Agenda item

Lincolnshire Sustainability and Transformation Partnership Update

(To receive a joint report from John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership and Sarah Furley, Programme Director, Lincolnshire Sustainability and Transformation Partnership, which provides information on the development of the Lincolnshire Sustainability and Transformation Partnership (STP) and the current position of the STP)

Minutes:

Consideration was given to a report on behalf of the Lincolnshire Sustainability and Transformation Partnership (STP) which provided the Committee with information on the development of the Lincolnshire STP and the current position.

 

John Turner (Senior Responsible Officer, Lincolnshire STP) and Sarah Furley (Programme Director, Lincolnshire STP) introduced the report and advised that good progress had been made on key areas of the STP.  It was also noted that the STPs had evolved over the last nine months from 'plans' to 'partnerships' with current thinking nationally describing STPs as working at a health and care system level.

 

There remained a strong case for change which was shared by the collective leadership, partner organisations and stakeholders in Lincolnshire.  The Case for Change was published in June 2016 and, despite the excellent dedication and commitment of staff, the NHS in Lincolnshire remained severely challenged in the following areas:-

·       Deteriorating Quality;

·       Significant Staffing Challenges; and

·       Deteriorating Finances.

 

The Committee was advised that the system deficit was anticipated to reach £100m and not £70m as noted within the report. 

 

As part of the STP as a plan (rather than a partnership or system), Lincolnshire had been focussing on seven key priorities since April 2017, all of which were now starting to deliver real change for people accessing care and support across the county.  The seven key priorities were noted:-

·       Mental Health;

·       Integrated Neighbourhood Working;

·       Implementation of GP Forward View;

·       Urgent and Emergency Care Transformation;

·       Operational Efficiencies;

·       Planned Care; and

·       Acute Care Reconfiguration/Acute Service Review

 

The Committee was advised that there was a specific challenge within mental health as there were too many Lincolnshire residents being treated out-of-county for mental health care.

 

In relation to Operational Efficiencies it was noted that integrated working for back office functions would be essential in the future and could, potentially, provide a saving of £60m over five years.

 

As part of the STP, the future configuration of acute services was being given greater consideration.  The Acute Service Review would also include all hospitals in neighbouring counties attended by Lincolnshire residents.  The review would focus on the following question:-

          What is the optimum configuration of ULHT services and the role of neighbouring  acute trusts, in order to achieve a thriving acute hospital service in Lincolnshire and for the population as a whole and to deliver clinical, staffing and financial sustainability across the Lincolnshire NHS health economy?

 

The first part of the review would engage with senior clinicians and the second part would look at the analytics of 32 specialities and how these could be configured to allow the best quality of care to be delivered whilst retaining the right level of staff.  Initial proposals would be identified by the end of February 2018, following which the proposals would be subject to the standard NHS England assurance processes.  All this would take place prior to any formal public consultation.

 

The STP accepted that more engagement, communication and information was required from the public, council, district council, patient groups, etc.

 

There was also a requirement to consult on major service reconfigurations and the Committee would be invited to consider proposals as and when required.

 

It was confirmed that the STP utilised the Joint Strategic Needs Assessment (JSNA) as a key source of demographic information upon which to build the Case for Change and identify the key priorities.

 

During discussion, the following points were noted:-

·       There had been a national directive to change from a plan to a partnership and this was intended to bring all local partners together;

·       Clinical analysis and business analytics would indicate what was required in different service areas to ensure that the best quality of care could be provided.  This work would highlight if services would be best concentrated to certain areas or if there would be benefit in having more local bases;

·       The STP was working with One Public Estate (OPE) to address estate issues.  Hospital services and specialities within the hospital estate were being reviewed to ascertain if the estate was fit for purpose;

·       The Committee expressed concern that public consultation appeared to be lacking despite a number of proposals within the plan.  It was explained that this concern had been noted at the last meeting and engagement with the public would increase as a result.  It was further confirmed that any significant changes to services would require formal public consultation in addition to this informal engagement;

·       NHS colleagues indicated that the relationship with senior executives within the County Council was strong and effective and the strength of the partnership was part of the reason why Delayed Transfers of Care (DTOC) had improved;

·       One member of the Committee noted that in December 2016 the County Council had agreed a motion that it had no confidence in the STP in its current form, and was dismayed with the NHS plans despite that decision;

·       Neighbourhood teams were intended to create integration between GPs, Social Workers, Health Visitors, Mental Health, etc, to ensure joint working to provide a better service.  It was reported that GPs in the south of the county were enthusiastic about Neighbourhood Teams as it was anticipated this would assist GPs in delivering the right care and the right time;

·       It was confirmed that the Psychiatric Clinical Decisions Unit did accept admissions from across the county but there were no plans to have more across the county until the impact and success of this unit could be measured.  100 additional clinical staff had been recruited by Lincolnshire Partnership NHS Foundation Trust (LPFT) who were on track to recruit a further 300 wte staff by 2021;

·       The membership of the Lincolnshire Coordinating Board included the chairmen of seven health organisations plus non-executive directors from East Midlands Ambulance Service (EMAS) and the Chairman of the Lincolnshire Local Medical Committee (LMC).  The Chair of the Lincolnshire Health and Wellbeing Board, in addition to Chief Officers and Chief Executives of all these organisations, also attended the meetings which met on a monthly basis;

·       The Committee did not see the correlation between the seven priority areas and how they would impact on the Case for Change.  It was agreed that the future reports would include the staffing, quality and financial impacts for each priority;

·       It was highlighted that the £100m savings required was £100m per annum and was recurrent and the Committee was keen to understand how these savings were to be made.  Project plans were in place and would be made available to the Committee in addition to the information requested against the seven priorities.

 

RESOLVED

1.    That the progress on the delivery of the Lincolnshire Sustainability and Transformation Partnership be noted; and

2.    That future reports on the STP to the Health Scrutiny Committee for Lincolnshire include the project plans; and staffing, quality and financial impacts for each of the seven priorities.

Supporting documents:

 

 
 
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