Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust (ULHT), which provides the Committee with a general update.  Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration and Simon Evans, Chief Operating Officer from ULHT will be in attendance for this item)  

The Committee gave consideration to a report from United Lincolnshire Hospitals NHS Trust (ULHT), which provided a general update on its services.

The Chairman invited the following representatives from ULHT to remotely present the report to the Committee: Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration and Simon Evans, Chief Operating Officer.

The Committee received an update on the current position in relation to the services, which made reference to the following:

·       That ULHT currently had one Covid-19 positive in-patient in Pilgrim Hospital, Boston. The Committee noted that to date the Trust had treated over 3,000 Covid-19 patients.  The Deputy Chief Executive and Director of Improvement extended thanks to staff in hospitals and across Lincolnshire for their continued support and commitment throughout the pandemic.  In contrast, it was noted that in Wave One the number of patients receiving treatment had peaked at 104; and in Wave Two the figure had risen to 253 patients being treated;

·       The hospital hub had provided over 41,000 vaccinations to social care staff across Lincolnshire.  It was noted that hospital hub had now closed;

·       That complex clinics continued to operate to accommodate patients with more complex medical conditions who required closer monitoring;

·       That the number of staff absences from work as a result of Covid-19 or having to isolate had reduced back to normal levels, which was a positive step forward for the Trust;

·       There had been an increase in bed occupancy due to an increase in emergency demand, which had also impacted on other partners such as the ambulance service.  It was also highlighted that there had also been an increase in the number of elective patients;  

·       That the Trusts waiting lists were being treated in order of clinical urgency, with clinicians applying priority status: priority one where patients were treated within 72 hours, and the Committee noted that currently there were no patients waiting in this priority group; and priority two where patients were treated within four weeks.  The Committee noted that currently this waiting time was at six weeks.  There was recognition by the Trust that there was more to be done to improve access.  It was highlighted that cancer patients were quickly prioritised and were receiving treatment within four weeks.  It was highlighted further that the waiting list in Lincolnshire during the pandemic had peaked at just over 2,000 patients waiting, and that this figure had now been reduced to 937; and that there was a commitment to reduce the waiting list further; and  

·       That the Grantham restoration was going to plan and that services would be restored to as they were in May 2020 with two additional services: Chemotherapy and additional theatres (it was highlighted that there were currently two additional theatres but one of these was due to be removed).  It was highlighted further that it was the intention to make Grantham Hospital, the principal elective surgery site.

Appended to the report at Appendix 1 was a copy of the Chief Executive's Report to United Lincolnshire Hospitals NHS Trust Board of Directors (1 June 2021) and Appendix 2 provided a copy of the Report to United Lincolnshire Hospitals NHS Trust Board of Directors (1 June 2021) on the Restoration of Services to Grantham Final Phase and Progress for the Committees consideration.

During discussion, the Committee raised the following points:

·       Clarification around the opening times of the accident and emergency department at Grantham being only from 8.00am to 6.30pm, when the Urgent Treatment Centre provided 24/7 provision.  The Committee was advised that a decision had to be taken to reduce the hours to support the overall delivery of services across Lincolnshire and that these would remain in place until the outcome of the Acute Services Review.  It was noted that during Covid-19, there had been the Urgent Treatment Centre (UTC), with the restoration plan now coming to fruition, these staff had now returned to their usual roles, and as a result the system was unable to sustain 24/7 cover.  Thanks were extended to the Lincolnshire Community Health Services staff who had maintained the UTC service at Grantham Hospital;

·       Personal experience of attending the Lincoln A & E, and the number of people waiting (around 60 people).  The Committee was advised that there had been an increase in number of people visiting A & E.  The Committee noted that both Lincoln County Hospital and Pilgrim Hospital, Boston were still operating in a Covid-19, socially distanced way; and as such hospitals had to make provision to be able to separate any Covid-19 positive patients or potential Covid-19 positive patients from non-Covid-19 patients;

·       Provision of medical beds at Grantham Hospital.  Reassurance was given that an appropriate level of medical beds would be available to meet demand;

·       The success of Moy Park.  The Committee was advised that the provision of services at Moy Park had been extended for a further six months, to allow some of the services to be moved back into Grantham Hospital and for other services to be re-located;

·       The possible cause for the increase in the number of patients visiting A & E departments.  One reason highlighted was whether this could be because some residents were unable to gain access to their GP.  It was reported that access to primary care was increasing also.  Reassurance was given that measures had been put in place to meet the increased demand at A & E departments.  It was also highlighted that there needed to be further communication messages informing residents not to use A & E unless it was an emergency and to encourage residents to contact 111 or their GP.  It was highlighted that residents were confused as to what services were available and how they were accessed; 

·       Reflection of what could have been done better during the pandemic.  The Committee was advised of two areas which the Trust representatives felt could have been done better. The first item highlighted was identifying one of the hospital sites as a green site earlier; and the other was allowing staff to take annual leave during beginning of the pandemic, when Lincolnshire was not being affected as much as elsewhere, as most staff had a 100 day stretch without being able to take annual leave;

·       Mobile breast screening service.  The Committee was advised that the mobile unit moved around the county particularly on the east coast.  Reassurance was given that the mobile unit would return to a hospital previously visited.  The Committee noted that the provision of breast screening was a system approach and agreed by colleagues from Public Health.  It was suggested that there needed to be more public awareness regarding this service;

·       What the identified risks associated with finances were? The Committee was advised that for 2021/22, finances had been split into two parts, H1 (the first part of 2021/22) which included additional funding in response to Covid-19.  It was highlighted that further work was then underway on mitigating the risks and on planning for the second half 2021/22 (H2).  It was reported that it was anticipated that the NHS would return to a more normal financial regime in H2, following the revised financial arrangements during the Covid-19 pandemic.  It was highlighted further that the return to the more normal financial regime would bring with it increased financial risk;     

·       The effect the new UTC at Lincoln had on reducing the number of patients into A & E.  The Committee was advised that, so far the impact had been that patients were being treated more quickly, and that there was an ability to expand more clinical rooms to see more patients; and

·       How the recruitment process was progressing and whether there was any overseas recruitment element?  The Committee was advised that recruitment had been very positive; the Trust had the lowest number of vacancies they had seen for quite some time.  This had been achieved by normal recruitment; and by being part of the national programme for the recruitment of health care support workers, with over 200 support works being recruited.  The Committee was advised further that the overseas recruitment had been suspended in response to Covid-19 restrictions, but had recently been reopened.  It was also noted that the development of the medical school at the University of Lincoln had also had a positive effect on recruitment.  It was agreed that recruitment details would be forwarded on to members of the Committee following the meeting.

The Chairman on behalf of the Committee extended thanks to the ULHT representatives for their presentation.

RESOLVED

1.    That thanks be extended by the Committee to staff for their efforts during the pandemic and in restoring services within United Lincolnshire Hospitals NHS Trust.

2.    That the information presented by United Lincolnshire Hospitals NHS Trust as part of the general update be noted.

3.    That a request be made for future reports from the Trust to focus on specific service areas such as cancer care.