Minutes of the Meeting of the

Health and Wellbeing Board

Held: Thursday, 18 January 2024 at 9:30 am

Present:
Councillor Sarah Russell (Chair)	Deputy City Mayor - Social Care, Health, and Community Safety, Leicester City Council (LCC)
Councillor Adam Clarke Rob Howard	Deputy City Mayor – Climate, Economy & Culture, LCC Director of Public Health, Leicester City Council
Dr Kath Packham	Consultant in Public Health, Leicester City Council
Helen Mather	City Place Lead - Leicester, Leicestershire, and Rutland Integrated Care Board (LLR ICB)
Ben Bee	Area Manager, Community Risk, Leicestershire Fire & Rescue
Ruw Abeyratne	Director of Health Equality & Inclusion, University Hospitals of Leicester NHS Trust (UHL)
David Sissling Harsha Kotecha	Independent Chair, LLR Integrated Care System Chair of Healthwatch Leicester and Leicestershire
Kevin Routledge	Strategic Sports Alliance Group
Kevin Allen-Khimani	Chief Executive, Voluntary Action Leicestershire (VAL)
Dr Caroline Trevithick Jean Knight Prof Bertha Ochieng	LLR ICB Chief Nursing Officer & LLR ICB Deputy Chief Executive Deputy Chief Executive, Leicestershire Partnership Trust (LPT) Integrated Health & Social Care, De Montfort University
In Attendance
Councillor Geoff Whittle Kate Galoppi Diana Humphries Jo Atkinson Sally Etheridge Nazira Vania Sarah Harrison Victoria Ball Andrew Beddow Amy Endacott Ruth Lake Gemma Barrow Harry Hughes Jacob Mann Alison Williams	Chair of Health Scrutiny, Leicester City Council Director of Adult Social Care and Commissioning, LCC Programme Manager - Health and Wellbeing Board (Public Health, LCC) Deputy Director of Public Health, LCC Programme Lead – Leicester Mammas Project Manager, Public Health, LCC City Centre Director, LCC (item 8 onwards) Service Manager Sports & Active Recreation, LCC Head of Sports, LCC Programme Manager – Long Term Conditions (Public Health – LCC) Director of Adult Social Care & Safeguarding, LCC Healthwatch Manager Job title not known, UHL Senior Governance Services Officer, LCC Public Health Admin, Leicester City Council (minute taker)

APOLOGIES FOR ABSENCE
Apologies for Absence were received from: - Councillor Vi Dempster - Deputy City Mayor (Education, Libraries & Community Centres), LCC - Councillor Elly Cutkelvin - Deputy City Mayor (Housing & Neighbourhoods), LCC - Sue Tilly - Head of the Leicester and Leicestershire Enterprise Partnership - Rani Mahal - Deputy Police and Crime Commissioner for Leicester, Leicestershire, and Rutland - Rupert Matthews - Leicester, Leicestershire & Rutland Police and Crime Commissioner - Rachna Vyas - Chief Operating Officer, LLR Integrated Care Board (ICB) - Sarah Prema – Chief Strategy Officer, LLR ICB - Prof Andrew Fry – College Director of Research, Leicester University

DECLARATIONS OF INTEREST
Members were asked to declare any interests they may have in the business to be discussed at the meeting. No such declarations were received.

MINUTES OF THE PREVIOUS MEETING
It was requested that the job role for Kevin Allen-Khimani be amended to “Chief Executive”. It was requested that Cathy Ellis be removed from the membership of the Board as she has left LPT. RESOLVED: That the Minutes of the previous meeting of the Board, held on 23 November 2023, be confirmed as a correct record once the correction noted above has been made. That the membership of the Board be amended as noted above.

QUESTIONS FROM MEMBERS OF THE PUBLIC
No questions from members of the public had been received.

MAMMAS BABY PROJECT REPORT SEPTEMBER 2023
Sally Etheridge (Programme Lead – Leicester Mammas) presented on the recent work of Mammas, which has been running for 15 years. The organisation focusses on supporting city families for the first 1001 critical days. There is a focus on those experiencing any vulnerabilities or living in areas of social deprivation. Details of the scope of the work can be found in the agenda pack – but some points noted from the presentation were:- • Although there is a focus on breastfeeding, the team support all feeding - and pathways are in place from pregnancy to 2 years. • DHSC funding in 2021 enabled the “Starting Well” project in conjunction with Heads Up Leicester (formally Centre For Fun & Families). This additional funding meant the offer to families, including antenatal classes, could be expanded. The project was externally evaluated by Leicester University – with findings including increased self-esteem/confidence and reduced social isolation/mental health concerns. • LPT sub-contract Mammas to provide the breastfeeding element of the 0-19 Healthy Child Programme (known locally as Healthy Together) via one-to-one or group support sessions. These were allowed to continue through pandemic lockdowns – but Zoom was also utilised for online sessions. • Leicester has higher rates than the England average for breastfeeding at six weeks (the NHSE datapoint) but Mammas will soon be collecting tracking data beyond six weeks. • The most deprived women are the least likely to establish breastfeeding – and also more likely to have premature babies or other vulnerabilities. • There is an information insert in the Red Book (given to all new mums). • Referrals come from various sources – and also via two helplines (one of which is for Gujarati and Urdu speakers). • WhatsApp is used for groups – and there are over 1200 mothers in the current network. The groups are closed and by invitation only. The participants reflect the demographic make-up of the city. • Antenatal courses have been running from Wesley Hall for a number of years, with around 250 parents per year attending; these are currently funded via Better Care Fund (BCF) and ICB monies. • Support is offered for as long as the family want – and at the level of the family’s personal preference. • Ambassador training can be given to anyone interested, but Peer Supporter volunteers need to have breastfed themselves. 44 women completed the Ambassador course last year. • Mammas offer free breast pump loans for as long as required. • There are face-to-face meets (at Parks, cafes, swimming pools etc) plus weekly Zoom sessions on a variety of topics such as sleep, bonding, oral health, weaning etc. • Some additional BCF funding has been secured which has allowed for additional sessions in South Leicester, New Parks and Thurnby Lodge. • The Mammas Baby Project has utilised BCF funds to support pregnant and new families facing adversity, which includes assisting with access to Healthy Start and providing vouchers for formula. Anyone can refer into this service (or parents can self-refer). • Mammas was consulted on the Unicef Baby Friendly Initiative’s guidance to local authorities on food insecurity for babies - and the guidance includes the Baby Project as an example of best practice. • “Rosa” (campaigners for the rights of women/girls) awarded Mammas £7000, which has been used for events and surveys; as a result, there were presentations at various national conferences and The Presenting Officer was part of the All Party Parliamentary Group on Infant Feeding. • Additional “Children In Need” funding has been used to provide sessions to address mental health (further details are in the agenda pack). • The resource developed to support infant feeding during Ramadan is the most viewed/downloaded resource on the Mammas website. Comments and questions from the Board:- • The Chair thanked the presenting officer and her team - and noted that this is a good example of work that the whole system benefits from. • The Director of Public Health commented that Leicester stands out, positively, for having the highest breastfeeding rates in the region. He was concerned, however, that high rates in the North and East can camouflage low rates in the South and West – and asked what the Board could offer to support Mammas in addressing those lower rates. The presenting officer responded that the upcoming Best Start For Life Workforce Pilot will address this through targeted work by the peer supporters placed within Leicester Hospitals. She asked for the Boards assistance in promoting the recruitment of these volunteers. • Members noted that the external evaluation highlights the positive impacts of Mammas work on loneliness and social isolation by building human connections. The Presenting Officer responded that Mammas hopes to expand this by getting city venues/cafes to offer warm welcomes by signing up to “Baby Friendly Leicester”. The Chair noted that the City Centre Director, Sarah Harrison, will be a good link for this work. • The Member representing UHL commented that Mammas’ work is helping to prevent longer term conditions. She also noted that UHL has more it needs to do to make UHL a Baby Friendly organisation. The Presenting Officer responded that she is already linked in with Midwifery and the Maternity Voices Partnership - but would be happy to hear from UHL Staff. • Members asked whether Mammas has the appropriate links to system leads. The Presenting Officer responded that Mammas list of key contacts is frequently being refreshed. • Members asked about networks addressing social isolation – and the Presenting Officer responded that the “Blossom and Bloom” project provides perinatal mental health support alongside physical and emotional health. She was aware, however, that partner capacity is an issue (for example within domestic abuse support services) so there is a danger that Mammas can be stretched by supporting beyond their remit. • Members asked whether Primary Care refer into Mammas. The Presenting Officer noted that this has been a challenge but, since presenting at a PCN event last year, the service is now receiving referrals from GPs and Social Prescribers. Helen Mather offered to provide a link between Mammas and GPs for the promotion aspect. RESOLVED: • That the Board thanked Officers for the presentation and asked them to take Members comments into account. • That the Board will promote Mammas as a service, and also support the recruitment of the hospital peer supporters.

COMMUNITY WELLBEING CHAMPIONS PROJECT
Nazira Vania (Project Manager, Public Health, Leicester City Council) presented an overview of the work of the Community Wellbeing Champions (CWC) project. The project was set up by Public Health, during the height of the Covid-19 pandemic, to support community engagement efforts in relation to vaccination and wider health/wellbeing needs. The following points were noted: • The champions can be any individual that promotes or supports health and wellbeing at a local level. There are currently 329 members in the network, from 145 organisations, and this is continually growing. • Examples of the work of the small team (comprising of Nazira Vania and Joel Carter) include:- o The “How Are You Leicester?” survey undertaken in 2022 o Events, focus groups and engagements – and particularly those that inputted into Health Needs Assessments and Consultations to give a broader range of voices. o Weekly emails to the network to share information, event details and research. o Three in-person conferences, with a fourth one taking place in February 2024 (which will focus on the topic of Mental Health and Social Isolation). o 13 Forums held to date – where initiative leaders can attend to present. o The Covid-19 Vaccine Confidence Programme. o Input into the Cost-of-Living Incident Management Team meetings. o Assisting the ICB to deliver the Super-Vaccinator Project. • It is difficult to measure outcomes, but increased reach and engagement can be demonstrated. In addition, network members have sent positive feedback, and the work has helped to strengthen the infrastructure for future crises. • Learning from the work, and upcoming challenges, includes:- o Some geographical gaps, o Some capacity issues around the growing demand, o Recruitment and retention of champions is a challenge, o Sustainability of projects due to uncertainty around funding (funding currently set to end March 2026). • Areas for development are:- o Increase presence, profile and training, o Strengthen partnership working, o Explore a Volunteer CWC role, o Aim to get a Graduate Project Officer joining the team. • The Presenting Officer asked members for comments on how the project can support the work of the Board, and how insight from the project can feed into the Health and Wellbeing Strategy. Comments and questions from the Board:- • The Member representing Voluntary Action LeicesterShire (VAL) noted that VAL is an accredited Volunteer Centre with volunteers that may be suitable for Public Health work. He will be meeting Kate Huszar in February – and this meeting will be extended to include the Presenting Officer. • The Director of Public Health was proud of this project and the approach of the small team around listening, understanding and then responding in a nuanced way. As such, this community engagement benefits all systems represented by the Board. He noted that the Department for Levelling Up had visited him on 12.1.24 to discuss community cohesion in Leicester – and this project had been presented to them as an example. • The Chair noted that conversations about funding will need to take place in the future. • Ruw Abeyratne noted that “indirect” work may be hard to demonstrate but has longer lasting impacts. She felt that the public sometimes report lack of trust in organisations – and the Board could support collective conversations around how we can measure trust. • Dr Packham noted that she is proud of the project. One example is the Public Health Expo at The Peepul Centre (which allowed voluntary sector organisations to make connections with each other at a face-to-face event). • Dr Ochieng echoed the challenge in measuring impacts of community engagement – and offered the support of De Montfort University in undertaking cost-benefit analysis. She was also happy to explore the use of student volunteers to look at the trust-building work noted above. • Ben Bee noted that there are ten Educators within Leicestershire Fire & Rescue Service who go into homes; this often requires multiple visits to build trust. He is happy for the learning/outcomes to be shared – and he will send the contact details for the Community Safety Manager in Leicestershire Fire Service. • Members suggested that the Board could support the project by reducing requests for proof of outcomes via spreadsheets. • The Chair noted that the offers of support demonstrate the benefit of the Health and Wellbeing Board. RESOLVED: • That the Board thanked the Officer for the presentation and asked them to take Members comments into account. • That the Presenting Officer will meet with the Member representing Voluntary Action Leicester (VAL) - in February - to discuss possible opportunities for existing VAL volunteers and methods for volunteer retention. • That the Board will be sent the link to the invitation to the Mental Health & Social Isolation Conference taking place on Tuesday 6 February 2024 at King Power Stadium. • That the Presenting Officer will accept the offer of support from De Montfort University – and progress this through conversations with the Member representative. • That the Presenting Officer will accept the offer of information on learning outcomes on trust-building from Leicestershire Fire & Rescue Service’s home educator work; the Member representative will send the contact details for the Community Safety Manager.

HEALTHWATCH ANNUAL REPORT/UPDATE
Gemma Barrow (Healthwatch Manager for Healthwatch Leicester and Healthwatch Leicestershire) presented on the work undertaken recently and the plans for the upcoming year. It was noted that: • Healthwatch Leicester (now sitting within VAL) is the City’s provider of this national programme providing a local health and social care champion. Details of the vision, mission and values were shown on the slides (also in the agenda pack). • Healthwatch is an independent statutory body. There are four staff per Healthwatch on average, totalling 595 full time equivalent staff across the UK. This encompasses 3700 volunteers. • Functions are carried out via:- o Public engagement and community outreach. o Local volunteers are trained to visit selected settings as part of the “Enter and View” programme. Reports are written and intelligence/recommendations are shared across the health and social care system. o The team work closely with partners (LCC, LPT etc) and the Care Quality Commission. o Healthwatch has a seat at Strategic Boards to advocate and influence. • In 2023 over 30,000 people in LLR were supported to either access advice/information – or to have a say on their care. • In the last year, LLR residents are reporting the following issues:- o Accessing primary care services (and particularly NHS dentistry) o Waiting times for mental health services o Accessing services for the aging population o The cost-of-living impacts o Language barriers – particularly in understanding health information Some examples of pieces of work in the last year were noted as:- o Vaccine uptake work o Work around access to dentistry and sharing intelligence data (including commissioner meetings and input into the Oral Health Joint Strategic Needs Assessment). o Dementia Survey (350 people responded) and input into the Council’s Dementia Strategy. o Presence at train stations for World Mental Health Day (600 engagements made) as part of the “R U ok?” campaign. o Engagement with the City and County hotels used to house asylum seekers – with subsequent reports available to view on the Healthwatch website. This was done in conjunction with LPT and City’s Public Health team. o Awareness raising of Lipoedema. o Profile raising via local radio broadcasts and leaflets/posters. o A visit and re-visit to the Accident & Emergency Department. • Plans for the coming year were noted as:- o Access and communication explorations with identified groups o Supported Living engagement o Continuing the Enter & View programme for Care Homes and GP practices – but including more Mental Health Units and Community Diagnostic Centres. o Network session and the Summer and Winter Tours (with a bigger focus on engaging with businesses). Comments and questions from the Board:- - The Member representing Adult Social Care thanked the Presenting Officer for Healthwatch’s valuable insights that were incorporated into the Dementia Strategy refresh. She was also keen to link with Healthwatch when they undertake the engagement around Supported Living. - The Chair noted that the names of the hotels housing asylum seekers had not been made public by LCC in case this made the residents vulnerable - and asked that these be removed from the reports on the Healthwatch website. The Presenting Officer noted that the provider had been asked to comment and approve the reports before being published – but was happy to review the content of the reports. - Members asked whether Healthwatch are linking in with the correct leads within the ICB around the dentistry work. The Presenting officer responded that all correct links are in place. RESOLVED: 1. That the Board thanked Officers for the report and asked that comments from the meeting are taken into account. 2. That links between Healthwatch and Adult Social Care will be part of the upcoming Supported Living work. 3. That the Presenting Officer will remove the names of the City hotels in the Asylum Seeker engagement reports (currently on the Healthwatch website).

ACTIVE LEICESTER STRATEGY
Victoria Ball (Service Manager – Sports and Recreation, LCC) and Andrew Beddow (Head of Sports, LCC) presented on the Active Leicester Strategy. It was noted that: The Strategy was published in the summer of 2023, and shared with the Board at that time. It was developed through a collaboration between Public Health and Sports within LCC. The Strategy has been adopted by LCC as guidance for the next 5 years. An action plan is being developed from the Strategy. The focus for this current Strategy (“Turning The Tide”) is on inactivity – which worsened during the Covid pandemic. The key aim is to reduce inactivity by 1% year on year – and this will be monitored though Public Health datasets. The physical and economic benefits for physical activity were noted. The Strategy runs from cradle to grave. The Strategy is a guidance document for stakeholders and partners. Although there is no budget attached, there is some resource via Sports and Public Health staffing. The suggestions are around making tweaks to garner change – and that this is more likely to attract the inactive through non-traditional, local and informal activities. Suggested priority groups include women/girls, Black or Asian residents (particularly in the East of the City), over 65s and residents not in work. As part of the Council’s own actions towards achieving the ambition, Aylestone Leisure centre has been designated as a Health & Wellbeing Hub – and this was kickstarted via a launch event. Sports staff are aiming to work with LCC Housing colleagues to offer tenants six months free access to the Leisure Centre (including free access to the swimming pool and “bring a buddy for free”). Leicester is currently in the second tranche for a new Place-Based Sport England fund (£250 million over four years for the whole of the UK). Presenting Officers felt this gives the partners represented by the Board a good opportunity to collaborate on a bid – and ideas were welcomed from members. Comments and questions from the Board:- The Chair urged Members to consider their workforces, as well as their communities, in relation to the suggestions in the Strategy. Councillor Clarke urged members to consider the opportunity of this Strategy to promote Active Travel – and particularly our current programmes delivered by Sustrans and Living Streets. The Member representing the Strategic Sports Alliance noted that all the main City Sports Clubs had inputted into the Strategy. He was concerned that the aims of reducing inactivity would be difficult to achieve. He also noted that offering free services in Council Leisure Centres will impact on revenue – and this is at a time when Council budgets are being squeezed and sport provision is not a statutory function for councils. He felt that delivery of the Strategy cannot be done solely by LCC. He also noted that Sport England strategies change each year, and therefore felt this would not provide a reliable source of continued funding. He noted that Active Essex put £20 million into their programme – and was keen to look at their outcomes. The Presenting Officer noted that the focus for the strategy had arisen from stakeholder feedback – but acknowledged it will be challenging to achieve the vision. Kevin Allen-Khimani offered the assistance of VAL in promoting activities and/or volunteering opportunities to the Voluntary Sector. The Director of Public Health noted that the Strategy will be working against an obesogenic environment – and urged members to adopt a “Health In All Policies” approach to help make difficult decisions to create environments more conducive to behaviour change. The Member representing De Montfort University offered to share data from a recent Sport England bid – and to be a critical friend going forward. The Presenting Officers accepted this generous offer. The Members representing LPT noted that staff activity is taken very seriously; this includes good links with Active Together, and “Health & Wellbeing Wednesday” for staff. She made a plea for activities to be seamless across LLR rather than being specific to the City. The Presenting Officer responded that the Strategy had been developed in conjunction with Active Together and hoped that stronger connections between City and County will arise from the Strategy actions. Helen Mather felt that sedentary working for ICB staff was an issue; this is being addressed internally – but she would welcome linking in with the Presenting Officers to maximise this. RESOLVED: That the Board thanked Officers for the report - and asked that comments from the Board be taken into account. That the Board will support and promote the Strategy – particularly by considering our workforce activity levels and the links to Active Travel. That the Chief Executive of Voluntary Action LeicesterShire will send the Presenting Officers the deadlines for VAL’s newsletters (to enable promotion of activities and volunteering opportunities). That De Montfort University will share their data from a recent Sport England bid.

LEICESTER CITY BETTER CARE FUND UPDATE Q2 23/24
Ruth Lake (Director of Adult Social Care & Safeguarding, LCC) presented an overview of the BCF, its background and how it is currently managed. The position at Quarter 2 is highlighted in the papers circulated – with some examples of achievements, challenges and case studies. It was noted that: The BCF is a pooled fund to support integrated approaches – and is now in its 10th year. Focus began with adults but has spread out now to encompass children and families. An aim of the projects supported is to delay the need for statutory services or hospital admission – or to assist in timely discharge when hospital admission cannot be avoided. All of the priorities are on track for Quarter 2. A key success of the work is the strong relationships and joint working that have been built. One example is the Unscheduled Care Hub, which has been nominated for awards. Another is the Rehabilitation, Reablement & Recovery programme (which went live 1.11.23); this has had an impact on reducing delayed discharge. Other examples are the Falls Response work, the 91-day outcome (and Leicester is consistently performing well against this metric), the Centre Project and the work of Mammas. Challenges were noted as:- Complex system influences and pressures Capacity issues within the Emergency Department and around beds The financial position within the system Comments and questions from the Board:- The Members representing Leicestershire Fire and Rescue noted that their service have seen an increase in issues around both falls and transport between home and hospital – and he was keen for the Control Room to be giving the correct advice on both issues. RESOLVED: That the Board thanked Officers for the report - and asked that comments from the Board be taken into account. That the Member representing Leicestershire Fire and Rescue will contact the Presenting Officer to enable correct advice to be passed on to Control Room staff around falls and home/hospital transport.

DATES OF FUTURE MEETINGS
The Board noted that future meetings of the Board would be held on the following dates:- Thursday 22 February 2023 – 9.30am Thursday 13 April 2023 – 9.30 am Meetings of the Board are scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

ANY OTHER URGENT BUSINESS
St Johns Ambulance city-centre evening sessions; a BID Leicester project: Following a recent presentation at the Community Safety Partnership, The Chair had asked Sarah Harrison (City Centre Director, LCC) to attend to present on this project. The sessions commenced in 2021 and run from 10pm to 5am. Using funding from the Police Crime Commissioners Office, this has now grown to 47 sessions in the last year. The work of the St Johns Ambulance staff has meant a reduction in NHS and Police time – and this has therefore meant savings for the system. Other regions in the UK are looking to replicate the project as an example of best practice. The service started as a static service – but now includes bicycle response. The service has been evaluated, and another bid has been made for Police Crime Commissioners Office funds to continue the project. Public Health in LCC have also been approached for funding. The Members representing the ICB were keen to make links, particularly as the project will impact by reducing pressures on the Emergency Department. The Member representing Adult Social Care noted that the vehicles had been useful during the heatwave for providing the public with drinking water; she felt that other uses/opportunities could be explored (and The Presenting Officer agreed with this). RESOLVED: That Members will support conversations to continue the project. That The Presenting Officer will send the presentation slides and Annual Report to the ICB representatives. That The Presenting Officer will have conversations, with the Member representing Adult Social Care, around additional uses for the St Johns Ambulance vehicles. There being no other business the meeting closed at 11.52 am. ____________________________