To receive a verbal update from John Turner, the Chief Executive of NHS Lincolnshire Integrated Care Board (ICB).

The Chairman welcomed John Turner, Chief Executive, NHS Lincolnshire Integrated Care Board (ICB) to the Meeting who had been invited to update the Committee on topics put forward by Members.  Following an introduction and a general overview of NHS matters and the strategic role of the NHS Lincolnshire ICB, the responses to the topics and questions and comments raised by Members were noted as follows:

How are we supporting the middle years where we know the foundations are laid for a healthier, longer life? And given the 40,000 caravans on the east coast and the associated healthcare challenges, what strategies are in place led by the Integrated Care Board?

Members were assured that the ICB worked with a wide range of partners to support all demographics and recognised that increased elderly population and child and adult obesity were significant challenges in East Lindsey particularly along the coast. 

The Chief Executive of the ICB advised Members that prevention strategies which encouraged healthy living and to improve the health and wellbeing of the population remained a primary focus.  Members were further advised that East Lindsey district had secured £15 million in funding for a new Community Diagnostics Centre in Skegness which was the largest investment the NHS has made in Skegness to date, and that the ICB continued to undertake innovative pieces of work and provide support for various initiatives including the Campus for Future Living in Mablethorpe to help deliver significant benefits for the local community.

• In reference to the Community Diagnostics Centre (CDC) in Skegness, a Member queried the effect that had been forecasted on Skegness Hospital.  In response, the Chief Executive of the ICB confirmed that Skegness Hospital remained separate to the CDC and was an important asset to the community which would be maintained for the long term.  The Chief Executive of the ICB confirmed that the CDC would serve Skegness and the east coast and support the hospital with a wide range of services.  Members were informed that a similar centre created in Grantham had proven very successful.

• In reference to the 1.7billion national funding formula, a Member queried who was responsible for making a decision on the amount and whether it was the correct amount when taking into account special circumstances in Lincolnshire.  In response, the Chief Executive of the ICB informed Members that the funding formula took into account all characteristics and assured Members that the ICB took every opportunity to secure additional NHS England funding.

Availability of GP appointments and ease of access to and communication with GP practices. Specifically, how easy it is for residents to get in touch with their surgery.

Members were informed that 16 GP practices operated in East Lindsey in comparison to 81 practices across Lincolnshire, and that 14 were rated as good and 2 required improvement by the Care Quality Commission (CQC).  The Chief Executive of the ICB informed Members that the ICB recognised that East Lindsey had significant deprivation on the coast and that the issues continued to be an area of focus.

Members were advised that the total number of GP appointments offered had increased by 20% in the last 12 months and that East Lindsey had been above the Lincolnshire average for residents seen on the same day and had been average for patients seen within 2 weeks.

In relation to communication, Members were informed that patient feedback was consistently received in relation to phone and website access and that all East Lindsey practices had moved to digital telephony and digital access services to provide improved services.

Members were advised that the development of the Additional Roles and Reimbursement Scheme (ARRS) had enabled the creation of additional roles and that £2.3m had been spent on them during 2023-24 with plans to extend spending to £4.9m in the East Lindsey area for 2024-25.

• In reference to the 20% increase in dental appointment availability, a Member queried whether face-to-face appointments were included in the statistics and highlighted issues where residents with hearing issues had experienced difficulty obtaining face-to-face appointments.  In response, the Chief Executive of the ICB confirmed expectations that appointments had increased both in person and on the phone and encouraged those with hearing difficulties to raise any concerns directly with their GP practice or if necessary, with the NHS ICB team.

• A Member commented that strategies that were not always what residents were looking for and highlighted the struggles that local residents were faced with in relation to NHS appointments and hospital accessibility due to lack of transport and further stated that urgent treatment in Louth was a critical service which required continued support.

• A Member highlighted the difference in strategies for dental and doctor provision in prisons compared to the provisions for the general public and commented that virtual appointments were not satisfactory for the elderly population when there were capability issues.

In response, the Chief Executive of the ICB informed Members that GP practices and their teams were fully committed to trying to meet their needs of their patients and that the ICB continually listened to the feedback Lincolnshire residents raised to support GPs and primary care teams to manage the level of demand.   The Chief Executive of the ICB further advised Members of a number of measures being taken which included an increase in multi-disciplinary roles to assist and expand the range of services and confirmed that Louth Urgent Treatment Centre was an important asset which would receive long term support.

• A Member queried how more GPs could be attracted to rural Lincolnshire.  In response, the Chief Executive of the ICB advised Members of progress made and that the recruitment of salaried GPs had proven less challenging than the recruitment of Partners. 

The Chief Executive of the ICB further advised Members that the new Medical School in Lincoln was encouraging GPs to stay and work in the area where they had trained and that the ICB were continuing to ensure that Lincolnshire was an attractive place to work in health and care and provided a unique opportunity to work in rural coastal medicine. 

Availability of NHS dentistry, particularly in areas of higher deprivation

Members were advised that dentist availability was a national issue and that 11 contracts were in place for East Lindsey with extended access in Louth and Skegness and that a contract had recently been awarded in Mablethorpe with a new dental provider.

The Chief Executive of the ICB assured Members that the ICB had strong working relationships with the North Lincolnshire and Goole Health Trusts and that the ICB continued to recognise the issues with dentist availability and supported national strategies which ensured change.

Members were further advised that the Dental Access Recovery Programme had enabled more funding for public practices alongside the Golden Hello dental incentive scheme for 2024/25 from NHS England and that Lincoln had been identified for future mobile NHS Dental Clinics.

• A Member queried promises that were made for Mablethorpe residents to obtain NHS dental appointments.  In response, the Chief Executive of the ICB advised Members that a contract had been awarded and that the ICB was working with the provider to commence the service as quickly as possible.

Fluoridation of the water supply

Members were informed that the ICB were very supportive of fluoridation of the water supply as it had a positive impact for the population.  The Chief Executive of the ICB further advised Members that fluoridation had been part of the previous Government’s strategy and that there were significant differences observed in oral health along the east coast of Lincolnshire where water had not been fluorinated.

• A Member commented that a significant factor for dental health was that the west of Lincolnshire was more affluent and less deprived compared to those who lived in the east of the county.  In response, the Chief Executive of the ICB acknowledged that a divide existed between east and west Lincolnshire and confirmed that oral health was affected by a number of factors not limited to fluoridisation of the water supply.  The Chief Executive of the ICB further advised Members that there was significant national pressure on the need for new contracts for dentists and that dentists were currently paid by the NHS by a variety of mechanisms and that with the release of the government’s Dental Recovery Plan, the ICB were looking to encourage more dentists to engage with NHS care.

Ambulance waiting times, particularly in remote areas.

Members were advised that Category 2 Ambulance performance for a range of conditions that were not immediately life threatening had a national target of providing a response within 30 minutes and that Lincolnshire had been over target during the last few months.

The Chief Executive of the ICB acknowledged that more work was required to reduce ambulance wait times including reducing handover delays at hospitals and that significant improvement had been made with an increased recruitment of East Midlands Ambulance Service (EMAS) staff which aimed to enable a reduction in ambulance waiting times over the next 6-9 months.

No further comments or questions were received.

The Chairman thanked the Chief Executive of the ICB for his informative update.

N.B. John Turner, Chief Executive of the ICB left the Meeting at 11.12am.