Agenda item

(To receive a report from John Turner, Chief Executive Lincolnshire Clinical Commissioning Group, which provides an introduction on the content of the consultation for the Lincolnshire Acute Services Review and invites the Committee to agree its arrangements for responding to the consultation)

The Chairman advised the Committee that before he invited the representatives from the Lincolnshire NHS Clinical Commissioning Group to present the report, he had received a request from Jody Clark (Fighting 4 Grantham Hospital) to speak at the meeting.  The Committee was advised that a time period of three minutes would be allotted to Jody to address the meeting via Teams.

The statement made reference to some of the following points: the opposition in Grantham to the overnight closure of Grantham A & E; the troubles with recruitment and retention of staff at Grantham Hospital; the travelling incurred by local patients due to the reduced service and the impact of travelling on families in the Grantham area; with no A & E provision, there was a need for a 24/7 Urgent Treatment Centre with walk in access, and access to medical and acute beds.

On behalf of the Committee the Chairman extended his thanks to Jody Clark for her statement.

The Chairman invited the following representatives from the Lincolnshire NHS Clinical Commissioning Group who were present in the Council Chamber to present the item to the Committee: John Turner, Chief Executive, Charley Blyth, Director of Communication and Engagement and Tom Diamond, Associate Director of Strategy (who attended the meeting via Teams).

The Chief Executive extended his thanks to the Committee for their continued interest and support shown over the last eighteen months.

The Committee was reminded that the on the 21 September 2021 the Chairman had received notification from the Chief Executive of the Lincolnshire Clinical Commissioning Group (CCG) that the CCG would shortly commencing a formal public consultation exercise in relation to the four NHS service change proposals.  It was noted that at the Lincolnshire CCG Board on 29 September 2021 had agreed to proceed with the consultation, which was then subsequently launched on 30 September 2021 for a period of twelve weeks up to 23 December 2021.

The Committee noted the four NHS services change proposals were in the following areas:

·       Orthopaedic Surgery – the development of a 'centre of excellence' in  Lincolnshire for planned surgery at Grantham and District Hospital and a dedicated day-case centre at County Hospital Louth, for planned orthopaedic surgery;

·       Urgent and Emergency Care at Grantham and District Hospital – the establishment of a 24/7 Walk in Urgent Treatment Centre, in place of the current Accident and Emergency department;

·       Acute Medical Beds at Grantham and District  Hospital – The establishment of integrated community/acute medical beds, in place of the current acute medical beds; and

·       Stroke Services – the development of a 'centre of excellence' in Lincolnshire for hyper-acute and acute stoke services at Lincoln County Hospital; which would be supported by the enhancement of the community stroke rehabilitation service to support stroke patients with more complex needs.

The Committee was advised that the vision was to provide the very best health care for the people of Lincolnshire and to continually improve services wherever possible. It was felt that the benefit of the proposed changes would improve the quality of care being provided; reduce waiting times; provide better outcomes for patients; increase the availability of staff to care for patients; and would be a better use of NHS funds, by reducing spending on temporary staff.

Detailed at Appendix A to the report was a copy of the Executive Summary of the Pre-Consultation Business Case for the Lincolnshire Acute Services Review; and Appendix B provided the Committee with a copy of the public consultation document relating to four of Lincolnshire's NHS Services.

It was reported that there was a programme of public consultation events happening around the County, some of which had already been held.  It was noted that the every effort was being made to publicise public consultation across the County. It was highlighted that flyers had been sent to every household, face to face events were being held, and that there was also the opportunity for members of the public to complete the questionnaire on-line.  

Page 21 of the report provided a proposed timetable to allow the Committee to respond to the NHS service changes. 

Whilst reviewing the report presented, the Committee raised the following comments:

·       The views of Grantham residents with regard to the provision of A & E services at Grantham and District Hospital.  Assurance was given that the views of residents of Grantham had been listened to.  The Committee noted that over a number of years there had been several changes made to A&E services at Grantham Hospital and the services being provided were far closer to that of an Urgent Treatment Centre (UTC).  It was reported that the vast majority of people needing care would be able to attend a UTC for their care and that making it a 24/7 walk in service would be an enhanced service.  A question was asked whether members of the public had been using the UTC when it had been temporarily changed during the pandemic.  The Committee was advised that during the temporary period, the UTC had been well used. Officers agreed to make the data available to members of the Committee;

·       Members of the Committee welcomed the public consultation.  A request was made for further information concerning the consultation and where that information could be found, so that it could be forwarded on to other organisations and members of the public;

·       What the timetable was for the remaining four areas of service.  The Committee noted that when the ASR commenced clinicians had initially looked at 35 services across the county; then as a result of due process, eight services had been identified for more detailed work.  Following this,  four areas had been selected for consultation, to implement these changes would require less capital expenditure (between £10 to £12million).  The intention was to enhance care, help workforce issues and to actually make a difference in services being provided for the residents of Lincolnshire. It was highlighted for the four remaining areas more capital investment was required (between £50 to £60 million).  Details relating to the financial impact of ASR following full impact of service changes were shown on page 52 of the report pack;

·       Cross border services for those residents in the north and south and west of the County;

·       Some concern was expressed regarding the rurality of East Lindsey and whether any engagement was being done in market towns.  Reassurance was given that the responsibility of the CCG was for the whole population of Lincolnshire.  It was further highlighted that whilst consulting on the four services, the NHS welcomed feedback on all aspects of the NHS.  The Committee was advised that market day events were being held in all market towns during December and that there was also the opportunity to participate in virtual events;

·       Whether the Lincolnshire Association of Local Councils (LALC) had been approached to help get the information out to town and parish councils.  The Committee was advised that LALC had been contacted prior to the launch of the consultation on 30 September as had other stakeholders.  The Committee was advised that 1,200 responses had already been received as of 12 October; and that this compared very well to a consultation in Gloucestershire, which had only received a total 715 responses for the whole consultation period. Emphasis was however made that it was not the quantity of responses; it was the quality of response that was very important.  A further question asked was whether there was capacity for someone to visit parish councils.  It was noted that there was a focus group and that as requests were received, visits could be arranged.  The Committee requested details of who to contact in these instances;

·       The issue of rurality for a patient experiencing a stroke and the prospect of a longer journey to a specialised unit; 

·       The emerging Humber Acute Services Review, and its potential impact on residents on the east of the county, and other neighbouring trust; and whether these changes had been taken into consideration with the planned Lincolnshire changes and the possible additional pressures on Lincolnshire trusts.  Reassurance was given that the CCG linked in very closely neighbouring trusts; and that this was an on-going process;

·       A request was made for the Committee to be kept updated regarding the number of responses received to the public consultation.  Thanks were also extended to the CCG for arranging a flyer to be sent to every household in Lincolnshire. The Chief Executive agreed to make information available to the Committee regarding the number of responses received.  A further question was asked as to how the despatch of the flyers was being monitored to ensure that each resident received a leaflet. The Committee was advised that every effort was being made to ensure that a leaflet was delivered to every household;

·       Whether Covid-19 would have any impact on proposed timetable for implementation.  Reassurance was given that contingency plans were in place in the event of a further wave of Covid-19;

·       What the proposed bed provision at Grantham hospital was going to be.  It was reported that the bed provision would make provision for overnight inpatients and day case patients;

·       Staff recruitment and retention in Lincolnshire.  It was noted that this was an issue in Lincolnshire in primary care and nursing staff.  It was noted that a recent successful recruitment exercise had managed to secure a number of health and care workers to key hospital services.  The Lincoln Medical School had been successful in helping to recruit trainees.  It was further noted that the focus on the east coast was to grow your own;

·       Reference was made to a number of outstanding questions not being answered following the attendance at a recent council meeting in Boston.  Reassurance was given that the questions raised would be answered;

·       The positives of having Grantham and District Hospital as a centre of excellence for  Orthopaedic surgery;

·       Some concerns were expressed regarding some services being centralised.  The Committee was advised of the significant investment that Pilgrim Hospital Boston had received.  The Committee was advised that the CCG was happy to provide more detail if required;

·       Whether financial constraints were the driving force for the proposed changes to services.  The Committee noted that the changes were not about financial savings.  The driving force was quality of care, services being reconfigured in the right way; reducing waiting lists; and ensuring the retention of staff;

·       The need to ensure that communication provided ensured that people understood what services were available now and what was going to change.  Particular reference was made to the Louth County Hospital site.  The Chief Executive agreed to provide in collaboration with United Lincolnshire Hospitals NHS Trust and Lincolnshire Community Health Services NHS Trust a list of services currently provided at the Louth County Hospital and what the proposed changes would entail for the East Lindsey District Council representative.  There was recognition that communication was key to the ensuring that the public were well informed of the proposed changes and the reasons for the changes;

·       Whether a patient from the East Lindsey area who had attended Grantham Hospital for orthopaedic surgery would be able to have a follow up appointment in Louth.  The Committee was advised that this would be checked and reported back;

·       Transport issues for those attending the proposed centres of excellence;

·       The need for members of the public to see the benefits of any change to service;

·       The need to take into consideration the Chief Medical Officer’s Annual Report 2021: Health in Coastal Communities.  The Committee was advised that the CCG and the Council worked very closely together regarding equitable service provision across the County;

·       Residents from Alford and Mablethorpe not being unable to attend breast and diabetic screening appointments as they had no transport available to them.  The Chief Executive agreed to look into this issue; and

·       A question was asked if a patient attended a proposed UTC had to be moved to an alternative site, would travel arrangements be made to bring the patient back to the original site.  The Committee noted that as the UTC was a local service, the majority of patients would have their care needs met without the need for any further transportation.  

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

RESOLVED

1.     That the introductory presentation on the public consultation on the Lincolnshire Acute Services Review be noted.

2.     That the arrangements for responding to the NHS's consultation on the Lincolnshire Acute Services Review in line with the following timetable be confirmed:

a)    Detailed consideration of two specific elements of the Acute services Review at each Committee's next two meetings on 10 November and 15 December 2021;

b)    Consideration of the interim feedback report on the consultation from the Lincolnshire Clinical Commissioning Group on 15 December 2021;

c)    Establishment of one working group to draft the detailed response to the consultation;

d)    Finalisation of the Committee's response to the consultation on 19 January 2022, for submission prior to 31 January 2022.

3.    That the working group be comprised of the following: Councillors Mrs S Harrison,     C S Macey, S R Parkin; Mrs A White, M A Whittington, L Wootten and R Wootten,