Agenda and minutes

The Chair welcomed those present and led introductions.

Apologies for absence were received from Councillor Aldred, Councillor Fonseca, Councillor Ghattoraya, Councillor Waller, Councillor Pantling, Ivan Browne, Ruth Lake, Mike Sandys, Dr Janet Underwood and Russell Smalley.

Noted that Councillor Les Phillimore was present as a substitute for Councillor Ghattoraya.

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

Members were asked to declare any pecuniary or other interest they may have in the business on the agenda. There were no such declarations.

The minutes of the meeting held on 5^TH March 2021 have been circulated as attached and the Committee is asked to confirm them as a correct record.

RESOLVED:

That the minutes of the meeting held on 5^th March 2021 be confirmed as an accurate record.

To note progress against actions of previous meetings not reported elsewhere on the agenda (if any).

Item 42 University Hospitals of Leicester NHS Trust Audit

Members noted that more details had been requested of the UHL accounts and  a response had been circulated in June. The Chair suggested that response needed to be further considered and informed Members that he would be pursuing that outside this meeting.

Referring to the meeting held on 14 December 2020 Councillor Harvey reminded that she had still not received the information around births, post-natal/partum care as requested in the supplementary questions.

ACTION: Richard Morris to pursue that response from the Clinical Commissioning Groups.

Members are asked to note the membership of the commission for 2021/22 as follows:

Councillor Kitterick (Chair)

Councillor Jonathan Morgan (Vice-Chair)

Councillor Aldred

Councillor Bray

Councillor Fonseca

Councillor Ghattoraya

Councillor Grimley

Councillor Hack

Councillor Harvey

Councillor King

Councillor March

Councillor Pantling

Councillor Dr Sangster

Councillor Smith

Councillor Waller

Councillor Whittle

RESOLVED:

That the membership of the LLR Joint Health Scrutiny Committee for 2021-22 be noted.

Members are asked to note the Terms of Reference/Working Arrangements for the Committee as attached.

Councillor Hack mentioned that when the meeting was hosted by the County Council there was provision for a general Member Questions item on the agenda.

The Chair was advised that there was no provision within the City Council’s constitution for general Member Questions however it could be worked into the Committees Terms of Reference and Working Arrangements if Members were agreed.

The Chair commented that he encouraged questions and participation and would be happy to institute a regular Question from Members item on the agenda. Members were in agreement with this course.

RESOLVED:

That the Working Arrangements and Terms of Reference for the Leicester, Leicestershire and Rutland Joint Health Scrutiny Committee be agreed subject to inclusion of a provision of a general item for Member Questions on the agenda of future meetings.

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

The Monitoring Officer informs that a petition has been received which asks the Committee to:

“arrange a meeting, as indicated in its minutes of December 2020, as a matter of urgency to scrutinise the Report of Findings, produced by Midlands and Lancashire Commissioning Support Unit following the public consultation, Building Better Hospitals for the Future, in the autumn. This report was completed in March but has only just been shared with the public. We call upon the Scrutiny Committee to request the three local Clinical Commissioning Groups, which are responsible for the Building Better Hospitals proposals, delay finalising their decision-making until they are able to incorporate the insights of scrutiny into their Decision-Making Business Case, and not to proceed with their meeting planned for 8^th June, if this is to approve the Decision-Making Business Case.

The Committee is recommended to consider the petition as part of the discussion on item 10 of the agenda “Analysis of UHL Acute and Maternity Reconfiguration Consultation Results.”

The Monitoring Officer reported that a petition had been received which asked the Committee to:

“arrange a meeting, as indicated in its minutes of December 2020,as a matter of urgency to scrutinise the Report of Findings, produced by Midlands and Lancashire Commissioning Support Unit following the public consultation, Building Better Hospitals for the Future, in the autumn. This report was completed in March but has only just been shared with the public. We call upon the Scrutiny Committee to request the three local Clinical Commissioning Groups, which are responsible for the Building Better Hospitals proposals, delay finalising their decision-making until they are able to incorporate the insights of scrutiny into their Decision-Making Business Case, and not to proceed with their meeting planned for 8^th June, if this is to approve the Decision-Making Business Case.

The Chair indicated that the points raised in the petition would be considered within the discussion on Item 10 of the agenda “Analysis of UHL Acute and Maternity Reconfiguration Consultation Results.”

The Monitoring Officer to report on the receipt of any questions, petitions, or statements of case in accordance with the Council’s procedures.

The following questions have been received:

From Jean Burbridge:

·         Following the Building Better Hospitals for the Future consultation, who are the patient representatives who were involved in reviewing the public feedback? In what ways are they representative?

From Giuliana Foster:

1)    You set out the estimated capital costs of the various parts of the proposals on pages 23 and 113 of the DMBC but these do not include the estimated capital costs for the freestanding midwife led unit on the site of Leicester General Hospital.  What are the estimated costs for both the trial and the ongoing existence of the unit and where will these funds come from?

2)    What are the estimated costs of the primary care urgent treatment centre and other community services planned for the site of the Leicester General Hospital and where will these funds come from?

From Brenda Worrall:

·         Why has a target of births of 500 been set when this is larger than all other Free Standing Midwife led units (FMUs) in the country. Is the FMU being set up to fail?

From Godfrey Jennings:

·         If adequate additional Public Dividend Capital (PDC) is not forthcoming, which elements of the scheme are you likely to alter? (p25 of the DMBC “Whilst the original funding of £450m PDC has been identified, in the event that further PDC funding is not made available to fund the additional national policy changes such as the requirement for New Zero Caron and Digital, then the scope of the scheme will be reviewed again in order to fit the budget available.”)

From Sarah Patel:

·         How does the profile of respondents in terms of a) ethnicity and b) deprivation match that of the population as a whole, taking Leicester, Leicestershire and Rutland each in turn?

From Kathy Reynolds on behalf of Rutland Health & Social Care Policy Consortium:

1.    We are told approximately £260,000 was spent on consultation by LLR CCGs. The people of Rutland submitted many comments and proposals to mitigate the impact of moving acute services from East to West and consequent increased complexity of journeys and increased travel times making access to services more difficult. The summary of decisions published on 26th June offers no clarity on how services will be delivered closer to home to mitigate these problems. Can the CCG explain why there are none?

2.    The CCGs have refused to say how alternative services will be funded where patients are unable to access the new facilities (They estimated this to be about 30% of patients in the PCBC). The consequences of this will result in more patients accessing services outside Leicester, Leicestershire and Rutland. As the CCGs will have to meet these costs can they supply the cash flow estimates for this work which will relocate elsewhere as a result of Reconfiguration?

3.    Any attempt to clarify with the CCGs how much capital and  ...  view the full agenda text for item 9.

The Monitoring Officer reported that several questions had been submitted by members of the public as set out on the agenda.

The Chair outlined the procedure for the meeting and advised that these questions would be taken and responded to within the main item 10 on the agenda “Analysis of UHL Acute and Maternity Reconfiguration Consultation Results.” Where a full response was not available at the meeting a written response would be provided outside the meeting and appended to the minutes.

Members will receive a presentation update on the UHL Acute and Maternity Reconfiguration Consultation Results.

Background papers, (Consultation findings and Decision-Making Business Case for the UHL Reconfiguration) have already been published and can be found at the following link:

https://www.leicestercityccg.nhs.uk/about-us/future-governing-body-meetings/

The Chair explained that a presentation would be received and taken in four subject areas with questions from the public to be taken under the relevant subject area followed by any questions from committee members.

Sara Prema, Leicester City CCG, presented the first subject area and outlined the consultation process and how that was undertaken, this included details of the range of media used such as social media: Instagram, snapchat, twitter as well as live events and the information gathered. Details were also given of the “reach” of the consultation using digital, print and broadcast methods and the work undertaken to engage people of all demographics across Leicester, Leicestershire and Rutland (LLR).

The Chair interposed questions from members of the public and invited officers to provide responses:

The Chair on behalf of Jean Burbridge asked: Following the Building Better Hospitals for the Future consultation, who are the patient representatives who were involved in reviewing the public feedback? In what ways are they representative?

Richard Morris, Leicester City CCG responded that the feedback received through the consultation was independently analysed and evaluated by Midlands and Lancashire Commissioning Support Unit, who produced the Consultation Report of Findings. The Report of Findings was then reviewed by the Public and Patient Involvement Assurance Group for Leicester, Leicestershire, and Rutland. It was not their role to approve the proposals that were being consulted upon. ACTION: Officers agreed to provide a full written answer in due course.

Sally Ruane on behalf of Sarah Patel asked: How does the profile of respondents in terms of a) ethnicity and b) deprivation match that of the population as a whole, taking Leicester, Leicestershire and Rutland each in turn?

Richard Morris replied that all details regarding profile were set out in detail in the report of findings which showed the people who participated in the consultation were statistically representative of the LLR population and endorsed through the Equality Impact Assessment.

Sally Ruane clarified that the question was about how the profile of respondents matched or did not match the profile of the area in terms of the broader population of Leicester, Leicestershire, and Rutland.

Richard Morris explained how the level of responses were reflective of LLR and the findings showed that of the responses received 46% were from Leicestershire, 26% were from Leicester city, and  6% were from Rutland, 28% of responders provided no post code or asked not to be profiled. There were various category breakdowns as an example there was a breakdown by age, this showed typically higher levels of engagement with people over 45 years old but there was another piece of work carried out with voluntary groups to engage with younger people between  25-34 years, this category represented 11.8% of the population, in terms of responses 16.4% of Leicester city replies were within this age category showing a fair representation of that age group. In relation to male/female by and large this was 50/50 across LLR, in terms of consultation responses it was found more women  ...  view the full minutes text for item 10.

Members will receive a presentation update on the Covid-19 Vaccination Programme with a focus on recent data including vaccination patterns across the City and County.

The Chair commented that given the late hour of the meeting he would move straight to taking any questions from Members on the Covid-19 vaccination programme.

There were no questions from Members.

Andy Williams, CCG Leicester, Leicestershire and Rutland confirmed there were no exceptional issues around the vaccination programme to raise at this time and a report on the work for the Autumn/Winter vaccination programme would be provided in due course.

RESOLVED:

That a report on the work for the Autumn/Winter vaccination programme be provided in due course.

The Scrutiny Policy Officer submits a document that outlines the Leicester, Leicestershire and Rutland Health Scrutiny Committee Work Programme for 2021/22.

The Committee is asked to consider the Work Programme and make any comments and/or amendments as it considers necessary.

RESOLVED:

That the item on Integrated Care Systems be rescheduled to an earlier date than March 2022.

Councillor Hack made the following submission:

In recent weeks there has been a raising of the profile of the medical procedure surrounding the fitting of Intrauterine devices, 

The NHS website states:

‘Having an IUD fitted can be uncomfortable and some people might find it painful, but you can have a local anaesthetic to help.’…’you can ask to stop at any time.’

1)    Do we have the information on the % of IUD procedures that are performed with a Local Anaesthetic? 

a.    Dr Louise Massey of the Faculty of Sexual and Reproductive Health Care of the Royal College of Obstetricians and Gynaecologists said on the BBC last week

‘the procedure can always be stopped if there is too much pain, discomfort or distress.  It is always an option to abandon it; it can even be done under General anaesthetic if necessary and appropriate’

Do we offer and what % of IUD are fitted with a General anaesthetic across the Trust?

2)    What % of procedures are unsuccessful and are stopped from completion in Leicester, Leicestershire and Rutland?

3)    What % of IUD’s need removing due to complications post procedure?

4)    If the data is not collected routinely is there any expected change in policy in light of the spotlight that has been placed on the procedure?

5)    The anecdotal evidence that has been collected and published so far, has indicated that the procedure is far from routine for some.  I note that the guidance on the procedure was recently updated on the national NHS website, but has there been any recent policy updates provided for those that fit IUD’s in LLR? Particularly on pain management or device fitting triggering past trauma.  If not, when will this be provided?

The CCG confirmed they had received these questions and gave a commitment to provide a response in writing outside this meeting.

RESOLVED:

That the relevant officers of the CCG provide a written response to these questions as soon as possible which will be read into the minutes of the next meeting.

Members are asked to note the scheduled meetings of the Committee for 2021/22 as follows:

·         Tuesday 16^th November 2021 at 5.30pm

·         Monday 28^th March 2022 at 5.30pm

Extra meetings may be convened in agreement with the Chair in accordance with the Committees working arrangements.

Future scheduled meetings noted as follows:

·         Tuesday 16^th November 2021 at 5.30pm

·         Monday 28^th March 2022 at 5.30pm

The Chair noted there had been comments about the timings of meetings and confirmed they would start at 5.30pm with an aim not to go beyond 9pm.

There being no further business the meeting closed at 9.10pm