Agenda item

Update of the delivery plan discussing strategy progress. 

Diana Humphries (Programme Manager – Health & Wellbeing Board, Public Health, LCC) presented slides to update members on the delivery plan and strategy progress. A copy of the slides was included in the agenda pack.

“Do”, “Sponsor” and “Watch” have been allocated to each of the 19 priorities in the Health & Wellbeing Strategy. Each theme area was presented in turn as below, but with a focus on the “Do” priorities:-

Theme A: Healthy Places

The main priority has been to “improve access to primary and community health and care services” in two main ways:-

a)    Develop integrated neighbourhood teams:-

·         The 10 City Primary Care Networks (PCNs) identified 5 Priorities that have been delivered throughout 2023/24 (Bowel Cancer Screening, Weight Management, Hypertension, Integrated Chronic Kidney Disease and Women’s Health). This has been achieved through work including:-

o   The “Joy” app

o   Care Navigators

o   Social Prescribing

o   Direct Enhanced Service

·         The next steps are:-

o   Sharing of best practice. 

o   Enable PCNs to co-design plans

o   Support PCNs to progress in their Maturity Matrix

b)    Deliver the Enhanced Access Service in Primary Care

·         This has been delivered across Leicester City from October 2022 and has seen a rise in the number of more accessible appointments.

·         The next step is to publish the PCN Direct Enhanced Access guidance/specification for delivery from April 2024.

Theme B: Healthy Start

The main priority has been to mitigate against the impacts of poverty on children and young people. This has been tackled in two main ways:-

a)    Peer Support Programme

·         This is underway, but there remains a risk of not recruiting enough peer supporters with the appropriate lived experience.The next step is around linking with existing voluntary sector programmes who already have volunteers with lived experience.

b)    Family Hubs

·         5 Family Hubs early adopter sites are in place.

·         Cllr Russell noted that there is Government Funding to develop these Hubs in the City – but it is only for two years and has 182 criteria attached (put in place by the Department for Education). Leicestershire County received less funding but without specific criteria attached to it. Cllr Russell would be happy for an update on Family Hubs to be brought to a future HWB Board meeting.

Theme C: Healthy Lives

The main priority has been to increase early detection of heart & lung diseases and cancer in adults. This has been tackled in two main ways:-

a)    Hypertension Optimisation

·         The ICB reviewed the data to January 2024 and identified the 20 GP practices with the lowest rates. These practices are likely to have low optimisation of blood pressure (which was explained by Dr Packham in the meeting).

·         The next steps are around targeting (using data), sharing best practice and promoting consistency.

b)    The Faecal Immunochemical Test (FIT) Test Pilot

·         This pilot has generated positive feedback and good results (although there is a risk that cumulative data can be misleading).

·         The next step is to review the pilot and extend if it has evaluated well.

·         Cllr Russell noted that this pilot is specific to lower gastrointestinal issues – but is included in this section of the Strategy as it connects to early detection of bowel cancer.

Theme D: Healthy Minds

The two main priorities have been to:- i) improve access for children & young people to Mental Health & emotional wellbeing services, and ii) improve access to primary & neighbourhood level Mental Health services for adults. This has been tackled in four main ways:-

a)    Mental Health Support Teams (MHSTs)

·         There will be 11 Leicester/Leicestershire/Rutland MHSTs (6 in the city) by the end of this academic term. Access to these is noted as a risk.

·         7,700 young people will have been reached through workshops, and data from that will be used to inform future work.

·         Cllr Cutkelvin asked if it was clear whether the MHSTs were targeting young people with low, medium or high mental health needs. The Presenting Officer responded that the MHST offer includes low-level offers (eg school assemblies) up to higher-level offers by way of one-to-one sessions. The Chair noted that a list, of who leads on each part of the mental health offer to young people, would be useful for the Board.

·         Members were keen to know how many children are resident in the City – and what percentage of these are covered by the MHSTs; the presenting officer will find out the answers.

·         Members were also keen to understand whether the MHSTs cover all schools or just Local Authority ones. The Chair responded that it is all schools – but the service is still being built and so coverage is currently  in “pockets”.

·         The Member representing UHL asked that any system conversation about mental health also include consideration of the home environment and support for parents.

b)     City Early Intervention Psychological Support (CEIPS)

·         250 children have been supported on this intervention at the time of the meeting. The contract for this has been extended to March 2025.

·         As this relates to an offer in the “middle-level” range of mental health support (and prior to CAMHS) this should be part of the discussion within the aforementioned future Board item.

c)     Awareness Raising Roadshow

·         This roaming roadshow has spoken with 327 people across 13 events. It has also reached hundreds of employees at Walkers, Tesco and other City businesses.

·         The next step will be to roll out “stands” in community spaces as part of the roadshow’s extension. Members felt parental support should be included in the extension plans.

d)    The '3 Conversation' Project

·         Reablement workers are based in Saffron and Eyres Monsell – with more sites coming on board.

·         The next step is to establish the programme (which is running until March 2025).

Theme E: Healthy Ageing

The main priority has been to “enable Leicester’s residents to age comfortably and confidently through a person-centred programme to support self-care, build on strengths and reduce frailty”. This has been tackled by the Discharge to Assess Project:-

·         401 people benefited from this service in its first 3 months (Nov 1^st 23 to Jan 31^st 24) - with 58% becoming fully independent with no ongoing care needs.

·         The next step is to support the high dependency cohort and reduce the risk of double-handed care by 1.6.24.

Comments and questions from the Board:-

The majority of the questions had been raised throughout the presentation – but the following were also noted:-

·        The 19 priorities in the Strategy had been agreed by the Board – but the Member representing the Strategic Sports Alliance asked whether these have Key Performance Indicators attached to them. He acknowledged impact will be difficult to measure – particularly the mental health related priorities – but without KPIs it is difficult to assess efficiencies and cost effectiveness. Dr Packham responded that, over the next four months, the priorities will be reviewed to check they are still current and whether more/fewer are required (eg should childhood immunisations or oral health be added) – and some targets will be developed as part of that process. The Chair noted that a development session would be useful to undertake this review.

RESOLVED:

·        That the Board thanked the Presenting Officer for the presentation and asked them to take Members comments into account.

·         That the Presenting Officer note The Chairs wish for an update on Family Hubs to be brought to a future meeting.

·         That the Presenting Officer noted The Chair’s wish, for future reporting to the Board, that evaluation on the impact of the FIT pilot to be related specifically to its links to the early detection of bowel cancer.

·         That the Presenting Officer will link Cllr Cutkelvin up with the Project Manager in charge of the MHST Service.

·         That the Presenting Officer will organise a future Board agenda item around “Mental Health for children and young people”. All the comments made during this meeting will be incorporated into the planning for this item (ie inviting the Project Manager, having a focus on the middle-level offer, considering the support for parents and including a list of who leads on each part of the mental health offer to young people).

·         That the Presenting Officer will find out how many children are in the City and what percentage of those are covered by the current MHSTs.

·         That the Presenting Officer will share, with Rob Melling at LPT, the comments about adding parental support to the extension plans for the mental health roadshows.

That the Presenting Officer will set up a Board Development Session to review the 19 HWB priorities and ensure they are the correct ones to focus on for the next 12-24 months. This will include discussions of any current issues or additional funding pots. Key Performance Indicators will be developed as part of this review.