Agenda and minutes

A webcast of the meeting can be viewed at: https://www.youtube.com/playlist?list=PLrlN4_PKzPXgH2NU3lNSh-0DlLIPEBe4d

 

The minutes of the meeting held on 14 June 2023 were taken as read, confirmed and signed.

 

The Chairman reported that the following questions had been received under Standing Order 34:

 

Questions asked by Giuliana Foster

 

1.           What assurances can be given that the proposed clinics will actually be instated at Feilding Palmer Community Hospital and not just ‘pop up – temporary’, given the extensive plans for outpatient clinics at Market Harborough and Hinckley?

 

2.           If FPCH is to lose its beds, we must ensure that the proposals are adequate for the people of Lutterworth, so we need guarantees that these clinics will be reinstated. The residents of the Lutterworth area are being asked to lose 10 inpatient beds in exchange for what?

 

3.           How often will each proposed clinic will be held?  For example, 1 x month or 3 times a week.

 

4.           The ICB have stated that the £5.3m is capital (presumably for all the refurbishment and installation of equipment) so where is the annual spending on services coming from? 

 

Reply by the Chairman:

 

1.      I have sought a response from the Integrated Care Board regarding the query raised and they have provided me with the following information:

 

The proposed plans for more community procedures and outpatient clinics at FPCH have been developed based on current evidence of need for the local population. The LLR ICB are committed to delivering additional clinics from Feilding Palmer on a permanent basis recognising the need for flexibility to meet changing demands in health needs.

 

2.     The proposal is to permanently close the 10 inpatient beds to provide an enhanced procedure suite and 6 consultation rooms.

 

3.      The Integrated Care Board has informed me as follows:

 

The proposal sets out a wide range of specialities and procedures that could be delivered from FPCH. We are currently working with UHL and wider providers to determine the exact procedures and clinics that will be provided recognising that there does need to be a degree of flexibility so that the offer can adapt to meet the changing needs in demand. It is likely that the clinics will operate ranging from 2 to 6 sessions per week dependent upon demand.

 

4.           The estimated capital for the refurbishment is £5.8m, the revenue costs will be funded through system finances.

Supplementary questions from Giuliana Foster:

 

1.           Where has the ICB gained its evidence regarding the needs of the local population?

 

2.           What is an enhanced procedure suite and are the 6 consultation rooms only for outpatient clinics or are there other uses in mind?

 

3.           The ICB said “The proposal sets out a wide range of specialities and procedures that could be delivered from FPCH”, they did not use the word ‘can’. What assurances can the ICB give that outpatient diagnostic clinics will be instigated at Feilding Palmer, in view of what the diagnostic plans are for Hinckley and Market Harborough?

 

4.           Regarding the £5.8 million funding identified required for the refurbishment how confident is the ICB they will be able to secure this money? Given the funding for Hinckley Community Diagnostic Centre was dependent on demonstrating extra capacity at Hinckley, will plans for Feilding Palmer have to meet the same criteria as Hinckley did in order to secure the funding?

 

The Chairman undertook to ensure that written answers to the supplementary questions would be provided after the meeting.

 

Questions asked by Rachel Hall (Falcon Support Services):

 

With respect we would like to raise some concerns in relation to the homeless support service consultation and feel the information provided to cabinet has been inaccurate.

 

The Cabinet Report on 23^rd June 2023 and Health Overview and Scrutiny Committee on 18^th January 2023 assert that  ...  view the full minutes text for item 14.

The Chairman reported that four questions had been received under Standing Order 7(3) and 7(5).

 

Questions by Mrs. Rosita Page CC:

 

My questions relate to the proposals for Feilding Palmer Hospital in Lutterworth and the upcoming public consultation on the proposals. We are aware that a business case is to be submitted to Government to secure funding to enhance the services at Feilding Palmer Hospital.

We are aware and accept that the 10 beds in the Feilding Palmer Hospital will be removed but we always understood that the business case was going to be made to enhance the existing provisions provided to the community, being mindful that South Leicestershire has a large aging population and that the plans for the Lutterworth East Strategic Development Area (SDA) when implemented will have a further impact on the population of the area. It is therefore important to ensure the long-term sustainability of healthcare for Lutterworth residents. 

We understood that the business case would build on existing clinics, to provide diagnostics so the need for lengthy travel to attend health appointments would be cut down not only for convenience but also to lower the carbon footprint. However, on closer scrutiny of the proposals it appears that the Lutterworth community will actually be short changed at the loss of approximately 9 clinics.

1.           Please explain what the money will be used for, should the bid be successful?

2.           I understand that the NHS (within all 43 Trusts) is committed to reducing its carbon footprint – and they are having a big ‘push’ on this.  Therefore, why is Corby Community Hospital referred to on the draft consultation document? It is 30.4 miles away from Lutterworth and totally inaccessible to those Lutterworth residents without their own transport as there are no bus routes.

3.           With reference to the chart comparison for Outpatient/diagnostic clinics being proposed (see accompanying chart below), Lutterworth has actually lost 8 clinics over the years but it is stated in the business case they are being offered extra services.

I have already made the following request to the Integrated Care Board but I would like it formally on record that I have asked for this information. Please provide a basic chart setting out what services Feilding Palmer Hospital is providing now and what the enhanced /proposed future provisions are going to be.

OUT-PATIENT CLINIC COMPARISON CHART FOR GILMORTON RD SITE LUTTERWORTH

CLINICS/DIAGNOSTICS	Proposed clinics for 2023 Consultation	Out -Patient Clinics FOI March 2023	Out -Patient Clinics FOI February 2020	Out -Patient Clinics FOI 2017
AAA Screening	x
ADHD	x	x
Cardiology	x			x
Dermatology	x		x
Dietary	x	x		x
ECHD	x
General Internal Medicine	x
General Surgery	x			x
Gynaecology	x	x		x
Heart Failure	x	x	x	x
Mental Health	x	x	x	x
MSK Physiotherapy	x		x	x
Ophthalmology	x
Out of Hours	x	x	x
Paediatrics	x		x	x
Parkinson’s Care	x	x		x
Psychiatrics	x
Psychiatric Nurse	x			x
Pulmonary and Cardio Rehab	x	x
Respiratory Medicine	x
Rheumatology	x
Speech and Language	x	x	x	x
Stoma	x			x
Trauma and Orthopaedics	x
Urology	x
Walking Aid Clinic	x	x
Memory Clinic				x
Midwifery Clinic			x
In Health Scans			x	x
Podiatry			x
Upper Abdominal				x
Cytology				x
Physical Therapies			x
Baby feeding/Parent group		x
Total	26	11	11	16

                                   

4.     Please clarify why and on what exactly are we having a costly and lengthy public consultation?

Reply by the Chairman:

1.           NHS Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) is undertaking a Pre-Consultation Business Case (PCBC) in regard to maximising access to services for the  ...  view the full minutes text for item 15.

There were no urgent items for consideration.

 

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

 

Mrs. M. E. Newton CC declared a Non-Registrable Interest in agenda item 10: Health Performance Update as she had two close relatives that worked for the NHS.

 

Mrs. B. Seaton CC declared a Registrable Interest in agenda item 10: Health Performance Update as she was a member of Silverdale Medical Centre Patient Participation Group.

 

There were no declarations of the party whip in accordance with Overview and Scrutiny Procedure Rule 16.

 

The Chief Executive reported that no petitions had been received under Standing Order 35.

 

The Committee considered a report of the Director of Public Health which sought the views of the Committee around the proposed homeless support offer as part of the consultation. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

 

The Chairman welcomed to the meeting for this item Rachel Hall, Deputy CEO, Falcon Support Services and invited her to make a representation before he took any questions from members.

 

Rachel Hall explained that the Falcon Centre had had a long-standing good relationship with the County Council over the years.  The Falcon Centre had been aware that the current contract was coming to an end and understood that this would provide an opportunity to review the service.  However, the Falcon Centre was not expecting that the review would result in a proposal to cease commissioning this specialist service.

 

Rachel Hall reiterated the concern raised in her questions (minute 14 refers) that the Cabinet had been provided with inaccurate and misleading information and suggested that the Falcon Centre would like an opportunity to work with all parties involved to find a solution to protect the most vulnerable.  She suggested that the proposed changes to how the service was provided would result in a worse service.

 

In response to questions from Members, Rachel Hall responded as follows:

 

(i)           The Falcon Centre could support 30 people at any one time and the accommodation was always fully occupied with a waiting list. In a typical year there would be a total of 100 different residents and the average length of stay was 4 months, in line with the Falcon Centre’s role as a provider of supported accommodation. There were other accommodation centres for homeless people in Leicestershire such as The Carpenter’s Arms in Loughborough and a rehabilitation facility in Hinckley. The Carpenter’s Arms was much larger than the Falcon Centre.

 

(ii)         The County Council had been commissioning the homeless support service provided by Falcon Support Services for 10 years. The contract value was £300,000 per annum and the contract would end on 31^st March 2024. The £300,000 was a small part of the overall budget for the Falcon Centre. However, the Falcon Centre was of the view that the homeless support service enabled it to be an exempt organisation in terms of housing benefit, which made the value of the contract significantly higher.

 

Rachel Hall also acknowledged that she had had a sufficient opportunity to raise concerns and questions.

 

Arising from discussions the following points were noted:

 

 

(iii)        In response to a question as to what proportion of the people that the Falcon Centre supported were from Leicestershire and what proportion were from outside of the county boundary, it was agreed that this information would be provided to members after the meeting.

 

(iv)       It was queried whether, given that the Falcon Centre was submitting that it was financially reliant on the funding from Leicestershire County Council and at risk of closure should the funding not be received, questions should be raised as to the financial sustainability of the Falcon Centre as a charity and whether further checks needed to be carried out regarding its status.

 

(v)         In response to a question from the Chairman as to how the County Council audited the provision of the services it commissioned it was explained that the Public Health department did not specify exactly how the funding should be spent, they were mainly concerned about whether the overall aims were being achieved. The contract with the Falcon Centre included Key Performance Indicators which the Falcon Centre was required to provide data on. Quarterly contract  ...  view the full minutes text for item 20.

The Committee considered a report of Leicester, Leicestershire and Rutland Integrated Care Board (ICB) which informed of a consultation on the plans to make changes to the usage of Feilding Palmer Hospital in Lutterworth to maximise access to health services for the local community. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Sarah Prema, Chief Strategy Officer, Integrated Care Board and David Williams, Group Director of Strategy & Partnerships, Leicestershire Partnership NHS Trust.

 

Arising from discussions the following points were noted:

 

(i)           It was not proposed to demolish the Feilding Palmer Hospital building. Instead, the interior would be refurbished with the space remodelled and an extension would be built. In response to a question from a member as to the precise timescale for the implementation of the proposals it was explained that the first building works would likely start in spring 2025 but a full timetable would be provided to members after the meeting.

 

(ii)         The £5.8m capital for the proposals was coming from the local budget which meant that the ICB would not have to go through time-consuming national processes. The funding had already been confirmed and was available for use.

 

(iii)        Prior to the Covid-19 pandemic there had been 10 inpatient beds at Feilding Palmer Hospital.  One of the beds was in a suite and was used for palliative care.  All these beds were closed during the pandemic as they did not meet the Infection, Prevention Control Inpatient standards and they remained closed for that reason. A member raised concerns that the new proposals for Feilding Palmer Hospital did not include inpatient beds and stated it was important for beds to be available locally to enable friends and relatives to visit patients easily. In response it was explained that the approach of modern healthcare was to treat patients in their own home as much as possible so that they could be kept mobile and did not suffer as much muscle degeneration as they would in a hospital bed. Virtual wards were being used to monitor patients at home.

 

(iv)       Replacing the inpatient beds would be 6 consultation rooms and an enhanced procedure suite for day-case procedures carried out without general anaesthetic.

 

(v)         The proposed plans for more community procedures and outpatient clinics at FPCH had been developed based on current evidence of need for the local population. The information on need had been collected from local engagements and consultations. The NHS also held data on which services residents from Lutterworth post codes most commonly accessed and used this to inform future planning.

 

(vi)       In response to a concern raised about Feilding Palmer Hospital being able to cope with the large housing growth projected for the Lutterworth area and the amount of elderly people, it was explained that it was predicted that the housing growth would actually increase the amount of younger people living in the area. Therefore outpatient clinics were likely to be the most appropriate type of provision.

 

(vii)      In response to a question as to what impact the new proposals would have on waiting times it was explained that the proposals were not specifically designed to tackle waiting times but there were many other initiatives being put in place in Leicestershire which would deal with that problem.

 

RESOLVED:

 

(a)        That the proposed consultation on the plans to make changes to the usage of Feilding Palmer Hospital in Lutterworth to maximise access to health services for the local community be noted;

 

(b)        That officers be requested to take on board the comments now  ...  view the full minutes text for item 21.

The Committee considered a joint report of the Chief Executive and the Integrated Care Service (ICS) Performance Service which provided an update on public health and health system performance in Leicestershire and Rutland based on the available data in August 2023. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

 

The Chairman welcomed to the meeting for this item Rachna Vyas, Chief Operating Officer, NHS Leicester, Leicestershire & Rutland, and Alison Buteux, NHS Midlands and Lancashire Commissioning Support Unit.

 

Arising from discussions the following points were noted:

 

(i)           Members asked that future performance reports contain regional and national benchmarking data to enable the Committee to assess Leicestershire’s performance in the wider context. In response it was confirmed that this type of data was now available and could be included in future reports. Members also asked that the performance reports provide greater clarity on the direction of travel for the metrics i.e. whether performance was improving or not over a period of time. It was agreed that links to online performance data would be circulated to members after the meeting.

 

(ii)         With regards to the Accident & Emergency metric of admission, transfer, discharge within 4 hours, 99% of LLR Urgent Care Centres were meeting the target and for the Emergency Department the target was being met with 61% of patients. One of the reasons performance against this metric was not better was a lack of beds and problems with flow of patients through the wider hospital. Some of the patients arriving at the Emergency Department did not need to be there and could have been dealt with elsewhere. In response to a question from a member it was clarified that according to data received at system level, it did not appear that staffing numbers were a problem, a lot of recruitment had taken place and workforce numbers in the Emergency Department were as per plan.

 

(iii)        In response to a question about the impact of strike action on Leicestershire’s performance data it was explained that acute care had been prioritised and the main impact had been on elective care. However, partnership working was taking place across the system to tackle the elective care backlog and GPs were assisting with some elective procedures.

 

(iv)       Members raised concerns that whilst bowel cancer screening coverage had improved, coverage for breast cancer and cervical cancer had declined. It was questioned which sections of the population were not coming forward for screening and what could be done to encourage them. It was acknowledged that there needed to be better communication with the public about screening programmes and the ICB agreed to provide documentation on screening to members after the meeting which could be circulated to the general public.

 

(v)         Members welcomed that Leicestershire was in the top quartile for the metric ‘Percentage of people who are resident in the HWB, who are discharged from acute hospital to their normal place of residence’.

 

(vi)       With regards to the metric ‘Long-term support needs of older people (aged 65 and over) met by admission to residential and nursing care homes, per 100,000 population’ the aim was to move into the second quartile when compared to similar authorities. There was confidence that this target would be met due to the large amount of partnership work taking place particularly the Home First initiative where patients were assessed to see what they needed to help them with reablement. It was also reassuring that the high level of performance against the metric had been maintained through the winter periods.

 

(vii)      With regards to Improving Access to Psychological Therapies (IAPTs) there  ...  view the full minutes text for item 22.

The Committee considered the work programme of the Leicester, Leicestershire and Rutland Joint Health Scrutiny Committee, a copy of which, marked ‘Agenda Item 11’, is filed with these minutes.

 

RESOLVED:

 

That the work programme of the Leicester, Leicestershire and Rutland Joint Health Scrutiny Committee be noted.

 

 

The next meeting of the Committee is scheduled to take place on Wednesday 1 November 2023 at 2.00pm.

 

RESOLVED:

 

That the next meeting of the Committee be held on Wednesday 1 November 2023 at 2.00pm.