Agenda and minutes

Apologies were received from Cllr Harvey, Stephenson, Knight and King and Helen Mather, Gemma Barrow, Rob Howard, Harsha Kotecha, Damian Roland and Sarah Smith.

Members are asked to declare any interests they may have in the business on the agenda.

Cllr Poland declared he works for Edward Argar, the MP for Melton and  Syston. Mr Argar had been particularly active in stopping the closure of the St Mary’s Birth Centre.  

Cllr Westley declared he is Chair of the patient panel at a local GP Surgery.

The minutes of the meeting held on 16^th June 2025 have been circulated and the Committee is asked to confirm them as a correct record.

The minutes of the previous meeting held on 16^th June 2025, were confirmed as a correct record.

The Monitoring Officer to report on the receipt of any petitions submitted in accordance with the Council’s procedures

It was noted that none were received.

Jean Burbridge asks:

1.    Why is UHL closing down St Mary’s midwife led birth centre? This birth centre is the stand-alone midwife led birth facility for the whole of Leicester, Leicestershire and Rutland. The Decision Making Business Case following public consultation for Building Better Hospital For the Future promised a replacement stand-along midwife led birth centre would be created at Leicester General Hospital but this has not happened.

2.    A stand-alone midwife led birth centre is supposed to be one of the four options made available to women for the births of their babies. However, St Mary’s in Melton Mowbray seems to be closed down with little discussion. Has this been brought before the Joint LLR Health Overview and Scrutiny Committee for detailed scrutiny?

3.    If not, can the chair give an assurance that no closure will take place before detailed scrutiny has taken place in this committee?

The following questions were asked:

Jean Burbridge asked:

1.    Why is UHL closing down St Mary’s midwife led birth centre? This birth centre is the stand-alone midwife led birth facility for the whole of Leicester, Leicestershire and Rutland. The Decision Making Business Case following public consultation for Building Better Hospital For the Future promised a replacement stand-along midwife led birth centre would be created at Leicester General Hospital but this has not happened.

2.    A stand-alone midwife led birth centre is supposed to be one of the four options made available to women for the births of their babies. However, St Mary’s in Melton Mowbray seems to be closed down with little discussion. Has this been brought before the Joint LLR Health Overview and Scrutiny Committee for detailed scrutiny?

3.    If not, can the chair give an assurance that no closure will take place before detailed scrutiny has taken place in this committee?

The Chair allowed a supplementary question:

So when you say temporary closed for safety reasons, what are those safety reasons?

Godfrey Jennings asked:

1.    Do the commitments in the 2021 Decision Making Business Case regarding Building Better Hospitals For the Future (now renamed Our Future Hospital) still stand? Several times, UHL has reaffirmed those commitments, although it is accepted that the Treatment Centre at the Glenfield Hospital will be different from that originally envisaged following the establishment of the separately funded East Midlands Planned Care Centre. The UHL webpage on Our Future Hospitals is vague and UHL has now stated its plan to close St Mary’s Birth Centre in Melton Mowbray.

2.    Will UHL give an assurance that the promised midwife led stand-alone birth centre at the General Hospital will be in place before any closure of St Mary’s?

The Chair allowed a supplementary question:

Commitments in the 2021 business case, Building Better Hospitals for the Future confirmed the commitments at Glenfield Hospital and East Midlands Care Centre. The Future Hospitals website stated plans to pause St Marys in Melton. Will NHS University Hospitals Leicester (UHL) give a promise that Health Centre at the General Hospital will be in place before the closure of St Mary’s?

Due to the questions relating to the same item of business, the Chief Medical Officer of the Integrated Care Board, chose to respond to the questions all at once. The following was noted:

·       The decision for closure was taken on 7^th July 2025.

·       The reason for the closure was due to low numbers of patients and limited staffing for the unit.

·       Pausing births and inpatient care at the centre from 7th July was a difficult but necessary decision. University Hospitals Leicester took this step to ensure the safety of women, mothers and babies using the service, and that safety must remain the highest priority.

·       The Integrated Care Board is currently working with University Hospitals Leicester to determine the next steps for Saint Mary’s Birth Centre and, as has been said, this is a pause at this point in time. This  ...  view the full minutes text for item 63.

The Integrated Care Board submit a report to update the Commission on digital tools for patients and those supporting them.

 A representative from the ICB presented a report to update the Commission on the  Digital Tools available for patients and the NHS app: 

• The core functionality of the NHS app was increased. Patients were given full digital access to their GP records on the app. In Leicester, Leicestershire & Rutland (LLR) only 8 GP practices do not have this feature, this was due to the nature of their services, but further access can be requested by registered patients.   

• Phase 1 of the integration brought University Hospitals of Leicester (UHL) services to the app so that patients can now manage, cancel and request bookings. It was noted that there was an average of over 250,000 views on the app per month. 

• Leicestershire Partnership Trust (LPT) integration to the NHS app was pending and was dependent on the outcome of a national pilot scheme into the connectivity of the app into extended clinical systems, such as mental health and community space.  

• Future ambitions for the service were detailed including patient initiated follow up, digital care plan management and two-way communication between patients and care teams. All of which was subject to national funding and the NHS app uplift which was being worked on. This was with the aim of making the app into a multi-faceted gateway tool for patients.   

• It was stressed that non digital methods were to remain supported so that nobody was left behind. The initiative pushed the two goals of maximizing online access for the 80% who are digitally enabled while continuing offline support for the 20%. There were over 60 digital inclusion hubs across LLR which are supported by the Good Things Foundation. The hubs were providing digital access, support and device recycling as part of their services. There was also an ambassador programme and public engagement events to promote digital services and support digitally excluded individuals.  

• It was highlighted that LPT was recently selected for the Vodaphone digital inclusion programme. They received 40 sim cards with contracts and data to assist homeless families, enabling them to keep in contact with support networks and NHS services.  

• The care record system, which was mentioned in a previous scrutiny meeting, allows for information sharing across health, social care and connected organisation. Some of the benefits of this system have been the accurate and timely sharing of information. There was also notable time savings in some areas, in social care there were some assessments that were completed 2 weeks earlier than before. Whilst surveys amongst staff have recorded up to a 30-minute reduction in time per log in, per person which was freeing up more time in the working week.  

Comments:  

• Members raised concerns about the impact of digitisation and fears that elements of the public will be digitally excluded from GP access. It was further suggested that this may result in a two-tier system of patient access to NHS services. The scarcity of digital inclusion hubs in rural areas of Leicestershire compared to the city was raised in support of this  ...  view the full minutes text for item 64.

University Hospitals Leicester (UHL) will give the Commission a verbal update on the current position.

The Chief Medical Officer and Deputy Chief Operating Officers gave a verbal update to the Commission on the current winter pressures. The following was noted:

·       An early surge in flu had been identified which had not been anticipated nationally and had taken trusts by surprise. Partners across acute, primary care and EMAS had worked together to identify additional actions and ensure plans remained effective.

·       The focus included improving ambulance response times, quicker handovers and ensuring ambulances arriving at the Leicester Royal Infirmary could transfer patients safely and promptly to release vehicles back into the community.

·       Work continued to improve A&E performance with an emphasis on increasing the number of patients seen within 4 hours and improving care for children. A paediatric surge had been experienced and a paediatric hub had opened at Groby Road Medical Practice for all children across LLR to be directed appropriately. This had begun operating during the week.

·       A first respiratory surge had also been highlighted, alongside the ongoing challenges with long A&E wait times, including waits of over 12 hours for patients needing a mental health bed. Work continued to reduce these times and improve patient flow through the hospital. Ensuring timely discharge for patients who were ready to leave was identified as essential to maintaining capacity and protecting staff and patients.

·       Work undertaken since the Emergency Care Action Plan and the winter plan was outlined. This included reviewing how to reduce demand, improve flow through services and strengthen discharge processes.

·       Same day emergency care services had been expanded, including direct access to surgical and medical reviews and clinics. Productivity within existing services was being improved, particularly for patients needing diagnostics.

·       Patients continued to be redirected to the most appropriate setting including hubs and urgent care centres. Improvements to discharge processes were being monitored against specific criteria and timeframes.

·       Additional capacity had come online for winter, including LOROS beds and new wards at the General Hospital and Preston Lodge community setting. The first floor had opened and the second floor was due to open in January.

·       It was noted that 6th January was historically the busiest day for health services and preparations were underway to manage expected pressures. Work also continued on supporting and deploying the workforce during the Christmas period, recognising limited staffing flexibility.

·       An update on primary care and pharmacy was provided, confirming that additional practice activity was underway to ensure patients were directed to the most appropriate services rather than attending A&E unnecessarily.

In discussions with members, the following was noted:

• Questions were raised about the KPIs shown in the winter planning slides, with a request for these to be shared in more detail at a future meeting to show performance against them. A progress update on the indicators was also requested, including how they were being monitored over winter.
• Clarification was sought on the additional LOROS beds supporting discharge and whether these were funded by the NHS. It was confirmed that four additional beds had been identified, with  ...  view the full minutes text for item 65.

A verbal presentation will be provided by Health Partners for the Commission on System Health Equity conducting a deep dive into longer waits at both the Emergency department and patients waiting for ambulances to assess the impact against protected characteristics.

The Director of Health Equality and Inclusion for UHL, gave a gave verbal presentation update on the Accident and Emergency Department’s waiting times: 

• The update was requested following a question relating to ambulance hand over times and the potential impact based on protected characteristics for patients waiting for ambulances at a previous meeting. To assess this question, data was examined from October 2025 which analysed sex, ethnicity, frailty and deprivation status of 1,800 patients and how these factors affected people waiting for ambulances. The findings were that there was no significant difference based on a protected characteristic and that clinical need and acuity of illness being the driving factor.  

• Further work was done to examine the experiences of patients and how different groups of people might experience waiting as well as how they might attend the Emergency Department. UHL Emergency Department (ED) data between 2022 and 2024 was investigated for the research, with wait times and frequency of attendance being examined. The Director hoped that this extra information would further add to conversation around the previous item on winter pressures. 

• Between July 2022 to November 2024 there was an 11% increase in ED attendance. This was fuelled by a 21% increase in Paediatrics and 7% increase in adults. While there was a noted increase in children's attendance, adult attendance outnumbered children by nearly a factor of 3.   

• There was an overall goal of simplifying the data so interventions can be had with specific groups and populations as well as what service changes need to be made to support this. There are different needs for different population groups with a clear need around deprivations status and age. The data showed that the most prominent groups in the Emergency Department were older patients of a white ethnicity, Black and Asian individuals and deprived groups. Black and Asian individual as well as deprived groups were all overrepresented in the Emergency Department, but their average patient acuity was lower. Older patients who are of a white ethnicity tend to wait longer but this was due to the complexity of their needs.  

• Emergency Department usage was becoming less concentrated amongst traditional high use groups. A broader, more complex patient mix was emerging across the population.  

• The data was collated on to maps, so the areas of LLR with particularly high Emergency department attendance can be identified. This was with the aim of passing this information on to primary care and community partners, so they can engage with the identified communities and develop interventions. Thus, driving down Emergency Department attendance in the future.  

In response to Members comments:

• The utility of the slides in relation to the previous topic was echoed by members and that it was stated that it would have been useful to see the slides before the meeting. It was commented how factors such as vaccinations and GP access in deprived and rural communities, ultimately accumulates in the Emergency department
• The GP to patient ratio in the City and its subsequent impacts on  ...  view the full minutes text for item 66.

Please note this item is for information only.

Leicester, Leicestershire and Rutland (LLR), Integrated Care Board (ICB) -

https://leicesterleicestershireandrutland.icb.nhs.uk/wp-content/uploads/2025/08/LLR-ICB-Annual-Report-and-Accounts-2024-25.pdf

University Hospitals Leicester (UHL) -

https://www.uhleicester.nhs.uk/publications/annual-report-and-accounts-2024-25/

Leicester Partnership Trust (LPT) -

https://www.leicspart.nhs.uk/wp-content/uploads/2025/09/LPT-Annual-Report-2024-25-FINAL.pdf

The item was for information only and the reports were noted.

The Chief Medical Officer for the Integrated Care Board (ICB) submits a report to give the Commission an overview of NHS Dental Commissioning across Leicester, Leicestershire and Rutland (LLR).

The Leicester, Leicestershire and Rutland (LLR) Integrated Care Board (ICB) submitted a report to update the Commission on NHS dentistry which continued to operate under a national contract, limiting the extent of local decision making despite efforts to focus activity on health needs and inequalities. The following was noted:

·       It was reported that progress had been made although national contractual constraints continued to pose challenges. Some areas of delivery were mandated nationally, including the requirement to provide seven hundred thousand urgent dental appointments nationally. Locally, an allocation of just over ten thousand appointments had been received. However, the ICB commissioned just under fourteen thousand appointments. Performance in this area had not been as strong as expected, and further targeted communications and awareness activity was planned to improve access for people with specific needs.

·       General dental activity across LLR was reported to be relatively positive compared to other areas. Activity was at forty nine percent which was slightly higher than previous levels and on track to meet its year-end target.  Providers had been invited to participate in an over performance scheme to deliver an additional ten percent of activity, equating to around thirty thousand appointments. Work was also taking place with providers who were underperforming to establish whether additional session time could be offered. 

·       Where practices continued to under deliver activity, contract values could be reduced and reinvested into other areas where need was greater. The ICB has commissioned additional funding to the Community Dental Service CIC for patients with learning disabilities, dental phobias or other complex needs who could not be treated in standard dental settings.

·       The Commission also received an update on oral cancer, with Leicester previously recorded as having the highest prevalence and mortality rates nationally. Partnership work with Turning Point was underway to identify at risk patient groups. Individuals engaged with relevant charities would be able to be referred directly into participating dental practices. A similar pilot had run successfully in the West Midlands.  In addition a care homes had been trialled in Charnwood, Hinckley and Bosworth. Training for early detection of oral cancer continued, with identified patients referred for appropriate treatment.

·       The overall programme was described as being aligned to the local targeted needs assessment with the intention of narrowing health inequalities.

In discussions with Members, the following was noted:

·       Reference was made to previous reports highlighting Leicester’s high rates of oral cancer and poor dental health outcomes for children. Concern was expressed that up to two thirds of children did not have access to an NHS dentist.

·       Members asked how the measures outlined would move the system from its current position to improved outcomes and what additional actions could be implemented. Further clarification was sought on contract rebasing, how it would apply to underperforming providers, and how a Unit of Dental Activity operated within the contract structure.

·       It was explained that children were included within the ten percent over performance scheme and that specific criteria were used when allocating additional units of dental activity.

·       Concerns  ...  view the full minutes text for item 68.

Members are invited to ask any questions that are not covered elsewhere on the agenda.

It was asked how the additional 2.5M hospital appointments were being allocated?

In response it was noted that Each Integrated Care Board were given an allocation and they would work through and see how much could be used.

It was raised that East Midland Ambulance Services were using private ambulances. What the cost per day and year was for the use of these?

It response it was noted that the figures would be shared with the Commission at the next meeting.

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

The Chair highlighted the work programme and invited Members to make suggestions.

With there being no further business, the meeting closed at 12.25pm.