Agenda and minutes

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

Apologies were received from Cllr Clarke and Cllr Westley.

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

The Chair asked members to declare any interests in proceedings for which there were none.

The minutes of the meeting of Public Health and Health Integration held on the 9^th September 2025 and 4^th November 2025 have been circulated, and Members will be asked to confirm them as a correct record.

The Chair highlighted that the minutes from the meetings held on 9^th September 2025 and 4^th November 2025 were included in the agenda pack and asked Members to confirm whether they were an accurate record.  
 
AGREED:

It was agreed that the minutes for the meeting on 9^th September 2025 and 4^th November 2025 were a correct record. 

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

The Chair announced that an additional LLR Joint Health Scrutiny was being scheduled for April.

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

It was noted that none were received.

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

It was noted that none were received.

The Director of Finance submits a report setting out the City Mayor’s proposed Draft General Fund Revenue Budget for 2026/27.

The Director of Finance submitted a report to the Commission to present the City Mayor’s strategy for balancing the budget for the next 3 years and to seek approval to the actual budget for 2026/27.

The Head of Finance, Education and Social care presented the report. The following was noted:

·       The Draft General Fund Revenue Budget set out the budget for 2026/27 and the medium term financial strategy for the following 2 years. It was based on the government’s Fair Funding consultation which ran over the summer. While the results were awaited, a forecast budget gap remained. As a result, the 5 strand strategy from the previous year would continue as follows:

­   To deliver budget savings

­   Constrain growth in areas such as Social Care and homelessness

­   A reduction in the Capital Programme

­   Releasing one off monies

­   A programme of property sales

·       The budget built in growth to meet ongoing costs in Social Care, homelessness and housing benefits. The scope for additional investment was limited but provision was made, particularly where services had previously been funded through grants which were no longer received.

In discussions with Members, the following was noted:

·       Members stated that it was difficult to scrutinise the budget without clarity on how the additional £5m would be spent and asked for greater transparency ahead of Budget Council in February. It was acknowledged that confirmation of the Public Health Grant was still awaited, however members requested sufficient detail to allow questions to be addressed in advance.

·       Officers advised members not to assume that the additional funding represented new money. It was explained that in recent years funding had been received through several separate streams, including the core Public Health Grant, additional funding for substance misuse and alcohol services, and further funding that was ringfenced for specific purposes such as increasing access to treatment. In addition, in the previous year, and potentially the year before, additional funding had been received for stop smoking services as part of the government’s smoke free generation initiative.

·       It was further explained that these funding streams had now been amalgamated into a single allocation. As a result, the grant appeared to increase from approximately £32m to £37m, however this did not represent a real increase in funding. It was stated that the actual uplift was likely only sufficient to cover inflationary costs and that there was no additional new money. Officers confirmed that, notwithstanding this, the total Public Health budget for the year was approximately £37m and that a breakdown of planned spend could be provided to members.

·       Members raised questions about whether funding had been lost through ICB investment and whether any reductions were expected in the current year. In response, it was explained that this did not represent a direct reduction in funding but related to the way services were delivered. Challenges were highlighted around running costs and the impact on staffing availability, particularly in relation to vaccination programmes and outbreak response, and it was noted that additional  ...  view the full minutes text for item 7.

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

The Director of Public Health gave a verbal presentation of the latest position of health protection. It was noted that:

·       It was reported that a key highlight was the work undertaken to increase MMR uptake in the city, which was beginning to show positive results. A range of engagement activity had taken place within communities, including work with faith groups and the deployment of the roving vaccination unit. As a result, 81.2 percent of 5 year olds had received the MMR vaccine, which was higher than comparable cities. However, it was emphasised that 95 percent coverage was required to achieve herd immunity and further work was needed.

·       It was noted that influenza had arrived early but had not escalated to the level initially feared, and rates were now decreasing. Vaccine rollout remained key to controlling flu rates, although overall uptake was lower than required. Additional targeted work was ongoing to improve vaccination rates amongst priority groups.

·       Covid rates in the city were reported as remaining steady. Although occasional peaks had occurred, they had not reached the levels seen in previous years. New variants had emerged which were not covered by earlier vaccines, making updated vaccine uptake important. Covid vaccination rates remained below target, with a significant disparity between uptake in the city and the county. This difference was highlighted as a continuing health inequalities issue.

·       Leicester was reported as having the highest tuberculosis rates in the country.

·       It was confirmed that there had been no new cases of measles. However, vaccination rates remained below target and cases in Birmingham were noted, meaning the situation continued to be monitored closely.

In discussion with Members, the following was noted:

·       Members raised concerns regarding the proposed merger of LLR with Northamptonshire to create a new NHS cluster and queried the potential impact on vaccine resources and focus on the city. It was confirmed that resources would continue to be directed to areas experiencing the greatest health inequalities. The work of Public Health outreach teams, particularly engagement with faith groups, was commended, and it was noted that public confidence and appetite for vaccines remained an important factor.

·       Members queried whether the current increase in tuberculosis cases represented a true surge or was linked to increased screening activity. It was explained that the city was experiencing a genuine increase in active TB cases, partly reflecting patterns of travel and migration from high prevalence countries. It was clarified that the figures presented related to active TB cases only and did not include latent cases referenced during the presentation.

·       Concern was expressed regarding low vaccination rates in the city, particularly the Covid vaccination rate of 23.1 percent compared to 50.9 percent in the county. Members stressed the need for appropriate resourcing and funding to address Leicester’s position at the lower end of national uptake tables. In response to questions regarding additional funding, it was explained that community engagement work was resource intensive. It was further noted that substantial work was already underway, although behavioural factors and public  ...  view the full minutes text for item 8.

The Director of Public Health submits a report to update the commission on the Prevention and Health Inequalities Steering group.

The Director of Public Health submitted a report to update the Commission on the Prevention and Health Inequalities Steering group which was established in June 2024. The following was noted:

·       The Leicester City Prevention and Health Inequalities Steering Group was a strategic group that provides direction and alignment on prevention priorities to address health inequalities in Leicester.

·       A strategic group had been established which reported to the Leicester Health and Wellbeing Board and operated as a formal subgroup of the Board.

·       In June 2024, the Director of Public Health established a new initiative in Leicester to address health inequalities with urgency and focus.

·       It was explained that a wide range of stakeholders had been involved in selecting 5 priority topics. The group had considered the contributors to health inequalities and reviewed supporting evidence.

·       The group decided on the following five priorities for the next 18 months:

­   Hypertension (High Blood Pressure) case finding

­   Healthy weight (neighbourhood focus)

­   HPV (Human Papillomavirus) vaccine uptake

­   Social isolation in people with severe mental illness

­   Bowel cancer screening uptake

·       The approach had been designed using an incident management model, similar to the measles response, and this methodology was now being applied to the prevention of long term conditions, tackling health inequalities and improving outcomes for local communities.

·       Hypertension had been identified as a priority, with work including the use of a roving health unit and encouraging follow up activity.

·       Targeted work on healthy weight had also been undertaken.

·       A focus on HPV had included engagement with secondary schools in the city, with HPV vaccinations delivered via the roving unit.

·       Social isolation amongst people with severe mental health needs had been identified, particularly noting that there was currently no clear pathway for homeless people. A bowel cancer pathway for this cohort was due to be launched in the spring.

·       Data analysis was being reviewed and refined, with a final version expected in March.

·       It was noted that the programme would continue to meet quarterly and would identify priorities for the next 18 months.

In discussions with Members, the following was noted:

·       Members requested further detail in March on early indications, ongoing priorities and what investment was being made, and sought clarification on whether the current priority strands would continue beyond the initial phase. It was advised that data analysis was being finalised and would provide greater clarity on impact and next steps, and that the programme would continue to review priorities over the next 18 months in line with emerging evidence and need.

·       It was commented that the evaluation approach was thorough and innovative, drawing on outbreak management principles and applying them to long term conditions. In response, it was explained that the programme was intentionally data and intelligence driven, starting with an understanding of the contributors to inequalities and impacts on life expectancy, before identifying evidence based interventions. The approach focused on proactively reaching communities and delivering practical short and medium term actions, although it was acknowledged that some areas, such  ...  view the full minutes text for item 9.

The Director of Public Health submits a report to update the Commission on cost of living projects being managed by the Health in All Policies (HIAP) team.

The Director of Public Health submitted a report to update the Commission on Cost of Living, Food Poverty and Fuel Poverty. The Project Manager for Public Health presented the item, the following was noted:

·       It was highlighted that poverty was strongly linked to poor health. People living in deprived communities were more likely to have lower life expectancy, spend fewer years in good health and experience greater barriers in accessing healthcare, contributing to both physical and mental health conditions.

·       Low income made it difficult for residents to afford essentials including food, heating and hygiene products.

·       A 2 year Fuel Poverty programme concluded in 2024. The programme raised awareness of fuel poverty issues and worked closely with National Energy Action. Although the formal programme had ended, partnership working continued, particularly in supporting complex cases. It was noted that deep and meaningful advice had been provided in some instances, including support with debt write offs.

·       The priority remained strengthening referral pathways and continuing to promote awareness of available support.

·       Period poverty was highlighted as a significant issue, defined as the inability to afford essential menstrual products. It was noted that stigma meant the issue often remained hidden. Data suggested over 25% of individuals had experienced period poverty, including borrowing products or using unsuitable alternatives such as socks, toilet roll or nappies, or using the same product for longer than recommended, increasing risk of infection.

·       Since December 2024, free menstrual products had been made available in 16 libraries across the city. The approach was designed to remove stigma by making products freely accessible without the need to ask. The scheme had also expanded into substance misuse centres and gyms. It was described as low cost with strong uptake and significant impact.

·       It was reported that 12% to 11% of adults had struggled to access food, with nearly 4% reporting having skipped food for a whole day due to lack of money.

·       Feeding Leicester, the local arm of Feeding Britain, brought together a wide range of organisations focused on addressing food insecurity. It was noted that many of the same communities experiencing food insecurity were also those with lower vaccination uptake.

·       At the start of the Cost of Living crisis, agencies had been brought together to coordinate support. It was noted that difficulty affording basics, including heating, had become normalised for many residents.

In discussion with Members, the following was noted:

·       Members welcomed the pilot programme which auto enrolled eligible pupils for free school meals and noted that over 1,000 students had been identified as eligible. Members asked when wider rollout would take place and what the timeline was for implementation across the city.

·       In response, it was explained that the main challenge was data protection legislation governing how eligibility data could be accessed and used. It was noted that the authority already held data indicating eligibility, however significant data analysis and cross referencing with DWP and NHS records was required. Other councils had developed frameworks which Leicester was reviewing and adapting. There was  ...  view the full minutes text for item 10.

The Director of Public Health submits a report to update the commission on Phase 3 of the Leicester City Drug and Alcohol Strategy for 2025-27.

The Director of Public Health submitted a report on Phase 3 of the Leicester City Drug and Alcohol Strategy 2025-2027. The following was noted:

·       The latest phase of the Leicester City Drug and Alcohol Strategy followed a national review of drugs and alcohol services in 2021 and the launch of the Government strategy “From Harm to Hope”. Local areas had been required to review their work and strategies, supported by a refreshed needs assessment which had highlighted the scale of need within the inner city.

·       A comprehensive drug strategy had been developed through the Combating Drugs Partnership. The strategy focused on four cross cutting themes and 32 actions were developed for implementation:

­   A significant increase in the number of adults accessing treatment.

­   A larger proportion of people leaving prison accessing ongoing treatment.

­   An enhancement of harm reduction programmes including carriage of naloxone across multiple organisations and stakeholders.

­   A significant expansion of outreach services across our communities.

• A 1 year progress summary was presented. The number of adults accessing treatment had increased by approximately 500, from around 2087 to 2500. The proportion of prison leavers leaving treatment successfully had increased from 21% to 55.2%.
• A wide range of harm reduction programmes had been expanded, supporting people to use drugs more safely and increasing engagement. The work had received an LGA award in the previous year.
• Police officers had received training to carry naloxone, and outreach services had been expanded with additional specialist staff and programmes.
• It was noted that the programme had started from a relatively low base but had made significant progress within a short period of time and was being recognised as good practice. Reducing inequalities remained central to the strategy.
• A stock take of the strategy had been undertaken during the previous year, leading to a refresh and the commencement of Phase 3. The original 3 year period had concluded and 6 working groups, involving a range of stakeholders and partners, had been established. Each group was developing detailed action plans through a series of workshops.
• Governance arrangements were outlined, including links to city and LLR partnership structures. It was noted that Phase 3 was at an early stage, with action plans now being implemented.

In response to Members comments, the following was noted:

·       Members welcomed the significant progress against key metrics and sought clarification on what constituted “treatment”. It was explained that treatment covered a wide range of interventions, including structured treatment through Turning Point, therapy, management of substance use, harm reduction measures and residential rehabilitation. The reported metrics related to structured treatment programmes.

·       Further clarification was sought regarding the 2500 individuals accessing treatment and how this compared to the wider population. It was acknowledged that this represented a relatively small proportion of the overall population and that there remained a significant level of unmet need. A breakdown of the data was to be shared with members.

·       Members highlighted the importance of evidence, oversight and harm prevention, particularly in relation to alcohol related  ...  view the full minutes text for item 11.

The Integrated Care Board (ICB) submits a presentation to update the Commission on the Leicester Neighbourhood Approach.

The Integrated Care Board (ICB) submitted a report to update the Commission on Leicester City Our Neighbourhood Approach. The following was noted:

·       The approach was not new but was now progressing through a 10 year plan.

·       There had been considerable debate regarding the configuration of neighbourhoods in Leicester. While not strictly geographical, the model had been designed to work across partner organisations.

·       The approach aimed to develop new ways of working that maximised staff capacity and involved the public more effectively.

·       Two health related priorities had informed the model, namely increased attendance at Accident and Emergency and rising emergency admissions. Although performance was comparatively better at University Hospitals of Leicester, it was recognised that too many people were attending hospital unnecessarily. Outpatient pressures within the city were also highlighted

·       It was emphasised that neighbourhoods mattered in delivering care closer to home. Distance to treatment and ease of access often led people to attend A and E as it was perceived to be simpler. It was noted that individuals often experienced multiple interconnected issues, for example asthma linked to housing conditions or mental health concerns in children associated with screen time and lack of exercise. Supporting residents to help themselves was described as crucial.

·       A strong partnership was described between health, social care and the voluntary sector, with a focus on directing people to support within their local communities and ensuring fair access for all.

·       The overarching aim was prevention. The 10 year plan was structured around three key areas: shifting care from hospital to community, moving from analogue to digital systems including use of artificial intelligence and technology to reduce waiting times, and embedding prevention. It was noted that this was a long term transformation and that plans needed to be measurable and auditable.

·       Key challenges included deprivation, life expectancy gaps, cancer outcomes and low vaccination uptake.

·       It was reported that there were 4 city neighbourhoods. Funding became available in pockets over time and partners would need to be creative in progressing priorities.

·       University Hospitals of Leicester had identified patterns of A&E discharge by area, including patients discharged without the need for treatment.

·       A neighbourhood steering group and workshops had been established to influence future practice. The Integrated Care Board, University Hospitals of Leicester and Public Health were developing a data pact to assess needs and inform priorities.

·       The model was moving towards a multi year locally led planning approach covering 2026 to 202

·       Proposed targets included reducing timeframes for cancer assessment and undertaking a full review of community paediatrics, which had not been analysed for some time.

·       The Initial priorities would focus on achievable improvements in 2026 and 2027, recognising that neighbourhood and provider level change would take 2 to 3 years to embed.

In response to members comments the following was noted:

·       Members expressed concern regarding what was perceived as another reorganisation and questioned the rationale behind the size differences between neighbourhoods. It was noted that one neighbourhood appeared significantly larger than another and this was seen  ...  view the full minutes text for item 12.

Members of the Commission will be asked to consider the work programme and make suggestions for additional items as it considers necessary.

The Chair reminded Members that any suggested items for inclusion in the work programme should be shared with the Chair and the Senior Governance Officer.

It was noted that an in depth review of Rheumatology would be scheduled for the April meeting.

Walk in Centres were also proposed for inclusion as a future agenda item.

With there being no further business, the meeting closed at 8.36pm.