Agenda item

Andrew Bennett, Director of Population Health (System Lead for New Hospitals Programme) and Andy Curran, Associate Medical Director, Lancashire and South Cumbria Integrated Care Board attended the meeting to present an update on transforming care in hospitals, and the New Hospitals Programme in Lancashire and South Cumbria.

The report circulated in the agenda pack provided an overview of the continued development of NHS Lancashire and South Cumbria Integrated Care Board (ICB), transforming care and the New Hospitals Programme. The report highlighted the three key elements of transforming care in hospitals: care for healthy communities, high quality and efficient services and population-centred care.

The Chair invited questions from committee members and a summary is outlined below:

·  The committee queried if the New Hospitals programme focused on increased community care, it was further queried how residents could see benefits to this practice. It was explained to the committee that the transformation of community services and people receiving care within the community was a key aim of the ICB. The committee were informed that transforming community services was a separate work programme, however, ran very closely with the transformation of hospitals work programme and one of the commissioning intentions was to commission within the community and out of hospital. Furthermore, it was explained to members that the views of the public were essential to this.

·  The committee queried if a funding settlement from central government was in place for the New Hospitals Programme. It was further queried if this funding was sufficient for 2 new Lancashire hospitals. It was confirmed the New Hospitals Programme had a financial envelope for both hospitals.

·  Regarding vascular services, the committee queried if this included stroke pathways. It was explained to the committee that this service did not include stroke services, as it was ringfenced to arterial vascular services.

·  In regard to the public consultation process once site selection had taken place, the committee were assured councillors would be utilised as much as possible during the consultation process. It was highlighted that the ICB had strong connections to several local organisations to ensure an effective response and breadth of reach to all communities.

·  Members queried how services were selected for each hospital, and whether there were certain criteria for one service to be in one hospital. The committee were informed that no decisions had been made regarding where services would be delivered in the New Hospitals Programme. Members were informed that it was dependent on the need of services of the population.

·  Members queried if funding would be available for Royal Preston Hospital and Royal Lancaster Infirmary for their maintenance and upkeep until the new hospitals were in operation. It was explained to the committee that the trusts received capital funding from the government for their maintenance and this would not end until they were no longer in use.

·  The committee queried if GP Services would have an opportunity to enhance the services they offered with the shift to community based care to further support hospital attendance. It was confirmed that there would be an opportunity for primary care services to receive more funding to expand their services.

·  It was further queried by the committee how much control there was over how funding was spent in the community sector. Members were informed that 90% of General Practice funding came from the services national NHS contract, 10% was determined by the ICB. It was highlighted to the committee that within a General Practice's national contract, they were required to deliver the range of traditional services. The goal of the ICB was to ensure GPs were integrated into a supported neighbourhood team model.

·  Concern was raised over the lower bed capacity planned within the new hospitals, and members queried if the provision was in place to support a care in a community-based model. It was highlighted to members that the goal of the ICB was to prevent people from hospital stays by managing any long-term illness within the community, and further meant that when an individual had a period of acute illness, they were cared for by a clinician that knew them. It was confirmed that extensive work needed to be done before moving away from hospital-based care. 

·  Members commented that the public may not have the awareness of available resources and queried how communication with the public could be improved. It was confirmed that work was being undertaken to improve awareness within the community and explained that social prescribing was a key aim in every primary care provider. It was also highlighted to the committee the importance of staff awareness of resources as they had significant contact with the public, as well as embedding health and wellbeing champions within the community.

·  A query was raised regarding how the advancement of medical technology by 2035 would affect the New Hospitals programme. The committee were informed that no certain information could be given regarding how hospital technology would look in ten years, however this information could be brought back to the committee at a later date.

·  Members raised concern over the programmes timescale being affected by the long site finding process and queried how this delay would affect the next steps of the New Hospitals Programme. It was explained to the committee that without a site, the next stages of the process could not move forward, and the ICB would return with further updates to the Health and Adult Services Committee at a later date.

·  It was confirmed that no speculation could be made regarding sites for the New Hospitals Programme, and this was dependent on the national programmes team.

Resolved: That

  i.  A more detailed update be provided in the Autumn to include site details.

  ii.  Further detailed work be undertaken in consultation with the Chair and the Scrutiny Officer on aligning NHS forward plan of clinical reconfigurations with committee work programme for 2024/5.