Agenda item

(To receive a report from the NHS Lincolnshire Clinical Commissioning Group (LCCG), which advises the Committee of an engagement exercise by Lakeside Healthcare at Stamford on its proposal to permanently close one of its two premises in Stamford from 1 December 2020.  Sarah-Jane Mills (Chief Operating Officer, LCCG) will be in attendance for this item) 

The Chairman advised the Committee that the item could be found on pages 97 to 108 of the agenda pack.

The Committee was advised that the Chairman had received three requests from members of the public to speak regarding the item; and that these would be heard first prior to the presentation, and that each speaker would be given three minutes.

The Chairman invited the first speaker to address the Committee: Mr Andrew Nebel, Chairman of Lakeside Healthcare at Stamford Patient Participation Group (PPG).

Mr Nebel advised the Committee that the proposed closure of St Mary's Medical Centre on the 1 December 2020 had not been communicated to patients or to the PPG and had only been confirmed by Lakeside when the PPG learnt of it on 26 August 2020.

The Committee was advised that patients had been disadvantaged by a lack of openness and poor communication; and that the practice had not worked with the PPG.

Concern was expressed that a full consultation process had not taken place prior to the decision to close the surgery and to whether a statutory Equality Impact Assessment had been completed.

The Committee was advised that based on the significant feedback received from patients the PPG opposed the closure.

In conclusion, the Committee was advised that PPG believed that is was possible to negotiate an affordable extension of the lease at St Mary's, which would allow for a review of the town and surrounding villages' growing primary care needs.

The Chairman invited Mr William Turner, Mayor of Stamford to address the Committee:

Mr Turner echoed the concerns of the previous speaker with regard to lack of consultation, and whether an Equality Impact Assessment had been completed.

Concern was also expressed to the parking provision at the Sheepmarket Surgery and to time consuming telephony system currently operated by the surgery.

The Chairman invited Councillor Gloria Johnson, South Kesteven District Council and Deputy Mayor of Stamford Town Council to address the Committee.

Councillor Johnson provided the Committee with her personal patient perspective of the St Mary's Surgery.

The Committee was advised that Councillor Johnson had been a patient at the surgery for some forty years; and that the service provided to patients had deteriorated when Lakeside had taken over the surgery.  Reference was also made to time taken get through to the surgery by phone (an average of 45 minutes); and patients not being able to get a face to face appointments.  Concern was also expressed whether the Sheepmarket Surgery would be able to accommodate the patients from St Mary's.

The Chairman extended his thanks to the three members of the public for their input.

The Chairman advised that the following presenters were in attendance for the item.  They were: Adam Cocks, Chief Operating Officer, Lakeside Healthcare, Andy Rix, Chief Operating Officer (South West Locality) Lincolnshire CCG and Sarah-Jane Mills, Chief Operating Officer (West Locality) Lincolnshire CCG.

The Committee was advised that the St Mary's Medical Centre had been closed to patients since the start of the Covid-19 pandemic, with all face to face appointments taking place at the Sheepmarket Surgery.  

The Committee noted further that the PPG had contacted the CCG and had raised with their concerns at the Annual Public Meeting.  The CCG had encouraged all residents to participate in the consultation. Copies of documents issued by Lakeside Healthcare at Stamford were attached as Appendices A, B and C for the Committee's consideration.

The Committee was advised that the CCG was currently having conversations with Lakeside and the landlord for St Mary's Medical Centre, with a view to St Mary's remaining open for the foreseeable future.  It was confirmed that these conversations had been positive so far, but were not fully concluded.

The Chief Operating Officer from Lakeside confirmed that the surgery was currently having conversations with the CCG.  The Committee was advised that primary care had been under pressure for the last four years, and like the rest of the country, the surgery had experience a shortage of GP's.

The Committee was advised there was an acknowledgement that the telephone system was not up to standard, and that work was on-going with the surgeries current telephony supplier to improve telephone access and to ensure there was sufficient capacity in place at Sheepmarket Surgery to accommodate any increase in call volume.

Confirmation was also given that there would be no change in patient parking capacity.  Reassurance was also given that there would not be a reduction in service for Lakeside patients; and that the expected growth of the Stamford population had been incorporated into Lakeside Healthcare's service plans.  The Committee was advised further that the Sheepmarket site was a more suitable building, which also provided disability access.

In conclusion, the Chief Operating Officer (West Locality) Lincolnshire CCG advised the Committee that as previously mentioned earlier in the presentation, active discussions were taking place with all parties, and that an update would be provided in due course.

The Committee were also reminded that an item relating to GP services was due to be considered by the Committee at the 11 November 2020 meeting.

The Chairman acknowledged that discussions were continuing on extending the lease of St Mary's Medical Centre, but advised the Committee they needed to consider the item as if were a proposed closure.

During discussion, the following points were raised:

·         Concern was expressed to the lack of communication and engagement and to the lateness of the consultation and the position of Lakeside healthcare as the sole provider of GP provision in Stamford.  A further concern was made to the accessibility of the on-line process.  The Committee noted that there was some fragility in Primary Care, and that some practices were closing; others were merging to ensure there was resilience in their locality by working in a more integrated way.  Assurance was also given that the points raised would be looked into;  

·         Whether Sheepmarket Surgery had the provision to cater for the extra patient capacity.  The Committee was advised that the survey was due to complete on 25 October 2020; following which there would be full evaluation of stakeholder and patient feedback.  It was highlighted that work was actively on-going with all parties to find a resolution to the issue;

·         Support was extended to the residents of Stamford; and that residents needed to be made aware of all the facts concerning the closure.  Reassurance was given that feedback was actively being listened to and that it was hoped that a solution would be reached;

·         Concern was expressed on the reference in Appendix C Communication and Engagement Timeline to the CCG Primary Care Commissioning Committee Wednesday 11 November 2020 approving the branch closure application.  It was agreed that this would be looked at after the meeting;

·         One member enquired as to how serious the search for alternative accommodation in Stamford had been. It was noted that an alternative site had been considered, but due to archaeological issues, this had not been proceeded with. Again, the point was reiterated regarding the life discussions and that there was a high degree of confidence that the St Mary's site would be retained; and

·         Reference was also made to page 106 of the report pack which stated that Lakeside had contacted the CCG initially in 2018 for help to locate to an alternative site in Stamford for St Mary's, which indicated that then there was a need for two sites, why had the view changed?.  The Committee was advised that the issue would be addressed.

Concern was expressed by the Committee to the proposed closure; and to the   unavailability of an equality impact assessment and demand and capacity information; and to the level of engagement with the residents of Stamford. 

RESOLVED

1.    That the Chairman be authorised to write to Lakeside Healthcare, recording the Committee's opposition to the proposal to close St Mary's Medical Centre in Stamford.

2.    That the Chairman be authorised to write to the Chairman of the Lincolnshire Clinical Commissioning Group's Primary Care Commissioning Committee urging that full account is taken of the views of Stamford residents when it makes a decision on the proposed closure of St Mary's Medical Centre.

3.    That the equality impact assessment; information on demand and capacity modelling; and the response of the patients to the survey on the proposal be circulated to the Committee when this is available.