Agenda item

(To receive a report from Lincolnshire Community Health Services NHS Trust (LCHS), which provides the Committee with a general update.  Maz Fosh, Chief Executive, and Tracy Pilcher, Director of Nursing, Allied Health Professionals and Operations from LCHS will be in attendance for this item)   

The Chairman invited Tracy Pilcher, Director of Nursing, Allied Health Professionals and Operation to remotely present the report to the Committee, which provided an update on the restoration and recovery of services provided by Lincolnshire Community Health Services NHS Trust (LCHS) following the Covid-19 pandemic.

A copy of the report had been circulated to members of the Committee on 19 June 2021.

In guiding members of the Committee through the report, mention was made to:

·       That all services had now been restored and were all back to pre-Covid-19 levels of performance; that Louth and Skegness Urgent Treatment Centres (UTCs) were now open 24/7, and that Gainsborough and Spalding had been restored as UTCs, providing a greater range of services;

·       Same Day Primary Care Appointments; LCHS was currently working with system partners on a short-term proof of concept to support two GP surgeries; in Gainsborough and Lincoln.  Details relating to the proof of concept were shown on page 4 of the report.  The Committee was advised that activity was increasing across all UTCs and that the Skegness activity was continuing to increase as in previous years.  The biggest demand being from 8am to 10pm with minimal activity overnight.  A breakdown for each UTC for restoration and recovery was shown on pages 5 to 8 of the report;

·       Community Hospitals – It was noted that as part of the restore programme a number of developments had been identified, including the piloting of an e-observation platform, further development of the direct admissions pathways for community hospital, as well as a review of the workforce models for community hospitals to support the wider out of hospital programmes of care.  The Committee noted that 67% of services had been partially restored;

·       LCHS Outpatient Services – This activity would be restored on the LCHS sites during June and July 2021;

·       Butterfly Hospice – The service had been restored and was providing significant contribution to the palliative and end of life pathway for patients within Boston and surrounding area;

·       Community Nursing – The Community nursing service was now fully restored; and that work was now ongoing in relation to embedding the new pathways of care, as well as supporting the increased number of patients with complex needs being cared for in the community.  Full details of referrals and discharges were shown on page 11 of the report;

·       Allied Health Professionals and Children's Services - It was highlighted that there had been challenges to fully restoring the services due to many of the Allied Health Professional services being stepped down during the first phase of Covid-19, in line with national policy, and staff being redeployed to support the wider organisational response;

·       Specialist Services – The Committee noted that 62% of services had been restored;

·       Post-Covid Syndrome Service – It was highlighted that since the commencement of this service , there had been 438 referrals, with 312 open referrals and 126 patients being discharged from the service; and

·       Covid-19 Vaccination Programme – It was highlighted that delivery models had been developed to safely, rapidly and efficiently vaccinate eligible cohorts.  It was noted that the Princess Royal Sports Arena, Boston and the Lincoln Showground were running well and were successfully delivery services in line with the national provider and operational specifications.

During discussion, the Committee raised the following points:

·       An explanation of the assistance provided to GPs to enable them to have extra capacity;

·       The number of Community Nursing vacancies in the county.  The Committee was advised that there was a staff establishment of 320 fte community nurses across the county and that this figure had increased from 284 fte in the previous year, but there were still some vacancies.  It was agreed that further information would be made available to members of the Committee, from which it would be established whether the Committee would need to look into this matter further;

·       Post Covid-19 Syndrome and the associated mental psychological health issues.  It was highlighted that someone with mild symptoms of Covid-19 in the first wave may not have been diagnosed as having Covid-19.  As a result there was a cohort of people who had a range of symptoms who had not been tested for Covid-19 who were suffering from fatigue, and other symptoms.  In these circumstances primary care would be requested to perform a range of diagnostic tests (in line with National Institute for Health & Care Excellence (NICE) guidance) before referring into the service.  Any one referred experiencing mental or psychological issues would be referred to the Lincolnshire Partnership Foundation NHS Trust; 

·       The Trusts intended plans for the St Mary's Medical Centre premises in Stamford following its use as a vaccination centre.  The Committee advised that this would be a matter for the CCG;

·       Whether there were any plans to review the overnight medical cover arrangements at Louth and Skegness urgent treatment centres, as there was no doctor on duty overnight.  The Committee was advised that there were two practitioners on duty overnight at Louth and Skegness, and that there was an on call doctor.  The Committee noted that the model had been reviewed and had been signed off as a safe and effective model.  There was an appreciation of the concerns and anxieties raised by staff and the public, but reassurance was given that there had been no incidents overnight; and it was highlighted that  arrangements were continually being monitored; and

·       What the capital investment was being used for in Skegness and Louth and when was work likely to commence? The Committee was advised that in Louth the refurbishment would be addressing environmental issues such as ventilation; and storage of medicines.  At Skegness there would be more significant investment to look at the whole environment, to take into account ventilation; self-isolation provision and the provision of an additional waiting area; and a children's waiting area.

The Chairman extended thanks on behalf of the Committee to the Director of Nursing, Allied Health Professionals and Operation for her update.

RESOLVED

1.    That the information presented by the Lincolnshire Community Health Services NHS Trust be noted and that thanks be extended to all staff involved in the Trust for their continued involvement in responding to Covid-19.

2.    That the establishment of new urgent treatments centres in Gainsborough and Spalding during the last year be welcomed.

3.    That the Committee's concerns about overnight medical cover at Louth and Skegness urgent treatment centres be recorded and that a further report concerning this matter be received at a future meeting.