Agenda and minutes

Apologies were received from Cllr Singh Johal and Harsha Kotecha, who sent Kash Bayani as a substitute.

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

Councillor King declared his wife was involved for Stroke Association.

The minutes of the meeting held on 17 March 2025 have been circulated and the Committee is asked to confirm them as a correct record.

The minutes of the meeting held on 17 March 2025 were agreed as a correct record.

Members are asked to note the membership of the committee for 2025-26 to

note as follows:

City Council representatives

Cllr Karen Pickering (Chair)

Cllr Nags Agath

Cllr Zuffar Haq

Cllr Melissa March

Cllr Liz Sahu

Cllr TBC

Cllr TBC

County Council representatives

Cllr Dr Sarah Hill (Vice Chair)

Cllr Kevin Crook

Cllr Moinuddin Durrani

Cllr Phil King

Cllr Kerry Knight

Cllr John McDonald

Cllr James Poland

Rutland County Council representatives

Cllr Lucy Stephenson

Cllr Samantha Harvey

The Membership of the Commission was agreed.

Members are asked to note the Terms of Reference and working arrangements for the Committee as attached at Appendix B.

The Commission noted the Scrutiny Terms of Reference.

Members are asked to note the dates of meetings for 2025-26 as follows:

·       Monday 16^th June 2025, at 10am

·       Thursday 27^th November 2025, at 10am

·       Monday 23^rd February 2026, at 10am.

The dates of the meetings for the Commission were confirmed as follows:

16^th June 2025

27^th November 2025

23^rd February 2025

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.

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

It was noted that none were received.

The Senior Communications & Public Affairs Lead for Communications and Engagement team at NHS Leicester, Leicestershire and Rutland submits a report on the NHS Transformation.

The Executive Director for Integration and Transformation for Leicester, Leicestershire and Rutland (LLR) submitted two papers to outline where the NHS in LLR were at financially in terms of budget.

As part of the presentation, it was noted that:

• During the last financial year, the system worked together to deliver a challenging joint financial plan. Despite the difficulty, the system saved £150 million by improved efficiency of service delivery.
• Demand for health and care services continued to rise, increasing the pressure to deliver further savings. The total budget for LLR was £2 billion, with a further £190 million in savings required.
• National and local changes announced earlier this year had intensified pressures. These included organisational restructures that were impacting staff, with the ICB in LLR required to reduce its running costs by up to 33%. NHS Trusts had also been given targets to reduce workforce growth, particularly in non-clinical/non-patient-facing roles and there had been a pause on recruitment in these areas.
• Health and care partners across LLR were tackling these challenges head on. Everyone working in the system remained committed to delivering the high quality care our communities expected and deserved. They were focused on making every pound count but the scale of the challenge meant they would need to make difficult choices about how services were delivered or potentially stopped.
• They would continue to work closely with partners, including councils, voluntary sector organisations, patients and the public to become more efficient and make the changes needed to meet financial targets.

The 3 key areas of focus were:

·       Recruitment and staffing – Prioritising the most critical, patient-facing roles, and reducing bank and agency spend, whilst maintaining a strong focus on putting patient safety first.

·       Tackling inefficiencies – including inefficient processes to delivering care that doesn’t meet patients’ needs. We can all help by improving how we work and making sure we are delivering the right care in the right way.

·       Redesigning services – It was essential that budgets funded the services our population required most. That may mean changing or potentially stopping some established services and rethinking how to deliver better outcomes for patients.

As well as focusing on these areas, they were contributing to the development of the national 10-Year Health Plan, which aimed to transform healthcare delivery by emphasising prevention, enhancing community-based care, and embracing digital technologies. The local shorter-term operational plans would be developed alongside this to ensure we are aligned nationally while responding to local needs.

In discussions with members and officers, the following was noted:

• Assurance was given that, despite savings pressures, progress had been made on initiatives such as mental health cafés and health checks.
• It was acknowledged that system transformation was discussed each year, with questions raised around how savings targets were being met and measured.
• The potential to include year-end reporting on the work programme was suggested.
• Concern was raised regarding the impact of workforce reductions, particularly a 33% reduction in ICB staffing, and how staff morale and wellbeing were being  ...  view the full minutes text for item 53.

The East Midlands Ambulance Trust will present the Commission will a verbal presentation on a current Digital Pilot Project.

The East Midlands Ambulance Service Senior Manager for Quality presented the digital programme pilot for stroke recovery which is a collaboration with University Hospitals of Leicester.

As part of the presentation, key points noted were:

·       The programme aimed to improve patient safety and equality. Stroke had been the 4^th largest cause of death and was the biggest cause of gained disability.

·       Stroke was hard to diagnose. A definitive diagnosis required a CT scan in hospital. The role of the paramedic was to recognise the symptoms and pre-alert the hospital. In 2022/23, data showed that 69% of cases were stroke mimics.

·       The pilot was intended to allow pre-hospital video triage. All ambulance technicians were provided with an iPad which allowed a direct video call with a stroke consultant when the team suspected a stroke. This allowed better preparation on the stroke ward and reduced the time for definitive treatment.

·       The technology allowed use of the shared care record allowing clearer signposting and pathways, reducing the burden on the Emergency Department.

·       The streamlining of the service through the video triage allowed ambulances to be back in the community faster, improved service efficiency, provided strong staff satisfaction, whilst patients received optimum care and experiences.

·       The pilot was launched in January 2024 and was intended to last 12 months. It was reviewed in January 2025 and funding was received to continue the project and launch it across further areas in the East Midlands.

·       Half of paramedics and technicians had been trained to use the technology in Leicester, Leicestershire and Rutland so far.

·       In September 2024 the pilot was moved to a 24/7 model, with 293 successful consultations completed.

·       The technology had prevented 28% patients being needlessly conveyed to hospital.

·       There was a higher occurrence of stroke in correlation with deprivation in Leicester. The pilot had therefore helped address health inequalities and offered an opportunity to improve health outcomes.

·       The accuracy of the video triage raised no risk or safety concerns for patients.

·       Barriers for the pilot included:

o   the challenge of linking 2 organisations on Microsoft Teams, particularly with consideration for data governance issues and information security. 

o   Difficulty providing 8 different stroke consultants with access.

o   The support needed to be provided quickly for potential stroke patients. This had led to the development of a one touch button for the ambulance technicians. If this failed to be answered by a consultant, the crew would revert to the pre-alert method. High levels of unanswered calls were an issue and reduced motivation so staff training was provided for crews and consultants and incentives were put in place until the process was fully embedded into the system.

·       A national move was now underway to embed this system in all ambulance services.

In response to questions and comments from members, it was noted that:

·       The pilot was a fantastic initiative.

·       The software used by the ambulance crews allowed roaming across different networks to maximise location use. There had been 3 cases where the signal could not  ...  view the full minutes text for item 54.

The Leicester Partnership Trust will give the Commission a verbal presentation on Shared Care Records.

The Leicester Partnership Trust (LPT) gave a verbal presentation on the Shared Care Records.

It was noted that:

• The Shared Care Record covered different patient groups and local authorities.
• The system brought together various data sets into one place, this offered a more holistic view of a person’s care, including any social care provision.
• Historically, social care teams had to wait for information before picking up cases, but this system aimed to reduce those delays.
• Around 1,100 social care users and professionals across the three local authorities had access to the record.
• The system also showed who was providing care across different organisations.
• GPs were in the process of being rolled out onto the system.
• Other services such as Pharmacy First, LOROS, EMAS, Rainbows, and patient care local terms were also being connected.
• Onboarding continued for new use cases and in alignment with national directions, while also focusing on local user needs.
• A pilot had started with Children’s Social Care groups, including Looked After Children, working on a data set to support direct care for individual children.

In discussions with Members, the following was noted:

• It was noted that Adult Social Care (ASC) had often been overlooked compared to health services. Questions were raised about who the 1,100 users accessing the shared care record were, as this only represented a small portion of the ASC workforce in the city. Concerns were expressed about whether frontline staff were benefiting from the system.
• Officers clarified that teams granted access had been prioritised by local authorities, such as front door, mental health workers, learning disability workers, social care workers and review teams and rapid response teams. The system was designed to link into existing platforms like Liquid Logic, avoiding the need for additional logins. Care homes also currently had access to SystmOne, with potential for integration with the care records.
• Members welcomed the progress and asked about the timeframe for enabling access to records during a person's hospital stay and how early in their care journey this could happen.
• Officers explained that timelines were dependent on work by system suppliers and aligned with financial year planning. While there were internal targets, no national deadlines had been set.
• Questions were raised on how the rollout would be paced and how different IT systems used by domiciliary care providers could be affected by the process. It was noted that many local authorities use Liquid Logic, which could help speed up national implementation. Careful management of consent, especially from families and informal carers was emphasised.
• Concerns were raised about data security, particularly regarding children. Members questioned safeguards in place to prevent full access to sensitive information stored in systems like Liquid Logic.
• Officers reassured that access was strictly for direct care and based on a need to know basis. Not all users had access to full records, and data visibility was limited to specific patients and relevant information only.
• Queries were made about the financial cost of the programme, especially in light of past failed attempts  ...  view the full minutes text for item 55.

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

Members raised concerns about dentistry across the LLR. Members were advised to contact the ICB and an item on dentistry would be added to the work programme.

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

The chair highlighted the work programme and items noted during the meeting would be added to the work programme. 

With there being no further business, the meeting closed at 12.30.