Agenda and minutes

Apologies for Absence were received from:

-    Councillor Vi Dempster - Deputy City Mayor – Education, Libraries & Community centres, LCC

-    Councillor Elly Cutkelvin - Deputy City Mayor - Housing & Neighbourhoods

-    Sue Tilly - Head of the Leicester and Leicestershire Enterprise Partnership

-    Ben Bee - Area Manager, Community Risk, Leicestershire Fire & Rescue

-    Simon Barton - Health Equality & Inclusion, University Hospitals of Leicester NHS Trust (UHL)

-    Dr Caroline Trevithick – LLR ICB Chief Nursing Officer & LLR ICB Deputy Chief Executive

-    Andy Williams - Chief Executive, LLR Integrated Care Board

-    David Williams – Director of Strategy & Business Development, LPT

-    Richard Mitchell – Chief Executive, University Hospitals of Leicester NHS Trust (UHL)

-    Cathy Ellis – Chair of Leicestershire Partnership NHS Trust (LPT)

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

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.

The Minutes of the previous meeting of the Board held on 21 September 2023 are attached and the Board is asked to confirm them as a correct record.

An amendment was requested to be made to record the apologies for Cllr Adam Clarke and Harsha Kotecha at the last meeting.

RESOLVED:

That the Minutes of the previous meeting of the Board, held on 21 September 2023, be confirmed as a correct record once the correction noted above has been made.

Jon Melbourne (Chief Operating Officer, University Hospitals Leicester) and Rachna Vyas (Chief Operating Officer, Integrated Care System) will present and outline the ICB/NHS winter plan and priorities for the 2023/24 winter period. Mayur Patel (Head of Transformation, LLR Integrated Care Board) and Nisha Patel (Head of Transformation, LLR Integrated Care Board) will present an overview of Primary Care Capacity Planning over the winter period.

Jon Melbourne (Chief Operating Officer, University Hospitals Leicester) and

Rachna Vyas (Chief Operating Officer, Integrated Care System) outlined the ICB/NHS winter plan and priorities for the 2023/24 winter period. It was noted from the presentation that:

·         The plan was a system plan and not just a UHL one.

·         The early publication of the national winter plan (in January 2023) was welcomed.

·         The local Winter Plan focussed on the following four areas:-

-       Increased capacity

-       Speeding up discharges from hospital

-       Expanding new community services

-       Helping people to access the correct care.

·         Ways that improvements to flow in and out of hospital were listed as:-

-       Opening Acute Respiratory Illness Hubs in Primary Care.

-       Provision of Virtual Wards.

-       Increasing the same-day emergency care within both Leicester Royal Infirmary (LRI) and Glenfield Hospital (GH).

-       A new Respiratory Ward, Chest Pain Centre and Respiratory Support Unit at GH.

-       The challenge around children and young people has been tackled by including them in the plans from the outset – and increasing the capacity in Paediatrics.

-       By reviewing pathways and increasing community capacity the blocks to discharge have been reduced.

·         There was a strong Elective Care Plan which incorporates protected capacity to reduce waiting lists. Metrics to indicate this waiting list reduction, including the Cancer waiting list, were included in the reports within the agenda pack.

·         Data in the pack highlighted the reduction in ambulance handover times and the reduction in the diagnostic backlog.

·        

Rachna Vyas’s presentation included the points below:-

·         Other impactful programmes included;

-       The Pulmonary Rehabilitation Programme.

-       A Crisis Pathway for clients living in inadequate housing (and this is linked to close liaison working with the Local Authority on Housing issues, damp and mould etc).

-       Unscheduled Care Hubs have representation from all agencies. These can meet the holistic needs of the patient (eg providing handrails for home), increasing flow and easing system pressures.

·         There had been an increase from 500,000 to 600,00 from last year to this for Primary Care appointments - with pathways in place to transfer burdens from GPs to services such as Pharmacy.

·         Ambulance handovers were at 1.5 hours last year.

·         At the last Health & Wellbeing Board (HWB) the Presenting Officer had reported on the 300 patients found to have not had their NHS Health Check; this had since increased and had been a valuable piece of work.

·         The plan had received national recognition for its partnership working – with regional colleagues asking for advice on how Leicester was achieving this.

Comments and questions from the Board:-

-       Members of the Board thanked everyone involved - and noted that this was a great example of progress through partnership.

-       Members of the Board commented that prioritisation and investment in prevention was vital.

-       Members agreed that prevention was not just the responsibility of Public Health - and called for there to be a commitment in the financial element of the ICB 5-year plan.

-       Members asked the presenting officers to  ...  view the full minutes text for item 30.

Kay Darby (Deputy Director Vaccinations and Immunisations, Leicester, Leicestershire and Rutland Integrated Care Board) will present an overview of the winter vaccinations and immunisations programme across the Leicester population for adults and children and young people.

Kay Darby (Deputy Director Vaccinations and Immunisations, Leicester,

Leicestershire and Rutland Integrated Care Board) presented an overview of

the winter vaccinations and immunisations programme across the Leicester

population for adults, children and young people. It was noted that:

·         The Autumn Covid and Flu vaccination programmes had started early and were going well.

·         There was less appetite for Covid jabs this year despite all efforts to drive uptake. Kay’s team are working with Public Health and meeting weekly to monitor and address uptake.

·         There had been a phased reduction in the age for Shingles jab eligibility.

·         A dedicated Inequalities Lead had been appointed for School Aged Immunisations – and one aspect they would be looking at is self-consent for children in Year 8.

·         There were now Measles cases in all regions of the UK.  5 confirmed cases in LLR (4 of these are in the City) plus another four probable cases. There had been considerable community engagement in the areas where there are cases or where uptake of vaccinations is low.

·         Commissioning wouldl transfer to ICBs from April 2025 – and there were transition arrangements in place.

Comments and questions from the Board:-

·         The Chair was concerned about vaccination levels among staff (particularly in Health and Social Care) as this may impact resilience in the winter and cause transmission to residents/patients/clients. She asked that this be a focus for next year.

·         The Chair offered the support of the Board around the informed consent for young people aged 12 plus.

·         The Director of Public Health noted the work that had been done – but felt there were still stark inequalities that need to be addressed.

·         Members were pleased with the current levels of vaccination within Care Homes. The Presenting Officer noted the input of the Local Authority in this work – and that the lessons learnt from previous rounds of vaccinations was used to improve the uptake.

·         One Member noted that immunisation programmes were offered to all residents - but urged for a “Proportionate Universalism” approach whereby the funding, time and personnel be directed most intensively to those with greatest need.

·         One Member noted that a current study in East Leicester has highlighted negative opinions on vaccination/immunisation – and felt these would need to be countered by sophisticated engagement.

·         Members asked whether the lessons learnt from Covid were being utilised now, and perhaps it would be useful to stop, check and reflect. One Member noted that Public Health undertook qualitative studies about vaccine hesitancy during the peak of the pandemic, and this could be revisited. Another Member, however, felt that the current picture is very different to when that research was conducted. The Presenting Officer responded that there was evaluation built into every programme.

·         Members noted that the Board could help support a request for a more sustained uplift in gelatine-free doses of MMR (as the 20 doses allocated is insufficient for the City’s requirements).

·         The Chair drew members attention to the call at the last meeting for better collective sharing of  ...  view the full minutes text for item 31.

Kate Galoppi, (Director of Adult Social Care and Commissioning, Leicester City Council), Mark Abbot (Head of Service, Social Work, Leicester City Council), and Jagjit Singh-Bains (Head of Independent Living, Leicester City Council) will present a summary of the actions in place locally to support a resilient social care system that is able to provide people and their carers with appropriate support this winter.

Kate Galoppi, (Director of Adult Social Care and Commissioning, Leicester City

Council), Mark Abbot (Head of Service, Social Work, Leicester City Council),

and Jagjit Singh-Bains (Head of Independent Living, Leicester City Council)

presented a summary of the actions in place locally to support a resilient Social

Care system that is able to provide people appropriate support this winter. It was noted that:

·         Providers/Staff had been sent a letter to thank them for their hard work in challenging times; this would be re-run soon in collaboration with Health colleagues and will incorporate a call to take up vaccinations.

·         Adult Social Care (ASC) played a critical role in supporting the whole system’s flow – and particularly so in winter.

·         Unpaid carers were acknowledged as a vital part of the system.

·         There were identified leads for vaccinations, and the strong existing Provider Forums could be used to promote messages around uptake.

·         A focus of the work has been to avoid hospital admission if possible – and the Integrated Crisis Response Service (ICRS) had been a major part of this. It was a 24/7 offer, with response rates within two hours.

·         430-500 patients were seen per month, and 80-85% then remained at home as a result.

·         There had been an 8% increase in demand from last year to this year, so the investment in commissioned beds had been retained.

·         A Reablement Rehabilitation Recovery (RRR) pathway went live from 1.11.23.

·         Some funding to set up the RRR came from the Integrated Care Board.

·         In the first two weeks of November the team saw more patients than the whole of last November.

·         A Night Service had been devised – and Presenting Officers were keen for this to help achieve ambitious targets for discharge from hospital.

·         Presenting Officers noted that the internal and external workforce were asked to check that houses are warm. In addition, the Better Care Fund’s Cold Homes Initiative enabled links to Housing colleagues so advice can be given on boilers, windows etc. 

The Winter Discharge Fund was received early this year.

Comments and questions from the Board:-

-       Members asked about the rates of reablement in Leicester compared to other regions. The Presenting Officers responded that a study of 54 Local Authorities showed that Leicester delivered some of the best outcomes with good value for money.

-       Members asked whether the models had sustainable funding attached or were reliant on pilot funding. The Presenting Officers responded that the base budget was from LCC and then matched by the ICB.

-       Members noted that Prevention could be ring-fenced within the Better Care Fund. 

-       Members noted that this work was an example of the power of partnership and collaboration.

-       The Chair noted that Leicester had been put forward for a National award for this work.

-       .

RESOLVED:

1.    That the Board thanked Officers for the report and asked that comments from the meeting are taken into account.

2.    That the Board offers support to the consideration of ways to commit funding for  ...  view the full minutes text for item 32.

Gurjinder Bans (Public Health Programme Manager, Leicester City Council) and Kate Huszar (Public Health Programme Manager, Leicester City Council) will share a presentation to outline programmes and initiatives to address critical winter issues.

Gurjinder Bans (Public Health Programme Manager, Leicester City Council)

and Kate Huszar (Public Health Programme Manager, Leicester City Council)

shared a presentation to outline programmes and initiatives to address critical winter issues.  It was noted that:

·         The Cost-of-Living crisis  exacerbated issues for this winter. An Incident Management Team (IMT), led by Public Health, brought partners within LCC together.

·         Leicester’s Baby Basics branch (providing expectant and new families in with essential equipment) was the second busiest branch in the UK. All members were asked to promote the “reverse advent calendar” detailed in the slides.

·         Some Emergency Food providers were moving towards low-cost models (eg pantry style schemes) to reduce stigma.

·         There was insufficient capacity within Public Health to go out to the community as much as the Presenting Officers would like – so Voluntary and Community Sector organisations were being utilised.

·         Mental Health Friendly Places were being set up, and training was being offered to settings such as Hairdressers and Cafes.

·         The Leicester Energy Action (LEA) Scheme was delivered by Public Health in collaboration with National Energy Action, with initial funding provided by the ICB and additional money via LCC’s Anti-Poverty Fund. The scheme was the first of its kind in the UK.

·         There was a variety of training provided via the LEA (from short & free webinars to a three-day City and Guilds Qualification for frontline staff).

·         There were “Warmth Packs” given out as part of the LEA scheme.

·         The LEA scheme had good links with partners to enable concerns about mould to be escalated appropriately.

·         Kate Huszar updated members about the “Warm Welcome” work which had seen Public Health collaborate with the LCC departments of Adult Learning and Neighbourhoods to establish warm spaces.

·         There was community outreach as part of the Public Health work around social isolation utilising the Voluntary Sector.

·         Let’s Get Digital had NHS funding - and offerd two free three-hour sessions. The sessions focused on staying safe online and meeting social needs (eg booking a GP appointment).

·         All the schemes linked in with Social Prescribers.

Comments and questions from the Board:-

-       Members noted that VCS was not listed as a partner within the report (but the Presenting Officer confirmed this was an error)

-       The Director of Public Health noted that the “Let’s Get…” and LEA schemes were gaining National interest.

-       The Chair noted that this item again highlighted joined up working.

-       Members asked whether the Let’s Get Digital was adequate in capacity/scope to tackle the increasing channel shift towards online services – and whether there needs to be a scaling up. The Presenting Officer responded that this programme was quite specific in its outputs, but there are links to other providers who gave digital support (eg Reaching People).

-       The Member representing Voluntary Action Leicester (VAL) asked for more details on what the voluntary sector could do to support this work (whilst noting that VAL has recently been reaccredited nationally as a volunteer centre) and liaise to ensure any new  ...  view the full minutes text for item 33.

The Chair to invite questions from members of the public.

No questions from members of the public had been received.

To note that meetings have been arranged for the following dates in 2023/2024 which were submitted to the Annual Council in May 2023.  Please add these dates to your diaries.  Diary appointments will be sent to Board Members.

Thursday 18 January 2024 – 9.30am

Thursday 22 February 2024 – 9.30am

Thursday 18 April 2024 – 9.30am

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 note that meetings have been arranged for the following dates in 2023/2024

which were submitted to the Annual Council in May 2023. Please add these

dates to your diaries. Diary appointments will be sent to Board Members.

-       Thursday 18 January 2024 – 9.30am

-       Thursday 22 February 2024 – 9.30am

-       Thursday 18 April 2024 – 9.30am

Meetings of the Board are scheduled to be held in Meeting Rooms G01 and G02 at City Hall unless stated otherwise on the agenda for the meeting.

      i.        The Chair drew Members attention to the fact that 23.11.23 was National Carers Day – and urged members to recognise Carers as part of the system. She urged all members to check that their organisation encourages flexible working, vaccine uptake and carers payments as appropriate. She asked that there be a focussed session on Carers at a future Board meeting.

    ii.        The Chair reminded Members about the Council’s commitment to the Armed Forces Covenant and the Veteran Friendly Accreditation Programme.

There being no other business the meeting closed at 12.04 pm.