Agenda and minutes

Apologies for Absence were received from:-

Councillor Sarah Russell          Deputy City Mayor Social Care and Anti-Poverty, Leicester City Council.

Ivan Browne                                Director of Public Heath, Leicester City Council

Professor Azhar Farooqi           Co-Chair, Leicester City Clinical Commissioning Group

Andrew Fry                                  College Director of Research, University of Leicester.

Angela Hillery                             Chief Executive, Leicestershire Partnership NHS Trust

Harsha Kotecha                         Chair, Healthwatch Advisory Board, Leicester and Leicestershire

Kevan Liles                                 Chief Executive, Voluntary Action Leicester

Martin Samuels                          Strategic Director of Social Care and Education

David Sissling                             Independent Chair, Leicester, Leicestershire and Rutland Integrated Care System

Andy Williams                             Chief Executive, Leicester, Leicestershire and Rutland Clinical Commissioning Group

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

Members were asked to declare any interests they may have in the business to be discussed at the meeting.  No such declarations were received.

To note the membership of the Board for 2021/22 approved by the Annual Council on 19 May 2022:-

City Councillors: (5 Places)

Councillor Vi Dempster, Assistant City Mayor, Health (Chair)

Councillor Piara Singh Clair, Deputy City Mayor, Culture, Leisure and Sport

Councillor Sarah Russell, Deputy City Mayor, Social Care and Anti-Poverty

Councillor Elly Cutkelvin, Assistant City Mayor, Education and Housing

Councillor Mustafa Malik, Assistant City Mayor, Communities and Equalities

City Council Officers: (4 Places)

Martin Samuels, Strategic Director of Social Care and Education

Ivan Browne, Director Public Health

Dr Katherine Packham, Public Health Consultant

1 Vacancy to be nominated by the Chief Operating Officer

NHS Representatives: (7 Places)

Richard Mitchell, Chief Executive, University Hospitals of Leicester NHS Trust

Professor Azhar Farooqi, Co-Chair, Leicester City Clinical Commissioning Group

Angela Hillery, Chief Executive, Leicestershire Partnership NHS Trust

Oliver Newbould, Director of Strategic Transformation, NHS England & NHS Improvement – Midlands

Dr Avi Prasad, Co-Chair, Leicester City Clinical Commissioning Group

David Sissling, Independent Chair of the Integrated Care System for Leicester, Leicestershire and Rutland

Andy Williams, Chief Executive, Leicester, Leicestershire and Rutland Clinical

Commissioning Group

Healthwatch / Other Representatives: (8 Places)

Harsha Kotecha, Chair, Healthwatch Advisory Board, Leicester and Leicestershire

Andrew Brodie, Assistant Chief Fire Officer, Leicestershire Fire and Rescue Service

Kevan Liles, Chief Executive, Voluntary Action Leicester

Rupert Matthews, Leicester, Leicestershire and Rutland Police and Crime Commissioner

Kevin Routledge, Strategic Sports Alliance Group

Chief Superintendent, Jonny Starbuck, Head of Local Policing Directorate, Leicestershire Police

Sue Tilley, Head of Leicester & Leicestershire Enterprise Partnership

1 Unfilled Vacancy

STANDING INVITEE: (Not A Council Appointed Voting Board Member – Invited by the Chair of the Board. and no set number of places)

Cathy Ellis, Chair of Leicestershire Partnership NHS Trust

Professor Andrew Fry – College Director of Research, Leicester University

Richard Lyne, General Manager, Leicestershire, East Midlands Ambulance Service NHS Trust

John MacDonald, Chair of University Hospitals of Leicester NHS Trust,

Professor Bertha Ochieng – Integrated Health and Social Care, De Montfort University

The Board noted the membership for 2022/23 approved by the Council on 19 May 2022 as follows:-

To note the membership of the Board for 2021/22 approved by the Annual Council on 19 May 2022:-

City Councillors: (5 Places)

Councillor Vi Dempster, Assistant City Mayor, Health (Chair)

Councillor Piara Singh Clair, Deputy City Mayor, Culture, Leisure and Sport

Councillor Sarah Russell, Deputy City Mayor, Social Care and Anti-Poverty

Councillor Elly Cutkelvin, Assistant City Mayor, Education and Housing

Councillor Mustafa Malik, Assistant City Mayor, Communities and Equalities

City Council Officers: (4 Places)

Martin Samuels, Strategic Director of Social Care and Education

Ivan Browne, Director Public Health

Dr Katherine Packham, Public Health Consultant

1 Vacancy to be nominated by the Chief Operating Officer

NHS Representatives: (7 Places)

Richard Mitchell, Chief Executive, University Hospitals of Leicester NHS Trust

Professor Azhar Farooqi, Co-Chair, Leicester City Clinical Commissioning Group

Angela Hillery, Chief Executive, Leicestershire Partnership NHS Trust

Oliver Newbould, Director of Strategic Transformation, NHS England & NHS Improvement – Midlands

Dr Avi Prasad, Co-Chair, Leicester City Clinical Commissioning Group

David Sissling, Independent Chair of the Integrated Care System for Leicester, Leicestershire and Rutland

Andy Williams, Chief Executive, Leicester, Leicestershire and Rutland Clinical

Commissioning Group

Healthwatch / Other Representatives: (8 Places)

Harsha Kotecha, Chair, Healthwatch Advisory Board, Leicester and Leicestershire

Andrew Brodie, Assistant Chief Fire Officer, Leicestershire Fire and Rescue Service

Kevan Liles, Chief Executive, Voluntary Action Leicester

Rupert Matthews, Leicester, Leicestershire and Rutland Police and Crime Commissioner

Kevin Routledge, Strategic Sports Alliance Group

Chief Supt, Jonny Starbuck, Head of Local Policing Directorate, Leicestershire Police

Sue Tilley, Head of Leicester & Leicestershire Enterprise Partnership

1 Unfilled Vacancy

STANDING INVITEE: (Not A Council Appointed Voting Board Member – Invited by the Chair of the Board. and no set number of places)

Cathy Ellis, Chair of Leicestershire Partnership NHS Trust

Professor Andrew Fry – College Director of Research, Leicester University

Richard Lyne, General Manager, Leicestershire, East Midlands Ambulance Service NHS Trust

John MacDonald, Chair of University Hospitals of Leicester NHS Trust,

Professor Bertha Ochieng – Integrated Health and Social Care, De Montfort University

To note the Board’s Terms of Reference approved by the Annual Council on 19 April 2022.

The Board noted the Terms of Reference approved by the Annual Council on 19 May 2022.

The Minutes of the previous meeting of the Board held on 28 April 2022 are attached and the Board is asked to confirm them as a correct record.

RESOLVED:

The Minutes of the previous meeting of the Board held on 28 April 2022 be confirmed as a correct record.

Dr Katherine Packham, Public Health Consultant, Leicester City Council to present a report providing an update on the progress of the Pharmaceutical Needs Assessment (PNA).

Dr Katherine Packham, Public Health Consultant, Leicester City Council presented a report providing an update on the progress of the Pharmaceutical Needs Assessment (PNA).

It was noted that:-

·         The Health and Wellbeing Board has a statutory responsibility to prepare a Pharmaceutical Needs Assessment (PNA) for Leicester City and publish it by 1st October 2022.

·         The PNA was subject to a 60-day statutory consultation period which  opened on 6th July 2022 and would close on 4th September 2022.

·         The PNA looked at current, projected and future needs and made recommendations on what could be done differently. 

In response to questions from Board Members, officers stated

·         Thew PNA took into account population projections for the next 10-30 years to assess the number of pharmacies per 10,000 population and address any issues.  Currently there were 85 pharmacies across the City and overall Leicester had more pharmacies per 10,000 population at 2.4 than the 2.1 average for England.

·         There was a move away from hard to reach groups to a focus on making service more accessible.  Those communities which were deemed to underserved by pharmacies tended to be the same groups who experienced, homelessness, language barriers and physical barriers to accessing premises. There was a need to make people aware of how to contact or when to contact services.  The officer groups dealing with this would pick these issues up.

·         Work was progressing with developing the support role in pharmacies to dealt with minor injuries, covid and lifestyle issues.  The issue was providing incentives to pharmacy committees to increase  the supply of community pharmacies and take on these additional roles.

·         The increase in electronic prescribing reduced the impact on travelling distance but could give rise to the impact on overall needs if pharmacies were in the wrong locations.   Customers with transport could also be disadvantaged if there were no pharmacies in a convenient location to them.  Pharmacies were also competing with internet style delivery services.

·         The Integrated Care Board design group engaged with pharmacies and were looking at a number of th issues commented upon especially the issues around the workforce changing and moving around facilities which could leave big gaps in service provision and were seeing how this issue could be supported.

The Chair commented that moving pharmacies to engage in primary care was  crucial and the cornerstone to going forward.  All Board partners were engaged in this and asked that they asked questions in their own organisations on how to engage and respond and what can be done in each organisation to help in promoting the messages to the public.

RESOLVED:-            That officers be thanked for the progress made on the development of the Pharmaceutical Needs Assessment and were asked to submit the final Pharmaceutical Needs Assessment after it had been completed taking into account the comments made by the Board Members.

Dr Katherine Packham, Consultant in Public Health, Leicester City Council to present a report providing a summary of the current status of Leicester’s Health, Care and Wellbeing Strategy and the next steps.

Dr Katherine Packham, Consultant in Public Health, Leicester City Council presented a report providing a summary of the current status of Leicester’s Health, Care and Wellbeing Strategy and the next steps.

It was noted that:-

·         A refresh of Leicester’s Health, Care and Wellbeing strategy has taken place over the last few months. This involved retaining the five themes of Healthy Start, Healthy Living, Healthy Ageing, Healthy Places and Healthy Minds from the previous strategy which was published in 2019.

·         The Board has previously approved a decision to refresh the strategy to reflect challenges that had been highlighted by the pandemic or where the need had increased as a result of the pandemic.

·         A Leicester Place-led Plan Core Working Group was set up to develop the strategy and priorities on behalf of the Board.

·         A series of engagement events, including working with a range of community groups and an online survey, were held between November 2021 and January 2022 with ongoing engagement with a number of partnership groups.

·         The strategy would be presented to Health and Overview and Scrutiny committee in August 2022 where comments and feedback would be sought, before the final strategy was brough back to the Board together with a draft delivery plan.

·         The delivery/implementation plan was in the early stages of development and focused on the six ‘do’ priorities of:-

o   Healthy Places: Improving access to primary and community health/ care services

o   Healthy Start: Mitigating the impacts of poverty on children and young people

o   Healthy Living: Increasing early detection of heart & lung diseases and cancer in adults

o   Healthy Minds: Improving access to primary & neighbourhood level Mental Health services for adults.

o   Healthy Minds: Increasing access for children & young people to Mental Health & emotional wellbeing services.

o   Healthy Ageing: Enabling Leicester’s residents to age comfortably and confidently -  proposed focus on reducing health inequalities through a person-centred programme of frailty prevention.  (this wording was subject to change).

Members of the Board commented:-

·         That a good majority of GP practices in east and south of the City had patients from different ethnicity and languages and it would be helpful to look at a mix and match of language skills and to see if these can moved around to have a robust system to improve language access to service to overcome the barriers.

·         Sports clubs would welcome a meeting with the Council as they were  keen to contribute to Healthy Minds through sport and physical activity  but were unsure how this could be developed and wanted to understand how to capture synergy, avoid duplication with other initiatives and add value and ensure they were delivering initiatives to the right people in the right circumstances

·         The strategy should influence how services were enabled in the future. The strategy should have elements of skilling within it so it built services but also taught people how to drive changes and improvements.

 In response to Members comments officers commented that:-

·         Three items in the delivery plan related to language and how  ...  view the full minutes text for item 72.

Tracie Rees. Director of Adult Social Care and Commissioning. Leicester City Council and Mark Roberts. Assistant Director. Leicestershire Partnership NHS Trust to present a report on work to improve the outcomes for people with a Learning Disability or Neuro developmental needs.  As part of the Integrated Care System for Leicester, Leicestershire and Rutland there is the option to create formal collaboratives.  These are commitments from organisations to work together and to build on the work already done, with a commitment that we continue working together to get the best outcomes for people.

The Chair stated that consideration of the report would be deferred to a future meeting as it required further details to be added.

Mel Thwaites, Head of Women and Childrens Transformation, Dr Farah Siddiqui, Consultant Obstetrician and Gynaecologist and Robert Howard,  Consultant in Public Health to present a report on the response to the LLR Local Maternity and Neonatal System (LMNS) and build on the plans outlined in Appendix 1 to address this disparity.

The Chair stated that consideration of the report would be deferred to a future meeting as it required further details to be added.

Steve McCue – Senior Strategic Development Manager, LLR ICB and Mark Pierce, Head of Population Health, LLR ICB to present a report informing the Board of the NHS requirement by NHS England and NHS Improvement to deliver against the CORE20Plus5 to support wider work to reduce health inequalities across Leicester, Leicestershire and Rutland (LLR).

Steve McCue – Senior Strategic Development Manager, LLR ICB and Mark Pierce, Head of Population Health, LLR ICB submitted a report informing the Board of the NHS requirement by NHS England and NHS Improvement to deliver against the CORE20Plus5 to support wider work to reduce health inequalities across Leicester, Leicestershire and Rutland (LLR).

It was noted that:-

·         NHS England defined health inequalities as the preventable, unfair, and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental, and economic conditions within societies.

·         The LLR ICS was aligned to the national vision of ‘exceptional quality healthcare for all through equitable access, excellent experience, and optimal outcomes. Health inequalities exist on a gradient throughout populations, and they were committed to using a proportionate universalism approach to reduce inequity wherever it existed across LLR.

·         Core20Plus5 was a national NHS England and NHS Improvement approach to support the reduction of health inequalities at both national and system (LLR) level. The approach defined a target population cohort – the ‘Core20PLUS’ – and identified ‘5’ focus clinical areas requiring accelerated improvement.

·         The Core 20 referred to the most deprived 20% of the national population as identified by the national Index of Multiple Deprivation  (IMD). The IMD has seven domains with indicators accounting for a wide range of social determinants of health.  In Leicester, Leicestershire & Rutland (LLR), 153,284 registered patients live in the 20% most deprived neighbourhoods in England. In Leicester this was 31.7% of the total number of registered patients compared to 3.2% for Leicestershire and 0.4% for Rutland.

• The Core20Plus5 framework set out five clinical areas of specific NHS focus. Governance for these five focus areas sat with national NHS programmes and national and regional teams coordinate local systems to achieve national aims. The five clinical areas included;

o   Severe mental illness (SMI): ensuring annual health checks for 60% of those living with SMI (bringing SMI in line with the success seen in learning disabilities)

o   Early cancer diagnosis: 75% of cases diagnosed at stage 1 or 2 by 2028.

o   Hypertension case-finding: to allow for interventions to optimise blood pressure and minimise the risk of myocardial infarction and stroke

·         Using this framework would not tackle all health issues but it was still a good tool to improve Health and Wellbeing.  There were also elements that are locally determined, and officers will be working on those and bring a report to a future meeting to see which specific needs to be involved or where services were not serving groups very well e.g. communities that experienced vaccination issues during covid etc.

During discussion Members of the Board commented that:-  ...  view the full minutes text for item 75.

The Chair to invite questions from members of the public.

No questions from members of the public had been received.

To note that future meetings of the Board will be held on the following dates:-

Thursday 13 October 2022 – 9.30 am

Thursday 2 February 2023 – 9.30am

Thursday 13 April 2023 – 9.30 am

Meetings of the Board are scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

To Board noted that future meetings of the Board would be held on the following dates:-

Thursday 13 October 2022 – 9.30 am

Thursday 2 February 2023 – 9.30am

Thursday 13 April 2023 – 9.30 am

Meetings of the Board are scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

It was noted that the meetings for October and February would be re-arranged as there were NHS meetings on those days involving a number of the Board Members.

There were no items of Any Other Business.

The Chair declared the meeting closed at 10.57am.