The Health Scrutiny Committee for Lincolnshire met to discuss general practice provision in the county, arrangements for quality accounts, and the committee's work programme. The committee noted reports on GP provision from NHS Lincolnshire Integrated Care Board (ICB) and the Lincolnshire Local Medical Committee (LMC), and agreed to request further reports in six months. Members also agreed to establish a working group to consider draft statements on quality accounts from Lincolnshire Community Health Services NHS Trust and United Lincolnshire Teaching Hospitals NHS Trust.

GP Provision in Lincolnshire

The committee reviewed general practice provision in Lincolnshire, receiving reports from Sarah-Jane Mills, the Director of Primary Care, Community and Social Value, NHS Lincolnshire ICB, Nick Blake, Programme Director – Primary Care, NHS Lincolnshire ICB, and Dr Reid Baker, Medical Director of the Lincolnshire LMC.

Ms Mills outlined that there are 81 GP practices across Lincolnshire, organised into 14 primary care networks (PCNs). These practices serve 824,000 registered patients and delivered 5.68 million appointments in the past year, a 4% increase. She noted that general practice is the front door to NHS services and that recent reports have highlighted it as a priority for the NHS, both nationally and locally.

Dr Baker highlighted the challenges faced by general practice, including a workforce crisis, with many GPs wanting to work more but unable to find work. He also noted that practices are closing or reducing services due to viability issues. He stated that while a new GP contract for 2025-26 is a step in the right direction, a new substantive contract is needed to ensure a flourishing general practice and wider NHS.

Several issues were raised by committee members:

• Funding: Councillor District C Morgan, South Kesteven District Council, asked about the risk of an either-or refunding situation, where investment in secondary care is reduced before community care is adequately funded. Ms Mills responded that the ICB is looking at how to use existing funding more effectively and redesign services to release funding for future investment.
• Did Not Attend (DNA) rates: Councillor R J Kendrick, Lincolnshire County Council, noted that a GP practice in his division was experiencing 64 DNAs a month and asked what more could be done to raise awareness. Ms Mills said that the ICB works with practices where DNAs are an issue and includes messaging about attending appointments in its communications campaigns.
• New booking systems: Councillor J Smith, Lincolnshire County Council, asked about support for patients struggling with new online booking systems. Ms Mills advised patients to talk to their practice, as most practices will support them and enter the information for them.
• Section 106 funding: Several councillors raised concerns about the thresholds for Section 106[^1] funding and the restrictions on its use. Dr Baker noted that the funding cannot be used to employ more staff, which is a challenge given the current workforce needs. Ms Mills clarified that GP practices receive revenue funding for each registered patient, but this may not be sufficient to employ another GP. [^1]: Section 106 agreements are legal agreements between local planning authorities and developers, used to mitigate the impact of new developments on the community and infrastructure.
• Well-woman clinics: Councillor K E Lee, Lincolnshire County Council, asked whether all GPs should be providing well-woman clinics. Dr Baker responded that while not explicitly stated in the contract, GPs provide a range of care for people from cradle to grave, including monitoring throughout their lifetime and national screening programmes.
• Pharmacy First: Councillor P M Martin, Lincolnshire County Council, asked about the scope to expand the Pharmacy First scheme[^2]. Dr Baker said that the ICB is working on developing the relationship between GPs, pharmacies, and the public, but that pharmacy capacity is a limiting factor. [^2]: Pharmacy First is a scheme that allows patients to receive treatment for certain conditions directly from a pharmacist, without needing to see a GP.
• ICB Restructure: Councillor District J Makinson-Sanders, East Lindsey District Council, raised concerns about the impact of a 50% cut to the ICB's budget. Ms Mills acknowledged that there would be an impact and a change in how the ICB works with general practice, but that the ICB is working to mitigate any negative consequences.

The committee agreed to thank the presenters for their reports, to record the continuation of ICB support for GP practices and the funding of necessary service expansion, and to request further reports on GP provision in six months.

Quality Accounts 2024-2025

Simon Evans, Health Scrutiny Officer, presented a report on the arrangements for the Quality Accounts 2024-2025. He explained that quality accounts are documents that certain providers of NHS services are required to produce each year, detailing the quality of their services.

Mr Evans noted that due to the County Council elections, the committee had not been able to make statements on the draft 2024-25 quality accounts. However, Lincolnshire Community Health Services and United Lincolnshire Teaching Hospitals Trust had extended their deadline, allowing the committee to provide a statement.

The committee agreed to establish a working group, consisting of Councillor P C Wimhurst, Lincolnshire County Council, Councillor District C Morgan, South Kesteven District Council, and Councillor R J Kendrick, Lincolnshire County Council, to consider the draft quality accounts of Lincolnshire Community Health Services NHS Trust and United Lincolnshire Teaching Hospitals NHS Trust and finalise a statement.

Work Programme

Simon Evans, Health Scrutiny Officer, presented the committee's work programme. He noted that there was scope for the committee to suggest additional items.

Councillor District C Morgan, South Kesteven District Council, requested feedback from the ICB on how they are planning for population growth. Councillor R J Cleaver, Chair of the Committee, suggested moving the dentistry item forward to the July meeting and cancer care to October.

The committee agreed to accept the work programme with the comments made.