Agenda item

Lincolnshire Sustainability and Transformation Partnership: Engagement and the NHS Long Term Plan

(To receive a report from John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP), which invites the Committee to consider the STP's plans for engagement with local communities and partners)


The Chairman welcomed to the meeting John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP), who reminded the Committee that at the 23 January 2019 meeting, consideration had been given to a summary of the NHS Long Term Plan.  At the said meeting, the Committee had agreed that the next steps for the NHS Long Term Plan included consideration of the engagement by the Lincolnshire Sustainability and Transformation Partnership (STP) on its plan to implement the NHS Local Plan; the Committee also indicated that it would like to consider proposals for the development of urgent treatment centres in Lincolnshire.


It was noted that the Long Term Plan (LTP) promoted that an integrated care system should be developed with NHS partners, public sector and third sector partners.  It was noted that since the publication of the LTP, there had also been further changes to GP Contract arrangements.


It was highlighted that the LTP set out requirements for the next five years and in certain instances for ten years; and that its objectives were consistent with the approach being undertaken in Lincolnshire, which would as a result help to accelerate the process.  It was highlighted further that there was a requirement for a local LTP to be developed by the autumn, which would be the subject of wide and open engagement with partners and the public.


The Committee was advised that the local LTP was in its final stages; and that public engagement would be starting shortly.  Confirmation was given that the engagement would be a comprehensive exercise across the county.  It was highlighted that engagement would involve healthy conversations taking place where there would be sharing of NHS thinking; and the NHS listening to the views of partners and the public.  It was noted that the engagement exercise would continue for the rest of the calendar year; and would cover areas such as: general health issues; self-care; mental health and learning disabilities; integrated care; hospital services including proposed reconfigurations; and urgent care.  It was reported that there would be a number of engagement events across the county and suggestions were welcomed from county council and district council colleagues as to how this could be developed.  The Committee was advised that there would also be material available on the website for people to view. 


It was noted that proposals reflected work that had been done internally with senior clinicians; and that the proposals were a good reflection of the thinking of senior staff locally.


In conclusion, it was emphasised that the next stage was not a formal consultation exercise; it was open engagement; and that feedback from the said engagement would help shape the proposals going forward, prior to the public consultation, which would commence in due course. 


During discussion, the Committee raised the following points:-


·         The need for more emphasis on public health and preventative measures, rather than provision just being responsive.  The Committee was advised that over the last few years, the focus had not been on public health and prevention.  It was highlighted that public health was a complex area as it influenced a range of issues such as environment, employment, housing etc.  It was hoped the exercise "Prevention better than Cure" would help the local population keep healthy.  It was confirmed that conversations were moving forward between the County Council's public health service and partners to further move towards a healthier population in Lincolnshire.  It was highlighted further that there was a vast amount of work still to be done concerning type 2 diabetes and obesity to develop an approach for Lincolnshire;

·         Promotion of self-care; and encouraging people to be responsible for their own health;

·         The need to reduce the number of missed appointments.  The Committee was advised that this was a sensitive issue, which GPs were looking into.  One member highlighted that the number of missed appointments quoted was not always as accurate as initially thought, as cancelled/rescheduled appointments were not always taken of the data base;

·         The confusion caused as a result in the continual morphing of proposals (from a Health and Care Plan, to a STP; then to a LTP); 

·         It was highlighted that some districts had already taken on board the public health issues and were already encouraging people to get healthy and fit, and that this area was largely for the County Council's public health function to take forward; and that the Committee needed to be focusing on aspects of the LTP relating to NHS-funded health care.  It was highlighted that residents just wanted to see some progress being made, rather than continual changes to plans;


Councillor Mrs P F Watson wished it to be noted that she was a representative of Magna Vitae.


·         One member highlighted that mental health issues for young people under 25 years of age needed attention;

·         The impact of increasing housing development on health services, particular reference was made for the need for a new hospital in Grantham.  The Committee was advised that the issue of additional housing across the county was an issue; and that these factors were taken into consideration as part of the proposals.  The Committee was advised that residents would have the opportunity to judge and assess if the local views had been listened to;

·         One member welcomed the open engagement but queried what would the public have engagement on?  The Committee was advised that it would be what had been done in the LTP, better prevention and self-care; and also the challenge and choice of how things were done in Lincolnshire;

·         One member highlighted that the Boston Golf Course was not a good venue for an engagement event due to its distance from the town centre;

·         A question was asked as to whether Lincolnshire would be adequately funded, to address the issues of rurality etc.; and whether Lincolnshire was being over ambitious.  The Committee was advised that this would be part of the positive engagement.  It was highlighted that there were significant issues to address in Lincolnshire.  It was highlighted further that details relating to funding were still being received.  The Committee noted that the four CCGs currently received £1.1bn for NHS services; and that this amount would be increased each year.  It was confirmed that by the end of the five years the amount would be increased to £1.4bn.  The Committee was advised further that details of the funding allocations were still to be received.  It was highlighted that there was still a requirement to make efficiencies; and there was an acceptance that more could be done in Lincolnshire, i.e. the Trusts and the CCGs working more closely together.  The Committee was advised that once financial allocation details had been received, these would be shared with members of the Committee.  It was confirmed that early indications were that Lincolnshire would gain more than the average uplift.  The Committee noted that one change had been that there was recognition of the needs of coastal communities;

·         It was highlighted that any proposals were dependent on increasing the numbers in the NHS  workforce; changes in health education; and Lincolnshire being able to attract people to live and work in Lincolnshire;

·         Clarification was sought as to when consultation would be commencing.  The Committee was advised that no definite date for formal consultation could be stated at this stage;

·         Concern was expressed that continued delays in going out to consultation had led to a fear factor amongst some residents; as some people were scared of getting ill; as a result of changes to service provision; and to the lack of staffing.  One member felt that the engagement and consultation process needed momentum, as local people were getting very frustrated at not knowing what was going on;

·         One member highlighted that prevention was key to everything that was being done in the NHS;

·         One member enquired whether staff would be having any input.  Clarification was given that all staff would be included in the process;

·         That better digital communication was needed, particularly with the proposed integrated care system.  Confirmation was given that better digital communication was necessary to help move any proposals forward; and

·         Support was extended to the invitation to the Committee for a workshop concerning the NHS Long Term Plan.


In conclusion, the Chairman on behalf of the Committee welcomed the proposed open engagement events.  Reassurance was sought as to whether timescales proposed would be adhered to, and whether any engagement would commence within the current year.  Some indication was given to the Committee that engagement would be starting in a matter of weeks rather than months.


The Chairman extended thanks to the Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP) for his update.




1.    That the update concerning the Lincolnshire Sustainability and Transformation Partnership; Engagement and the Long Term Plan be received; and that the local element of the plan be added to the work programme of the Health Scrutiny Committee for Lincolnshire for consideration at a future meeting.


2.    That once the calendar of events has been compiled, a copy of the said document be circulated to all members of the Committee.


3.    That the Health Scrutiny Officer makes arrangements for a workshop to be held during May 2019 to allow the Committee to consider the Long Term Plan further.

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