Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust, (ULHT) which provides the Committee with an update regarding Covid-19.  Senior representatives from ULHT will be in attendance for this item)

The Chairman invited Andrew Morgan, Chief Executive of United Lincolnshire Hospitals NHS Trust and Simon Evans, Chief Operating Officer, United Lincolnshire Hospitals NHS Trust, to present the report which provided the Committee with a Covid-19 update.

Detailed at Appendix A to the report was a copy of the Report to United Lincolnshire Hospitals NHS Trust Board of Directors (1 December 2020) – Report of the Chief Executive.

The Chief Executive of United Lincolnshire Hospitals NHS Trust advised the Committee that as of 15 December 2020, the Trust was treating a total of 204 Covid-19 in-patients, 126 in-patients at Lincoln County Hospital and 78 in-patients at Pilgrim Hospital, Boston.

The Committee was advised further that the increase in the number of Covid-19 in-patient cases and reduced staffing levels had resulted in the Trust having to declare and manage an internal critical incident.

It was reported that currently there were 1,140 staff absent, as a result of having Covid-19, or having to self-isolate.  It was noted that this represented approximately 14% of the workforce.  The Trust was therefore under significant pressure to manage the service.  The Committee noted that the Trust was doing all it could to keep its staff healthy and well, with the recent introduction of Covid-19 lateral flow tests for front line staff; and the commencement of the vaccination programme for staff at high risk across the system.

It was reported that United Lincolnshire Hospitals NHS Trust had been selected as one of the 50 national hub hospitals to administer the Pfizer/BioNTech vaccine, and that this was focussed on the Lincoln County Hospital site.  The Committee noted that the vaccination programme had started at the hospital on 8 December 2020.  The Committee was advised that NHS England/NHS Improvement, together with the Department for Health and Social Care was talking responsibility for providing information on the number of vaccines provided.  The Committee was advised further that two Primary Care Networks had also started vaccinations at Louth and Grantham Hospitals, and that further clinics would be opening shortly.

The Committee noted that the Trust was managing to continue elective surgery and provide support to cancer patients at the Grantham Hospital 'Green Site', however, as the number of Covid-19 in-patients has increased, Lincoln County and Pilgrim Hospital, Boston had paused some cancer activity at their sites. 

During discussion, the Committee raised the following comments:

·       The vaccination programme – The Committee was advised that the programme's initial priority was to vaccinate the over 80's and front line staff in care homes, and those providing care in the community; and NHS staff.  It was noted that there was an aspiration for all NHS staff to have received their two vaccinations by the end of March 2021;

·       Thanks were extended to health services staff for the professional service being provided in the most difficult times.  Particular praise was given to staff providing support at Grantham Hospital;

·       Percentage of beds taken by Covid-19 in-patients.  The Committee was advised that at its peak 30% of in-patient beds had been taken by Covid-19 in-patients; and that a further 30% of patients were query Covid-19, in effect awaiting test results;

·       How the service was coping with the increased demand.  The Committee was advised hospitals were being reconfigured to meet demand, particularly with regard to self-isolating.  It was noted that reduced staffing levels was having an impact; as the Trust was not able to offer extra capacity at the moment, and that this matter was being carefully managed.  The Committee noted that the Trust was working with all agencies, to ensure that plans were in place should a further wave occur;

·       A question was asked as to how much notice would be needed to extend the temporary arrangements currently operating at the Grantham Hospital site.  The Committee was advised that it was not the Board's intention to extend the period beyond 31 March 2021, and that the arrangements would be reviewed by the Board in February 2021;

·       Use of bank or agency staff to help back fill some of the absences.  The Committee noted that providing cover was proving more difficult than it used to be, as some people were not prepared to put themselves at risk.  It was noted further that other organisations were also seeking staff, which had also had an effect on the availability of agency staff;

·       Clarification was sought with regard to the reference to the triggers set for the return to pre-Covid-19 reconfiguration having not been met in the last month (page 30 of the report).  The Committee was advised that there were a number of indicators and that these were reviewed against a number of scenario's, for example, a major incident, or a surge in critical care.  The Committee was advised that all indicators were looked at on a daily basis.  Reassurance was given that there had not been a time when these had been met.  If this was to occur, then the service would be reverted back to the previous model, and that this process could take up to 12 weeks to complete;

·       Reference was made to a statement in the press that 30% Covid-19 cases were reported to have contracted Covid-19 in hospital.  The Committee noted that across the county, hospital Covid-19 rates tended to correlate with community rates of infection.  Confirmation was given that currently infection rates were reducing.  Reassurance was given that the Trust was applying NHS best practice and Care Quality Commission guidance as effectively as it could;

·       Some concern was expressed regarding the effectiveness of lateral flow testing.  The Committee was reassured that the lateral flow test was not the only measure relied on by staff. It was reported that staff had a suite of measures available to them, and that care home staff were applying a similar approach;

Note: Councillor Mrs R Kayberry-Brown (South Kesteven District Council) joined the meeting.

·       System Financial Position for a planned year-end deficit of £4m.  Clarification was given that responsibility for the deficit with the Lincolnshire system, was overseen by the Clinical Commissioning Group;

·       The percentage of Covid-19 in-patients having underlying conditions; and how this compared with a bad flu season.  The Committee noted that 90% of Covid-19 in-patients had underlying conditions; and that the number of in-patients was higher than the Trust would experience in a flu season;

·       Whether residents from the East Lindsey District Council area who had Covid-19 and were being taken to the Diana, Princess of Wales Hospital, Grimsby were included in the Lincolnshire figures.  Confirmation was given that in the instance of in-patients Covid-19 cases, these would be included in the figures for Northern Lincolnshire and Goole NHS Trust; and that these figures could be obtained from that Trust if the Committee wished to see them;   

·       Outcome of the Acute Services Review National Panel review (page 24, bullet point 4).  The Committee was advised that some questions had been received from NHS England and NHS Improvement, which were currently being considered.  Confirmation was given that no date had been received for the next National Panel review meeting. 

The Chairman on behalf of the Committee extended his thanks to all staff at United Lincolnshire Hospitals NHS Trust; and to the presenters for attending the meeting.

RESOLVED

1.    That the Committee's support and thanks to all staff at United Lincolnshire Hospitals NHS Trust for their efforts in maintaining NHS services in Lincolnshire be recorded.

2.    That a further update be received at the 17 February 2021 meeting.