The Health Scrutiny Committee for Lincolnshire met on Wednesday 19 November 2025 to discuss cancer care, winter planning, and the committee's work programme. The committee was scheduled to hear updates from representatives of the NHS Lincolnshire Integrated Care Board (ICB) and Lincolnshire Community and Hospitals NHS Group.

Cancer Care in Lincolnshire

The committee was scheduled to receive a report from the NHS Lincolnshire Integrated Care Board providing an update on cancer services and the living with cancer programme in Lincolnshire. According to the report pack, the NHS Long Term Plan set a goal to diagnose 75% of cancers at stage 1 or 2 by 2028. The report stated that the Lincolnshire programme aligned with national pillars, while tailoring interventions to local needs. Initiatives included a locally delivered ovarian cancer awareness campaign co-produced with individuals with lived experience of cancer, enhanced GP education on referral pathways and safety netting, and practice level initiatives that use local data to increase screening participation. The report also noted that Lincolnshire ICB is part of a clustering arrangement involving NHS Derby and Derbyshire ICB, and NHS Nottingham and Nottinghamshire ICB, and that for cancer, this should mean a single system plan with clear ownership, faster and more consistent pathways, and targeted action on early diagnosis and inequalities. The report stated that national waiting time standards have been simplified to focus on measures that matter most to patients and clinicians, and that the legacy Two-Week Wait has been retired and replaced by the Faster Diagnosis Standard (28-day FDS): maximum of 28 days from urgent referral to communication of a diagnosis or the ruling-out of cancer. The report noted that system performance against the 62-day standard remains under pressure but is improving. The report also stated that United Lincolnshire Teaching Hospitals NHS Trust (ULTH) has maintained a solid 31-day position overall, reflecting strong day-to-day operational grip and rapid escalation where bottlenecks arise. The report stated that ULTH remain outside of tiering for cancer. Cancer tiering is a system for categorising and trusts based on their cancer waiting times performance, where trusts in the highest tier receive targeted support to improve. The report noted that North West Anglia Foundation Trust (NWAFT) typically sits at around 80% for the Faster Diagnosis Standard, and the Trust remains on course to meet the national requirement by the end of 2025/26. The report stated that North Lincolnshire and Goole NHS Foundation Trust's (NLAG) FDS performance has worsened overall, and that NLAG are currently in tier 1 for cancer performance. The report also detailed improvement work in urology, colorectal, and gynaecology pathways. The report stated that NHS Lincolnshire ICB published a procurement opportunity in June 2025 for a lead provider to deliver the Lung Cancer Screening programme locally, and that delivery of the programme will be rolled out in stages with the expectation that 100% of the eligible population within Lincolnshire will have been invited to an initial screening appointment by Quarter 3 2029-2030. The report noted that Lincolnshire's rurality means many people live far from hospitals and specialist centres, and that the county has an older population with more long-term illnesses like heart and lung disease and diabetes. The report also stated that health inequalities are clear in some coastal and more deprived areas, including parts of East Lindsey and Boston. The report detailed the Living with Cancer (LWC) programme, stating that the programme aim is to develop person-centred local support for people living with cancer, their carers and significant others in Lincolnshire. The report noted that the 2024 National Cancer Experience Survey showed no change in overall patient satisfaction score at 8.8/10. The report stated that the Acute programme consists of a programme of work that takes place within United Lincolnshire Teaching Hospitals NHS Trust, and that by August 2025 78% of patients were offered a Holistic Needs Assessment¹ within 31 days of diagnosis. The report detailed the Interface programme, stating that Lincolnshire has a well evolved psycho-oncology model for people living with cancer and caregivers who are experiencing emotional distress and mental health problems because of their cancer diagnosis. The report noted that the Community Development Programme focuses on the development of Information, Advice and Support in the community, integration with primary care and locality teams, supporting teams with complex cases, community development and health and wellbeing interventions, and that 'Fighting Fit' is a collaboration with the Lincoln City Foundation and leisure providers across the county. The report stated that the Macmillan LWC Co-Production group celebrated its sixth birthday on 22 May 2025. The report also detailed the ACE (Advancing Cance Equity) project working in collaboration with the ICB's Health Inequalities Team and Lincolnshire Voluntary Engagement Team, and the Health Inequalities Bowel Screening Project. The report listed achievements since September 2024, including presentations at conferences and publications in journals. The report noted challenges and risks, including financial constraints, staffing issues, and the risk of future provision of Psycho-oncology services.

Lincolnshire Integrated Care System Winter Plan 2025/26

The committee was scheduled to receive a report from Rebecca Neno, Deputy Director for System Delivery, NHS Lincolnshire Integrated Care Board, which invites the Committee to consider the Lincolnshire Integrated Care System Winter Plan for 2025/26. The report stated that the purpose of this Winter Plan is to highlight the local assumptions for winter and set out the planned response to manage the urgent care and patient flow pressures that the system will inevitably experience. The report noted that the plan is designed to supplement the ongoing improvements and developmentsin urgent care in line with the National 25/26 Urgent and Emergency Care Plan and is inclusive of those requiring both physical and mental health care. The report stated that during June 2025 NHS England Midlands Regional team shared a set of Key Lines of Enquiry (KLOEs) to support development of local winter plans. The report noted that the plan clearly outlines the system risks for winter, mitigations and any residual risks following mitigations. The report stated that the Lincolnshire Integrated Care System (ICS) Winter Plan for 2025/26 has been developed collaboratively and influenced by national and regional Urgent and Emergency Care (UEC) guidance issued by NHS England, as well as applying learning from previous winters within our local system, regionally and nationally. The report noted that as in previous years, NHS Lincolnshire Integrated Care Board (ICB) will lead on the delivery of the winter plan and will host the system winter director. The report stated that during the summer of 2025, the Lincolnshire system continued to experience increased levels of demand aligned to the seasonal pattern of visitors to our East Coast. The report noted that the Lincolnshire system has implemented measures to manage the risks associated with infectious diseases, including arrangement with our community provider to prescribe influenza prophylaxis to those meeting the clinicalrequirements, Care Home Infection Prevention and Control (IPC) support including local outbreak management support, with dedicated Senior Health Protection Nurse for each setting, Integrated Health Protection approach across the system and Infection Prevention and Control collaborative in place, and ICB engagement in all outbreak meetings across the system. The report stated that the Lincolnshire target agreed by our immunisation Programme Board has been set at 45% which is an increase of 2% on last year's uptake, and in line with the national Urgent and Emergency Care Plan for 25/26. The report noted that the system has seen positive results in addressing the vacancies and reducing the overall need for agency through additional strategies such as implementing rota clinics to support staff to maximise capacity and resource. The report stated that the Lincolnshire system operational plan included a workforce plan which has considered the need to ensure a flexible workforce across winter to meet the changing needs of activity that the system may possibly face. The report noted that the system has identified a small pot of funding to utilise for any additional winter initiatives, acknowledging that workforce to deliver any additionality would be challenging, and that priority areas for investment include Paediatric pathways and increased clinical capacity at our front doors, Respiratory clinical capacity and Acute Respiratory Infection pathways, Transport capacity, Attendance and admission avoidance initiatives across community, and Discharge support. The report stated that Primary Care, community services and the developing neighbourhood approach in Lincolnshire are all key to our ability to support attendance and admission avoidance and to reduce the reliance on acute services. The report noted that the implementation of the Mental Health Urgent Assessment Centre in Lincolnshire continues to be a great success and ensures that those patients with a mental health need only, do not need to attend our hospital Emergency Departments and instead they can attend a more appropriate environment which provides a better patient experience and improved outcomes. The report stated that patients in Lincolnshire will continue to be supported by robust crisis and home treatment teams and the integration of those services with NHS 111 option 2 Mental Health service is now embedded. The report noted that Children and Young People both with physical and mental health needs continue to be a priority cohort for the Lincolnshire system this winter. The report stated that planning for effective hospital care and discharge must start at the point of arrival at one of our acute or community hospitals. The report noted that throughout 2025/26 there has been a focus on review of front door pathways, with an ambition to fully integrate co-located Urgent Treatment Centers and Emergency Departments, and to further develop our Same Day Emergency Care (SDEC) units and assessment units to ensure that only those people that need the facilities and skill of an Emergency Department attend or remain in the Departments. The report stated that where patients are admitted to inpatient areas for care we will ensure that they are discharged in a timely way with the correct level of support and with full assessments taking place outside of the hospital setting. The report noted that the ethos of Discharge to Assess (D2A) is well embedded within the system which means we should have capacity and skill available to make patient assessments in their own home rather than in a hospital setting, and wherever possible and safe to do so, support patients in their own home rather than in a bedded service. The report stated that the system Urgent and Emergency Care programme maintains a risk register which is routinely reviewed as part of programme delivery but also in the context of winter, the Winter Director will have ownership of any risks in relation to this plan, managed by the Winter Delivery group and reporting into the Urgent and Emergency Care Partnership Board. The report noted that the Lincolnshire SCC has been fully embedded into the system since 2022 and ensures that there is robust oversight of all system pressures and is operational 8am – 6pm, 7 days per week, reporting to the ICB Deputy Director for System Delivery, System UEC SRO and Winter Director. The report stated that the use of the NHS Operational Pressure Escalation Levels (OPEL) Framework and associated Action Cards are fundamental to the delivery of assurance and governance for our system. The report noted that the Urgent and Emergency Care Winter Communications Plan for 2025/26 aims to co-ordinate the joined-up communications work already happening across Lincolnshire into a single point of reference for stakeholders.

Health Scrutiny Committee for Lincolnshire - Work Programme

The committee was scheduled to consider and comment on the contents of its forthcoming work programme. The report pack included a table of current work programme items, including:

• Cancer Care in Lincolnshire and the Living with Cancer Programme
• Lincolnshire Integrated Care System Winter Plan 2025/26
• NHS Dental Services
• GP Practice in Lincolnshire
• Lincolnshire System Workforce update Health and Care
• Introductory Item from Northern Lincolnshire and Goole NHS Foundation Trust
• Community Mental Health Hub and Community Connector Model
• Non-Emergency Patient Transport
• Neighbourhood Health Update
• Planning for the Impact of Emergencies on the NHS
• Recommendations from Previous Annual Reports of the Director of Public Health
• Director of Public Health Report 2025
• Arrangements for Quality Accounts 2026
• East Midlands Ambulance Service: Emergency and Urgent Care Services

The report pack also included a table of items to be programmed, including:

• Community Pharmacy / Availability of Prescription Medicines
• Stamford Health Engagement Exercise
• Humber Acute Services Review
• Transport and Travel Review (including car parking) by Lincolnshire Community and Hospitals NHS Group
• NHS Lincolnshire Integrated Care Board Clustering Arrangements
• Stroke Services at United Lincolnshire Teaching Hospitals NHS Trust
• East Midlands Immediate Care Scheme
• NHS Planning for Demographic Changes
• North West Anglia NHS Foundation Trust - Annual Update
• Maternity and Neonatal Services