Agenda item

The Committee considered a report of Leicester, Leicestershire and Rutland (LLR) Clinical Commissioning Groups which provided an update on progress with redesigning adult community health services across LLR and set out the next phase of the work. A copy of the report, marked ‘Agenda Item 7’, is filed with the minutes.

The Committee welcomed Tamsin Hooton, Director lead for Community Services Redesign, West Leicestershire Clinical Commissioning Group to the meeting for this item.

Arising from discussions the following points were noted:

(i)          It was expected that the real benefits of the Community Services Redesign would become apparent in future years rather than the current financial year. Whilst LPT was expected to provide additional services under the community services redesign and the LPT community teams were to be restructured in the current financial year, no additional funding would be provided for 2019/20 and LPT were expected to provide the services using existing staff. A review would then take place of LPT capacity and how it was dealing with demand with the expectation that in the following financial year the CCGs would invest in LPT. The NHS Long Term plan was helpful in this regard as it set out how investment should take place in community services and primary care. 

(ii)         LPT Community staff had been consulted and engaged with regarding the redesign. Several focus meetings had been held. At a recent focus group of 20 staff members only two were unhappy with the proposals. Therapy staff had initially expressed concerns about the changes to the way they worked but now the majority of those staff were in support. No concerns had been raised by staff about the move to working seven days a week. Concerns had been raised by some staff that worked for the Intensive Community Support Service that they would lose their specialisation and skills when the service became more closely aligned with GP Practices.

(iii)       A member raised concerns regarding the capacity of therapists given that they often had long travelling times between each appointment. Reassurance was given that some therapists had two patient contacts a day and it was possible to increase this to five or six even including travelling time. The therapists were organised around geographical hubs and therefore would not have to travel that far to patient’s homes. Members would be provided with further details regarding team structures after the meeting. In response to a concern raised by a member regarding the potential impact on the environment of community services practitioners travelling extensively round the county by road, it was acknowledged that the amount of travel needed to be minimised. It was clarified that CCGs did not purchase vehicles for their staff to use, staff could use their own car and claim fuel costs or purchase a lease car.

(iv)       Consideration had been given to whether a Locality Decision Unit should be located in Rutland however there was not felt to be the demand for one. Nevertheless, efforts were being made to ensure the best offer for Rutland and conversations were being had with colleagues in Social Care at Rutland Council.

(v)        A number of patients were being discharged into reablement ‘Pathway 3’ beds in care home settings rather than the current community hospital inpatient beds. One of these care homes was in Leicester City and 10 were in the County area. There was less demand for reablement beds in Rutland because of the success of the Integrated Care Team.

(vi)       Patients discharged from Peterborough hospitals could be dealt with by Home First, however LPT only dealt with patients referred by LLR GPs.

(vii)     A member referred to reports in the media that the Intensive Community Support (ICS) service was being pressurised to take on patients that were not ready to be discharged from hospital and questioned whether the new Community Services model would resolve this. In response it was acknowledged that this was a concern which was why funding for medical cover had been prioritised and conversations were taking place with UHL and LPT regarding improving the discharge process.

(viii)    An Equality Impact Assessment had been carried out in relation to the community services redesign and this would be reviewed as the redesign was implemented and any concerns raised by members would be fed into the Assessment. A further update would be provided to the Committee in the new year regarding Community Services Redesign, and the updated Equality Impact Assessment, when phase 1 and phase 2 had been completed.

RESOLVED:

(a)        That the update on the redesign of adult community health services across Leicester, Leicestershire and Rutland be noted;

(b)        That the reliance of the Community Services Redesign project on Leicestershire Partnership NHS Trust having the capacity and funding to carry out new services be noted with concern;

(c)        That officers be requested to provide members with further information regarding the equalities impact assessment that was carried out in relation to the Community Services Redesign, and keep members updated regarding any equalities work which is carried out in future.