Agenda and minutes

The Chair welcomed those present and led introductions.

Apologies for absence were received from Councillor Charlesworth; Ruth Lake; Becky Cassidy (UHL) and Julie Hoggs (UHL).

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 interests they may have in the business on the agenda.

There were no such declarations.

The minutes of the meeting held on 27^th June 2022 have been circulated and the Committee is asked to confirm them as a correct record.

RESOLVED:

That the minutes of the meeting held on 27^th June 2022 be confirmed as a correct record.

The Chair referred to the discussion around dental services at the last meeting noting that a number of key partners had agreed to explore the issues raised, however there was no-one present at this meeting who could provide any further progress update to that.

It was noted that Councillor Hills had recently given a very good interview on the radio and spoke about his experience as a dentist.

There was a brief discussion about ongoing concerns over dentistry services, particularly across Rutland which had seen its main dental practice return its contract (25% NHS provision) and no other dentists taking NHS patients.

The Chair confirmed that following the last meeting a letter had been written to the Secretary of State and a response was awaited.

The Chair also advised that in relation to maternity services a further report outlining current provision and performance of the service had been requested to the City Health & Wellbeing Scrutiny Commission, since this was an important area and needed further assurance.

RESOLVED:

That an update report on Dental Services and provision across the area be brought to a future meeting.

None at this time.

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

The Monitoring Officer reported that no petitions had been received.

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

The Monitoring Officer reported that no questions, representations or statements of case had been received.

Members to receive a presentation report on the UHL Financial Accounts for the financial years 2019-20 and 2020-21 including details of how improvements have been made and to highlight any further anticipated issues.

For background information members can access the full published accounts on the links below:

19/20

(2022) - Thursday 31 March 2022 - All Documents (leicestershospitals.nhs.uk)

20/21

(2022) - Friday 9 September 2022 - All Documents (leicestershospitals.nhs.uk)

Members received a report containing details of the University Hospitals Leicester (UHL) Finances and Accounts for the financial years 2019-20 and 2020-21.

Lorraine Hooper, Chief Financial Officer, UHL, informed members that:

·         The accounts for 2019-20 were finally adopted and published with a disclaimer opinion on 31^st March 2022.

·         The audited accounts for 2020-21 were adopted by the Trust Board on 9^th September 2022 with an adverse opinion. Due to the Queens passing the Board met in private but did subsequently meet in public on 6^th October to ratify that decision.

·         In relation to the 2019-20 accounts, external auditor Grant Thornton had provided an updated audit findings report which included the restated balance sheet, this saw the deficit moving from £76.8m to £122.7m following adjustments agreed during the course of the audit.

·         Grant Thornton recognised the considerable improvement in account process and culture within the finance team at UHL since their original audit findings report but also recognised some errors still to be addressed and work to do on financial statements to address risks to the Trust’s financial sustainability.

·         The 2020-21 draft accounts had been produced in line with the National timetable (June 2021) which was a significant step forward.

·         The financial position in 2021 improved by £29.8m to £46.2m largely as a result of repatriation of expenditure into the previous financial year as a result of the 2019-20 balance sheet restatement.

·         The current financial year (2021-22) accounts were on track and undergoing external audit with KPMG (new external auditor) and it was  anticipated those accounts would be adopted in February 2023 by the Trust Board.

In relation to the issues uncovered around the 2019-20 accounts, members were informed that it was clear standards previously fell short of anything that was an acceptable standard, and since those challenges considerable change and improvement had been made across the whole organisation.

Members were advised that the Trust Board had been set up and in place for 14 months, the Board had a wider experience and a committee Chair who ensured challenge was robust. Governance had been revised across the Trust and financial decision making was much tighter and more robust.

The entire finance department had been restructured and a clear skills requirement for each grade had been put in place together with weighting of staff within the structure and a considerable amount of staff training. Mandatory training had been undertaken by budget holders and there was now in place a regular reporting system. All control processes had also been refreshed, reviewed, and rewritten where necessary.

Members noted that as a consequence of the financial challenges  the Trust was placed in financial special measures and was now in a recovery support programme so there was additional oversight from NHS England and the Trust was making good progress to be able to exit that programme.

The Chair invited members to comment which included the following points:

Members remarked that this was clearly a serious historical issue at the hospital and new people  ...  view the full minutes text for item 25.

Members to receive a report on the Corporate Complaints Procedure including details of how formal complaints are managed, current performance levels and actions being taken to improve.

Members received a report highlighting the management and oversight processes of formal complaints, in University Hospitals of Leicester NHS Trust (UHL) including current performance and actions being taken to improve.

Richard Mitchell Chief Executive Officer UHL introduced the report and noted that the Trust had undertaken a review of its complaints process over the last 12 months and taken steps to improve the management and oversight of its complaints processes as it was felt the complaint process was not working as it should and had probably deteriorated throughout the Covid pandemic.

Members were informed that during the review it was found that it was difficult for patients and people to informally make complaints and so UHL were looking to open up drop in options at some sites across the city centre for people to come in and raise their concerns without the formality of writing a complaint.

It was also found to be difficult for some people to understand how best to contact the organisation and so the Trust was looking at dedicated phone lines that would be answered by people who understood what was being asked as well as making improvements to the website which was not always easy to navigate.

It was noted that 28% of people living in Leicester City did not speak English as their first language so UHL were aiming to take account of that when responding and looking at ways to ensure responses aligned to the diverse needs of population. UHL were working towards a clearer process for handling and responding to complaint letters in clear succinct language and recognised the importance of listening to views of patients and public. Some progress had been made although there was more to do and UHL were committed to engage with patients and communities.

Members welcomed the initiatives being taken forward to improve the complaint procedure and expressed interest in hearing about complaints that led to compensation and figures of money being paid out.

Members were impressed by the move to have drop in options to enable people to informally raise their concern and understood the motivation to reduce complaints although there was some hesitation that it may lead to an increase in “complaints” as more people were likely to drop in as most people don’t take the time to write complaints or did not have confidence to write a complaint.

It was commented that complaints should be resolved as quickly as possible and if someone can’t get what they expect then their feelings should at least be acknowledged.

Members noted that from an organisational point, complaints were opportunity to learn but it was also important to view them alongside any compliments received.

Richard Mitchell CEO agreed with the points made and commented that a primary reason for making the changes was to also ensure it was easier for those who were waiting months and couldn’t make contact to be able to raise their concerns and reduce anxiety about waiting etc as well as making services more  ...  view the full minutes text for item 26.

Chair agreed to a change in the running order of the agenda to take members questions on matters not covered elsewhere on the agenda.

A question was raised about the possibility of nurses striking and the impact that might have on services across Leicester, Leicestershire and Rutland and any steps put in place to alleviate potential disruption.

Richard Mitchell, CEO UHL advised that a nursing union had balloted last week, and the outcome was to strike, however the criteria had not been met at University Hospitals Leicester, so in terms of this ballot UHL nurses were not striking.

Members were informed that the UHL Winter Plan included various contingencies and was about ability to maintain services. UHL had a responsibility to support people to choose, and it was noted one other union had gone out to ballot and there was also a Junior Doctor’s ballot so if those voted to go out then UHL would be preparing to manage the situation through its contingency plan.

Members to receive a report providing details of the Autumn Winter vaccination programme focusing on the latest position across Leicester, Leicestershire and Rutland and providing details of the areas of particularly low uptake and the reasons behind that.

Members received a report providing an update on the Autumn and Winter Covid-19 and flu vaccination programme across Leicester, Leicestershire and Rutland.

Kay Darby gave a brief summary of the report which included the following points:

·         Reminder of the background policy framework and previous decisions.

·         The Autumn campaign was greater than in previous campaigns, but the pattern of uptake was considerably lower and that was consistent across Leicester Leicestershire and Rutland.

·         Teams had started to see slowdown in uptake figures, with Covid at around 2-3% per week, in response there was a concerted push towards Christmas to get people protected.

·         Targeted approaches were also being taken to address inequalities and directing resources to areas of lowest uptake as well as specific initiatives for young people, and specific clinics for people with learning disability.

Members discussed the report which included the following comments:

Concerns expressed about low uptake levels across the City but also in Rutland where text messaging from GP’s had caused confusion and there was a need to make people better aware of the options available. In response it was advised that vaccination programmes were not in a steady state so there were still different approaches to communication, and it was accepted there was still some confusion as there was not one consistent way of inviting people in.

Concerns had been raised by residents about family members on autistic spectrum and the need for different environments to get vaccinated noting that for Rutland residents the nearest facility catering for special needs was in Melton, which had costs of travel and time implications e.g. if a person finds it stressful then the length of journey is a time when those stress levels are increasing. Officers agreed to consider that point and look at what was being done for those with special needs.

Regarding accessibility for elderly or vulnerable people that had difficulty travelling it was noted that there was now an offer of transport using council vehicles and the team were engaging and co-ordinating efforts to create hubs and get the resources together to provide, targeted ward hubs for vaccination of these groups.

In terms of the issue about all GP surgeries not providing the Covid vaccination it was reminded the limitations, because the vaccine had to be specifical stored with specific expiry requirements which all GP surgeries could not meet, and it was important to avoid vaccine wastage which was monitored as it is an expensive vaccine to produce. It was noted that although vaccine producers were looking to develop the vaccine to be just one, they were not at that point yet.

As far as the issues of low take up in the city it was advised that was not through lack of trying and a lot work had been undertaken with public health colleagues but despite that some populations were particularly resistant. Other steps being taken to drive uptake included work with street teams, targeted campaigns and specific engagement activity around educating people why it is important.  ...  view the full minutes text for item 28.

The latest version of the work programme is attached and members of the committee will be asked to note the contents and consider any further items for inclusion.

Members received and noted the updated work programme.

None notified.

To note the date of the next meeting rescheduled to take place on Monday 6^th February 2023 at 12.30pm at City Hall Leicester.

To note the next meeting scheduled on Monday 6^th February 2022 at 12.30pm.

There being no further business the meeting closed at 2.22 pm.