Agenda item

The Integrated Care Board submit a report to update the commission on how the LLR ICB want to create a service that’s easier to use, fairer for everyone, and makes the best use of NHS resources.

Leicester, Leicestershire and Rutland ICB Deputy Chief Operating Officer for Integration and Transformation presented the report.

The LLR ICB wanted to create a service that was easier to use, fairer for everyone, and made the best use of NHS resources. That meant:

­   A simpler system where people would only need to remember two main contact points: their GP practice and NHS 111

­   A consistent offer across the city, including evening and weekend GP appointments

­   Reducing unnecessary steps so people would spend less time navigating the system and more time getting the care they need

It was noted that:

·       The main focus moving into 2026/27 would be on meaningful engagement rather than lengthy discussions.

·       Access to care could be simplified into two steps. The first step encouraged residents to consider self-care options such as the NHS App, the NHS website, 111 online or local pharmacies before seeking appointments. The second step involved contacting GP practices or calling NHS 111 to ensure the right care was accessed in the right place.

·       It was highlighted that traditional literature was often ineffective as many residents did not read leaflets. Instead, investment had been made to commission VCSE organisations to deliver targeted engagement work. Surveys were planned across the city, county and Rutland, with the Leicester survey including questions on same day access appointments. Messaging would be targeted at specific groups including families with children under 10, young professionals, homeless people, refugees, and other groups facing barriers to healthcare.

·       The programme in Leicester was funded to provide practical support through VCSE groups, with materials such as business cards and reference guides designed to be accessible in community settings. The approach would focus on real-life options, self-care, and engagement by people already embedded in communities. Work was also underway with PCNs and local authorities to ensure consistent messaging. The same day access model was due to go live in October 2025.

·       Further detail was provided on the commissioning of approximately 20 VCSE organisations to deliver services. These groups represented the diversity of the city and had received training to tailor messages to their own communities. The emphasis was on teaching people to support others and raising awareness of what the NHS is, beyond hospitals, in multiple languages.

·       Outreach activity was being delivered across areas such as Belgrave, Spinney Hills and Braunstone, and through collaboration with GPs, pharmacies, community groups and local initiatives including sports clubs, gospel groups and neighbourhood hubs. Work was also taking place with LPT mental health neighbourhood leads to support access to NHS services, including mental health care.

·       Partnerships extended to Leicester City Council, housing, adult education and ESOL teams, with basic first aid training delivered jointly. Engagement also included universities, schools, wardens in halls of residence, supermarkets and shopping centres. Translation services were available to reduce language barriers.

·       Feedback was being gathered through community channels, with findings independently evaluated to ensure accurate reflection of community needs and experiences.

In response to member discussions, it was noted that:

·       It was confirmed that feedback from patients and clinicians had shown some required longer than the standard ten-minute appointment. Same day access would therefore include GP-led appointments, with PCNs linked across ten hubs. Pharmacy First had supported longer appointments, particularly in evenings and weekends. It was explained that same day appointments after 6pm would be with a GP if required.

·       Members queried the targeting of specific population groups and raised concerns about whether white men over 40, who are at high risk of suicide, and elderly residents were sufficiently included. It was explained that the targeted groups were identified from A&E attendances and reflected those most likely to face barriers to care, while the whole population would still be included. Elderly people and those with long-term conditions would move directly into step two of the model, with step one designed for generally healthy individuals. It was noted that suicide prevention work could also be incorporated.

·       Members highlighted that engagement of this kind could be very effective and asked what metrics would be used to measure success. It was explained that behaviour change took time, but metrics would include GP attendances and A&E activity. Success would be demonstrated by reductions in inappropriate A&E attendances, with the programme starting in September to provide early impact ahead of winter pressures.

·       Clarification was sought on the use of terms such as “GP led,” “GP access” and “GP appointments.” It was explained that general practice had changed significantly since 2017, with PCNs expanding the workforce to include advanced nurse practitioners, mental health practitioners and other professionals. Access would depend on patient need, with GP input provided for cases where other healthcare staff could not meet the requirement.

·       Members requested data on the overall number of GP appointments for 2024/25 and 2025/26. It was confirmed that historically hubs had been commissioned to provide same day appointments and that data would be brought to the next meeting, including the impact of longer GP-led appointments during evenings and weekends.

·       Members welcomed the focus on simplicity and online access. It was noted that national work was ongoing to ensure NHS sources appeared first in search results, with further community education to be provided.

·       It was confirmed that five-minute extensions to appointments would be treated separately from GP appointments. Patients contacting their practice during the day would be triaged and offered a same day evening appointment where necessary. Standard ten-minute appointments with other healthcare professionals would continue, with GP appointments available for those unable to wait. Training would include the importance of recording additional information.

·       Members asked when the changes would begin. It was confirmed that a questionnaire would be launched on 10 September with supporting engagement events, and changes to GP access in the city would commence on 1 October. Feedback would be collated and used to refine the model.

·       Members welcomed the increased promotion of the NHS App and asked whether doctors would use its features. It was confirmed that training was being provided to encourage this and that many patients were unaware of how to enable notifications.

Agreed:

1.    That the Commission note the report.

2.    That GP appointments would be an agenda item at the nest meeting.