Updates from Group Board – May 2024

Dear colleague, Welcome to the first edition of Updates from Trust 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 Hospitals NHS Trust (ULHT). The Group Board operates as a the board in common and decision-making body for […]

Dear colleague,

Welcome to the first edition of Updates from Trust 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 Hospitals NHS Trust (ULHT).

The Group Board operates as a the board in common and decision-making body for both statutory organisations and this update is designed to inform colleagues of the discussion and decisions being taken at both the Group and individual Trust level.

We held our first Group Board meeting on Tuesday 7 May 2024, and virtually welcomed members of the public. The full Board papers can be found on the Board meetings pages of our website.

Celebrating success: Three departments across Lincolnshire’s hospitals were celebrated in the Trust’s Diamond Quality Accreditation Scheme. This recognises wards and departments across ULHT that demonstrate consistently high standards of patient care and evidence of their improvement journey, which is demonstrated through a variety of metrics. This will soon also be extended to LCHS services.

Pilgrim hospital Maternity Ward gained a Silver accreditation, and one of the examples given to demonstrates their achievement was a project that has taken place, improving training and competence for midwives in wound care. As the service has seen an increase in C-sections, midwives wanted up-skilling to ensure they could better care for people with associated wound care issues. The response was a review of wound care stock, development of a simple step-by-step guide to wound care and tea trolley teaching for midwives, which has enabled them to feel more empowered and has reduced referrals to tissue viability teams. It also reduced their postnatal re-admission rate around wound infections.

Grantham hospital Outpatient Department achieved a Bronze Award, and the example they gave was around development of a one-stop clinic for dermatology patients. This clinic is aimed at patients attending for assessment of skin conditions, who would previously have had to attend multiple appointments for adequate treatment. With the engagement of the full multi-disciplinary team, the one-stop clinic was developed, where patients can have their review and treatment or even surgery at the same appointment, significantly improving patient experience.

Theatres at Pilgrim hospital achieved a Bronze Award and gave an example of an important piece of work they have undertaken around the care of deceased patients in theatres. Theatres previously had an inconsistent approach to providing care and respect to people who have passed away in theatre, and so they introduced a training package for staff and chronological tick list to ensure consistency of approach. They also developed a relatives room so that they can see loved ones away from the main theatre.

LCHG establishment and strategy: The Group arrangement between LCHS and ULHT formally came into being at the start of April. The Group does not constitute a merger, as both Trusts retain their separate statutory names and legal obligations. The Trusts are, however, working together ever more closely, with the aim of integrating care for the benefit of the communities that they serve.

The Trusts remain separate legal entities but the two Boards of Directors now meet as a Group Board in Common, supported by a Group Executive Leadership Team and harmonised corporate governance arrangements which enable and support closer Group working. Work has already commenced to bring together a number of the committees of the Boards into ‘in common’ arrangements, to help promote greater synergy and learning between the two Trusts, while strengthening assurance across the Group.

Work has been underway to ensure that LCHG has a unified strategy for 2024/25. The strategy has strategic aims relating to patients, people, services, partners and population health. The objectives underneath each aim are predominantly Group-focused, with only a small number being specific to either LCHS or ULHT.

Patient story: The Board heard a fantastic patient story about an innovative piece of equipment and the difference it makes to young patients who need to attend hospital for an MRI scan. The Kitten Scanner, which has been installed in the Kingfisher Unit at Grantham hospital thanks to the support of the ULH Charity, is an interactive toy which helps children understand how an MRI scanner works, what it feels like to have a scan and how the results can help them in their recovery. This reduces the need for sedation or general anaesthetic for the majority of young children undergoing a scan. The Board heard from nine-year-old Phoebe who has used the Kitten Scanner and said it made her scan much less scary and she thinks it will reassure other boys and girls about scans.

Paediatric audiology service: The Board accepted a report on the ULHT paediatric audiology service, which has been among services across the Midlands subject to a review following issues identified with a similar service in NHS Lothian in Scotland. The Lincolnshire review looked at whether the children’s audiology service is safe, accessible and effective, and identified some gaps in documentation and audit processes within ULHT, but did not find any harm caused to children. The performance of the service overall was rated Good and the Trust is seeking accreditation under UKAS IQIPS for the service by October this year.

Sexual health services: From Monday 1 April, sexual health services in Lincolnshire, North Lincolnshire and North East Lincolnshire are now delivered by LCHS. The Lincolnshire elements of the service, known as Lincolnshire Integrated Sexual Health Services (LISH),  have been delivered by LCHS in Lincolnshire for over 10 years. Following a competitive tender exercise, the local authorities across Greater Lincolnshire

also selected LCHS as the provider of these services in the other two local authority areas to make it a true Lincolnshire-wide service.

Finance: The Lincolnshire NHS system ended the financial year 2023/24 with a financial deficit of £19.5m against a planned deficit of £12m, which was in line with the expectations of NHS England. The £7.5m variance to plan was due to the system not receiving the return of surge funding. During the financial year, LCHS delivered a surplus of £1.38m against a plan of break-even, including Cost Improvement Programme (CIP) savings of £6.9m against a plan of £6.6m. ULHT delivered a deficit of £20.8m which was in line with the plan and included CIP savings of £34.2m against a plan of £28.1m.

Performance:  All parts of the system remain busy, but work continues across the Group in order to cope with the ongoing operational pressures. This has resulted in significant improvements in urgent and emergency care performance in particular. Notably, the number of ambulance handover delays in emergency departments has reduced significantly in recent months, and by working together there has been a marked increase in the number of patients being seen, treated and either admitted or discharged within four hours of their arrival to emergency departments or urgent treatment centres (UTCs), which is an important national measure of performance and quality of patient care.

Our staff:

  • ULHT gender pay gap report: The Gender Pay Gap report has now been published as part of statutory obligations. This report is an opportunity to review the pay position within the organisation and align improvement with an action plan. Positively, it found that  the gender pay gap for ULHT has improved since 2022, and now stands at 14.9% (against a national average of 14.3%).
  • ULHT Equality Delivery System (EDS): The EDS framework looks at how organisations perform in three domains relating to commissioned or provided services, workforce health and wellbeing and inclusive leadership. The Board received a report on ULHT’s performance for the last year, which has been extensively peer reviewed and in which the Trust received the rating of ‘Achieving’ for all three domains. The ambition is now to work towards an ‘Excelling’ rating in all areas.
  • Group Staff Awards: The first ever Group Staff Awards are now open for nominations, with the previous separate staff awards for LCHS and ULHT being brought together this year into a single staff awards process and ceremony.

Anyone can make a nomination in the 14 award categories, including staff, patients, and members of the public. Find out more on our website.

Executive changes: This was the final Trust Board meeting for Group Chief Executive Andrew Morgan, who has worked in the NHS for 42 years including 19 roles across 14 organisations. The Group Chair reflected that Andrew is a great leader of people and a strong advocate for the NHS, whose work has positively impacted upon the lives of hundreds of  thousands of people. As previously communicated, he will retire at the end of June this year.

It has been announced that Professor Karen Dunderdale will be the substantive Group CEO with effect from Monday 1 July. This follows an extensive national assessment and recruitment campaign.

If you have any feedback on the discussions and decisions made at our board, please contact [email protected].

Kind regards

Elaine Baylis           Andrew Morgan

Group Chair             Group Chief Executive