Agenda item

Lincolnshire Sustainability Transformation Plan

The Chairman introduced Sarah Shaw (Health Co-ordinator) and Gary James, (Accountable Officer for Lincolnshire East CCG) to give a presentation on the Lincolnshire Sustainability Transformation Plan.  The headline information being:-

•       A nationally required 5 year health and care plan for the whole of Lincolnshire – our plan must improve health and wellbeing and quality, as well as bring the whole health system back into financial balance by 2021

•       “Big Ticket” Items - STPs bring together local partners to resolve deep-seated issues, but local solutions must be whole system and realistic to succeed

•       One System, One Budget - The funding pressures on each part of the system cannot be solved in isolation, so each STP identifies the totality of the health and social care challenges it faces

•       Stakeholder Engagement and public consultation - Ownership of local plans requires meaningful engagement with all stakeholders, including public consultation on any major service change

•       Integration - A commitment to integration sits at the heart of the STP process

•       Governance - Robust governance and clear lines of accountability will be central to the successful implementation of STPs

The process for development was set out in the presentation along with the challenges and the vision for 2021.  Plans were set out to overcome the gaps in Health and Wellbeing, Care and Quality, and Finance and Efficiency by 2021.

A radically different governance and organisational structure was proposed which included:-

•       Neighbourhood Teams

•       Multispecialty Community Providers

•       A more efficient way of working

•       Partnerships out of county

•       Working together to plan and deliver services

•       An ongoing commitment to work with patients and the public

The financial implications were described:

•       21 October 2016 submitted a balanced financial plan for the Lincolnshire

•       Health spend will increase from £1.266bn (16/17) to £1.4bn (20/21)

•       Do Nothing £182m deficit by 2021;

•       Solutions ‘Do Something’ £130m

•       Assumed Strategic Transformation Funding of £52m (in 2020/21)

•       Model is inclusive of workforce, activity and capital models

The impact on West Lindsey Residents was

•       Improving the quality of care in all local services: GP appointments, joining up health and care, better access to care – less cancelled operations, more investment and resources for prevention, health and wellbeing and self-care, expanded A&E to include an urgent care front door, more choice and personalised support for women and families 

•       Exploring options for better utilisation of the facilities at John Coupland eg. primary care hub

•       Potential changes to hospital services: still to be finalised before May 2017 public consultation but likely to cover options for the following areas:

•       Balancing quality and access:  arguments for centralising some services to ensure sufficient workforce seeing a high volume of complex cases, with expertise on one site.

•       Understanding the local perspective: engagement, discussion, concerns about travel times and access, patient choice.

The key dates for the future included:-

•       Jan-March 2017 – Engagement and dialogue on our Plan with public, staff and stakeholders

•       25 Jan 2017 - Options Appraisal Event scoring of proposals for major service change which will require full public consultation

•       20 Feb 2017 – Clinical Senate review of major service change

•       March 2017 – NHSE assurance on Pre Consultation Business Case

•       May 2017 – post election public consultation

The Chairman thanked Mr James for his presentation and sought questions or comments from Members.

It was asked why Grantham A&E had been closed before any consultation, causing great inconvenience for residents needing to travel to other centres.  The response was that this had been an emergency measure due to sustainability issues, and was done with reluctance.  Steps were being taken to assess the situation and provide urgent care facilities.

Members expressed concerns that the main urban centre of Lincoln was not easily accessible for those in rural areas.  Mr James responded that no major site closures were planned but there was to be consultation on where services should be provided.

It was questioned as to whether the NHS could ever be sustainable in light of the current influx of ‘health tourists’.  The response was that the Government were trying to address this issue.  There was also a national recruitment pilot ongoing, General Practices needed to be sustainable.

Further questions were raised regarding the lack of consultation to date, however it was stated that the consultation so far had been with regulators and following shortlisting of the crucial issues the public consultation was to commence.

Some Members suggested that Lincoln University should have a medical school where local students could be recruited as doctors and nurses.  It was proposed that all health organisations would be working together to design one integrated plan, which had never been done before.

Note Councillor Trevor Young declared a personal interest as being a senior NHS manager.

The Chairman noted that it was necessary to hold a local meeting, and a date would be fixed.  The Chairman of Governance and Audit proposed that the matter be incorporated into the ongoing health commission being undertaken by the Council, this was seconded and agreed.

RESOLVED that the issues raised within the presentation and subsequent discussion be incorporated into the ongoing health commission, through the Prosperous Communities and Challenge and Improvement Committees.