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 local community in Lutterworth.  A PCBC provides an assessment of any proposals against the government’s five tests of service change, and NHS England’s best practice checks.  If following the discussion with the NHS England team, the LLR ICB can evidence they have sought and acted upon the feedback, they can progress to public presentation of the proposals.

 

The PCBC is not seeking capital funding of the proposals for Lutterworth.  Depending on the decisions made in regard of the proposals after the public consultation the LLR ICB we will use LLR System capital to fund the scheme.  The investment would fund the internal refurbishment of Feilding Palmer Hospital.

 

2.           The LLR ICB have reassured me that they are committed to reducing the carbon footprint.  The increase in the number of outpatient and diagnostic services at Feilding Palmer Hospital is estimated to reduce the number of miles travelled by patient by 377,492 per year.  The draft consultation document, co-produced with the Lutterworth Public Consultation Task and Finish Group, does list a number of hospitals, clearly stating their proximity to Lutterworth in terms of miles and journey times. The purpose of listing them is to illustrate that the plans will reduce the burden of travel and provide more care closer to home, avoiding the need for people living in Lutterworth to travel a distance to receive some care.

 

3.           The Pre-Consultation Business Case (PCBC) has been drafted and has only been shared with NHS England.  It will go into the public domain, along with other key documents, when LLR ICB has approval to commence a public consultation. A draft consultation document has been co-designed with the Lutterworth Consultation Task and Finish Group.  It lists the services provided from Feilding Palmer Hospital pre-pandemic and those currently provided.  Under the proposals both the number of conditions treated would increase, as well as the number of appointments provided.  Therefore, the consultation document also lists the services it is proposed to provide which include the provision of 17,000 outpatient and diagnostic appointments each year in over 25 branches of medicine.

 

The table below shows the current and proposed outpatient activity.

 

Service we are consulting on	How it is provided now	How we propose to provide it
Increase the number of outpatient activity providing in Lutterworth	The following services are provided at Feilding Palmer Hospital or were provided pre-pandemic: ·        Abdominal Aortic Aneurysm screening ·        Attention Deficit Hyperactivity Disorder support ·        Dermatology ·        Dietary ·        Echocardiogram or ECHO ·        Heart Failure ·        Mental Health ·        Musculoskeletal or MSK Physio ·        Out of Hours ·        Paediatrics (children) ·        Parkinsons care ·        Psychiatrics ·        Psychiatric nurse ·        Pulmonary and Cardio Rehabilitation ·        Speech and Language Therapy - Adult and Children ·        Stoma ·        Walking aid clinic   Other diagnostic and outpatient services are provided outside of Lutterworth e.g. acute hospitals	We would expand the current services providing approximately 325 patient appointments per week at Feilding Palmer Hospital or at a location in Lutterworth.  The services are: ·        Abdominal Aortic Aneurysm screening ·        Attention Deficit Hyperactivity Disorder support ·        Cardiology ·        Dermatology ·        Dietary ·        Echocardiogram or ECHO ·        General internal medicine ·        General surgery ·        Gynaecology ·        Heart Failure ·        Mental Health ·        Musculoskeletal or MSK Physio ·        Ophthalmology ·        Out of Hours ·        Paediatrics (children) ·        Parkinsons care ·        Psychiatrics ·        Psychiatric nurse ·        Pulmonary and Cardio Rehabilitation ·        Respiratory medicine ·        Rheumatology ·        Speech and Language Therapy - Adult and Children ·        Stoma ·        Trauma and orthopaedics ·        Urology ·        Walking aid clinic

 

4.           The NHS has a duty to involve people in any change to the provision of NHS services which involves a shift in the way front line health services are delivered, usually involving a change to the range of services available and/or the geographical location from which services are delivered.

Using Cabinet Office principles for public consultation (updated January 2016) and NHS England guidance ‘Planning, assuring and delivering service change for patients’ (published in November 2015), the Lutterworth proposals have been assessed on their specific attributes and would require a public consultation to meet the NHS duties.

The range of legislation that relates to the LLR ICB decision making has also been taken into account including:

·       Equality Act 2010;

·       Public Sector Equality Duty Section 149 of the Equality Act 2010;

·       Brown and Gunning Principles;

·       Human Rights Act 1998;

·       NHS Act 2006;

·       NHS Constitution;

·       Health and Social Care Act 2012;

·       Communities Board Principles for Consultation.

 

The NHS would in any public consultation pay due regard and consciously consider the equality duty: eliminate discrimination, advance equality of opportunity and foster good relations.