Healthier Communities and Older People Scrutiny Panel – 12 January 2010

PRESENT: Councillor Barker in the chair.

Councillors Wells (Vice-Chairman), Collinson, Eckhardt, Jawaid, Simpson and Sidell.

The panel met at Pittwood House, Scunthorpe.

222 DECLARATIONS OF PERSONAL OR PERSONAL AND PREJUDICIAL INTERESTS AND DECLARATIONS OF WHIPPING ARRANGEMENTS (IF ANY) – There were no declarations of personal or personal and prejudicial interests.

No whip was declared.

223 PUBLIC REQUESTS TO SPEAK There were no requests received.

224(19) PROMOTING THE HEALTH AND WELLBEING OF NORTH LINCOLNSHIRE COUNCIL EMPLOYEES – Members received a visual presentation from Ian Jerams, Chief Operating Officer and Carole Hirst, Director of Psychological Therapies, Rotherham, Doncaster and South Humber (RDaSH) Mental Health NHS Foundation Trust.

Members received information on how RDaSH had specifically designed its service to meet the requirements of the residents of North Lincolnshire. Carole explained that a stepped care model had been introduced and that services were now available within every GP surgery. A full range of evidence based interventions were also available and the link with specialist services had been introduced.

Ian and Carole went on to explain the different ways in which services could be accessed. These included new innovative schemes such as private therapy sessions now being available through the internet, self help service where patients could be prescribed information and books, group work and also prescribing information.

Further discussion took place and touched on the stigma often related to mental health illness, how physical sickness can often be attributed to an underlying mental health issue, and the national cost of mental health illness for employers.

Resolved – (a) That Ian and Carole be thanked for their valuable presentation, and (b) that the position be noted.


Andrew North initially provided the panel with information on the current 2009/10 financial position for Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, which he confirmed was within £40,000 of the expected target. This was despite an increase in service demand over and above what had been expected. Emergency admissions had increased by 3.7%, planned admissions had increased by 3.8%, diagnostic admissions had increased by 4.4%, however A&E admissions remained constant. The greatest increase in referrals was to Ophthalmology which had seen an increase of 30%.

Despite the increase in admissions, the panel was advised that infection control was much improved in both MRSA and also Cdiff, and a marked reduction had been seen, with Northern Lincolnshire and Goole Hospitals NHS Foundation Trust now having one of the lowest rates in the Strategic Health Authority area.

Looking ahead, Andrew referred Members to the Department of Health document – ‘NHS 2010/2015 – from good to great’. This was a five year strategy which focused on reducing the number of patients in hospitals and the number of referrals/inpatients and explained how the health service would be shaped over the next five years. The document highlighted the need to move away from diagnose and treat, to more of a predict and prevention service.

Focus would be given to those at risk of/who had suffered a stroke, coronary complications and cancer. The service would focus more on the impact of current lifestyle on such conditions ie alcohol misuse, lack of exercise and smoking and thirdly maternity care would be addressed, focusing on teenage pregnancy, breastfeeding and women who smoked during pregnancy.

An additional Department of Health document – ‘The operating framework 2010/11’, highlighted the short term changes. Limitations to the funding received would have to lead to a reduction in the number of emergency admissions as the PCT would no longer be expected to pay the full tariff. No increase in funding in real terms could be expected for 2011/12 and 2012/13.

In addition to a reduction in funding, Andrew explained that penalties would be applied if the reduction in Cdiff cases target was not met, if the 18 week waiting list was not met, the four hour maximum wait in A&E and also mixed sex accommodation was not addressed.

The long term effect of this was that over the next four years 10% of funding would be reliant on patient satisfaction. Tariff rates would no longer be mandatory, and therefore the maximum price offered would open up competition.

Andrew also explained that significant savings would be needed next year, therefore changes were needed to the way in which the service was delivered to meet the savings expected. These equated to 20% of the total NHS budget. The panel was advised that the NHS North Lincolnshire budget was £285m and therefore approximately £50m needed to be saved over the coming five years.

In order to achieve the savings necessary, radical changes had to be made to the service. Andrew advised the panel that nothing would be ruled out, and that every aspect of the service would be scrutinised. This would include looking into unscheduled admissions, the operation of the A&E department and the possible introduction of senior clinical consultants seeing patients at the start who could then can make the decision whether to admit a patient or assess, treat and send home.

To meet the service requirements it was confirmed that more treatment would be conducted within the community rather than at hospital, this would include treatments such as chemo-therapy for example.

Resolved – (a) That Andrew and Karen be thanked for their attendance at the meeting and for a very informative discussion, and (b) that the position be noted.

226 (20) LEADER OF THE COUNCIL’S FORWARD PLAN – JANUARY TO APRIL 2010 – The Service Director Legal and Democratic circulated the Leader of North Lincolnshire Council’s Forward Plan for January to April 2010.

The plan contained details of all matters and issues likely to be the subject of key decisions for a period of the next four months, updated on a monthly basis. Members discussed various items on the Forward Plan.

Resolved – That the position be noted.

227 DEVELOPMENTS IN HEART ATTACK AND STROKE CARE – The Service Director Legal and Democratic advised members of the panel that he had been contacted by Alan Nobbs, lead for heart attack and stroke care, who had advised that there were proposed changes to the treatment moving away from Thrombolysis and towards Angioplasty and the usage of stents.

Members were advised that Alan had offered to attend a future meeting to discuss the proposed changes.

Resolved – (a) That Alan Nobbs be invited to attend a future meeting of the panel to discuss heart attack and stroke care, and (b) that the invitation be extended to members of the ‘Who Cares’ group.

228 ONGOING REVIEWS ON CHILDREN’S CARDIAC CARE AND NEUROSURGERY SERVICES – The Service Director Legal and Democratic advised members that the proposed visit to a regional scrutiny event had been abandoned due to the recent adverse weather conditions. He confirmed that information from this event would be received in due course and circulated to all members of this and the Children and Young People Scrutiny panel.

Resolved – That the position be noted.

229 TEENAGE PREGNANCY – The Service Director Legal and Democratic confirmed that the Children and Young People Scrutiny panel were currently trying to arrange a meeting with Frances Cunning, Director of Public Health to discuss the latest results. Members were advised that this would be open to members of this panel to attend. Details would be confirmed at a later date.

Resolved – That the position be noted.

230 INVERSE CARE LAW – Draft report – The Service Director Legal and Democratic confirmed that the draft report would be brought back to a future meeting of the panel for further consideration, following further discussion with NHS North Lincolnshire.

Resolved – That the position be noted.

231 COMMUNITY EQUIPMENT AND ADAPTATIONS REVISIT – The Chair confirmed that he would like a sub-group to undertake a revisit of this review.

Resolved – (a) That the position be noted, and (b) that a meeting with all relevant stakeholders be arranged to discuss progress on the panel’s recommendations.