Agenda and minutes

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

Apologies for absence were received from Councillor Zaman and the Deputy City Mayor for Social Care, Health and Community Safety – Cllr Russell

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

The Chair asked members of the commission to declare any interests in the proceedings for which Cllr March declared that she is an employee of Citizens Advice.

The minutes of the meeting of the Public Health & Health Integration Scrutiny Commission held on 9 July 2024 have been circulated, and Members will be asked to confirm them as a correct record.

The Chair noted that the minutes of meeting held on 9 July 2024 were included within the agenda pack and asked members to confirm that they could be agreed as an accurate account. 

AGREED:

·       Members confirmed that the minutes for the meetings on 9 July 2024 were a correct record.

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

The Chair thanked the ICB for hosting a briefing session on virtual wards providing members with assurance of the process and expressed the members commendation for the expansion of virtual wards to ensure people can continue to receive care whilst returning home safely.

It was further noted that the Chair and Cllr Sahu had met with the ICB, LPT and DHU for an update on actions agreed following concerns about the number of GP mental referrals being sent back to practices for children and young people. The Chair highlighted that it was pleasing that terminology had been changed and concerns has been taken on board as health colleagues committed to work with the LMC and a number of GPs to review the PRISM form. It was noted that to allow time for these changes to be implemented, a report has been requested to be presented to the Commission in the New Year.

The Chair also highlighted that assurances are being provided through regular communication with the ICB who are monitoring GP collective action situation and ensuring details of urgent care centres are promoted. It was noted that details can be circulated to members and any issues that may arise would be shared with the Commission.

The Chair thanked Members who had expressed their interest to form the task group with the Housing Scrutiny Commission to look at services and the impact of homelessness on health, particularly those with complex needs. Members were reminded that if they wished to take in the inquiry day to contact the governance officer as soon as possible.

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 will provide the Commission with a verbal update.

The Director of Public Health gave a verbal update of the latest position of health protection, and it was noted that:

·       TB had previously been mentioned as a topic of concern as rates are higher than would like in the city. There was a successful reduction of TB rates in the early 2000’s but there had been an upward trend, with Leicester now having the second highest rates in the country. New figures will be released next month, and it is suspected Leicester will be rated as having the highest rates of TB.

·       Work has been ongoing across the public health team, the ICB and UK Health Security Agency (UKHSA) and a new strategy has been developed with a steering group Chaired by the Director of Public Health with a host of actions.

·       University Hospitals Leicester have an amazing TB service, but it does not have the resources for managing the levels of TB in the city. A business case has been created to increase the capacity for the service.

·       TB treatment is difficult and lengthy taking 6 months. Latent cases are particularly difficult to maintain treatment as patients feel healthy in themselves, yet the treatment can have side effects making them feel ill.

·       Identifying and treating cases of latent TB screening is a main objective through GP practises, however funding is an issue. A case has been made to NHS England for doubling funding locally in order to reduce TB rates in the city.

·       The Loughborough strain is more severe and contagious, and treatment can take up to 9 months but there are fewer cases.

·       Mpox has become a global concern with a new (clade 1b) potentially more severe and contagious to affect younger people although data is not yet available. There have been cases in Europe but none in the UK to date. The UKHSA has outlined a plan should it come to the UK and is monitoring the situation.

Members were reassured that there is a strategy in place for controlling the rates of TB, but it was concerns were acknowledged in that Leicester was likely to have the highest rates in the country. In response to questions and comments from Members, it was noted that:

·       Public Health are hopeful that the request for additional resources for latent TB testing would be successful.

·       A joint letter from the Health and Wellbeing Board, the Deputy City Mayor for Social Care, Health and Community Safety and the ICB had been sent to the UK Health Security Agency to request additional funding. The business case had been put through urgently with the hope that an outcome would be achieved before the usual time span of 6-8 weeks.

·       As part of the strategy implementation to address TB there had been lots of work with health partners around screening, data analysis, communications, and a particular focus on addressing the stigma that is often associated with TB to help break down barriers for screening or treatment.

·       TB requires a resource intensive treatment, so  ...  view the full minutes text for item 78.

The Director for Public Health and the Strategic Director for Social Care and Education along with partners from the Health Sector submit a report to summarise health and care system planning to manage winter pressures across Leicester Leicestershire and Rutland (LLR) in 2025/2025.

The report comprises of:

1. Urgent & Emergency Care Plans

2. Immunisation Programme Campaign Update

3. Adult Social Care Winter Plan Update

4. Fuel Poverty and Health Programme

Members are requested to note the report presented for scrutiny and assurance and pass any comments or queries to relevant City Council Directors and Health Sector partners.

The Chair asked members that the various reports all be presented, and that comments and questions be taken at the end in which members agreed.

The LLR Director of Emergency and Urgent Care presented the LLR winter planning update. It was noted that:

·       Vaccination programmes are important to ensuring citizens and staff are safe during the winter and communication campaigns encourage take up to help ensure immunisation coverage. There has been a slower take up of coronavirus vaccines amongst health workers, but communication is ongoing to promote safety to staff, families and patients when vaccinated. 

·       The RSV vaccination programme commenced nationally in September and paediatric consultants are confident of a positive impact on children. The programme is aimed at under 2’s, pregnant women, and those over 75.

·       Seasonal planning is crucial and partners across health and care work collaboratively to develop and refresh plans. They have also been reviewed by clinical and operational leaders to ensure the right areas are being focussed on.

·       Staff wellbeing and support has been identified to ensure resilience and that services are equipped to serve patients.

·       Communication leads have been working on joint campaigns for citizens and staff to ensure clearer messaging on the right pathways and access to services.

·       There is a focus to increase capacity for urgent treatment and joining up the frailty offer. There are good services across adult social care and acute community services but are not always interlinked in the best way so will be a focus.

·       There is confidence in discharging patients requiring social care in the city.

·       Data indicates a clear increase in demand and activity of zero length of stay and same day access, including use of virtual wards. A focus will therefore be to ensure there is awareness of alternative services for ambulances and primary care to access for patients to be treated sooner.

·       There has been an increase in investment in the voluntary and community sector for supporting individuals with mental health, learning disability or autism and evidence from last year highlights support helped alleviate individuals attending the emergency department.

The Strategic Director for Education and Social Care presented the adult social care winter plan update in which it was noted that:

·       Adult Social Care services are considered to experience consistent pressures year-round and escalation plans are therefore developed and monitored throughout the year by analysing data. The service looks across the system to ensure there is a balance of care providers across care homes, domiciliary care and exit planning for all pathways at any given time.

·       Hospital discharges and supported for patients who require social care support. There has been investment through the discharge grant which has allowed the reablement offer and timely discharge of patients seven days a week. A domiciliary care contract is in place and provision can be accommodated for discharged later in the day to receive required support during the evening when returning home.

·       There tends to be low numbers of patients waiting for social care to be discharged at  ...  view the full minutes text for item 79.

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

The Chair requested that adult mental health be added to the work programme and be discussed at the next meeting to be considered alongside the suicide strategy.

Members were also invited to make suggestions for the work programme in which it was noted that the suicide strategy item include provision for self-harm and that an item be added for the commission to further discuss why Leicester residents are 20% sicker than they were four years ago.

The Chair reminded members that the next meeting would take place on 5 November 2024 and that the inquiry day with housing scrutiny commission would be taking place beforehand.

Councillor Haq raised concerns in relation to parking and the use of surrounding streets to avoid hospital parking charges. It was requested that joint consideration be given to improve transport services and encourage use of public transport.

AGREED:

·       Communication and engagement of transport options to be reviewed and enhanced where possible.

There being no further business, the meeting closed at 19.27.