Agenda and minutes

Apologies were received from:

-    Councillor Vi Dempster - Assistant City Mayor

-    Councillor Adam Clarke – Deputy City Mayor

-    Harsha Kotecha – Healthwatch Leicester

-    Andy Williams - Chief Executive, LLR Integrated Care Board

-    Susannah Ashton – Divisional Manager for LLR, East Midlands Ambulance NHS Trust

-    David Sissling - Independent Chair, Leicester, Leicestershire, and Rutland Integrated Care Board

- Richard Mitchell – Chief Executive, University Hospitals of Leicester NHS   Trust (UHL)

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

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

The Minutes of the previous meeting of the Board held on 29 June 2023 are attached and the Board is asked to confirm them as a correct record.

RESOLVED:

The Minutes of the previous meeting of the Board held on 29 June 2023 be confirmed as a correct record.

Dr Katherine Packham (Consultant in Public Health, Leicester City Council) will present a highlight report summarising key progress against actions to address the six priorities selected for initial focus outlined within the Joint Health, Care and Wellbeing Strategy, outlining proposed next steps, and highlighting any significant risks to the Board.

This update will cover a six-month period from February to July 2023.

Jo Atkinson (Consultant in Public Health, Leicester City Council) and Andrea Thorne (Public Health Project Manager, Leicester City Council) will present a report on the evaluation of the CURE programme, which is a tobacco dependency treatment service within acute, mental health and maternity hospital settings, since it’s implementation.

Jo Atkinson (Consultant in Public Health, Leicester City Council) and Andrea Thorne (Public Health Project manager, Leicester City Council) gave a slide-desk presentation, to accompany the document in the agenda pack, on the evaluation of the CURE programme since its implementation. The CURE programme was a tobacco dependency treatment service within Acute hospital settings, mental health inpatient settings (within LPT) and maternity hospital settings – but this evaluation was only about the Acute inpatient arm of the service delivered within University Hospitals of Leicester NHS Trust (UHL). It was noted that:

·         The service launched gradually due to the Covid-19 pandemic.

·         Thanks were noted to the small project team under Andrea Thorne, and to partners/leads in UHL, ICB and Leicestershire Partnership Trust (LPT).

·         Smoking was the leading cause of premature preventable deaths – and this programme was part of the NHS Long Term Plan to address that.

·         Smoking prevalence in Leicester adults was reported as 12.8% in 2021.

·         The NHS Long Term Plan had a target for all inpatients being offered support to stop smoking by 2023/4.

·         East Midlands Tobacco Alliance funding helped with the set-up costs for the first phase in Glenfield Hospital in April 2021. The Leicester Royal Hospital came on board in Summer 2022, and finally Leicester General Hospital in April 2023.

·         The pathway was described as:-

o   Admission to hospital

o   A Making Every Contact Count (MECC) assessment being completed by UHL staff.

o   A smoking status in the MECC assessment generates an automatic referral to the Tobacco Dependency Advisers (TDAs) within CURE.

o   A TDAs see the patient at their bedside and offers support.

o   Nicotine Replacement Therapy was prescribed.

o   On leaving the hospital the patient was offered continued support for a further 12+ weeks within the community Local Authority smoking cessation teams (City or County as appropriate).

·         The focus of the paper in the agenda pack was the evaluation conducted in collaboration with Dr Shilpa Sisodia (Public Health Registrar at the time of the project) using the RE-AIM methodology*.

·         *RE-AIM stood for Reach, Effectiveness, Adoption, Implementation and Maintenance.

·         REACH;

o   3615 clients were referred between October 2022 and February 2023. There was an average referral rate of 700-800 per month.

o   At the time of the evaluation 31% of the referrals were seen at bedside; this was low due to staff sickness at that time. By April 2023 this had improved to 40% and is currently sitting at 50%. 100% will never be achievable as the staff only work Monday to Friday 9am-5pm – but the team are aiming for 60%. The pilot in Glenfield Hospital achieved 73%.

o   53% of the clients were from Quintiles 1 and 2 – and this indicated the project was reaching the most deprived cohort.

·         Effectiveness;

o   65% of those supported maintained a quit at four weeks; this was higher than the community rates (55-60%) and may have been due to the personalised support by the TDAs.

o   75% received pharmacotherapy.

o   84% of those seen at bedside  ...  view the full minutes text for item 20.

Chris Burgin (Director of Housing, Leicester City Council) will present an update on the positive progress which has been made towards addressing the significant health and service challenges which are faced by complex tenants, and the development of a cross-agency working group, since bringing this issue to the Health and Wellbeing Board in January 2023.

Chris Burgin (Director of Housing, Leicester City Council) presented a slide-deck update on the progress which had been made towards addressing the significant health and service challenges which are faced by complex tenants since bringing this issue to the Health & Wellbeing Board in January 2023. It was noted that:

·         Previous presentation to the Board on 26.1.23 had resulted in the setting up of a Joint Agency Working Group. This has now met three times and Chris Burgin, as Chair, had been impressed by the collective intelligence and passion of the members.

·         The group used the Changing Futures platform to co-ordinate a system-change and embed the new practices. Each output of the Action Plan had a named lead.

·         When the group met initially there were some clients that were not known to all members – so a data trawl was undertaken to collect information to use to register the cohort through Changing Futures. This allowed these clients to be supported on an intensive basis.

·         Public Health had undertaken a Joint Service Needs Assessment (JSNA) which was almost completed; this will give added evidence and intelligence to enable further development of an Action Plan and strengthening of pathways.

·         Mark Pierce (ICB) had been heading an investigation into why outpatients do not attend appointments. 

·         Wayne Henderson at Inclusion Healthcare had been leading on the primary care aspects of the workstream.

·         It was envisaged that the JSNA will indicate the need for non-general housing – and may show that the 20,000 current Council homes are not suitable for certain people with complex needs. There was an appetite for mental health/drugs/alcohol support to be included as part of the housing offer to those tenants.

·         Public Health were leading on a piece of work to prevent people from becoming homeless via early prevention alongside partners.

·         The Board were thanked for setting this work in motion – and thanks were passed on to everyone who involved in the Working Groups.

Comments and questions from the Board:-

-       The Chair asked that some case studies be brought to the Board to better demonstrate the impact of this work on individuals and the system as a whole. One example had been an individual, who previously attended A&E twice a week, who was now registered with a GP and only attended the practice once a month.

-       Councillor Cutkelvin noted that the Housing service was required to become more agile when the pandemic struck – and at that same time there was a rise in single men entering the service. The service found that there were antisocial issues, however, when these men were moved on from the temporary accommodation.

-       Councillor Cutkelvin noted that she attended national forums where “Housing First” and “Psychological Informed Environments” were discussed.

-       Councillor Cutkelvin felt that Services should work to reduce barriers and encourage self-care – and this could include things such as dentistry and haircuts. She asked that all partners around the table input into agile wrap-around services to achieve this.

-  ...  view the full minutes text for item 21.

Kevin Allen-Khimani (Head of Operations and Services, Voluntary Action Leicester) will present an overview of the scope and remit of Healthwatch Leicester, which will include achievements over the last financial year and an outline of the priorities for the current year under the new contract with Voluntary Action LeicesterShire (VAL).

As Kevin Allen-Khimani and Harsha Kotecha had both sent apologies – this item was deferred.

Board members are asked to note that the numbers in tab 4 (Capacity and Demand) are amended from the version published in the Health and Wellbeing Board agenda for June 2023.

The amended document was noted by the Board (the Capacity & Demand figures in Tab 4 have been amended since the version published with the June 2023 Health & Wellbeing Board papers).

The Chair to invite questions from members of the public.

No questions from members of the public had been received.

To note that meetings have been arranged for the following dates in 2023/2024 which were submitted to the Annual Council in May 2023.  Please add these dates to your diaries.  Diary appointments will be sent to Board Members.

Thursday 23 November 2023 – 9.30am

Thursday 18 January 2024 – 9.30am

Thursday 22 February 2024 – 9.30am

Thursday 18 April 2024 – 9.30am

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.

The Board noted that future meetings of the Board would be held on the following dates:-

Thursday 23 November 2023 – 9.30am

Thursday 18 January 2024 – 9 30 am

Thursday 22 February 2024 – 9.30am

Thursday 18 April 20234– 9.30 am

Meetings of the Board were scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

There being no other business the meeting closed at 10.59 am.