Agenda item

The Integrated Care Board submits a report to provide assurance regarding the plans in place to manage health system pressures across Leicester, Leicestershire and Rutland (LLR) over winter 2025/26.

The Chief Medical Officer introduced the item. It was noted that:

·       The winter plan was developed annually.

·       There were urgent emergency care challenges throughout the year, with increased challenges over winter, due to respiratory viruses and seasonal pressures.

The LLR ICB Head of Emergency Care gave an overview of the planning process and detailed the steps in place to ensure correct intervention levels were in established. Key points to note were as follows:

·       NHS England had adopted a different approach when asking ICB’s to develop their winter plans, with an increased emphasis on detail and mandated content.

·       All ICB’s develop Winter Plans, which were tailored to meet their particular area requirements.

·       Plans must include the Health and Care position on surge and super surge. (Suge being increased activity owing to flu, COVID or RSV and Super Surge pertaining to a combination of respiratory challenges.)

·       Workforce deficit planning was vital to allow for winter illness and infection outbreaks.

·       NHS England mandated planning timelines.

·       Regional stress testing events enabled further planning consideration.

·       The NHS currently developed its own plans. The LPT plan had been to board that week, while the UHL plan was scheduled at their board at the end of the week.

·       Engagement was ongoing with a variety of working groups.

·       The vaccination plan was a key focus for the upcoming winter, covering Covid 19, Flu & respiratory vaccines, targets were in place.

·       Key prioritised groups included pregnant women, young children, school age children, older adults, those with existing health issues and staff.

·       The approach consisted of two key components:

o   Ensuring accessible access to vaccination services.

o   Increasing awareness among key groups.

·       GPs surgeries would continue to provide the core offer, with community pharmacies also providing the service. Mobile vaccination units would be in place 3 days a week throughout the winter.

·       This year the vaccine offer would be extended to children aged two to three years.

·       A community sites pilot had been initiated to address the low vaccine uptake in pregnant women.

·       Every care home across LLR would be included in the vaccine programme.

·       Those discharged from Care Homes would be eligible for vaccination, through agreed arrangements with LPT and UHL acute providers.

·       The parental consent process was to be made more accessible to increase children’s vaccine uptake during the course of the school day. 

·       Vaccine awareness promotions would include national invites, GP recall, voluntary sector work with key groups and promotion of the vaccine hub website.

In response to comments from members, it was noted that:

·       Leicester childhood vaccine uptake was below half the national average. Improvement efforts were ongoing, particularly in identified concerning areas.

·       Engagement work included the school age immunisation link nurses.

·       Improvements to the childhood vaccine consent process would enable better liaison with parents. An HPV vaccine pilot had shown early evidence of improved consent rates.

·       The school age immunisation service provider was Leicestershire Partnership Trust.

·       Member support and promotion within the communities was welcomed.

·       The National Covid Fund enabled the vaccine buses. There had been a 69% funding reduction, and numbers of clinics would be halved. Targeted resourcing continued.

·       Funding of Super Vaccinators continued for areas with notably low uptake.

·       Services currently remained commissioned by NHS England, but it was hoped that when delegation occurred there could be more efficient use of funding.

·       There was a clear emphasis on working with local communities to raise vaccine awareness.

·       Vaccine uptake improvement targets included the:

o   5% improvement for staff Flu vaccine.

o   3% improvement for 2-3 year olds.

·       Childhood immunisation statistics could be shared which showed an improvement for the city.

·       Numbers would be shared on website traffic, success with vaccine site was noted and a QR code was available.

·       Funding for outreach services was designed for short-term purposes and it was not yet known how much would be allocated in the next financial period. There had been a 69% reduction in outreach funding, which was created in response to COVID. Bidding was in place to secure short term-funding.

·       The majority of the funding was long-term and in budget.

·       Historically health data had been analysed across LLR but was now more focused on local priorities.

·       Services remained stretched and risk of critical incidents remained, due to increased hospital admissions and primary care. Patient waiting times were still excessive and a hard winter could take a toll.

·       Community engagement was vital to mitigate public vaccination concerns.

·       A communications toolkit was distributed widely and could be issued to the committee.

·       Paediatric staff worked solely with children and children’s KPI’s were in place to enable priority.

·       Vaccinations didn’t always require a pre-booking and there was a roving health care unit.

·       Primary Care Networks received funding for enhanced access.

·       Injectable antibiotics could be administered by community teams and pharmacies to reduce the strain on GPs and hospitals. 

·       A range of consultation options were available and could be tailored to patient’s needs, these included telephone, online and AI contact.

·       Campaigns were in place to promote mental health support and signpost to help.

·       There were an increased number of dental appointments available. Dental practices self-managed triaging.

·       Winter planning had not reduced but there was a tougher financial environment. Funding from NHS England for Primary Care was less likely to be available this year. Resource management was a key focus.

·       New initiatives had come in to reduce ambulance waiting times.

·       There was a focus on access points for early intervention to ease the strain on hospital admissions.

·       There was not a freeze in place in hospital bank staff.

·       LLR had one of the highest utilisations of pharmacies and work was ongoing to meet with capacity. LLR had around 200 community pharmacies, around 100 of these were within Leicester. All but 2 of the Leicester pharmacies were signed up to the Pharmacy First Scheme.

·       There were around 88k planned Pharmacy First consultations with around 86k being delivered across LLR last year. Data showed a delivery of 8-10k for the first quarter of this year which was in line with targets.

AGREED:

1.    The Commission notes the report.

2.    Childhood immunisation statistics would be shared with the committee.

3.    Statistics on website traffic would be shared with the committee.

4.    The Communications Toolkit would be distributed to the committee.