the report,  some reference was made to the challenges facing urology services in early 2021; the 12 week consultation period; the update provided to the Committee at its 16 February 2022 meeting regarding the reconfigured service; the case for change; evaluation of performance, it was noted that from patient feedback, the main area of concern highlighted had related to communication and access to appointments, with no concerns being raised relating to the service reconfiguration itself;  public/patient engagement; and staff engagement; the elimination of cancellations, and the number of re-admissions had reduced; and the challenges of reducing the backlog. 

The Committee was advised that prior to the implementation of the new model, there had been a high reliance on agency medics.  As a result of investment into the service and the new model of working it was expected that there would be a cost improvement of approximately £160,000.

Paragraph 7 on page 161 of the report highlighted the key risks and issues to the continued success of the programme, which included the retention of middle grade doctors, compliance with the new service model and the establishment of a urology-trauma hub.

In conclusion, the Committee was advised that the model had now become embedded and accepted within the Trust as a safe and effective means of delivering urology services. There had been performance improvements, but these had been impacted by the significant urgent and emergency care pressures the Trust continued to experience.

To ensure that performance remained on track, the urology department, along with information services, were monitoring and tracking the key expected benefits via a dedicated dashboard.

It was also highlighted that a lessons learned exercise had been carried out by the project team to ensure knowledge transfer was shared across the Trust.

Appendix A to the report presented provided a copy of the Quality Impact Assessment for the Urology Services reconfiguration for the Committee to consider.

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

·       One member extended his congratulations to staff within the urology services for providing an excellent service;

·       Transport concerns were raised for patients attending Pilgrim Hospital, Boston and then being transferred to Lincoln.  The Committee noted that there was three levels of patients accessing Pilgrim Hospital, the first level were those requiring minor intervention; the second level were those with significant problems for example an obstruction, they would receive their imagery and diagnostics at Boston, and such patients would then be transferred to Lincoln; the third level, would be patients who were critical, and for these patients there was a critical care team in attendance at Boston and an on  ...  view the full minutes text for item 100.

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

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 177 to 179 of the report pack.

The Committee noted that the Humber Acute Services Review item would now be considered by the Committee at its 13 July 2022 meeting.

The Committee was advised that both the Quality Accounts Working Group and the Pharmaceutical Needs Assessment Group were both on course, and that the remit of the Suicide Prevention and Mental Health Working Group was being considered and discussed by members of the working group, and that a meeting would be scheduled shortly.

The Committee was also advised that the item ‘Staffing Challenges in Hospitals and NHS Lincolnshire People Plan’ scheduled for the 13 July 2022 meeting would answer some of comments raised by members earlier in the agenda regarding recruitment and retention.

It was also reported that there would be a GP Services update item for the 12 October 2022 meeting.

During consideration of this item, the following suggestions/comments were put forward:

·       Update on the Medical School at the University of Lincoln and its impact for Lincolnshire relating to recruitment and retention of staff, with a visit to the Medical School also suggested; and

·       To ensure that the Dental Services item, due to be considered on 15 June 2022, provided the necessary information for the Committee, the Chairman advised that he would be meeting representatives from NHS England to discuss the content of the item, including the potential of a dental school in Lincolnshire.

RESOLVED

That the Committee’s work programme as detailed on pages 177 to 179 of the report pack be received, subject to the comments/suggestions made above and the item agreed at minute number 99(2).