Agenda item

This paper is a response to the request to update the H&WB about detection and management of Heart Disease in Leicester City. The paper provides brief overview of the profile of Cardiovascular Disease across LLR and  summarises some of the initiatives being delivered by the ICB's Long Term Conditions team, with the focus on CVD in Leicester City.

Jeremy Bennett (Senior Integration & Transformation Manager, LLR ICB) presented a paper as a response to the request to update the H&WB about detection and management of Heart Disease in Leicester City. The paper provides a brief overview of the profile of Cardiovascular Disease (CVD) across LLR and summarises some of the initiatives being delivered by the ICB's Long Term Conditions (LTC) team, with the focus on CVD in Leicester City.
It was noted that:

·                A Communications Plan is key to the work – to raise awareness and allow patients to be signposted (eg diabetics to retinopathy).

·                Case finding and early detection are key (eg hypertension and atrial fibrillation). The ICB’s LTC Team are supporting Primary Care Networks (PCNs) to identify cases. There is also a mobile van that now has space for blood pressure and pulse monitoring.

·                Secondary Prevention is key to LTC management – and there is redirection into other broader offers (eg Diabetes Services and Live Well).

·                As part of the hypertension work – 500 patients were identified and invited for an appointment.

·                Another example of the team’s work is that there were focus groups carried out with clients who failed to attend for Pulmonary Rehabilitation; the results of those focus groups showed a lack of understanding of their medical conditions.

Comments and questions from the Board:-

-        Members asked why the stroke map (from Item 5) does not follow expected patterns – and whether the fact that PCNs are not geographically aligned impacts on focussing on the groups most in need. The presenting officer noted that the PCNs have access to all information systems – and the ICB’s LTC Team support the practices to identify the correct patients. The COO of the ICB noted that, for the purposes of LTC management, practice level data is more useful than PCN level data.

-        The Chair asked whether there is consistency of referrals to Live Well - and would appreciate any mapping of those referrals by GP Practice and long term condition in order to optimise our prevention services. She also felt the feedback loop is useful to evidence impact.

-        The COO of the ICB noted that a joined-up plan, that is owned by the whole Board, would benefit the system. The Chair agreed, and felt this may be easier if a small piece of focussed work is chosen - that we all work on for a short time - and then show the difference that can be made when all agencies come together. Dr Prasad noted that this approach has worked well for GPs in the past (eg 10 years ago there was an atrial fibrillation drive, and then 1 year ago there was a collective focus on hypertension).

-        Dr Prasad noted that the system needs space to think about how deprivation affects a family rather then constantly firefighting. This can then help develop enthused patients who create demand. The Chair agreed that all organisations involved in anti-poverty work are experiencing this firefighting to ensure clients have gas/electric and a roof over their heads. The DPH agreed that it was the remit of the Board to recognise pressures and check that resources are allocated to those most in need (and not shirk away from withdrawing services from more affluent areas if necessary).

-        The Chair asked that the Board consider what health support we can add to help alleviate the cost-of-living pressures – whilst acknowledging this may not be quantifiable. This may be a case of allowing the space to have conversations with clients about accessing existing services rather than creating new ones.

-        The COO of the ICB warned about being driven by data – but instead urged members to use collective knowledge to address poverty and obesity to turn the tide of health issues in 10 years. An example of this is the three new hospital wards being built in the City.

-        In response to the above comments, the presenting officer agreed that active secondary prevention is about supporting patients to make beneficial choices.

-        The UHL representative noted that the Alcohol Liaison Team are an example of a cross-working team. He felt that every £1 invested in that kind of work releases £3 downstream.

-        The DPH noted that there will be two new methods to progress the prevention work in 2024/25. The first is that Public Health and Social Care will be systematically working with primary care (this has been ad-hoc in the past). The second is that there will be a new Prevention and Inequalities Group for the City – which will have members from ICB, PH, Social Care, UHL and Primary Care. Plans are being drawn up – and this group will focus on specific conditions in a robust, targeted way.

-        The Chair noted that many people only seek medical assistance when they are very ill – so anything we can do to encourage people to have their blood pressure or pulse taken could help early detection/diagnosis. Sports events have been used to reach people for these tests in the past – but could we now look to include the festivals/events programme in the City? Cllr Clarke noted that Star Diabetes already attend our festivals/events – but was happy for this to expand via the HWB.

RESOLVED:

That the Board thanked Officers for the report - and asked that comments from the Board be taken into account.