Agenda and minutes

To issue a welcome to those present, and to confirm if there are any apologies for absence.

The Chair welcomed everyone to the meeting and led on introductions. It was noted apologies were received from Cllr Clarke and Cllr Westley.

Members will be asked to declare any interests they may have in the business to be discussed.

Health Partners provide a report detailing a system update for the winter pressures across Leicester, Leicestershire and Rutland as requested by Commisison Members.

Health Partners from across the Leicester Partnership Trust (LPT) and the Leicester, Leicestershire and Rutland (LLR) Integrated Care Board (ICB) submitted a report to update the Commission on the winter pressures across Leicester. The following was noted:

·         It was noted that winter pressures are consistently challenging every year between December and January, regardless of the provisions in place, and this has been the case for over 20 years. This winter had additional complexities, including flu circulating around 3 weeks earlier than expected and periods of industrial action occurring at a critical point in the season. These factors added strain to an already pressured system, though many of the challenges reflected those typically experienced during winter.

·         Updates were provided on urgent and emergency care performance, including ambulance response times and handover delays. Improvements had been made across key metrics, particularly ambulance handovers within 45 minutes, pre handover waiting times, and the ability to release ambulances back into communities. These improvements were driven by an improvement plan, increased capacity, and escalation frameworks. While progress had been made, it was acknowledged that the experience of patients waiting in ambulances was not acceptable and continued work was required.

·         Performance against the 4 hour emergency department standard was outlined, covering the time from arrival to being seen, treated, discharged, or admitted. Performance across emergency departments had been improving, with national benchmarking showing positive movement for Leicester, Leicestershire and Rutland compared to other trusts.

·         A range of improvement actions were highlighted, including developments at minor injury and urgent care services, the use of appointment slot based systems, and work to improve local blood test processes. It was noted that formal point of care processes were not yet in place but were expected to be introduced in March.

·         Work was ongoing to improve access to emergency and urgent care units through direct referrals from GPs, ambulance services, and emergency departments. Progress was also being made towards establishing an urgent treatment centre and demonstrating the impact of recent developments. Efforts were underway to ensure patients were directed to the most appropriate clinical setting rather than defaulting to emergency departments, supported by improved clinical pathways.

·         Length of stay and discharge performance were discussed, including work to reduce average lengths of stay and improve ward based discharge processes. Focus had been placed on patients with no ongoing care needs who could return to their normal place of residence. While progress had been made, it was recognised that further work was required, with an aspiration to achieve a 70 percent discharge rate.

·         Pharmacy was identified as a critical part of the discharge process. Delays were sometimes caused by medication queries or the preparation of take home medicines. Work was ongoing with pharmacy teams to improve both simple and complex elements of this process.

·         In response to questions submitted in advance, updates were provided on corridor care. A release to respond protocol had been implemented, with specific spaces identified to reduce corridor care. This included converting assessment areas, reopening spaces overnight, and  ...  view the full minutes text for item 177.

The Chief Medical Officer will provide a brief verbal update on the current position.

The Chief Medical Officer and the Chief Executive of the ICB gave a verbal update on the additional LOROS beds.

The ICB had undertaken work with LOROS Hospice to increase bed capacity. Currently, 4 beds had been made available for use, with this expected to increase to 6 shortly. The beds had been used to transfer end of life care patients out of LPT, thereby freeing up beds for other patients. Further work was being undertaken to explore whether capacity at LOROS could also be increased to support UHL patients.

Comments:

• Members commented on the number of beds available at LOROS and the potential to increase capacity. One Member advised that he had personally contacted LOROS and had been informed that an additional 10 beds were available and could be staffed. The Chief Medical Officer explained that the ICB had commissioned a formal contract with LOROS, which provided a more stable funding arrangement than the previous grant funding. It was further confirmed that the Chief Medical Officer and Chief Executive were due to meet with LOROS to discuss increasing capacity further.

• Members raised questions regarding the disparity in hospice funding between Northampton and LLR. It was stated that Northampton received between 60% and 70% of hospice funding from the ICB, whereas LLR received approximately 20%. Members questioned whether funding would be equalised under the new cluster arrangements. In response, the Chief Executive explained that this reflected the differing financial positions of the two systems. It was noted that LLR’s budget plan for the year was forecasting a £15 million deficit, whereas Northampton was projecting a surplus. It was acknowledged that the ICB was exploring ways to harmonise arrangements across both regions, although this would take time.

• Members expressed concern about how services would be equalised between LLR and Northampton and emphasised the need to recognise the distinct circumstances and experiences within Leicester.

AGREED:

The Commission noted the verbal update.

With there being no further business, the meeting closed at 7.40pm.