Agenda and minutes

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

The Chair led on introductions and welcomed everyone to the meeting.

Apologies were received from Cllr Singh Johal and Cllr Westley. Cllr Singh Patel was present as substitute.

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

There were no declarations of interest.

The minutes of the meeting of the Public Health and Health Integration Scrutiny Commission held on 24^th March 2026 have been circulated, and Members will be asked to confirm them as a correct record.

AGREED:

The minutes of the previous meeting held on 24^th March 2026 were confirmed as a correct record.

The Chair is invited to make any announcements as they see fit.

The Chair announced that the Care Quality Commission (CQC) had published a report on Leicestershire Partnership NHS Trust’s mental health crisis services and health-based places of safety, rating them as ‘Good’ following an inspection in May 2025.

Any questions, representations and statements of case submitted in accordance with the Council’s procedures will be reported.

It was confirmed than none had been received.

Any petitions received in accordance with Council procedures will be reported.

It was confirmed than none had been received.

The Director of Public Health will provide the Commission with a verbal update.

The Director of Public Health provided the Commission with a verbal update. Slides were presented as attached.  Additional points to note were as follows:

·       Public Investment Funds funded voluntary schemes for screening and vaccination.  This could be brought back to scrutiny.

·       There had been no meningitis outbreaks seen in Leicester since the last update.

·       Healthy Life Expectancy (the number of years an individual can expect to live in good health) was declining.  It was unusual to see such a decline. 

·       Flu was at low levels, but vaccination rates in Leicester were lower than the national rate.  It was hoped that improvement may be seen once more up-to-date statistics were released.  It was a similar pattern for Covid.

·       There had been no change on TB since the last update.

·       There had been no new cases of Measles, but more vaccinations were needed to reach the herd-immunity rate of 95% uptake.  The uptake was higher in the early years and then dropped off after five years old, this was used as a rationale to administer the second dose after 18 months.

·       Statistics were presented on Childhood Immunisation in the period 2022-24 as outlined on the slide.  It was noted that whilst this was lower than hoped, each level had increased slightly.

·       There was an evidence base for the HPV vaccine in reducing cervical cancer and it was hoped that with a higher vaccination rate the beginning of the elimination of cervical cancer could start to be seen.

In response to member questions and discussions, the following was noted:

·       With regard to healthy life expectancy, poor health was defined as people declaring that they had chronic conditions or illness that affected quality of life.  As to whether or not this was a measure of good preventative healthcare, it was noted that awareness could make a difference, but more of a factor was whether or not people had a chronic condition or illness.  There had been significant disinvestment in public health and Local Authority Services from 2013, so this would affect people in poverty and deprivation more than others

AGREED:

1.     That the update be noted.

2.     That comments made by members of this commission to be taken into account.

The University Hospitals Leicester (UHL) to give an update on Rheumatology Services in Leicester.  

The University Hospitals Leicester (UHL) Provided a verbal presentation into Rheumatology Services across Leicester. The following was noted:

·       An apology was provided on behalf of UHL for the late submission of the report, with paper copies circulated at the meeting. It was noted that this was not common practice and that learning had been taken from the issue.

·       The service overview highlighted that Rheumatology covered more complex conditions such as rheumatoid arthritis and lupus, requiring ongoing care rather than discharge.

·       Services were delivered across Leicester Royal Infirmary and Leicester General Hospital, with 12 consultants and specialist nurses supporting adult and paediatric clinics, treatment and follow up care. This included DMARDs, biologics, physiotherapy, pain management, an advice line and joint procedures.

·       Activity levels had increased significantly, with 2,670 referrals in 2025 to 2026, representing a 34% rise. This was linked to chronic conditions and an ageing population.

·       Around 17,000 follow up appointments had been delivered. The DNA rate was 3.2%, which was in line with the national average.

·       Performance against the 18 week referral to treatment standard remained challenged due to increased demand, with 42% of patients treated within 18 weeks.

·       It was noted that longer waits were influenced by the prioritisation of urgent cohorts, particularly within early inflammatory arthritis pathways.

·       The early inflammatory arthritis clinic was highlighted as a key area of strong performance, with earlier treatment leading to improved patient outcomes and remission rates. Performance had improved from around 50% to 56% 3 years ago to 96% of patients now treated within 6 weeks with a DMARD, making the service one of the best performing nationally.

·       The British Society for Rheumatology was undertaking a case study on the service due to its high performance, which exceeded other trusts both regionally and nationally.

·       It was noted that the service had previously been a poor performer but had significantly improved by 2025 to 2026.

·       Work was taking place to support referral to treatment recovery included moving towards a single point of access model to provide early guidance and reduce demand on the service.

·       Increased use of patient initiated follow up had been introduced, enabling patients to re access the service when required.

·       A need to expand the clinical workforce was identified, with a business case being developed to secure additional funding.

In discussion with Members the following was noted:

·       Concern was raised regarding risks to patients alongside a 20% year on year increase in referrals, with continued growth expected. It was queried whether moving towards advice and guidance models could create additional risks by delaying early intervention, and what the current position and capacity was for 2026 to 2027. It was explained that demand had increased significantly, with a historic backlog and capacity pressures, although earlier diagnosis had improved from around 10 years to 2 years for some conditions, particularly inflammatory arthritis.

·       Referral to treatment performance had remained largely static over the past 2 years, with ongoing challenges in managing both new and long term patients. It was explained that many  ...  view the full minutes text for item 33.

The Director of Public Health, Leicester City Council and Dr Suzi Armitage, LLR Designated Doctor for Child Deaths, Leicestershire Partnership Trust will outline the work of the Child Death Overview Panel (CDOP) and present the findings of the CDOP annual report to the Commission.

Due to the similarity in the items, the LLR Child Death Overview Panel Annual Report and the report on Reducing Infant Mortality were taken together.

The Director of Public Health, Leicester City Council and the LLR Designated Doctor for Child Deaths, Leicestershire Partnership Trust outlined the work of the Child Death Overview Panel (CDOP) and presented the findings of the CDOP annual report to the Commission.

Slides were presented as attached with the agenda pack.  Additional key points to note were as follows:

·       This was a very challenging area, but the team supported families.

·       A report had been produced to collate the narratives and to prevent future deaths.

·       The data was based on child deaths notified to the service.

·       A key issue was support for the family.  The team acted as a key worker for families.  Families were supported to participate in the review process and feedback.

·       Once a child dies, there was a period of decision making.  Following this there was an investigation and information gathering.  This could take the form of anything form a criminal investigation to a post-mortem.  Once this was concluded, staff were brought in for review and analysis was begun to look at what may have contributed to the death in order to capture learning.  This was reviewed at a panel for final independent scrutiny.

·       All data went into the national database.

·       Infant mortality in Leicester was higher than in England and in the county of Leicestershire.  Work was being undertaken to understand what was driving this.

·       In terms of wider context, it was key to note that deprivation was strongly associated with child mortality.  Babies in the most deprived fifth percentile of the population had twice the deathrate of the least deprived.

·       The first dataset reviewed were the notifications as there was a statutory duty to notify of a death.  There had been 92 notifications in total, a quarter of which required a joint-agency response.

·       Over half of notifications were death after birth, but while the baby was still in hospital.  Many of these were pre-viable gestation.

·       20% died at home.  Some of these had died suddenly, but others had planned end-of-life care.

·       Prolonged information gathering could cause reviews to take a long time to complete.  The majority of cases were complete within 12-18 months.

·       Nationally, most deaths were perinatal or neonatal, the second biggest category were chromosome or congenital anomalies and the third were malignancy or unexplained issues.

·       Contributory factors were factors that could have contributed to the death, often in terms of family, social and environmental factors, and social services received.  A modifiable factor was a factor that, if it had been different, might have led to a different outcome.

·       Early warning scores could help to catch risks early but did not always work.

·       When safety mechanisms needed to interact but worked in different systems, this could be a risk.

·       Information gathering was carried out, and interpretations were made before a decision was made.  Therefore, it was necessary to have access to  ...  view the full minutes text for item 34.

The Acting Consultant in Public Health submits a report to update the Commission on the Infant Mortality Rate in Leicester.

Due to the similarity of the items, the LLR Child Death Overview Panel Annual Report and the report on Reducing Infant Mortality were taken together. The discussion and minutes are recorded under the previous agenda item.

Members of the Commission will be asked to consider the work programme and make suggestions for additional items as it considers necessary.

The Chair reminded Members that any suggested items for inclusion in the work programme should be shared with the Chair and the Senior Governance Officer.

 It was suggested that a item would be added to the work programme for GP Health Referrals for Children.

With there being no further business, the meeting closed at 8:11pm.