Agenda item

(To receive a report from Annette Lumb, Head of Planning and Corporate Governance, Lincolnshire West Clinical Commissioning Group, which invites the Committee to consider the proposed consultation document and consultation plan)

Councillor Mrs K Cook wished it to be noted that she was currently a patient of Lincolnshire Partnership NHS Foundation Trust.

The Chairman welcomed Dr Sue Elcock, Medical Director, Lincolnshire Partnership NHS Foundation Trust and Jane Marshall, Director of Strategy and Performance, Lincolnshire Partnership NHS Foundation Trust to the meeting.

The Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership introduced the item and provided some background information to the proposed consultation plan.  Attached at Appendix A to the report was a copy of the proposed consultation document for the Committee's consideration.

In a joint presentation, the Director of Strategy and Performance, Lincolnshire Partnership NHS Foundation Trust (LPFT) and the Medical Director, Lincolnshire Partnership NHS Foundation Trust advised the Committee that following the temporary closure of the inpatient service at Long Leys Court, extensive engagement had been undertaken with patients, family members and the wider public to explore what already worked well in learning disability services in Lincolnshire; and to also establish what could be done better.  The feedback received from patients, family members and staff had then informed the development of a new integrated community service, which had been in place from 1 April 2016.

It was reported that the current community service had significantly reduced the delays that often occurred between different teams of professionals, and ensured that most patients were treated in their own home.  It was highlighted that the service was more consistent and was accessible across Lincolnshire, as the four hubs were situated in Boston, Lincoln, Spalding and Grantham.

The Committee was advised that in addition to the community service, and working alongside the hubs, was a Crisis Home Assessment and Treatment (CHAT) team which operated 24 hours a day, seven days a week, to provide intensive support in service users' homes.

It was highlighted that on the occasions when people needed more than the community service, more intensive support was provided into the person's home environment.  And on the rare occasions some patients with a learning disability required admission to a specialist learning disability hospital, a specialist inpatient bed would be sought from outside of the county.  The Committee noted that since the 1 April 2016, when the new community model had become fully operational, only three service users had needed to be admitted into a specialist learning disability hospital.

The Committee was advised that the £5 million a year expenditure on the new community based learning disability services was approximately the same as the former inpatient service.  Reference was made to the '£635,000 STP footprint' saving cited in the report and a request was made for more detail on the expenditure of the former and current service.

In conclusion, it was felt that the current community service had proved to be very successful and it was believed that it should be retained. It was believed that there was no longer a need for a dedicated inpatient unit in Lincolnshire.

During discussion, the Committee raised the following issues:--

·         One member enquired whether in some cases, would travel costs be subsidised.  The Committee was advised that journeys would be subsidised in certain instances; 

·         The Committee was advised that Long Leys Court had been temporarily closed in June 2015, due to quality and safety concerns, then following a period of engagement with patients, staff, and stakeholders, an interim community service had then been launched in April 2016.  The Committee noted that the new service had been positively received, with only 10% of the patients using CHAT being admitted to hospital and two of the cases had been as a result of them being referred at a too late stage for admission to be prevented;

·         Funding - The Committee was advised that LPFT wanted to see the £5m maintained and protected for the Learning and Disability service;

·         Some members expressed their support for the positive report presented; and to the proposed service;

·         One Member requested more details on where patients were sent when they were placed out of county.  The Committee was advised that this depended on where the patients lived.  The Committee was advised further that a full analysis was conducted, before any placement was made.  It was reported that at present there were five people with learning disabilities who had been placed out of county.  It was highlighted that patients were only placed out of county to ensure that they received the right service to meet their individual needs; and

·         One member enquired whether patients with lower needs were signposted by GPs to get help.  The Committee noted that there were some gaps, but these were being developed.  Particular reference was made to patients with dyspraxia.  One of the Trust representatives agreed to speak to the organiser of the Lincoln Dyspraxia Group.

Overall, the Committee felt that engagement concerning Long Leys Court should be targeted to people with learning disabilities, their carers and their families.

RESOLVED

1.    That the Committee's preference be recorded for targeted engagement with people with learning disabilities, their carers and their families on the proposed closure of Long Leys Court.

2.    That the reason for the decision in (1) above be based on the specialised nature of the service provided in this instance; and the fact that alternative provision had been in place since 1 April 2016, with no serious adverse comments received since that time.