The Health Scrutiny Committee for Lincolnshire met to discuss several key issues, including updates on the reduction of out-of-area mental health placements, the progress of the Stamford and Rutland Hospital Day Treatment Unit, and the development of neighbourhood health services. The committee also reviewed its work programme and identified priorities for future meetings.

Reducing Inappropriate Out of Area Mental Health Placements

The committee received an update from the Lincolnshire Partnership NHS Foundation Trust (LPFT) on actions taken to reduce inappropriate out-of-area mental health placements. The committee was asked to note the report and support future work to reduce the use of out of area mental health inpatient beds.

The report noted that NHS England has imposed a requirement for all systems to eradicate the use of inappropriate out of area adult (and older adult) acute mental health placements.

The report stated that adult acute inpatient demand has consistently exceeded the available local bed capacity in Lincolnshire. However, following targeted actions to increase alternatives to admission for people in a mental health crisis, reduce the length of stay of individuals admitted to acute inpatient wards, and improve discharge planning, the number of out of area placements has reduced significantly, at times achieving zero in the last six months.

The most significant ongoing barrier to consistently achieving zero inappropriate out of area acute and psychiatric intensive care unit (PICU) placements is the number of patients who are clinically ready for discharge but who remain in an acute inpatient bed because of challenges securing appropriate accommodation and /or an appropriate community support / residential care packages.

To address this, LPFT is commissioning a new step-down mental health unit at Ashley House, Grantham, initially as a two-year pilot project, for patients who are clinically ready to be discharged from inpatient mental health wards. The service will open in the autumn of this year and will provide 15 beds for people in a nonclinical based environment, following their discharge from one of the current inpatient wards across Lincolnshire, or Lincolnshire residents who have been placed out of area. It will be ran by Turning Point, a leading social enterprise on behalf of the Trust.

North West Anglia NHS Foundation Trust Update

The committee received an update from the North West Anglia NHS Foundation Trust (NWAFT) on the Trust's activities, including the development of the Day Treatment Centre at the Stamford and Rutland Hospital, and waiting list recovery activity for all patients. The committee was asked to note the contents of the report.

The report stated that the construction programme to build the new Day Treatment Unit on the Stamford and Rutland Hospital site is close to completion and the trust is on track to welcome its first patients there in the Autumn. The £21 million two-storey treatment unit represents the largest investment in the hospital site for many years and will help the trust deliver its strategic objective of increasing activity to meet population demand for day case procedures and provide a much improved patient and staff experience.

The report also noted that concerns have been raised by patients and staff over the length of wait for patients using the walk-in phlebotomy service at Stamford Outpatients Department (OPD), and that since 2017/18 there has been an 82% increase in activity, primarily driven by increased use of the service by primary care. Trust operational teams have met with NHS Cambridgeshire and Peterborough ICB operational colleagues, and it was agreed to develop a proposal for the Stamford Hospital phlebotomy service capacity to be increased, utilising an appointments-based model.

The report stated that reducing the time patients wait for both planned and emergency care is a priority for the Trust and is the focus of its recovery work across all specialities. Through the Trust's Back on Track programme, colleagues are working on specific actions that positively impact patient flow which, in turn, speeds up waiting times for patients in our emergency departments.

Neighbourhood Health

The committee received a report outlining the proposals for neighbourhood health within the context of the Fit for the Future – 10 Year Health Plan for England, and summarising work already undertaken in Lincolnshire to reorientate services into local communities. The committee was invited to note the information presented on neighbourhood health.

The report noted that the government's 10-year health plan sets out a new vision for a model of care fit for the future centred on three transformative shifts: from hospital to community; from analogue to digital; and from sickness to prevention. Central to this vision is the establishment of a new Neighbourhood Health Service, designed to deliver care locally by integrating professionals into patient-centred teams.

To reduce pressure on hospitals and refocus care delivery, a new Neighbourhood Health Service is being introduced with the aim of bringing care closer to communities by:

• delivering services locally
• bringing together professionals into patient-centred teams
• ending fragmented service delivery
• replace the NHS's traditional 'one size fits all' approach with more tailored, responsive care
• reintegrate healthcare into the 'social fabric' of places.

Key components of a new Neighbourhood Health Service are firstly, an ambition to have Neighbourhood Health Centres (NHC) in every community – starting in places where life expectancy is the lowest, NHCs will be a 'one stop shop' for patient care and the place from which multidisciplinary teams will operate. Secondly, Neighbourhood Teams (NTs) organised around people with similar needs, rather than NHS institutional siloes made up of a diverse mix of health professionals, social care and the voluntary and community sector NTs will deliver seamless care in the community.

Chairman's Announcements

Councillor R J Cleaver, Chair of the committee, made several announcements, including updates on:

• The Fit for the Future: Ten Year Health Plan for England.
• A national investigation into NHS maternity and neonatal services.
• Increased parking charges at Boston Pilgrim Hospital, Grantham and District Hospital and Lincoln County Hospital.
• The publication of 2024–25 Quality Accounts by local NHS providers.
• A proposal to relocate orthopaedic follow-up clinics from Lincoln County Hospital to a new modular unit at the Lincoln Community Diagnostic Centre.
• Current engagement and consultation exercises listed on the NHS Lincolnshire Integrated Care Board website.

In response to the announcements, members raised concerns about increased car parking charges, including limited public transport, impact on residential parking, and the role of visitors in patient wellbeing. A Member requested a future agenda item on parking charges for staff and the public, including the rationale behind certain exemptions (e.g. motorcyclists). A request was also made to add an item to the Work Programme to consider the NHS 10- Year Plan and its expected impact on Lincolnshire.

The committee resolved to note the chairman's announcements.

NHS Prescriptions for Gluten-Free Food Products

The committee noted that following a period of public consultation, NHS Lincolnshire Integrated Care Board (ICB) has made the decision with effect from 1 August 2025 to stop prescribing gluten free products.

The ICB stated that historically, the availability of gluten free products for people with coeliac disease was limited, leading to them being available for some people on prescription. However, these products are now much more widely available, with all major supermarkets and many other retailers offering a variety of gluten-free products.

The ICB has taken the decision to stop prescribing gluten free products, for the following reasons:

• The ICB has a responsibility to spend taxpayers' money wisely, particularly now, when NHS funding is under immense pressure and more patients with complex health issues are being seen than ever before. The price paid by the NHS for gluten free products on prescription is much higher than the supermarket prices paid by individuals.
• Whilst gluten free products are typically more expensive than their gluten containing equivalents, the difference in price is not as wide as it once was. There is also greater availability of gluten free products, and food products are generally better labelled, meaning people can easily see whether they are free from gluten.
• Around the country, 40% of the 42 ICBs do not routinely prescribe gluten-free products, 14% have moved to restrict gluten free prescribing to select groups, and 43% continue to prescribe gluten free products. In the East Midlands, Derbyshire, Nottinghamshire and Leicestershire have all stopped the prescribing of gluten free products.

NHS Lincolnshire Integrated Care Board - Clustering Arrangements

The committee noted that the Department for Health and Social Care and NHS England have approved a 'clustering arrangement' between NHS Lincolnshire Integrated Care Board (ICB) and two other integrated care boards in the East Midlands: NHS Derby and Derbyshire ICB and NHS Nottingham and Nottinghamshire ICB. Nationally, it has been reported that the 42 integrated care boards will be grouped into 26 clusters, with the emphasis on making smaller integrated care boards sustainable.

The NHS has stated that the objective of clustering is to strengthen integrated care boards as strategic health commissioners, which will be central to realising the ambitions set out in the national Ten-Year Health Plan.

Evaluation of the Community Mental Health Hub and Connector Model

The committee noted that an evaluation report of Lincolnshire's Community Mental Health Hubs and Community Connectors by the Lincolnshire Open Research and Innovation Centre (LORIC) has been published, which has concluded that the hubs are making a significant difference to people's wellbeing.

The evaluation report states that between September 2023 and March 2025, Lincolnshire's Community Mental Health Hubs welcomed over 107,000 visits and delivered £7.76 in social and environmental benefits for every £1 spent.

Current NHS Lincolnshire Integrated Care Board Engagement and Consultation Exercises

The committee noted the details of the current NHS Lincolnshire Integrated Care Board engagement and consultation exercises listed on the Board's website:

• Palliative Care and End-of-Life Care Services
• Community Dermatology Services
• Sharing Experiences of Care

Current Lincolnshire Community and Hospitals NHS Group Engagement Exercises

The committee noted the details of the current Lincolnshire Community and Hospitals NHS Group Engagement Exercises listed on the Trust's website:

• United Lincolnshire Teaching Hospitals NHS Trust
• Lincolnshire Community Health Services NHS Trust

Health Scrutiny Committee for Lincolnshire - Work Programme

The committee considered its work programme and suggested potential items for future consideration. Members requested that the following items be considered for inclusion on the Work Programme:

• Car Parking Charges at United Lincolnshire Teaching Hospitals NHS Trust
• Maternity Services
• Developments with the NHS Lincolnshire Integrated Care Board
• Children's Dentistry and Oral Health.

The committee also requested if it were possible for the item scheduled on 19 November 2025 on the NHS Winter Plan could be brought forward to the meeting on 15 October 2025.

The committee resolved to agree to the Work Programme.