Agenda and minutes

Apologies were received from County Councillors Lizzi Collinge, Stuart Morris, Erica Lewis, and Councillors Viv Wilder, Martin Gawith, Barbara Ashworth, Vickie Cummins and Fiona Wild.

Members are asked to consider any pecuniary and non-pecuniary interests they may have to disclose to the meeting in relation to matters under consideration on the agenda.

No interests were declared.

Resolved: That the minutes of the meeting held on 25 October 2023 be confirmed as an accurate record.

Kevin Lavery, Chief Executive, Lancashire and South Cumbria Integrated Care Board and Maggie Oldham, Deputy CEO/Chief of Transformation and Reconfiguration, Lancashire and South Cumbria Integrated Care Board attended the committee to give a presentation on the development of NHS Lancashire and South Cumbria Integrated Care Board (ICB) as well as an update on the Recovery and Transformation Programme.

It was reported to the committee that the since the inception of the ICB, they had agreed a planned deficit with NHS England of approximately £80 million and that it was recognised there were some considerable challenges in the area related to spending. The Transformation and Recovery programme had been established to reduce that deficit by reconfiguring and integrating services, with the core aim to improve patient outcomes and provide sustainable services across the area.

It was highlighted that there were many opportunities to improve efficiencies across the board including reducing costs in areas such as consolidating back-office support services, which would increase funding to front line services. As well as this, it was noted that a cost saving opportunity had been identified in terms of streamlining clinical specialties and focussing on prevention programmes with local authority public health teams, which would in turn lead to greater patient outcomes.

Comments and questions were as follows:

·  In relation to the area of the report which mentioned NHS intervention, the committee queried what that would involve. It was explained that usually when intervention is required, a director would be implemented to lead on consultancy work to diagnose issues and produce a report outlining changes to the strategy. In the case of the Lancashire and South Cumbria ICB, it has been established that this would not be required as the diagnostic work to identify challenges has already been completed and it has been requested that staff are brought in to assist in conducting the changes that need to be made.

·  Concern was raised regarding the plan to move people from acute beds into community-based care, and it was noted that this could have worse outcomes for patients if not handled properly and if enough investment wasn't put into the areas of community care. It was highlighted to the committee that, although there was a need to move patients into community care, the focus was more on preventing and avoiding admission than moving those already in hospital beds.

·  Members queried what was meant by Core20+ which was referred to throughout the report, and it was clarified that this was an approach to reducing healthcare inequalities whereby service improvements could be made in communities where there were problems, and the approach could assist with identifying the wider determinants of the health of communities. It was noted that approaches under this format were already being implemented, and an example was given of using the approach to understand the factors surrounding increased out of hours usage in the most deprived areas of Blackburn.

·  Concern was raised that workforce levels would not be sufficient to staff the new hospitals which  ...  view the full minutes text for item 4.

County Councillor David Westley provided a verbal overview of the Health Scrutiny Steering Group meeting which took place on 15 November 2023.

It was noted that two updates were provided to the Steering Group from the Transformation and Recovery Programme, and the Shaping Care Together Programme. The report outlined that the issues and concerns that had previously been raised around the pause to the move to 24/7 thrombectomy and associated stroke services had been resolved, and the group received a positive report which stated the business case had now restarted and work was underway. It was further noted that, within West Lancashire, the Southport and Ormskirk Hospital Trust had now become part of the Mersey and West Lancashire Teaching Hospital Foundation Trust which was allowing for investment in the area's A&E services as well as greater patient outcomes.

Resolved: That the report of the Health Steering Group be received.

The committee received a report which provided information on the work programme of the Health and Adult Services Scrutiny Committee and Health Steering Group work programmes.

It was queried whether an update on the Public Health team's review into smoking in pregnancy could be brought to a future meeting of the committee. It was confirmed the team would be asked to bring an update to the January meeting.

Resolved: That the Health and Adult Services Scrutiny Committee Health Steering group work programme be agreed.

An item of urgent business may only be considered under this heading where, by reason of special circumstances to be recorded in the minutes, the chair of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency. Wherever possible, the chief executive should be given advance warning of any member's intention to raise a matter under this heading.

There were no items of Urgent Business.

The next meeting of the Health and Adult Services Scrutiny Committee will be held on Monday 22 January at 10:30am in Committee Room C – The Duke of Lancaster Room, County Hall, Preston.

Resolved: That the next meeting of the Health and Adult Services Scrutiny Committee will be held on Monday 22 January 2024 in Committee Room 'C' – The Duke of Lancaster Room, County Hall, Preston.