The Health Scrutiny Committee for Lincolnshire met to discuss the Lincolnshire Community and Hospitals NHS Group, and local mental health, dementia, learning disability and autism services. The committee agreed to thank the presenters from the NHS for their attendance, presentation and answers to questions, and to record concerns about hospital discharge arrangements, patient readmissions, waiting times for some diagnostic services and communication of their results. The committee also agreed to note the information presented on local mental health services, and to thank the presenters for their report, attendance and answers to questions.

Lincolnshire Community and Hospitals NHS Group (LCHG)

The committee received a report from Daren Fradgley, Chief Integration Officer, and Anna Richards, Deputy Director of Commons and Engagement, from the Lincolnshire Community and Hospitals NHS Group (LCHG), which provides an overview of the group's arrangements, aims, performance and current challenges.

LCHG was formed in April 2024, bringing together Lincolnshire Community Health Services NHS Trust (LCHS) and United Lincolnshire Teaching Hospitals NHS Trust (ULTH) under a single board and executive leadership team. Both trusts retain their separate statutory names and legal obligations.

The group's strategy for 2025-2030 focuses on providing high quality care, improving population health and making it easier for staff to deliver care. A key element of the strategy is the move towards a neighbourhood health model, bringing care closer to residents' homes.

Positive developments

• Teaching Hospital Status: ULHT was granted teaching hospital status in August 2024, becoming United Lincolnshire Teaching Hospitals NHS Trust (ULTH).
• Pilgrim Hospital Award: Pilgrim Hospital, Boston, received £23 million for energy efficiency and clean power upgrades as part of the Public Sector Decarbonisation Scheme[^1]. [^1]: The Public Sector Decarbonisation Scheme provides funding for public sector bodies to install heat decarbonisation and energy efficiency measures.
• Emergency Department at Pilgrim Hospital: The first phase of a multi-million pound transformation of the Emergency Department at Pilgrim Hospital, Boston, opened in May 2025.
• Community Diagnostic Centres (CDCs): The group has opened three CDCs in Grantham, Lincoln and Skegness.
• 'Martha's Rule' Call for Concern Service: A service offering patients, families and carers 24-hour access to a rapid review if they have concerns about a person's deteriorating condition is now operating in both Lincoln and Boston.
• Electronic Patient Records (EPR): Progress is being made towards introducing an Electronic Patient Record at ULTH and upgrading the one at LCHS.
• Greater Lincolnshire Integrated Sexual Health (GLiSH): LCHS secured the contract to continue providing integrated sexual health services in Lincolnshire and expanding to cover North Lincolnshire and North East Lincolnshire.
• New Endoscopy Unit for Lincoln County Hospital: Work is underway on building a £20 million Endoscopy Unit at Lincoln County Hospital, due to open later this year.
• Community Nurses and Paramedics supporting EMAS: A pilot project where LCHS community nurses and community paramedics support staff in the East Midlands Ambulance Service NHS Trust emergency operations centre.
• Improvements in Skegness Hospital: The patient environment on Gloucester Ward at Skegness Hospital was enhanced.
• Lancaster Ward, Lincoln County Hospital: One of the wards at Lincoln County Hospital became a community bed-based setting in an acute hospital.

Performance against national indicators

• Urgent and Emergency Care: Performance against the four-hour A&E target has remained strong, with 78.2% achieved in March. Ambulance handover times have also improved.
• Planned Care: The number of patients waiting more than 18 weeks from referral to their first appointment has significantly decreased in community services. In acute services, referral to treatment performance was 54.18% in May 2025.
• Waiting Times for Diagnostics: In 2024/25, up to 73% of patients had their diagnostic test within six weeks of referral.
• Readmission Rates: Emergency readmission rates to hospitals within 30 days of discharge were 12.5% in 2024/25.

Challenges

• The government's announcement of significant national decisions, including the formal abolishment of NHS England and the expectation for ICBs to make a 50% reduction in their running costs.
• The focus in 2025/26 for the NHS is on performance recovery, bringing down the hospital waiting list and reducing A&E waiting times.

Finances

• At the end of the last financial year ULTH's year-end financial position was a £18.3 million deficit, £11.4 million adverse to the planned deficit. LCHS's year-end financial position was a £31,000 surplus, £66,000 favourable to the planned position.
• At month 2 (2025/26), ULTH's year to date financial position is a £7.1million deficit, in line with plan. LCHS's year to date financial position is a £1million deficit, £0.1million favourable to plan.

Recruitment and retention

There is an improved position in relation to recruitment and retention across both trusts within the Group. The recruitment market for medical staff and staff in urgent care remains a challenge.

Care Quality Commission Ratings

• ULTH - The outcome from the most recent inspection in 2021 was 'requires improvement'.
• LCHS –The outcome of the last inspection in 2018 was 'outstanding'.

Questions from the committee

• Councillor K E Lee asked about wound care services and whether they would be available at GP centres in the future. Daren Fradgley, Chief Integration Officer, responded that the neighbourhood health model will move services like wound care into that neighbourhood approach.
• Councillor C Morgan asked about waiting times for diagnostics, resources for patients who cancel appointments, emergency readmission rates and agency staffing figures. Daren Fradgley, Chief Integration Officer, responded that there has been a pilot to look at a different way of rebooking and diagnostic slots, and that the community diagnostic centres are starting to work with GPs to do diagnostics before referral. He also said that the readmission rate is too high and that the trust is doing three things to address it: a patient and carers survey, a new discharge process and plugging the community services into the discharges from the acute services.
• Councillor S Welberry asked about occupancy rates at Lincoln Hospital, changes in patient records and community contracts and hospices. Daren Fradgley, Chief Integration Officer, responded that both Boston and Lincoln have high occupancy rates, that the trust is working with providers in northern Lincolnshire to align records and that the trust is bringing all of the funding and all of the focus for our end of life services together under the group.
• Councillor Liz Ball asked about improvements to the discharge process. Daren Fradgley, Chief Integration Officer, responded that the trust is walking in the shoes of the families, the patients and the carers and seeing what that journey looks like so that they can correct that pathway.
• Councillor P M Martin asked what is being done to actually listen to the patient through their journey through the system. Daren Fradgley, Chief Integration Officer, responded that the inception of the group was to remove the barriers between the two organisations and that the inception of the alliance and the partnership is to remove the barriers between primary care and themselves.
• Councillor J Makinson-Sanders said that she represents east Lindsay and that she feels that they are the very poorest relations in health care in the county. Daren Fradgley, Chief Integration Officer, responded that quite a lot of the structural investments have gone into sites that are in other areas, but that there is a new community diagnostic in Skegness, a redesign of some of the ward space at Skegness and that they are lobbying really hard for a rebuild of the Skegness UTC.
• Councillor C Morgan asked about winter pressures and a resident who has a warfarin issue. Daren Fradgley, Chief Integration Officer, responded that Lincolnshire has probably got some of the most impressive winter plans that he has seen in any area of the English NHS and that he would like to have a look at the warfarin issue himself.
• Councillor P C Wimhurst asked how much the EDI is going to be costing to implement across the board and how much the climate change net zero stuff is costing. Daren Fradgley, Chief Integration Officer, responded that to the best of his knowledge they haven't got a budget line exclusively for EDI deployment and that the climate change net zero stuff is not costing the people of Lincolnshire because it's coming through a national grant.
• Councillor R J Cleaver asked can you expand on Lancaster Ward at Lincoln County Hospital, how will these neighbourhood teams actually work on the ground with GPs and PCNs and will the space allow for an improvement in the number of emergency patients waiting for more than 12 hours between decision to admit and admission taking place. Daren Fradgley, Chief Integration Officer, responded that Lancaster was always a pilot, that the integrated neighborhood teams will be a multi-disciplinary team and that moving the orthopedics and fracture clinic allows them to put more people through SDEC.

The committee agreed to thank the presenters from the NHS for their attendance, presentation and answers to questions, to welcome the developments over the last year and to record concerns about hospital discharge arrangements, patient readmissions, waiting times for some diagnostic services and communication of their results.

Overview of Local Mental Health, Dementia, Learning Disability and Autism Services

The committee received a report from Chris Higgins, Chief Transformation Officer, Lincolnshire Partnership NHS Foundation Trust (LPFT), which provides an overview of the services offered for local mental health, dementia, learning disabilities and autism.

LPFT provides a broad spectrum of support services to all age groups, predominantly mental health services, but also some services for dementia, learning disabilities and autism. The trust's strategy is to support people to live well in their communities and maximise people's life chances.

Recent developments and achievements

• Transformation of community support with increased mental health workers working alongside GP surgeries and increased work with the voluntary, community, faith and social enterprise sector.
• Increase in crisis and urgent care support with the introduction of a new NHS 111 mental health option 2, 24/7 mental health liaison in emergency departments and expanded Night Light Cafes.
• All age mental health urgent assessment centre in Lincoln.
• Dedicated team proactively supporting the homeless community in Lincoln (Holistic Health for the Homeless service).
• New Virtual Autism Hub supporting those with/or seeking an autism diagnosis to connect with groups and activities in their local community.
• New £25m adult acute mental health wards in Lincoln providing improved privacy, dignity and therapeutic environments. A similar scheme is also underway in Boston.
• Expanded specialist eating disorder offer for those with mild/moderate symptoms.
• Continued rollout of mental health support in schools across the county.
• Closure of low dependency mental health rehabilitation ward, to implement new county wide community rehabilitation service.
• Pilot of Dementia Home Treatment service.
• Introduced a new dedicated service for those with a personality disorder and complex trauma.
• Increased support into the criminal justice system with dedicated mental health professionals in custody suites and working with those due to be released from prison.
• Increased support for those with a learning disability or autistic people to help navigate local health services and support any reasonable adjustments they may need to support them to access services.
• Increased capacity in talking therapies for those with mild to moderate mental health concerns such as stress, anxiety and depression.
• Increased capacity into local children and young people services to help meet the increasing demand on these services.

Demand and challenges

• Rising demand for mental health services, and more complex presentation when people reach crisis point.
• Increased awareness in neurodiversity has led to a significant increase in referrals for the adult autism diagnosis pathway.
• Waiting lists for some services are higher than desired.
• People having to inappropriately travel outside of Lincolnshire for inpatient care.
• Ongoing workforce challenges, particularly in specialist roles such as consultant psychiatrists, pharmacy and more experienced nursing roles.
• Ensuring the organisation is financially sustainable in the future.

Questions from the committee

• Councillor S Grantham asked how the development in the trust will affect the development in any way. Chris Higgins, Chief Transformation Officer, responded that they were able to secure external funding outside of linkage from a special next.
• Councillor S Welberry asked about neurodiversity and late diagnosis autism. Chris Higgins, Chief Transformation Officer, responded that they have seen a significant increase in the number of people seeking diagnosis and that they are trying to get those weighting lists down.
• Councillor C J Reeve asked if there is something that exists around suicide first aid that is available at all. Chris Higgins, Chief Transformation Officer, responded that they have got a number of different offers in the county and that they work quite closely with public health.
• Councillor A Currier asked about the holistic health for the homeless service. Chris Higgins, Chief Transformation Officer, responded that it is a Lincoln service and that they are gathering the evidence about how effective that is to hopefully demonstrate the impact so that they can roll that out in other using that service.
• Councillor J Smith asked what is being done to help reduce the suicide rate in Lincolnshire. Chris Higgins, Chief Transformation Officer, responded that there are a number of reasons why the suicide rate is as high as it is and that they are working with public health to try and address this.
• Councillor K E Lee asked if as an elected member they wanted to contact somebody about any services, who should they contact. Chris Higgins, Chief Transformation Officer, responded that they should drop him a message and he will make sure they get to the right person.
• Councillor C Morgan asked about the 117 after care issue. Chris Higgins, Chief Transformation Officer, responded that they have got people who are often waiting longer than they would want them to do in hospital for that package of care to be set up and that often those package care often the market is managed by the local authority.
• Councillor J Makinson-Sanders asked where the 50% of the schools are that aren't our well-being board that we got some we've got the help we needed in the east of the county. Chris Higgins, Chief Transformation Officer, responded that they can get her a map of the mental health support teams.
• Councillor S Welberry asked what is your relationship now with the police given that they're and farm workers. Chris Higgins, Chief Transformation Officer, responded that they are really confident that they have got the right services in place to support people and that actually it's right if you're if you've got a mental health need.
• Councillor C Morgan asked about the newly published 10-year NHS plan. Chris Higgins, Chief Transformation Officer, responded that they are obviously digesting the plan at the moment and that they are confident that what they plan is talking about.

The committee agreed to thank the presenters for their report, attendance and answers to questions and to note the information presented.

Work programme

The committee considered its work programme and agreed to the following:

• The winter plan will be brought forward to October.
• The parking item will be fitted into the slot that's created.
• The committee will talk about the maternity services patient.
• The committee will have a special session on children's teeth and children's health.