The Health Scrutiny Committee for Lincolnshire met to discuss several key healthcare issues, including the future of dementia services in Grantham, an overview of maternity and neonatal services across the county, and the progress of neighbourhood health initiatives. The committee supported the permanent closure of the Manthorpe Ward in Grantham, favouring the continuation of the Dementia Home Treatment Team. Members also reviewed updates from the North West Anglia NHS Foundation Trust and discussed the committee's future work programme.

Dementia Intensive Support and Hospital Care

The committee supported the proposal to permanently close Manthorpe Ward in Grantham and continue with the Dementia Home Treatment Team (DHTT). This decision followed a consultation on local dementia intensive support and hospital care.

Eve Baird, Chief Operating Officer at Lincolnshire Partnership NHS Foundation Trust (LPFT), presented the findings of the consultation, which indicated clear support for continuing the DHTT approach. The DHTT provides a hospital at home service, offering intensive assessment and support in patients' homes to prevent hospital admissions.

The DHTT has been successful in providing a stepped-up level of care from the current community mental health offer, enabling more intensive support to be provided at home, rather than in hospital.

Of 1,029 referrals to DHTT since 2020, only 13% of patients required admission to Langworth Ward, the alternative inpatient facility in Lincoln. The average length of stay in the DHTT was also significantly shorter than in Langworth Ward (38.80 days compared to 77.70 days in 2023-24).

The East Midlands Clinical Senate also reviewed the proposals, commending the Trust on its extensive engagement and supporting the direction of travel. The senate recommended a health needs assessment, a detailed workforce strategy, and an analysis of travel implications.

During the consultation, concerns were raised about travel distances for families if the Manthorpe Ward closed. The Trust responded that it would develop a protocol to support families with transport costs and explore digital options for maintaining contact.

The committee had previously indicated its support for the preferred option in January 2025, and the final decision now rests with the Trust's Board and NHS Lincolnshire Integrated Care Board (ICB).

Overview of Maternity and Neonatal Services in Lincolnshire

The committee received a report providing an overview of maternity and neonatal services in Lincolnshire. The report outlined the roles of Local Maternity and Neonatal Systems (LMNS) and the NHS England Three-Year Delivery Plan.

Terry Vine, Associate Director of Nursing at NHS Lincolnshire Integrated Care Board, and Emma Upjohn, Director of Midwifery at United Lincolnshire Hospitals NHS Trust, presented the report, which highlighted key functions of LMNS, including strategic planning, service integration, quality improvement, and co-production.

The NHS England Three-Year Delivery Plan focuses on four strategic themes:

• Listening to and working with women and families
• Workforce growth and support
• Culture of safety, learning, and support
• Standards and structures for equitable care

The report also included data on delivery episodes within hospitals, showing a decrease in the number of deliveries over the past seven years, mirroring a national trend. However, the proportion of deliveries to Lincolnshire women at United Lincolnshire Teaching Hospitals NHS Trust (ULTH) has increased.

The committee noted the information presented in the Overview of Maternity and Neonatal Services in Lincolnshire.

Neighbourhood Health

The committee considered a report outlining proposals for neighbourhood health within the context of the Fit for the Future – 10 Year Health Plan for England.

A Public Health Consultant provided an overview of the plan, which prioritises shifting care into community and neighbourhood settings, emphasising prevention, integrated care, and coordinated management for patients with complex needs.

The committee discussed several aspects of the proposals, including:

• How neighbourhood boundaries would be determined and how equitable access to services would be ensured.
• The impact of reduced hospital resources on waiting times for complex procedures.
• The relocation of the orthopaedic clinic from Lincoln County Hospital to the Lincoln Community Diagnostic Centre, particularly regarding accessibility.
• Alignment of the 10 Year Health Plan with NHS proposals regarding obesity, substance misuse, smoking, and dual diagnosis with mental health.
• Effective communication across multidisciplinary teams.
• Workforce availability in Lincolnshire and efforts to ensure appropriate staffing of Neighbourhood Teams.
• The impact of ICB clustering arrangements on the Neighbourhood Health model.

The committee supported the principle of Neighbourhood Health but requested more details on how it would work in Lincolnshire and asked for further updates as details become available.

North West Anglia NHS Foundation Trust Update

The committee received an update from North West Anglia NHS Foundation Trust (NWAFT) on the Trust's activities, particularly at Stamford and Rutland Hospital.

The Deputy Chief Executive of NWAFT, the Chief Medical Officer, and the Chief Finance Officer presented the report remotely. They acknowledged the Trust's Segment 4 rating in NHS League Tables due to financial pressures and access challenges, but assured the committee that recovery and improvement plans were in place.

Investments to infrastructure and patient services were highlighted, including a new day treatment unit at Stamford Hospital. It was confirmed that no changes were planned for the Minor Injuries Unit at Stamford and Rutland Hospital.

During the discussion, members noted the impact of NWAFT's recent NHS League Table rating and wished the Trust well with ongoing improvement initiatives. A question was raised regarding NWAFT's aspirations for the minor injuries unit at Stamford Hospital, and the Deputy Chief Executive confirmed the Trust's commitment to supporting community-based facilities.

The committee welcomed the proposed opening of the Day Treatment Unit at Stamford and Rutland Hospital and expressed interest in the expansion of urgent treatment services at the hospital.

Health Scrutiny Committee Work Programme

The committee considered its work programme and suggested potential items for future consideration.

It was confirmed that members of the Health Scrutiny Committee had been invited to the Adult Care and Public Health Scrutiny Committee on 3 December 2025, for its consideration of the Integrated Lifestyle Service.

Items suggested for prioritisation in the work programme included community pharmacy, stroke services, emergency planning, the Stamford Health engagement exercise, parking charges at United Lincolnshire Teaching Hospitals Trust, and an update from Northern Lincolnshire and Goole NHS Foundation Trust.

The committee agreed to the work programme.

Chairman's Announcements

Councillor R J Cleaver, Chair of the committee, made several announcements, including updates on Care Quality Commission (CQC) assessment reports for emergency departments at Lincoln County Hospital and Boston Pilgrim Hospital. He also highlighted that all acute hospital trusts serving Lincolnshire were ranked in the lowest segment of the recently published NHS League Tables.

Concerns were raised regarding proposed Integrated Care Board (ICB) clustering arrangements and potential misalignment with Greater Lincolnshire and East Midlands structures.

The committee noted the Chairman's announcements.

Reducing Inappropriate Out of Area Mental Health Placements

The committee received an update on actions undertaken to reduce inappropriate out-of-area mental health placements.

The Chief Operating Officer of LPFT reported that the demand for inpatient beds exceeded local capacity, resulting in some residents receiving care outside Lincolnshire. LPFT had implemented measures that contributed to a reduction in out-of-area placements.

The committee noted that patients clinically ready for discharge remained in hospital due to difficulties in securing appropriate housing, community support, or residential care. LPFT was commissioning a two-year pilot at Ashley House in Grantham to provide a step-down service for patients ready for discharge.

During the discussion, members questioned why Ashley House would not be CQC regulated and enquired about the original use of the building. Concerns were raised about the closure of Ash Villa in 2020 and how the needs of children and young people were being met.

The committee congratulated Lincolnshire Partnership NHS Foundation Trust on their efforts to reduce out-of-area placements, including the plans for Ashley House, and supported further work on reducing out-of-area mental health placements.