Agenda and minutes

Apologies for absence were received from Councillors J Makinson-Sanders (East Lindsey District Council and J McGhee (West Lindsey District Council).

An apology for absence was also received from Councillor S Woolley (Executive Councillor NHS Liaison, Integrated Care System, Registration and Coroners).

Councillor R J Kendrick wished it to be noted that he was one of the Council’s representatives on the Lincolnshire Partnership NHS Foundation Trust – Council of Governors Stakeholder Group.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 6 December 2023 be approved and signed by the Chairman as a correct record.   

Further to the announcements circulated with the agenda, the Chairman brought to the Committee’s attention the supplementary announcements circulated on 23 January 2024, which referred to the following:

·       That Councillor Mrs D Rodgers had been replaced by Councillor J McGhee as the representative of West Lindsey District Council; and that Councillor M Westley would be the named replacement  member;

·       Information requested at the previous meeting relating to the National Prostrate Screening Trial;

·       Funding available for Autism Community Groups; and

·       Women’s health priorities for 2024. 

During consideration of this item, one member expressed disappointment that the data supplied in Appendix A to the Chairman’s announcements did not indicate the average number of appointments per person by age cohort, as it was felt in its present form the data did not provide the full picture.  The Committee noted that data on GP activity was often referred to as ‘experimental’ data.  The Health Scrutiny Officer agreed to check if there were any other sources of information available.

Further concern was expressed to the proposal to close the Springcliffe branch of the Brant Road GP Surgery in Lincoln, particularly when GP services were already stretched. One question posed was whether consultation was with patients of the surgery only or with the wider Lincoln community.  It was suspected that the consultation would have been circulated to registered patients rather than a wider consultation. The Health Scrutiny Officer agreed to confirm the extent of the consultation.

RESOLVED

That the supplementary announcements circulated on 23 January 2024 and the Chairman’s announcements as detailed on pages 15 to 24 of the report pack be noted.

(To receive a report from the East Midlands Ambulance Service (EMAS) NHS Trust, which provides the Committee with an update on current EMAS performance in the Lincolnshire Division and provides further assurance on progress made since June 2023.  Sue Cousland, EMAS Lincolnshire Divisional Director will be in attendance for this item)    

The Committee considered a report from the East Midlands Ambulance Service (EMAS), which provided an update on current EMAS performance in the Lincolnshire Division, which included information relating to:

·       A vision for the NHS Ambulance Sector, created by the Association of Ambulance Chief Executives;

·       Performance improvement, including activity for Greater Lincolnshire, resourcing and hours lost as a result of delays at hospital emergency departments;

·       Recruitment and retention; and

·       Emergency preparedness, resilience, and response, i.e., for Storm Babet

The Chairman invited the EMAS Lincolnshire Divisional Director, and the EMAS Head of Operations for Lincolnshire Division, to remotely present the item to the Committee.

During consideration of this item, the following comments were noted:

·       The Committee noted that at paragraph 3.3 of the report, second line, there was a typographical error the date should have been ‘Nov 2022’;

·       That a further Appendix would be circulated to members of the Committee following the meeting relating to paragraph 4.3 of the report pack;

·       Confirmation was provided that sickness levels were still high.  The Committee noted that the service was aiming for a 5% sickness figure which was in-line with national expectations.  It was highlighted that the long-term sickness elements were because of an ageing workforce, and that musculoskeletal reasons for absence aligned to the more mature workforce; and that some staff members who were exposed to traumatic incidents had to take time away from work with support from EMAS.  The Committee noted further that short-term sickness elements, were Covid, flu, cough, colds etc., as ambulance staff were constantly coming into contact with poorly patients;

·       The Committee was advised that Category 2 performance was still being maintained and that for the month of January it was at 41 minutes.  It was noted that the trajectory was to be closer to 30 minutes; and it was felt that quarter 4 would see that period of stability;

·       A request was made for future reports to include information relating to Category 1 performance;

·       The Committee was advised that ‘post-handover’ were actions that needed to be taken before the ambulance was available to respond to its next call.  For example, re-stocking, cleaning the vehicle and paperwork;

·       It was reported that there were a multitude of career options open to a paramedic, that could be in higher education, research primary care etc. The Committee was advised that the approach being taken was to make it easier for staff who chose to have multiple opportunities throughout their career, to gain more experience;

·       That figures relating to the rate of participation in the most recent staff survey would be made available to members of the Committee;  

·       It was reported that all elements of healthcare were experiencing high patient numbers.  It was noted that in some cases individuals could access alternatives to GP practices and A & E departments by employing self-care in the first instance.  It was noted further that education regarding access to the most appropriate health service would be continuing across the Lincolnshire system to improve the situation;

·       The Committee was  ...  view the full minutes text for item 61.

(To receive a report from NHS Lincolnshire Integrated Care Board and East Midlands Ambulance Service NHS Trust, which provides the Committee with an update on the Non-Emergency Patient Transport Service. Tim Fowler, Assistant Director of Contracting and Performance, NHS Lincolnshire Integrated Care Board, Sue Cousland, East Midlands Ambulance Service (EMAS) Lincolnshire Divisional Director and Joy Weldin, Head of Non-Emergency Trasport Services EMAS will be in attendance  for this item)

Consideration was given to a report from NHS Lincolnshire Integrated Care Board (ICB) and East Midlands Ambulance Service NHS Trust (EMAS), which provided the Committee with an update on the Non-Emergency Patient Transport Service (NEPTS).

The Chairman invited the Assistant Director of Contracting and Performance, NHS Lincolnshire Integrated Care Board, and the EMAS Head of Non-Emergency Transport Service, to remotely present the item to the Committee.

The Committee noted that the ICB had taken a modified approach within areas of the contract by transforming the traditional penalty Key Performance Indicators (KPIs) within the contract to overarching aims and objectives.  It was noted further that in addition there was a Local Incentive Scheme which was designed to continuously improve delivery in three key areas over the period of the contract:

·       Zero re-beds;

·       Delivery of a social value plan; and

·       Patient and Healthcare professionals’ satisfaction and partnership working.

EMAS Service Delivery Principles were detailed in Appendix A and details of the Performance of Service Delivery Principles were shown in Appendix B to the report presented.

In conclusion, it was noted that EMAS NEPTS services in Lincolnshire had seamlessly mobilised and were continuing to develop in line with the mobilisation plan and contractual requirements.

During consideration of this item, the following comments were noted:

·       The Committee was advised that with the structured contract, EMAS had to demonstrate as the contractor/provider that they were working to a local incentive scheme that included patient and healthcare practitioner satisfaction. For instance, for patients being collected from their appointment on time, if this was not achieved then when work was being done to assess patient satisfaction, patients would not be satisfied, which would mean that EMAS potentially would have a financial penalty, which would result in them losing some income from the contract.  It was noted that there was not a penalty attached to each of the delivery principles.  It was noted further that doing the contract this way provided a more holistic approach which helped the ICB as commissioners and EMAS have an insight into how patient satisfaction overall might work.  There was recognition that there was more to be done, but it was hoped that having EMAS as the transport provider allowed for greater synergy between patient service and the emergency service, and it also provided more career opportunities for individuals who joined the Patient Transport service who might want to progress into the emergency service. Some concern was expressed to the lack of outcomes and financial penalties. The Committee noted that the NHS was moving away from KPIs to working more collaboratively, and that the best way to find out whether that would work was to measure whether patients felt they were getting a good service or a poor service. There was recognition that this was a new way of working, but representatives were optimistic that the new way of working would provide a better service;

·       It was reported that at the moment there was no consistent comparison data in terms of performance  ...  view the full minutes text for item 62.

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

The Chairman invited the Health Scrutiny Officer, to present the report, which invited the Committee to consider and comment on its work programme, as detailed on pages 178 to 180 of the report pack.

The Heath Scrutiny Officer briefed the Committee on the items for consideration at the 21 February 2024 meeting.  It was noted that the update item from the Northwest Anglia NHS Foundation Trust was now being moved to the 20 March 2024 meeting, and that pressures on Services at Lincoln County Hospital would come forward from the items to be programmed list to the 21 February 2024 meeting now for consideration.

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

·       Delivery of healthcare provision and how that fits into the national picture; and

·       Pharmacy Services – Sourcing prescription Medicine.

RESOLVED

That the work programme presented on pages 178 to 180 of the report pack be agreed, subject to the inclusion of the suggestions put forward by the Committee above and the requests made at Minute numbers 61(3) and 62(3).

(To receive a report from NHS Lincolnshire Integrated Care Board, which provides the Committee with a summary of the proposed health care service provision to support the residents who would be living at RAF Scampton. David Harding, Deputy Director - Asylum and Detention Accommodation Programme from the Home Office will be in attendance for this item)

The Committee considered a report from the NHS Lincolnshire Integrated Care Board, which provided a summary of the proposed health care service provision to support Asylum Seekers at the former RAF Scampton.

The Chairman invited David Harding, Deputy Director – Asylum and Detention Accommodation Programme, Home Office to remotely present the item to the Committee.

The Committee was advised that since March 2023 there had been significant engagement with the NHS England’s Department for Health and Social Care and NHS Lincolnshire Integrated Care Board (ICB) to work through the specifics of the health care provision to be provided on the site, and to reduce the impact on local health services, particularly those living in the local vicinity.

It was reported that the existing medical centre on the site had been refurbished and the expectation was that the ground floor would be used to conduct both health assessments and the first floor would be utilised for secondary or further appointments with the medical team.

Confirmation was given that due to ongoing legal challenges, there was no confirmed date at which the site would be ready for occupation.  It was however noted that the Home Office had agreed a funding package with the ICB that covered both the set-up costs and costs to the end of the year.

The Committee was advised that when the site was ready to take an inflow of people, this would be done in a very controlled way, 30 individuals a day, no more than 150 individuals a week between Monday and Friday.

During consideration of this item, the following comments were noted:

·       It was reported that the medical provision on site would be in alignment with what was provided at the Wethersfield site in Essex, and essentially would be the same as would normally be expected at a local doctor’s surgery.  It was noted that referrals for more serious issues would be made into the local system.  Confirmation was given that there would be mental health provision.  Details relating to how many staff would be employed to provide primary care and mental health services and where health care professional were going to be recruited from were not known, and it was agreed this information would be requested after the meeting;

·       As details relating to the funding package between the Home Office and the ICB for the provision of health services at RAF Scampton were not available at the meeting, this information would be requested after the meeting;

·       Concern was expressed that staffing the medical provision at RAF Scampton would effect provision locally, as Lincolnshire’s healthcare system was already under huge pressure and continued to have issues with recruiting and retaining doctors, nurses and dentists. Confirmation was provided that there would not be any reliance on primary healthcare from the wider community, and that the GP provision set up on site would be paid for separately.  The Committee noted that having access to primary GP services on site would reduce the burden on GP services in  ...  view the full minutes text for item 64.

(To receive a report from Simon Evans, Health Scrutiny Officer, which provides the Committee with a copy of the Humber and Lincolnshire Joint Health Overview and Scrutiny Committee’s response to the consultation by the NHS Humber and North Yorkshire Integrated Care Board on services at Scunthorpe General Hospital and Diana Princess of Wales Hospital in Grimsby)  

Consideration was given to a report from the Health Scrutiny Officer, which provided the Committee with details of the Humber and Lincolnshire Joint Health Overview and Scrutiny Committee’s response to the consultation undertaken by the NHS Humber and North Yorkshire Integrated Care Board on services at Scunthorpe General Hospital and Diana Princes of Wales Hospital in Grimsby.  Details of the Joint Committee’s response was shown in Appendix A to the report.

During consideration of this item, members of the Committee who were members of the Lincolnshire Joint Health Overview and Scrutiny Committee expressed their concerns regarding the lack of consultation events held, the issues for Lincolnshire residents regarding travel and transport, and to the fact the response document should have identified the commonalties amongst the Councils which would have provided a firmer response to the proposed changes.  

RESOLVED

1.      That the Committee’s disappointment be recorded with the Joint Committee process, given that in this instance five local authorities were selected by NHS Humber and North Yorkshire Integrated Care Board as participants in the Joint Committee and there was minimal or no impact on the hospital services in two of those local authority areas.

2.      That the Committee’s position of not supporting the NHS Humber and North Yorkshire Integrated Care Board’s proposals for acute hospitals in Grimsby and Scunthorpe be confirmed, because of the potential negative impact on Lincolnshire residents and the lack of planning with regard to travel and transport.