Agenda and minutes

To issue a welcome to those present, and to confirm if there are any apologies for absence.

The Chair led on introductions and welcomed everyone to the meeting, No apologies were received.

Members will be asked to declare any interests they may have in the business to be discussed.

Councillor March declared that she had been involved in the Community Wellbeing Champions programme.

The minutes of the meeting of the Public Health & Health Integration Scrutiny Commission held on 29^th April 2025 have been circulated, and Members will be asked to confirm them as a correct record.

The minutes from the meeting on 29^th April 2025 were agreed as a correct record.

Members will be asked to note the membership of the Public Health and Health Integration Scrutiny Commission for 2025/26:

Councillor Pickering (Chair)

Councillor Agath (Vice Chair)

Councillor Clarke

Councillor March

Councillor Singh Johal

Councillor Westley

Councillor Haq

Councillor Sahu

The membership of the commission were confirmed as follows:

Councillor Pickering (Chair)

Councillor Agath (Vice Chair)

Councillor Clarke

Councillor Haq

Councillor March

Councillor Sahu

Councillor Singh Johal

Councillor Westley

Members are asked to note the commission meeting dates as follows:

·       Tuesday 8^th July 2025

·       Tuesday 9^th September 2025

·       Tuesday 4^th November 2025

·       Tuesday 27^th January 2026

·       Tuesday 24^th March 2026

·       Tuesday 28^th April 2026

The dates of the meeting of the Commission were confirmed as follows:

8 July 2025

9 September 2025

4 November 2025

27 January 2026

24 March 2026

28 April 2026

Members are asked to note the scrutiny terms of reference.

The Commission noted the Scrutiny Terms of Reference.

The Chair is invited to make any announcements as they see fit.

The Chair highlighted that scrutiny was an opportunity for members to work together to act as a critical friend and other’s views should be respected. The Chair emphasised that the Commission valued youth representatives’ participation and the insights they provided.

It was noted that papers were to be taken as read for the most effective use of time at the meetings.

Any questions, representations and statements of case submitted in accordance with the Council’s procedures will be reported.

It was noted that none had been received.

Any petitions received in accordance with Council procedures will be reported.

It was noted that none had been received.

The Director of Public Health, alongside key health partners, will deliver a presentation providing the Commission with an overview of local public health services and the wider health and care system, including current structures and areas of integration

The Director for Public Health, in agreement with the Chair, deferred this item for outside the meeting for the members who required an introduction.

The Director of Public Health will provide the Commission with a verbal update.

The Director for Public Health gave an overview and presentation of the latest position of health protection issues in Leicester including Bowel Cancer Screening, TB, Measles, COVID-19 AND a vaccination summary. It was noted that:

• The Director outlined the role of public health in outbreak control, screening and vaccination promotion, working alongside the ICB and NHS England.
• Health Protection relied heavily on partnership work and relationships. The three areas of health protection are:

1.    Communicable disease control

­   Outbreak control (e.g. measles, TB, diarrhoea)

­   Screening and immunisation

­   Infection prevention control

2.    Emergency preparedness and planning

3.    Environmental health

Annual work highlights

• Outbreak control

­   Bed bugs IMT

­   Bed bugs look back exercise

­   Community measles outbreak

­   TB

­   Scabies

­   Respiratory infections in care homes

• Infection prevention control

­   IPC audit of all care and nursing homes

­   Urinary tract infection quality improvement

­   NICE guideline development

­   Safe discharge guidelines

• Screening & immunisations

­   Cervical cancer elimination strategy

­   HPV school vaccination

­   Childhood immunisations

­   Community engagement

­   Evaluation of LIST project

• TB

­   HNA final draft

­   LLR TB strategy development

­   ICB business case

­   Information sessions to multiple community groups and GP practices

•  Monthly health protection CPD sessions for all staff.

• The importance of community infection prevention was highlighted, with a shared responsibility across systems, particularly in care home settings.
• Broader health protection work continued throughout the year, with a strong focus on pandemic preparedness, building on lessons learned from COVID-19. This included ongoing exercises to ensure systems are equipped for future public health emergencies.
• Environmental health and trading standards played a key role, particularly in relation to food safety and managing outbreaks. This included incidents such as bed bugs in care homes, measles, TB, flu, and COVID-19.
• Specific cases were highlighted, including one involving an individual with autism and recurring urinary tract infections, which contributed to wider work on infection reduction in care settings. This work aligned with NICE guidance and included efforts to improve care quality and discharge procedures.
• Screening responsibilities lie with the ICB and NHS, but public health continued to support efforts to improve uptake, particularly around HPV and childhood immunisations. There had been an increased focus on engaging with communities to build trust and confidence in vaccination programmes, both locally and nationally.
• An update was provided on TB, a health needs assessment and strategy were ongoing, with work focusing on identifying and supporting individuals with dormant TB. Leicester remained involved in the regional TB control group and the LLR TB strategy group, with efforts aimed at increasing visibility and consistency across the programme.
• Care home discharge notifications were also discussed, with the recent measles outbreak used as a positive example of effective partnership working. Nearly 600 MMR vaccinations were delivered during the outbreak, and no new measles cases had been reported since last summer. While MMR uptake had dipped in recent years, some recent improvement was noted.
• The HPV school vaccination programme continued, with visits to secondary  ...  view the full minutes text for item 143.

The Senior Communications & Public Affairs Lead for Communications and Engagement team at NHS Leicester, Leicestershire and Rutland submits a report on the NHS Transformation.

The Deputy Chief Operating Officer of Integration and Transformation and the Chief People Officer from the Integrated Care Board (ICB) presented the update. It was noted that:

·       Last year £150million had to be saved from the NHS budget, this was incredibly difficult but was achieved. This year it was expected that £190million needed to be saved.

·       These savings were expected to come from reducing the workforce in non-patient facing roles and reducing the use of agency and bank staff. Services were to be redesigned and recommissioned to remove any duplication, to maximise productivity and ensure value was being provided while promoting equitability.

·       A big area of cost identified was prescribing so medication was to be non-branded where possible.

·       These savings were a huge ask for the NHS.

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

• The ICB was to provide a paper for circulation on the savings to provide further details.
• The £190million savings were across the whole of the NHS – including the ICB, LPT and UHL. £74million of the savings were the responsibility of the ICB.
• Prescribing had cost £205million, it was hoped £17.9million would be saved from this through switches and optimisation.
• Lot of smaller chunks were to be saved, including the staffing costs at the ICB. £11million was to be saved from the system development fund by closing down and stopping pilots.
• Other savings were to be made by pathway redesigns to improve efficiency, but there was lots of work to be done to make them happen and risks needed to be considered.
• The pressure on budgets had significantly increased in the last 10 years.
• There was the possibility of underspends if there was good financial house keeping.
• Some services which were to be cut would not reach the threshold for public consultation so it was important that the voices around the table raised concerns.
• Saving £150million was incredibly hard and required a continued, concerted effort. It was public money though so there was a responsibility to ensure value for money.
• The team were unable to comment on national government announcements on NHS funding and service expansion as no details were known yet, but it could be that the extra funding was for a particular provision such as digital innovation.
• Members were concerned that Leicester was the worst city for GP rations, faced significant health inequalities and had poorer health outcomes and the impact of £190million cuts were going to have. The NHS was in a difficult position of meeting the needs of the population and improving health outcomes whilst balancing the books.
• The ICB reassured members that safeguarding was only going to move to provider level once there was confidence in the handover, there were statutory duties which the ICB had a legal duty to discharge.
• Further work was going to occur on the full implications of the cuts as well as an equality impact assessment.
• The Chair requested a more in-depth update be brought back to the Commission in September as the  ...  view the full minutes text for item 144.

The Director of Public Health submits a presentation on Oral Health.

The Director of Public Health submitted a presentation to update the commission on oral health in Leicester. It was noted that:

• Leicester had experienced persistently poor oral health outcomes across both children and adults. Over one in three children examined were found to have dental decay, and when enamel decay was included, the figure rose to over 42% of five-year-olds.
• These early signs of decay were particularly prevalent in the east of the city, which consistently showed the worst oral health outcomes.
• Aylestone was an outlier with much lower rates and required further investigation.
• Leicester reported the third highest oral cancer mortality rate in the country, highlighting the serious implications of poor oral health for the population.
• Analysis revealed that areas with water fluoridation and comparable deprivation levels had significantly lower rates of dental decay.
• Emergency tooth extractions were notably higher among children in the east of the city, suggesting that many were not accessing care until urgent intervention was needed.
• A new enamel decay indicator had been introduced to identify early warning signs before decay progressed further. Four in ten children aged five showed signs of enamel decay, and these were less prevalent in fluoridated areas, indicating the potential of water fluoridation as a preventative measure.
• Public health actions focused on leading the Oral Health Promotion Partnership Board to drive improvements and reduce inequalities.
• A formal request was submitted to the Secretary of State to consider water fluoridation across Leicester, Leicestershire and Rutland.
• Broader health improvement initiatives were promoted through the Live Well service, covering key areas such as diet, smoking including smokeless tobacco and E-Cigarettes, alcohol and physical activity.
• National campaigns like Fizz Free February, National Smile Month and Mouth Cancer Action Month were supported, alongside the distribution of oral health resources for people of all ages.
• A major focus was placed on the supervised toothbrushing (STB) programme for children. This evidence-based initiative was offered to early years settings and primary schools across the city and had contributed to significant improvements in oral health before the pandemic.
• However, the programme was paused due to COVID-19, and while it had since resumed, uptake had not yet returned to pre-pandemic levels. As of quarter three in 2024/25, uptake reached 45% in early years settings, 13% in primary schools and 33% in SEND schools. In total, over 4,000 children were participating in daily toothbrushing activities within their education settings.
• Efforts were made to increase programme participation, particularly in priority areas, by reallocating and recruiting staff, developing mentoring schemes and enhancing educational resources.
• Surveys highlighted common barriers such as limited time in the day, implementation challenges and uncertainty over whether schools or parents were responsible. A community-based approach was being developed to address these issues and promote shared ownership.
• Leicester received £119,088 in additional funding from central government to support the rollout of supervised toothbrushing in the most deprived communities. A collaboration with Colgate-Palmolive provided thousands of toothbrushes and tubes of toothpaste to be distributed to children. The funding enabled staffing and  ...  view the full minutes text for item 145.

The Integrated Care Board (ICB) will provide the commission with an overview of same day access.

The Urgent and Emergency Care System Clinical Director for LLR and the Deputy Chief Operating Officer of Integration and Transformation, the Engagement and Insight Manager and the Senior Engagement and Insights Lead from the ICB presented the item. As part of the presentation, it was noted that:

• There was lots of work across services to improve access, whether this was GP practises, urgent treatment centres, pharmacies or the Emergency Department (ED).
• The number of patients who presented at ED was growing 4-7% each year which had increased the pressures on the NHS and pathways for access.
• There were peaks in the demand such as winter or heat waves but a large proportion of the patients required care that was not an ED issue and was more suitable for presentation elsewhere.
• Patient presentation at the wrong place was not just an ED issues, it was seen across all primary care areas. It was ultimately down to patient choice but this was putting a lot of onus on the patient, and where they presented may be out of their control. All areas were needed to address this challenge.
• Despite the ongoing funding challenges that faced the service, extra capacity was being provided. This included 100 extra urgent centre appointments per day and an expansion of Pharmacy First appointments.
• When a patient presented at ED, they were offered an appointment at another premises that was more suitable. This was to prevent overcrowding in ED. It also reduced risks to patients who came into the ED with time critical illnesses.
• There had been work with health partners and wider partners within the community to understand how to direct patients and to right size services, to ensure access was available where it needed to be. This had been hindered by historical arrangements and old contracts. There were 3 hubs in the city which were a suitable solution historically but Pharmacy First and other new arrangements provided more suitable access. These services were put into place as a safety net while the future was considered.
• A clinical audit was planned to assess use and the needs of the patients.
• Engagement was occurring with communities on how services would best be accessed. The feedback was to be reviewed and themes identified. There had been previous work with communities, the Local Authority and Adult Education Service on keeping people out of ED which had been very successful.
• There was to be a focus on promoting and educating NHS 111 services, Pharmacy First, self-care and translation services. Through partnership working with GP’s and PCN’s there was going to be interactive sessions and practical workshops that would be facilitated by communities.
• It was important to work differently with different audiences.
• There was funded engagement aimed at those who lived on the main route into the city, families with babies and young children under the age of 10, people within the age categories of 21-30 and 31-40, homeless, asylum seekers and refugees, Eastern European, Black, Asian and Minority Ethnic Communities and  ...  view the full minutes text for item 146.

The Director of Public Health submits a report to give an overview of workstreams and initiatives currently underway across the Community Engagement and Wellbeing Champions (CWC) project.

The Director of Public Health submitted a report on the Community Wellbeing Champions Project and network. This project was created to bring community organisations and trusted community figures together with Public Health and other partners to share insight on health needs, barriers, and enablers for the residents of Leicester, reach communities with key messages and services, and collaborate on addressing health and wellbeing priorities for the city. It was noted that:

• A community engagement programme was implemented in 2021 in response to concerns about non-compliance with COVID-19 regulations and low vaccination rates.
• The aim was to better understand the barriers faced by communities, respond to their needs, and provide more effective access to information, support and services.
• The engagement work successfully helped to increase vaccine confidence and ensure that key public health messages reached communities. Building on that success, the intention was to continue the programme beyond the pandemic, recognising the strong relationships that had developed with community groups and the genuine care partners had shown for the people they worked with.
• A key strength of the programme was its commitment to open, honest and trusted dialogue with voluntary, community and social enterprise (VCSE) organisations.
• As of 2025, the network included 298 members, a slight decrease from previous years following the introduction of a new sign-up process in February 2025.
• This process was designed to promote more consistent working, strengthen collaboration, and improve the quality of data and network profiling. Feedback from organisations that had left the network was also gathered to inform ongoing improvements.
• Communication was maintained through a weekly email bulletin, which typically shared 10 to 12 items of interest from public health, Leicester City Council, and other network members.
• A monthly online forum had also been established in October 2022 in response to member requests for a regular space to connect and learn from each other. This was valued highly by participants and complemented by attendance at wider health and wellbeing conferences, where opportunities were taken to build relationships and align work with city-wide priorities.
• The programme also supported the delivery of community engagement grants, enabling VCSE organisations to carry out activities that improved health outcomes for local residents.
• In total, 32 organisations were funded after committing to open their doors and run sessions for their communities. An evaluation of this work was underway. A pilot internship project had also emerged from the network’s forum, providing a route for passionate individuals to learn more about public health and contribute to projects. Three paid internships were offered to volunteers and staff from member organisations, each lasting four months and involving 15 hours of work per week.
• Throughout, the programme promoted an inclusive community engagement approach based on equal participation and mutual respect. Efforts were being made to enhance engagement with underrepresented groups, ensuring that lived experiences continued to inform and shape all areas of activity.

In response to comments and questions, it was noted that:

·       It was noted that some relationships had been developed with social prescribers across  ...  view the full minutes text for item 147.

Members will be asked to note the work programme and consider any future items for inclusion.

NHS dental access was to be added to the work programme. It was highlighted that the minutes from Joint Health Scrutiny were available online if anyone wished to view them.

It was raised that a letter to the Secretary of State was recommended to consider concern son current GP access and levels of patients at full council on 16^th January 2025. This was not actioned immediately, but the letter had since been sent.

There being no further business, the meeting was closed at 20.36.