Agenda item

(To receive a report from Jane Marshall, Director of Strategy for Lincolnshire Partnership NHS Foundation Trust, which updates the Committee on the full feedback received from the targeted engagement events held with the public and patients concerning the proposals for changes in the Learning Disability (specialist health) services run by Lincolnshire Partnership NHS Foundation Trust (LPFT))

The Chairman welcomed to the meeting Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust and Richard Eccles, Chief Commissioning Manager Mental Health, Learning Disabilities and Autistic Spectrum Disorder, South West Lincolnshire Clinical Commissioning Group.

Consideration was given to a report on behalf of Lincolnshire Partnership NHS Foundation Trust, which provided the Committee with full feedback from targeted engagement events that had been held with the public and patients to discuss the proposals for changes in the Learning Disability (Specialised Health) Services.

Appended to the report for the Committee's consideration were the following documents:-

·         Appendix A – Feedback from the notes taken at the Learning Disability Engagement Events held in February and March 2018; and

·         Appendix B – Transforming Care in Learning Disability Services – Staff Survey January 2018.

The Director of Strategy, Lincolnshire Partnership NHS Foundation Trust highlighted that at the 11 October 2017 meeting, the Health Scrutiny Committee for Lincolnshire had recommended to Lincolnshire Partnership NHS Foundation Trust that it commence a period of targeted engagement with the public, patients and staff concerning the model of service provision of specialist health services to people with a learning disability in Lincolnshire.  It was noted that this decision had followed the temporary closure of the learning disability in-patient service at Long Leys Court in Lincoln in July 2015.

The report provided details of the targeted engagement response from five events to which a total of 72 people had attended.  Appendix A provided the Committee with patient feedback from each event.  In addition to the planned events, an online survey had also been issued to all staff based in Lincolnshire Partnership NHS Foundation Trust to capture their views on the proposed service change.  Appendix B provided the Committee with the feedback from the on-line staff survey.

It was reported that the main themes from the feedback received from the events and the on-line survey were as follows:-

·         There was support to move to community based services and there was no objection to the moving to a community based model of service;

·         There was support for the Community Home Assessment and Treatment Team, a 24/7 service dedicated to rapid response and preventing the need for admission;

·         A comment was raised to the lack of beds for people with learning disabilities, if they needed an inpatient bed;

·         There had been concern about the gaps in services for people with Autism and their carers' and families;

·         Concern had also been expressed that services needed to be more integrated and seamless; and that more needed to be done to sign post people to services;

·         There was concern about transitions of care between services and agencies; as people were having to tell their stories over and over again to different providers; and concern was also expressed to the lack of carer support and carer breaks;

·         The main themes from staff were that the majority of respondents were supportive of the new model; there was concern about gaps in services for people with Autism; and some staff expressed concerns about the new model and other aspects of the service; and

·         Feedback from Healthwatch had also been broadly supportive, some concern had been expressed that the response had only been received from 72 respondents; and about planning for transition to adult services; and the lack of services for people with Autism/Autistic Spectrum Disorder.

In conclusion, the results of the engagement event had supported the move to a community based model of service on a permanent basis.

The Committee was invited to comment on the engagement exercise.

During discussion, the Committee raised the following issues:-

·         Reference was made to page 87 particularly the need to understand individual needs and diagnosis.  The Committee was advised that work was ongoing with schools concerning children with mental health issues, ensuring that intervention was made at an early stage, and that the Lincolnshire Learning Partnership had commissioned 'Healthy Minds' to help support young people with their mental health.  It was also highlighted that the South West Lincolnshire CCG and LPFT were working with children with Autism aged 0 – 25, to help fill the gaps that had been identified within the feedback received;

·         Response to the staff survey – The Committee highlighted the low staff response rate to the on-line survey;

·         Out of county placements – The Committee was advised that prior to the new service model there had been 16 beds in the county and 8 Learning Disability beds out of county; currently there were 10 out of area placements, which included learning disabilities and Autism.  It was noted that the costs for out of county beds were around £170,000 per year based on an average, and other costs would be based on individual needs.  Some members welcomed the community based support; but highlighted that there was more work to do to integrate it into LPFT; A & E and primary care; and

·         One member highlighted that members of the Committee would benefit from having a better understanding of mental health and Autism; and that a briefing document would be welcomed.  A suggestion was made for the Committee to consider the Autism Strategy at a future meeting, as this would help the Committee gain a better understanding of Autism.

Overall, the Committee supported the permanent closure of Long Leys Court and to sharing the reports with relevant Executive Councillors and Scrutiny Committees; and to the inclusion of the Autism Strategy in the Committee's work programme.

RESOLVED

1.    That the Health Scrutiny Committee for Lincolnshire extended support to the permanent closure of Long Leys Court.

2.    That the Future Model of Service Provision of Specialist Health Services to People with a Learning Disability report be brought to the attention of County Council's Executive Councillors for Adult Care, Health and Children's Services and NHS Liaison and Community Engagement, so that they can continue to be aware of the links between specialist health services for people with a learning disability and other services.

3.    That the Future Model of Service Provision of Specialist Health Services to People with a Learning Disability report be brought to the attention of the Chairmen of the County Council's Adults and Community Wellbeing Scrutiny Committee and the Children and Young People Scrutiny Committee.

4.    That the Autism Strategy be included as a future agenda item in the Committee's work programme.

The Committee adjourned at 12.25pm and re-convened at 2.00pm.

Additional apologies for absence for the afternoon part of the meeting were received from Councillors M T Fido, C Burke (City of Lincoln Council).

An apology was also received from Councillor Dr M E Thompson (Executive Support Councillor for NHS Liaison and Community Engagement).