Introduction and overview

Welcome to the Annual Report and Accounts for Lincolnshire Community Health Services NHS Trust (LCHS), which gives an overview of our progress and performance over 2022/23. We continue to work with our partners and people to provide great care, close to home.

As we reflect over the 12-month period covered by this report we note that 2022/23 has been yet another very challenging year for our staff, patients, carers, families, and partner organisations. This was not only due to the ongoing pressures relating to the COVID-19 pandemic, but also the overall demand for health and care services in Lincolnshire (and beyond.) While the NHS was and still is catching up on activities that were paused due to COVID and continue to manage waiting lists for many services locally and nationally. This was especially evident when pressures on the acute hospitals and Accident and Emergency Departments in our county required all partners to work even more closely together to manage patient flow and ensure those who are fit to be discharged can receive support in the community – an initiative we called Breaking the Cycle Too. Despite the demand and the pressures, our staff and teams came together to support each other throughout these uncertain times.

Our staff and volunteers continued to show passion, dedication, and innovation to ensure our patients receive the very best care and treatment. All this while our staff were managing the personal impacts of burnout and juggling work with the needs of family and personal lives following a couple of very demanding years.

In 2022/23 the Trust has experienced a number of changes to the Board, welcoming a new medical director, chief operating officer and director of nursing, allied health professionals and quality and new non-executive directors. We have also said our farewells to the long-standing chair, Elaine Baylis as she came to the end of her term. Details of these appointments are included in the Director’s Report – Composition of the Board of Directors.

Creating the right environment for our staff to support them in giving our patients the best care possible is very important to our Board. The Board has continued to prioritise equality, diversity, and inclusion and has been particularly pleased to continue to work with LCHS staff networks and participate in key events such as LGBTQ+ History Month, Black History Month, International Women’s Day, and UK Disability History Month.

We would like to thank each and every member of the LCHS team and recognise their vital work. We would also like to thank our communities which continue to support our caring, compassionate, and dedicated services and our staff. This is reflected in visible support to our NHS Charity in fundraising and donations and many smaller, everyday gestures of appreciation and thank you cards from patients, carers, families, and local people. There is a lot of love and support for our community hospitals from local communities, which value having this facility close to home. For example, a class from Morton Primary School visited John Coupland Hospital in Gainsborough last year to deliver their ‘random act of kindness’. Children gave thank you cards to our staff, which were proudly displayed in the hospital for everyone to see. Throughout this report, we have included other examples of what communities do to support LCHS.

As a Board, we are committed to ensuring we listen to our patients, volunteers, and our staff. We want to continue to use this feedback to inform the ongoing development of the Trust to ensure we remain staff and patient-centred and continue to make a difference every day.

The Trust and wider NHS services remain under enormous pressures and challenges; however, we are proud of the way LCHS has continued to step up to provide great care, as close to home as possible. Our staff and volunteers have yet again experienced testing times, but we have also experienced many successes. As we enter the new financial year, we are confident that we have created a strong base to face the forthcoming year in the usual LCHS Way.

Malcolm Burch, Chair

Maz Fosh, Chief Executive

Our purpose is described as “Great care, close to home”.

Lincolnshire Community Health Service NHS Trust provides a wide range of community care across the county to meet the physical health needs of our community as close to their homes as possible.

We are working closely with our partners across health and care as part of the Lincolnshire Integrated Care System (ICS), which in our county is called Better Lives Lincolnshire. The ICS brings together all those involved in planning and providing NHS services (providers and commissioners of NHS services across a geographical area with local authorities and other local partners) to take a collaborative approach to agree and deliver ambitions for the health of their population.

There is a long history of joint working in Lincolnshire between the NHS, local authority, social care, voluntary, community and social enterprise sector partnerships, housing, and children’s services, to address factors that determine health and to seek to reduce demand on healthcare services in a more preventative and proactive manner. ICSs are part of a fundamental shift in the way that the health and care system is organised. Following several decades during which the emphasis was on organisational autonomy, competition and the separation of commissioners and providers, ICSs depend instead on collaboration and focus on places and local populations as the driving forces for improvement.

Our focus on the NHS Long Term Plan priorities and our local population health needs continue to provide opportunities to make positive changes to healthcare in Lincolnshire ensuring care is close to home and acute care is focussed on those people in most need.

We will see a renewed and refreshed focus on pathways of care developed with partners and patients through the Better Lives Lincolnshire ICS. We will work even closer with GP practices and their overarching Primary Care Networks (PCNs) and use population health information and data to make sure health funding is directed to those that need it, in the most efficient way. This will support patients and their families to manage and own their healthcare needs, enabling them to look after themselves to get better quicker and see great outcomes.

The Trust has a wide portfolio of healthcare services that includes:

• community nursing to support patients to get better care closer to home
• children and young people’s services, including children in care (previously known as looked after children) and children’s therapy services
• electronic assistive technology service (EATS)
• general and specialist integrated community nursing, immunisation, and vaccination services
• inpatient beds and outpatient clinics
• 4 community hospitals
• urgent care services including urgent treatment centres at Boston, Gainsborough, Louth, Lincoln, Skegness, and Spalding
• musculoskeletal (MSK) physiotherapy services
• occupational therapy, physiotherapy and speech and language therapy
• podiatry service
• primary care services in Boston and Spalding (until September 2022 and February 2023 respectively)
• safeguarding services for both children and adults
• integrated sexual health and contraceptive health.

LCHS cares for patients across the whole of Lincolnshire.

The services we deliver are commissioned by a number of organisations including NHS Lincolnshire Integrated Care Board (ICB) (formerly NHS Lincolnshire Clinical Commissioning Group), Lincolnshire County Council (LCC) and NHS England.

Our services are delivered from over 64 different sites; our main sites are:

• Trust Head Quarters – Beech House, Lincoln
• Lincoln County Hospital
• Louth County Hospital
• Pilgrim Hospital, Boston
• Grantham and District Hospital
• Grantham Community Base
• John Coupland Hospital, Gainsborough
• Johnson Community Hospital, Spalding
• Bourne Health Clinic
• Riversdale Health Clinic, Sleaford
• Lindon House, Lincoln.

We deliver a diverse portfolio of community healthcare services, we have a range of trained healthcare professionals including nurses, allied health professionals, public health professionals, medics and GPs enabling great care across our communities. Our services are delivered through over 2500 of our committed substantive and bank staff. Throughout the last year, our amazing workforce has been an integral part of the Lincolnshire health and care system, ensuring patients receive care close to home without the need to be admitted to an acute hospital.

Our staff provide high quality clinical care and expertise, coordinate, connect and advocate for our patients and carers in addition to driving digital innovation to improve access to services. This includes core areas such as:

• leading integration and joint working opportunities
• supporting people with long-term conditions
• frailty and end-of-life care, including better dedicated care home support
• urgent care
• specialists in prevention, case management, risk management and appropriate discharge
• details of our services are available on our website.

Our approach to care and working together is important to us. Our values are described as ‘LCHS Way’ which reinforces the right behaviours and approach we take in everything we do, contributing to better care for our patients and a better working environment in our Trust.

The LCHS Way is “we listen, we care, we act, we improve.”

We listen: we engage with everyone we work with | we are united | we are always positive

We care: everyone is valued, respected and developed | knowledge and skills are nurtured | success is celebrated

We act: Clear goals and the right resources | freedom coupled with accountability | emphasis on simplicity

We improve: we are creative, resourceful and innovative | integration and collaboration is the way forward | we’re always striving to do better.