Agenda Item 8

THE HEALTH SCRUTINY COMMITTEE FOR

Boston Borough East Lindsey District City of Lincoln Lincolnshire County Council Council Council Council North Kesteven South Holland South Kesteven West Lindsey District District Council District Council District Council Council

Open Report on behalf of David O’Connor, Executive Director Performance and Governance

Report to Health Scrutiny Committee for Lincolnshire

Date: 5 June 2013

Subject: An Introduction to the NHS in Lincolnshire

Summary :

This report provides an introduction to the main NHS organisations in Lincolnshire, including their main responsibilities.

Actions Required:

To develop an understanding of the responsibilities and roles of the main NHS organisations in Lincolnshire. This will enable the Committee to better perform its overview and scrutiny function.

1. Commissioners

Following the reforms of the NHS arising from the Health and Social Care Act 2012, there are now 211 clinical commissioning groups (CCGs) in England, which are responsible for most of the NHS budgets and the commissioning of the majority of NHS services. In Lincolnshire, there are four CCGs: -

• NHS Lincolnshire East CCG • NHS Lincolnshire West CCG • South Lincolnshire CCG • South West Lincolnshire CCG

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NHS Lincolnshire East CCG

NHS Lincolnshire East CCG represents 30 GP practices across the East Lincolnshire area, with a registered population of 240,000. The CCG incorporates three localities: East Lindsey, and Coast, and Boston. There are three within the area: Pilgrim , Boston; Skegness Community Hospital; and Louth County Hospital.

The CCG will lead on the commissioning of services provided by Lincolnshire Community Health Services NHS Trust; the East Midlands Ambulance Service; LIVES [Lincolnshire Integrated Volunteer Emergency Services]; and services associated with the urgent care pathway. The CCG will also be an associate commissioner for services provided by Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, which operates Diana Princess of Wales Hospital in Grimsby and Scunthorpe General Hospital.

NHS Lincolnshire West CCG

NHS Lincolnshire West CCG represents 38 member practices in the north western part of Lincolnshire and includes the City of Lincoln; West Lindsey District, and parts of North Kesteven. It is responsible for commissioning the health care for over 220,000 people.

NHS Lincolnshire West CCG will lead on the commissioning of services from United Lincolnshire Hospitals NHS Trust and St Barnabas Hospice.

NHS South Lincolnshire CCG

NHS South Lincolnshire CCG represents 15 practices across south Lincolnshire, with a registered population of 157,000, covering 585 square miles. It includes the towns of Spalding, Holbeach, Long Sutton, Bourne, Market Deeping and Stamford. It contains two hospitals: Johnson Hospital, Spalding; and Stamford and Rutland Hospital. NHS South Lincolnshire CCG will be the lead in Lincolnshire for commissioning services from Peterborough and Stamford Hospitals NHS Foundation Trust.

NHS South West Lincolnshire CCG

NHS South West Lincolnshire CCG represents 19 practices across the South West Lincolnshire area, with a registered population of 128,000, covering the towns of and Grantham and villages such as Ruskington, Ancaster and Corby Glen. The area contains Grantham and District Hospital.

NHS South West Lincolnshire CCG is the lead commissioner for services provided by Lincolnshire Partnership NHS Foundation Trust and is also the lead in the county for issues relating to Nottingham University Hospitals NHS Trust. NHS South West Lincolnshire CCG will also host the commissioning safeguarding team.

Page 20 NHS Commissioning Board / NHS England

The NHS Commissioning Board (also known as NHS England) has assumed from 1 April 2013 several functions, previously carried out by former primary care trusts, as well as a number of functions previously undertaken by the Department of Health. The new arrangements will ensure that all primary services are commissioned using the same model, which up to now has been done differently by primary care trusts.

Within NHS England, there are 27 Commissioning Board Local Area Teams. The Leicestershire and Lincolnshire Local Area Team (LAT) covers the Lincolnshire area. The LAT is responsible for the development and assurance of CCGs. The Leicester and Lincolnshire LAT will also take a lead on specialised commissioning.

NHS England manages the contracts with primary care providers, such as GPs and dentists. Arising from this arrangement, NHS England manages the 102 GP practices in Lincolnshire.

Greater East Midlands Commissioning Support Unit

All the Lincolnshire CCGs will receive their commissioning support through the Greater East Midlands Commissioning Support Unit, which is also referred as GEM. GEM also provides other support to the CCGs in the county.

2. Providers of Secondary Care

The main providers of NHS services for Lincolnshire residents are: -

• East Midlands Ambulance Service NHS Trust • Lincolnshire Community Health Services NHS Trust • Lincolnshire Partnership NHS Foundation Trust • Peterborough and Stamford Hospitals NHS Foundation Trust • United Lincolnshire Hospitals NHS Trust

In addition, a number of residents in Lincolnshire use hospitals in neighbouring trusts, such as Northern Lincolnshire and Goole Hospitals NHS Foundation Trust and Nottingham University Hospitals NHS Trust.

East Midlands Ambulance Service NHS Trust

The East Midlands Ambulance service provides emergency ambulance services throughout the East Midlands region, including Lincolnshire. Within the East Midlands, the co-ordinating CCG is Erewash CCG based in Derbyshire.

Page 21 Lincolnshire Community Services NHS Trust

Lincolnshire Community Health Services NHS Trust provides a range of health care services for Lincolnshire residents. It runs and provides services at four community hospitals:

• John Coupland Hospital, Gainsborough • Johnson Hospital, Spalding • Louth County Hospital • Skegness and District Hospital

The Trust which employs over 2,800 staff, also provides other services, which include the health visiting and school nursing service; children's therapy services; smoking cessation and weight management services; sexual health; community nursing and specialist nursing teams, community response and rehabilitation; adult therapy services; and speech and language services.

Lincolnshire Partnership NHS Foundation Trust

Lincolnshire Partnership NHS Foundation Trust provides a full range of mental health care services and operates in 74 sites in the county. These services include:

• initial mental healthcare, for common issues such as anxiety or depression, which are provided through primary care GP practices, pharmacies, health centres, prisons and other settings within local communities; • more specialist services, including some social care, for adults, children, families and older people; • assessment and treatment for people with learning disabilities; • help and support for people with substance misuse problems such as drugs or alcohol addiction. • psychological therapies. • occupational therapy.

The Trust operates locally based community mental health teams and a number of other outreach, crisis and home treatment services. It has 248 inpatient beds, the majority of which are on their main sites in Lincoln, Grantham and Boston. The Trust has an annual budget of £94 million and employs more than 1,800 staff.

Peterborough and Stamford Hospitals NHS Foundation Trust

Peterborough and Stamford Hospitals NHS Foundation Trust operates Peterborough City Hospital and Stamford and Rutland Hospital in Stamford. The Trust employs in excess of 3,500 staff across its two sites. Peterborough and Stamford Hospitals NHS Foundation Trust provides hospital services to the local community and to a catchment that extends 30 miles from the hospital – thereby overlapping into a number of different local authorities, including Lincolnshire.

Page 22 The Trust's services include accident and emergency, intensive care, medical and surgical services, elderly care, paediatric, maternity and diagnostic and clinical support services and radiotherapy. In addition, the Trust provides a range of community services including community midwifery. The Trust also provides rheumatology and neurology services. Most of these services are provided at Peterborough City Hospital, which was opened in November 2010.

United Lincolnshire Hospitals NHS Trust

The United Lincolnshire Hospitals NHS Trust is one of the largest hospital trusts in the country. It provides a comprehensive range of hospital-based medical, surgical, paediatric, obstetric and gynaecological services at three main hospitals. It also provides services at the four community hospitals in the county.

The Trust employs over 7,500 staff. The Trust's budget exceeds £390 million each year. In an average year, the Trust treats more than 180,000 accident and emergency patients, nearly half a million outpatients and almost 100,000 inpatients.

The Trust's hospitals are:

• Grantham and District Hospital • Lincoln County Hospital • Pilgrim Hospital, Boston

The Trust also provides services at the following community hospitals:

• John Coupland Hospital, Gainsborough • Johnson Hospital, Spalding • Louth County Hospital • Skegness and District Hospital.

3. Conclusion

The Committee is requested to develop an understanding of the responsibilities and roles of the main NHS organisations in Lincolnshire. This will enable the Committee to better perform its overview and scrutiny function.

4. Consultation

This is not a consultation item.

5. Appendices – None

5. Background Papers - No background papers within Section 100D of the Local Government Act 1972 were used in the preparation of this report.

This report was written by Simon Evans, who can be contacted on 01522 553607 or [email protected]

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