Tuesday 7 January 2025
Dear colleague,
Welcome to Updates from Group Board for the Lincolnshire Community and Hospitals NHS Group (LCHG). This Group is made up of Lincolnshire Community Health Services NHS Trust (LCHS) and United Lincolnshire Teaching Hospitals NHS Trust (ULTH).
The Group Board operates as the joint board and decision-making body for both statutory organisations and this update is designed to inform colleagues and stakeholders of the discussion and decisions being taken at both the Group and individual Trust level.
We held our most recent Group Board meeting on Tuesday 7 January 2025, and virtually welcomed members of the public. The full Board papers can be found on the Board meetings pages of our website.
Winter pressures: The Board reflected on an incredibly challenging period experienced over the last few weeks, when NHS services across Lincolnshire have faced increased pressure.
Nationally, urgent and emergency care services have seen a surge in attendances by acutely unwell patients in recent weeks, and Lincolnshire has experienced the same. There has been particular surge in patients suffering from respiratory illnesses such as flu, COVID-19 and RSV, as well as norovirus.
The Lincolnshire system has robust plans in place to manage winter pressures, but the Board recognised that the experience of some patients has not been as positive as colleagues would want to provide, due to delays in treatment and admission. The Board extends its apologies to patients who have experienced long waits, and thanks to the staff who have gone above and beyond to care for patients during this challenging period.
Reintroduction of face masks: Due to an increase in respiratory illnesses, additional infection prevention measures were introduced in some high-risk areas during December. Patients and visitors are now asked to wear hospital-provided Type II face masks in high-risk areas across the Group, including Emergency Departments, Urgent Treatment Centres (UTCs), admission wards and haematology/oncology wards to reduce the spread of respiratory illnesses and provide better protection to themselves and those around them. All visitors to sites across the Group are also asked to wear masks when visiting.
Celebrating success: Greetwell Ward at Lincoln County Hospital and Harrowby Ward at Grantham and District Hospital were celebrated for achieving Bronze awards in the Group Diamond Quality Accreditation Scheme. This recognises wards and departments that demonstrate consistently high standards of patient care and evidence of their improvement journey, measured through a variety of metrics.
Greetwell Ward presented an example of a project they have undertaken around improving the care of patients with a tracheostomy, which includes the introduction of ‘tracheostomy transfer bags’ to support and speed up the discharge of patients from the ward, and the use of electronic whiteboards to improve communication with patients who often struggle to communicate due to their condition.
Harrowby Ward described extensive work they have done around the design of the ward environment to optimise it for the care of patients with dementia, recognising the huge impact that environment can have in improving the care of these patients. This includes changing the colour of wards areas and curtains to aid patients’ navigation of the ward, all of which has resulted in a reduction in avoidable falls on the ward and the use of chemical sedation of patients.
Patient story: The Board heard a very thought-provoking story from William and Joanne, a Deaf couple who shared their experiences of being cared for at Pilgrim hospital in Boston. It was a very difficult story to hear, where the couple bravely shared their story of issues around communication, lack of Deaf awareness among staff and some aspects of their care, and what they would like to see change to improve the care of people with hearing loss. This story also included information on actions being taken to address the concerns raised. It elicited a strong response from Board members, who thanked the couple for sharing their story so that practice can change and others do not experience the same challenges that they did. It is a great learning experience. William and Joanne’s story is captured on this short video.
CQC unannounced assessment at Pilgrim Hospital, Boston: A team from the Care Quality Commission (CQC) undertook an unannounced assessment visit to Pilgrim Hospital, Boston on Wednesday 27 November, focussing on the urgent and emergency care pathway, medical and surgical wards. The Board heard that the CQC reported improvements since their previous visit to the site, and they thanked staff for all the help and support offered throughout the day of the visit. Despite the visit taking place during a period of extreme operational pressure, the CQC noted a number of positives around staff and patient feedback, well managed, safe and flexible boarding arrangements for patients and good sepsis management within the Emergency Department.
Some areas for potential improvement were identified, around IPC and cleanliness, advanced care planning and the use of discharge lounge and frailty SDEC as medical overflow areas. The Trust is now putting together a plan of action to address the concerns raised and awaits the formal report following the visit.
Heart failure – a Lincolnshire success: The Board received a presentation on an impressive system-wide piece of work that has taken place to transform the care of patients with heart failure. Working with patients, primary care, community and acute teams, the heart failure service was re-designed to develop a new seven day a week community and acute service, virtual wards, new heart failure beds and new pathways. This resulted in a 13% reduction in admissions and care closer to home for patients.
Good news stories:
- Scotter ward: Scotter Ward at John Coupland Hospital in Gainsborough has undergone a £4.5m transformation and will shortly be open to patients. It will play a vital role in preventing patients from having to be admitted to acute hospitals by offering community hospital care and has been co-designed with staff and patients to meet their needs.
- Community Diagnostic Centres (CDCs): In late November a new Community Diagnostic Centre (CDC) opened in Skegness. In the last year, approximately £42million has been invested into CDCs in Lincolnshire, of which £15m has been invested into the Skegness CDC. This significant NHS investment enables the offer of a range of elective (planned) diagnostic services, away from the main hospital sites which provides easier and quicker access to tests, closer to patients’ homes.
- Group Staff Awards: The first Group Staff Awards ceremony took place on Friday 15 November, celebrating hundreds of staff from across both organisations. The staff awards had a number of categories including recognising excellence in patient care, compassion and respect amongst other things.
- Call for Concern launch: Having successfully being identified as a pilot site, in December ULTH launched the Martha’s rule Call For Concern service, which offers patients, their families and carers 24-hour access to a rapid review if there are concerns about a person’s deteriorating condition. This has been launched as part of the Secretary of State for Health and Social Care and NHS England commitment to implement Martha’s rule in the NHS nationally, and builds on the existing safeguards already in place in our hospitals to offer a clear and direct way to escalate concerns.
- Neonatal team award: Lincoln hospital Neonatal team recently won the Active Workplace award at the Lincolnshire Sport and Physical Activity Awards 2024. The awards provide an opportunity to recognise and celebrate the outstanding achievements of those who inspire and enable the county to be active. The Neonatal team goes above and beyond in supporting families on the Neonatal Unit, and this award highlights the importance of keeping active to improve physical and mental wellbeing to their team, patients and families.
Group development plan: As ULTH and LCHS have now come together in a Group arrangement, work continues to help the organisations work more closely together to improve the care delivered to patients and to support colleagues to work effectively together. The Board reviewed the Group Development Plan, which outlines a range of actions being taken, including a focus on leadership and accountability, reporting, governance, HR, organisational development and culture, estates and digital, finance and communications.
Finance: At Month 8, ULTH’s year to date (YTD) financial position is a £24.9m deficit, which is £15.2m adverse to the planned £9.7m YTD deficit. So far this year, the Trust’s Cost Improvement Programme (CIP) has delivered savings of £21.3m, which is £0.4m lower than planned savings of £21.7m.
LCHS’s YTD financial position is a £0.7m deficit, which is £0.2m better than the planned £0.9m deficit position. So far this year, LCHS’s CIP has delivered savings of £4.4m, which is £0.5m ahead of plan.
If you have any feedback on the discussions and decisions made at our board, please contact [email protected].
Kind regards
Elaine Baylis Karen Dunderdale
Group Chair Group Chief Executive