Agenda and minutes

Apologies for absence were received from Councillors J McGhee (West Lindsey District Council) and S Welberry (Boston Borough Council).

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

The following declarations of members’ interest were made at this stage of the proceedings:

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.

Councillor T J N Smith advised that in relation to agenda item 6, he was a member of the Veterans Advisory Pension Committee.

Councillor C Morgan wished it to be noted that she was on the Patient Panel of United Lincolnshire Hospital Trust.

And Councillor C Matthews (Executive Support Councillor for NHS Liaison, Integrated Care System, Registration and Coroners) wished it to be noted that he was also 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 24 January 2024 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 20 February 2024, which referred to the following:

·       An update relating to information requested at the previous meeting;

·       Government consultation on Giving the General Dental Council Powers to register Dentists on a Temporary Basis;

·       An update on the latest position concerning Reinforced Autoclaved Aerated Concrete.  The Committee noted that the 18-month project which began in December 2023 by a team of specialist engineers being carried out at the Queen Elizabeth’s Hospital, Kings Lynn was progressing well; and

·       That Andrew Morgan was continuing to be the Group Chief Executive of Lincolnshire Community Health Services NHS Trust (LCHS) and United Lincolnshire Hospitals NHS Trust (ULHT) until the end of June 2024, to allow for recruitment and a period of transition for the new postholder.

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

·       Some concern was expressed regarding the potential loss of beds following the review of high dependency mental health rehabilitation services provided at The Vales, a 15-bed ward located at Discovery House, Lincoln;

·       Further concern was raised regarding the delayed re-opening of the Hartsholme Centre, due to high levels of the legionella.  The Health Scrutiny Officer advised that as there were now a couple of issues regarding Lincolnshire Partnership NHS Foundation Trust, it was suggested that an update item could be considered at a future meeting;

·       That more needed to done regarding the NHS Dental Recovery Plan, with particular reference being made for the need to change dentistry contracts from 2006;

·       One member advised that the parameters regarding patient transport were set at a national level, and that any changes in policy would have to be made by NHS England.  The Chairman advised that any updates in this regard would be provided via Chairman’s announcements; and

·       Confirmation was provided that further information regarding ambulance conveyances to Grantham Urgent Treatment Centre was contained within Chairman’s announcements on page 18 and 19 of the report pack.

RESOLVED

That the supplementary announcements circulated on 20 February 2024 and the Chairmans’s announcements as detailed on pages 15 to 20 of the report pack be noted.

(To receive a report from Derek Ward, Director of Public Health, Lincolnshire County Council, which invites the Committee to note the contents of the Annual Report by the Director of Public Health – Adding Life to Years)

Consideration was given to a report from the Director of Public Health, which invited the Committee to note the contents of the Annual Report by the Director of Public Health – Adding Life to Years. 

The Committee noted that the Director of Public Health had a statutory duty to produce an annual report and that the County Council had a statutory duty to publish the said report.  A copy of the annual report was attached at Appendix A to the report presented for members of the Committee to consider.

The Chairman invited the Director of Public Health, Lincolnshire County Council to present the item to the Committee.

The Committee noted that this year’s report was a joint report between the Director of Public Health and Glen Garrod Executive Director of Adult Care and Community Wellbeing who was due to retire in April 2024.

It was highlighted that the annual report described how the World Health Organisation (WHO) Age Friendly Cities Framework could be applied to the older population of Lincolnshire.  It was noted that as part of the strategic partnership with the Centre for Ageing Better, the Committee was advised that this year the Director of Public Health’s report was focused on Ageing Better in Lincolnshire.  It was noted that the report described the key determinants of healthy ageing and what could be done to support and improve the well-being of older residents, particularly those living in rural and coastal areas. Figure one on page 27 of the report pack provided a diagram of the key elements for ageing better in the form of a flower with eight petals, the Committee noted that each of the areas (petals) were connected which was vital for each element to be taken forward.

The report highlighted that Lincolnshire had an ageing population and that projections were that the over 65 population in the next twenty years would increase by more than 40%; and that the over 85 population would double in its projection.  There was recognition that people were now living loner and as a result there was a need to change services, to support individuals to age well and to be as healthy as they could.

In conclusion, the Committee were advised of the five recommendations of the report, these were shown on pages 53 and 54 of the report pack.  The Director of Public Health advised that he would be having conversations with all stakeholders to ensure that these were taken forward.

During consideration of the Director of Public Health’s Annual Report – Adding Life to Years document, the following comments were noted:

·       That further consideration was needed to target younger age groups, particularly with regard to preventative measures, for example, avoiding trips and falls, healthy diet, keeping fit and healthy etc.  There was recognition that there was more to be done to encourage younger age groups to improve their balance and core strength, and that by removing environmental factors to avoid trips and falls, such as having proper slippers, not  ...  view the full minutes text for item 70.

(To receive a report from Derek Ward, Director of Public Health, Lincolnshire County Council (LCC) which invites the Committee to comment on the Joint Health and Wellbeing Strategy for Lincolnshire 2024 and the Better Lives Lincolnshire Integrated Care Partnership Strategy 2024, prior to their approval and publication in March 2024.  Michelle Andrews, Assistant Director Integrated Care System, Public Health LCC, Alison Christie, Programme Manager Strategy and Development LCC and Pete Burnett, Director of Strategic Planning, Integration and Partnerships, NHS Lincolnshire Integrated Care Board will also be in attendance for this item)

Consideration was given to a report from the Director of Public Health, which invited the Committee to consider and comment on the draft Joint Health and Wellbeing Strategy (JHWS) 2024 and the Better Lives Lincolnshire Integrated Care Partnership Strategy 2024 (ICP), prior to their approval and publication in March 2024.

The Chairman invited the Director of Public Health, Lincolnshire County Council (LCC) the Programme Manager Strategy and Development (LCC) and the Director of Strategic Planning, Integration and Partnerships, NHS Lincolnshire Integrated Care Board to present the item to the Committee.

The Committee noted that in Lincolnshire, the County Council shared the same geographical boundary as the Integrated Care Board (ICB), and that this area was the basis for the integrated care system, and as a result there was a requirement to have both a Health and Wellbeing Board (HWB) and an Integrated Care Partnership (ICP) with each being required to publish its own strategy.  It was highlighted that the local ambition had been to align the HWB and the ICP by connecting the JHWS and the ICP Strategy to avoid any duplication and gaps.  It was highlighted further that each strategy would keep its identity with the JHWS focusing on ‘the what’ for example, the population health and wellbeing priority areas, the evidence in the Joint Strategic Needs Assessment; and the ICP strategy would focus on ‘the how’: the key enablers that the health and care system would  focus integration efforts on, to support the delivery of the JHWS and its priorities, and the system’s overarching ambition and aims.

It was reported that the JHWS aimed to inform and influence decisions regarding the commissioning and delivery of health and care services in Lincolnshire as a system, by adopting a life course approach.

The five priorities of the Joint Health and Wellbeing Strategy were detailed on page 63 of the report pack.

It was reported that the Integrated Care Partnership Strategy brought together a system approach to ensure there was more connectivity between statutory bodies, voluntary organisations, social enterprise and the independent sector.

The five strategic enablers identified were shown on page 92 of the report pack.  Each of the five enablers were then presented in more detail throughout the strategy, identifying why each one was an enabler, and during delivery what each enabler was going to focus on.

It was highlighted the five strategic enablers would ensure that as a system all organisations could play their part in delivering the collective ambitions.  The Committee noted that each enabler had a Senior Responsible Officer and a delivery lead for the system who would support and challenge the system to embed the strategy.

The Committee was advised that the shared ambition was ‘For the people of Lincolnshire to have the best possible start in life, and be supported to live, age and die well’.

It was reported that as the two strategies were so linked, they would be published together along with a shared single introduction which was detailed in Appendix  ...  view the full minutes text for item 71.

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to note the amendments to the health scrutiny regulations and parts of a new schedule to the National Health Service Act 2006 which came into force on 31 January 2024, together with revised guidance for health overview and scrutiny committees, and new statutory guidance for the NHS; and to agree in principle to a revised protocol being developed between the Committee and NHS Lincolnshire Integrated Care Board)

The Committee considered a report from the Health Scrutiny Officer, which advised of the amendments to the health scrutiny regulations and parts of a new schedule to the National Health Service Act 2006 which had come in to force on 31 January 2024, together with revised guidance for health overview and scrutiny committees, and new statutory guidance for the NHS.  The Committee was also asked to agree in principle to a revised protocol being developed between the Committee and NHS Lincolnshire Integrated Care Board.  A summary of the main changes were detailed within the report on pages 108 to 109.

It was highlighted that the Health Scrutiny Committee had developed a strong relationship with the NHS Lincolnshire Integrated Care Board (and the NHS Lincolnshire Clinical Commissioning Group prior to this), which had been underpinned by a protocol, which allowed for the Committee to be advised in almost all instances in advance of reconfigurations in ‘borderline cases’. It was hoped that an initial draft of the new protocol would be considered at the Committee’s next meeting on 20 March 2024.

During consideration of this item the following comments were noted:

·       Thanks were extended to the Health Scrutiny Officer for his report which summarised the main changes and identified several new roles for the Committee arising from the document entitled ‘Reconfiguring NHS Services – Ministerial Intervention Powers’;

·       Some concern was expressed to the gatekeeper role of the Committee and the potential workload impact this could potentially have moving forward; and the power to refer to the Secretary of State being taken away;

·       A question was posed as to whether under the new powers the Committee would be able to refer the matter relating to the poor consultation relating to the Humber Acute Services Review. The Committee was reminded that a decision was yet to be made concerning the proposals arising from the Humber Acute Services Review. The Health Scrutiny Officer agreed to liaise with colleagues administering the Joint Committee; and

·       One member suggested that the Committee should make representation to the Secretary of State for Health and Social Care, The Rt. Hon. Victoria Atkins MP expressing the Committee’s concerns on the arrangements for the new ministerial intervention powers.

RESOLVED

1.      That the following changes that came into effect on 31 January 2024 be noted:

(a)    Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) (Amendment and Saving Provisions) Regulations 2024;

(b)   Local Authority Scrutiny – Guidance from the Secretary of State for Health and Social Care;

(c)    Schedule 10A of the National Health Service Act 2006 (in Part); and

(d)   Reconfiguring NHS Services – Ministerial Intervention Powers -Statutory Guidance from the Secretary of State for Health and Social Care.

2.      That agreement in principle be given to a revised protocol being developed between the Health Scrutiny Committee for Lincolnshire and the NHS Lincolnshire Integrated Care Board, with a view to an initial draft being submitted to the Committee’s next meeting on 20 March 2024.

3.      That representation be made to  ...  view the full minutes text for item 72.

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

The Chairman invited the Health Scrutiny Officer, to present the item, which invited the Committee to consider and comment on its work programme, as detailed on pages 125 to 136 of the report pack.

The Health Scrutiny Officer briefed the Committee on the items for consideration at the 20 March 2024 meeting.

The Committee noted that the item: Use of Planning Mitigation Funding for NHS Facilities would be considered at the 17 July 2024 meeting; and that it was hoped that an update from Lincolnshire Partnership NHS Foundation Trust would be available for the 17 April 2024 meeting.

The Health Scrutiny Officer also advised that some members of the Committee had received an email regarding a meeting taking place at the Priory Hotel, Louth at 7.00pm on Thursday 22 February 2024.  Councillor C M Macey advised that he was unable to attend, as he already had other engagements in his diary.  Cllr C Morgan advised that she would be attending the meeting and would provide feedback to the members of the Committee.

(Note: Councillor S R Parkin left the meeting at 12:31pm and Cllr L Hagues left the meeting at 12:33pm).

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

·       Whether the meeting on 17 April 2024 would go ahead, due to the pre-election period for the Police and Crime Commissioner (PCC) elections.  It was highlighted that the Committee’s business would not normally be affected by the PCC elections;

·       An update on the Stamford Minor Injuries Unit; and

·       Availability of Pharmacies.  It was agreed that it might be useful to have an item relating to the overview of pharmacy services and prescription medicines.

RESOLVED

That the work programme presented on pages 125 to 136 of the report pack be agreed, subject to the inclusion of the suggestions put forward by the Committee as detailed above.