Agenda item

(To receive a report from the Lincolnshire Sustainability and Transformation Partnership, which provides the Committee with an update on the progress of the Lincolnshire Sustainability and Transformation Partnership (STP).  Sarah Furley, STP Programme Director, John Turner, Senior Responsible Officer STP and Andrew Morgan, Chief Executive Lincolnshire Community Health Services NHS Trust will be in attendance for this item)

The Chairman welcomed to the meeting:-

·         John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP);

·         Andrew Morgan, Chief Executive, Lincolnshire Community Health Services NHS Trust; and

·         Sarah Furley, STP Programme Director.

The Committee gave consideration to a report from the Lincolnshire Sustainability and Transformation Partnership, which provided information on the progress of the Lincolnshire Sustainability and Transformation Partnership.

Appended to the report the Committee's considerations were the following Appendices:-

·         Appendix A – Joint Letter from NHS England and NHS Improvement concerning 'working closer together'; and

·         Appendix B – Joint Letter from NHS England and NHS Improvement concerning NHS Regional Geographies.

The Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership advised that the Committee had received regular updates in relation to the development of the Lincolnshire STP, which had included quarterly updates relating to the overall progress of the STP as a whole, and then monthly examinations of specific work programmes within the STP. 

It was reported that the Lincolnshire STP was one of 44 "footprints" established in England; and that during 2017/18 the STPs had evolved from plans to partnerships; and that current national thinking described STPs as working at a system level, with a co-ordinating function.  It was highlighted that as local STPs were systems working closely together to develop collaborative relationships, so were NHS England and NHS Improvement.

The Committee noted that over the last 12 months Lincolnshire had been developing in line with the emphasis being placed on a system approach.

The report provided the Committee with updates on some key outcomes for 2018/19, which included Mental Health; Integrated Neighbourhood Working; implementation of GP Forward View; Urgent and Emergency Care Transformation; Operational Efficiencies; Planned Care and Other Enabling Programme.  It was highlighted that the Committee, over the last five months, had already received detailed reports relating to Mental Health Services, Urgent and Emergency Care Services, Operational Efficiency Programme, The GP Forward View Programme and Integrated Neighbourhood Team Working.

The Committee was advised that paragraph 5.6 of the report highlighted the key successes that had been completed in respect of the Planned Care Programme (100 day programme).  As a result there had been rapid improvement across Dermatology, Ophthalmology and Diabetes.  It was noted the 100 day methodology had demonstrated some excellent results and had been evaluated well by all those involved.

It was reported that since December 2017, work on the Acute Service Review was continuing at pace.  Paragraph 6 of the report provided the Committee with more detailed information concerning the review.

The Committee was advised the NHS would put detailed options into the public domain, once they had been fully assessed for clinical viability and financial sustainability; and had passed through the NHS England assurance process.  It was highlighted that as many of the elements of this process were national, it was not possible to say when the public consultation would commence.  It was anticipated that it would not take place in the current calendar year.

Reassurance was given that the NHS in Lincolnshire, including the STP was fully committed to engaging with the public, and that this work was ongoing.  The Committee was referred to the paragraph on page 95 (an extract from the NHS England guidance document), which detailed the process the Lincolnshire STP was required to follow.

It was highlighted that over the last two years there had been engagement with members of the public across the County, NHS staff and other key stakeholders, which had informed the development of the five year plan.   It was highlighted further that public engagement was taking place on how to improve local mental health and dementia services for older adults.

It was also highlighted that engagement was taking place with the public, staff and stakeholders regarding a pilot to improve trauma and orthopaedic services at the four main hospitals.  

The Committee was also advised that by early July 2018, it was hoped the Lincolnshire STP website would be relaunched to include updated information on progress; the case for change and the acute services review.  The Committee was advised further that a number of public engagement events would be held across the County during the summer; and that an online survey would be launched as a further method by which the public could share their views.

During discussion, the following points were made:-

·         The link between neighbouring STPs.  The Committee was advised that the Lincolnshire STP team worked very closely with STP teams from bordering areas to ensure that the STP Plans were aware of any service changes in these areas.  It was highlighted that some neighbouring STP teams were six to nine months behind Lincolnshire in the process at the moment;

·         One member asked as to whether the proposed re-organisations would actually benefit the patient, or were they solely for financial savings.  Confirmation was given that there was no re-organisation in Lincolnshire, as there were still four CCGs and three provider Trusts; and that NHSE and NHSI were not merging, but were just working more closely together;

·         Financial Deficit – A question was asked as to whether new working models going forward would be more affordable to help bridge the financial gap.  The Committee was advised that services going forward would look to reduce the size of the gap, but it would take a period of time to address it.  It was highlighted that there was a plan going forward that would create a more balanced position; and a master plan which would describe how this was to be achieved, which would take into account health and safety issues, sustainability; and what would ultimately lead to a better financial position.  One member felt that more information was required to enable the Committee to scrutinise and monitor performance as the STP progressed.  The Committee was advised that officers understood the frustration arising from the lack of available information; and agreed to look into the level of information that could be made available to the Committee to alleviate their concerns, without compromising the STP;

·         Community Pain Management Service – One member expressed concerns relating to the proposed changes and to the distress being caused to patients.  The Committee was advised that the current service was not working well enough; and was not structured in the right way.  Confirmation was given that there would not be any changes made until suitable alternative arrangements had been put in place. The Committee noted that Lincolnshire West CCG was leading with this service and would be communicating with those patients affected by the changes.  It was highlighted that there might be two seperate issues as one member advised that ULHT was also making changes to their pain management arrangements, it was therefore agreed that further clarification was needed;

·         A question was asked as to whether the closer working between NHS England (NHSE) and NHS Improvement (NHSI) would accelerate the Acute Services Review.  It was reported that the closer working between the two areas would not speed up the review, but that following the public consultation, the joint arrangements might help accelerate the implementation;

·         Page 91, fourth bullet point.  A question was asked as to whether there would be public consultation around the change to Urgent Treatment Centres; and when would this take place.  It was highlighted that in the engagement plan they were known as Urgent Treatment Centres, however it was noted that a test pilot was being conducted in Louth; the outcome of which would then be rolled out elsewhere; and

·         Page 97, third paragraph – A question was asked as to how many public engagement events were planned across the County; where would these be held; and where would they be publicised.   The Committee was advised that a timetable was being created showing all engagement events across the whole of the STP was being finalised which would show specific dates for specific locations; and that these would be starting at the beginning of July 2018.  It was highlighted that the first event would be conducted and then issues raised would be taken into account, in readiness for the next event.  It was noted that the events would be advertised on the website.  Once the timetable was agreed, a copy would be sent to all members of the Committee.

RESOLVED

1.    That the STP Update presented be received and that a further regular update be received by the Health Scrutiny Committee for Lincolnshire at the 12 September 2018 meeting.

2.    That the Chairman be authorised to discuss with the Senior Responsible Officer, Lincolnshire STP the issue of financial information.