Agenda and minutes

Apologies were received from Councillor Julie Robinson (Wyre Borough Council) and Councillor Frank Cant (Burnley Borough Council).

It was noted that County Councillor Samara Barnes replaced County Councillor Mohammed Iqbal and Councillor David Borrow replaced Councillor Jennifer Mein at this meeting only.

The committee considered a report detailing the chairmanship, membership, and Terms of Reference of the Health Scrutiny Committee and its Steering Group for 2021/22.

Resolved: That

i)  The appointment of County Councillors David Westley and Carole Haythornthwaite as Chair and Deputy Chair of the committee for the remainder of the 2021/22 municipal year be noted;

ii)  That the new membership of the committee, following the county council's Annual Meeting on 27 May 2021, be noted; and

iii)  The Terms of Reference of the committee be noted.

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.

County Councillor Steve Rigby declared a non-pecuniary interest in relation to Item 8 as Interim Chair of the Healthwatch Lancashire Board, and County Councillor Lizzi Collinge declared that her spouse was employed by NHS England.

Resolved: That the minutes of the meeting held on 23 March 2021 be confirmed as an accurate record.

Dr David Fearnley, Chief Medical Officer and Chris Oliver, Chief Operating Officer at Lancashire and South Cumbria NHS Foundation Trust presented a report to update the committee on the strategic outline for the Community Mental Health Transformation Programme.

The following points from the report were highlighted:

·  The programme was based largely around primary care and the VCFSE sector, with access to care provided at the neighbourhood level of the community model;

·  The model was designed with colleagues in line with evidence and best practice and reviewing complaints and incidents;

·  By April 2022, each locality would have its own Initial Response Service to provide a single point of access for care and requests for help;

·  Leadership and governance of the programme was provided in part by the Community Mental Health Transformation Steering Group, which was co-chaired by the mental health and voluntary sectors;

·  Each region had its own Partnership Delivery Group to implement the national framework for mental health transformation at a nuanced, local level in order to address each area's needs; and

·  The scale of recruitment necessary for the programme was a key risk to the project, which a specific Workforce Group had been established to address.

In response to questions, the following information was provided:

·  The project was deliverable within the resources available, though workforce and recruitment remained a key risk. The programme used a tried and tested model, which was currently operating successfully in Cheshire and Merseyside, and the transformation programme in Lancashire and South Cumbria would coincide well with the expansion and re-design of other service areas.

·  To date, there had not been sufficient engagement with service users, but better engagement was planned for current and future stages of the timeline.

·  The project would be rolled out incrementally, based on the recommendations of stakeholders in the primary care networks. The potential risk of overwhelming services had been recognised from the start of the project.

·  The recruitment process for the project would not be without its challenges and work was being completed to overcome this. A number of measures were hoped to reduce the risk of recruitment problems, including the phased delivery of the Initial Response Services, which in turn would allow for phased recruitment; the support of the VCFSE sector; continuing to deliver some care digitally, which had proved effective during the pandemic; promoting the Trust as an attractive employer and place to work; collaborating with local colleges and universities, such as to encourage trainee nurses to become registered; and investigating opportunities for overseas recruitment.

·  The development and commissioning of housing support by the NHS, where vulnerable people and those living with mental health issues did not always receive sufficient support, needed to be further explored by the Trust.

·  The promotion and communication of the new service would be led by NHS England. The Lancashire and South Cumbria crisis line was also staffed 24/7, which continued to be promoted at a community level and through social media. It was recognised that the project's communication and engagement  ...  view the full minutes text for item 5.

Mark Hindle, Managing Director at Lancashire and South Cumbria Pathology Services presented a report to update the committee on the planned formation of a single pathology service for Lancashire and South Cumbria.

The following points were highlighted:

·  Although public consultation was not necessary, the project leadership recognised the importance of stakeholder engagement to the new service's success;

·  The resilience and efficiency of Lancashire and South Cumbria's pathology service would be improved through collaboration, new infrastructure and the technology facilitated by the project;

·  Most of the region's pathology services would be carried out at the new pathology hub in Samlesbury, but urgent testing would continue at hospital sites; and

·  The majority of pathology staff would be moved from their current roles to the new pathology hub. To enable this change, all staff and budgets would be combined by the end of the 2021-22 financial year under the new pathology service, in advance of the new hub's opening in Autumn 2023.

In response to questions, the following information was provided:

·  With the combined budgets there would be sufficient funding available to the Pathology Collaboration to continue running current pathology services until the opening of the new hub. If more money was required, there were opportunities to retain revenue, bid for capital, and bid for investment from shareholders.

·  Approximately 400-550 staff would be relocated to the new hub, and 200-250 staff would remain at hospitals to provide urgent services. The importance of consulting and informing staff of the changes was recognised. Although the views of staff had not been formally surveyed, it was expected that regular information sharing and discussions with consultants would lead to general consensus in favour of the service changes. The potential for difficulty and disruption to staff and work practices was also acknowledged.

·  A breakdown of the views of different stakeholders in relation to the changes had not been provided in the report, but more detailed information and analysis could be provided to the committee with a future report and presentation. In summary, GPs were generally unconcerned by the changes as long as the quality of service was unaffected; some within the pathology services and unions opposed the changes due to significant disruption that would be caused to current working practices.

·  Currently, the pathology services did not meet quality targets for transported samples and, as a result, samples frequently had to be retaken. A number of measures would be introduced under the new service to overcome and prevent these problems, such as the use of drones to transport samples across the region, the preparation of samples at GP and hospital sites to reduce the likelihood of deterioration, and the use of refrigerated vans.

·  The service changes would facilitate better use of the workforce by bringing staff together to enhance the service, encourage specialisation, and standardise training. No staff would be made redundant as a result of the changes and the NHS terms and conditions of employment would remain in place under the new service, which staff had communicated  ...  view the full minutes text for item 6.

The committee considered the report of the Health Scrutiny Steering Group from its meetings held on 7 and 14 July 2021.

Members of the Steering Group were thanked for their time and commitment.

It was agreed that the possibility of reviewing access to GP appointments as part of the committee's review of the GP workforce shortage (scheduled for the meeting on 2 November 2021) would be discussed by the Steering Group at its next meeting on 22 September 2021.

In response to a question about the New Hospitals Programme, the Chair advised that an update would be provided at a point at which the committee could make a difference. It was noted that the Steering Group would receive an update on the New Hospitals Programme at its next meeting on 22 September 2021, and that County Councillor Collinge was prepared to informally collect the views of committee members ahead of the meeting.

It was noted that access to dentists would also be raised at a future Steering Group meeting.

Resolved: That the report of the Health Scrutiny Steering Group be noted.

The committee reviewed the Health Scrutiny Work Programme 2021/22 which included topics identified at the committee's work planning workshop held on 29 June 2021 and finalised by the Steering Group and its meetings held on 7 and 14 July 2021.

Resolved: That the Health Scrutiny Work Programme for 2021/22, as presented, 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.

None.

The next meeting of the Health Scrutiny Committee will be held on Tuesday 2 November 2021 at 10.30am at County Hall, Preston.

It was noted that the next meeting of the Health Scrutiny Committee will be held on Tuesday 2 November at 10.30am, at County Hall, Preston.

The Chair highlighted the value of meeting at 10.00 am, before the meeting start, to discuss potential questions and thanked members for their attendance.