Agenda and minutes

Apologies for absence were received from the following:

Dr Avi Prasad, Place Lead, Leicester, Leicestershire and Rutland Integrated Care Board

Benjamin Bee, Area Manager Community Risk, Leicestershire Fire and Rescue Service

Jean Knight, Deputy Chief Executive, LPT

Kevin Routledge, Strategic Sports Alliance Group

Rachna Vyas, Deputy Chief Executive & Chief Operating Officer, Leicester, Leicestershire and Rutland Integrated Care Board

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.

Members are asked to note the membership of the Board for 2025/26,

approved by Annual Council on 15 May 2025:

City Councillors (5 places)

­   Councillor Vi Dempster, Assistant City Mayor, Health, Culture, Libraries and Community Centres (Chair)

­   Councillor Elaine Pantling, Assistant City Mayor, Children and Young People

­   Councillor Geoff Whittle, Assistant City Mayor, Environment and

Transport

­   2 Vacancies

Council Officers (4 places)

­   Laurence Jones, Strategic Director of Social Care and Education

­   Rob Howard, Director of Public Health

­   Dr Katherine Packham, Public Health Consultant

­   Vacancy

NHS Representatives (7 places)

­   Caroline Trevithick, Chief Executive, Leicester, Leicestershire and

Rutland Integrated Care Board

­   Rachna Vyas, Chief Operating Officer, Leicester, Leicestershire and

Rutland Integrated Care Board

­   Dr Avi Prasad, Clinical Place Leader, Leicester, Leicestershire and

Rutland Integrated Care Board

­   Helen Mather - Associate Director of Elective Care, Cancer and

Diagnostics, Leicester, Leicestershire and Rutland Integrated Care Board

­   Ruw Abeyratne, Director of Health Equality and Inclusion, University

Hospitals of Leicester NHS Trust

­   Jean Knight, Deputy Chief Executive, Leicestershire Partnership NHS

Trust

­   1 Vacancy

Healthwatch / Other Representatives (8 places)

­   Harsha Kotecha, Chair, Healthwatch Advisory Board, Leicester and

Leicestershire

­   Rupert Matthews, Police and Crime Commissioner, Leicester,

Leicestershire and Rutland

­   Barney Thorne, Mental Health Partnership Manager, Leicestershire

Police

­   Benjamin Bee, Area Manager Community Risk, Leicestershire Fire and

Rescue Service

­   Kevin Allen-Khimani, Chief Executive, Voluntary Action Leicester

­   Kevin Routledge, Strategic Sports Alliance Group

­   Sue Tilley, Head of the Leicester and Leicestershire Enterprise Partnership

­   Bertha Ochieng, Professor of Integrated Health and Social Care at De

Montfort University

The membership for 2025-26 was noted and was approved at Full Council.

The Minutes of the previous meeting of the Board held on 6^th March 2025 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 18^th April 2025 be confirmed as a correct record.

The Chair to invite questions from members of the public.

It was noted that none had been received.

The Director of Adult Social Care and Safeguarding submits the Better Care Plan 2025-2026 and requests for this to be endorsed by the Health and Wellbeing Board.

(Documents will be circulated to members via email.)

The Chair agreed to combine items 6 and 10 of the agenda together.

The Director of Adult Social Care and Safeguarding presented the items.

It was noted that:

·       The governance for the Better Care fund was managed through the Integrated Care Group for Leicester City and there was not a distinct Better Care Group that meets monthly to manage the operational detail, support the planning process, ensured that the fund is delivered in line with the national conditions and achieves the right outcomes for the people of the Leicester.

·       The Better Care fund for 2025-2026 had received approval from the national team as a plan. The Quarter 3 template had also been submitted to the national team and had been accepted.

AGREED:

That the board notes and approves the Better Care Plan 2025/26 and the Better Care Fund Quarter 3 Template  2025/26

The Digital and Transformation Lead for Leicester City South PCN submits a report on a population health management approach to addressing health inequalities using social prescribing:

• 3 Conversations
• Multimorbidity population support with understanding their medication
• Overview of project and its impact

The Digital and Transformation Lead for Primary Care presented the report, it was noted that:

·       There was two key projects underway, the first being "3 Conversations" part of the approach to population health management was working with ICB, Midlands and Lancs partners, and clinicians within the organisation to get their insights in to the people in the area and develop a model.

·       A lot of data was used to support and identify different themes across the Primary Care Network (PCN) and some tailored interventions were developed to address the at risk population in the area.

·       A cohort of patients were identified that were not engaging with the general practice services for health needs and were often presenting in crisis at out of hours services.

·       The process of contacting a patient was reviewed and a particular theme was identified where 2 forms of contact were made to try and engage a patient and get them back on track. Due to pressures and resources in PCN these patients were not followed up with after the second form of contact was attempted.

·       Reports from the emergency department and Police Protection Notifications (PPNs) were used to identify high-contact individuals not accessing support and showed significant health concerns, this led to the clinical directors to assess this across the whole primary care network and review who they were trying to engage.

·        When the 3 Conversations training was delivered, this cohort of patients were looked at to be supported and engage with their health needs.

·       The population chosen for the project were registered across 3 practices based in Saffron and Eyres Monsell, individuals over 18 years old and had received a PPN with mental health issues raised in the last 6 months.

The "3 Conversations" Approach:

­   Conversation 1: Understanding what matters to the individual and connecting them to local resources to live independently.

­   Conversation 2: Supporting people in crisis.

­   Conversation 3: Helping individuals build a good life and take responsibility for their health and wellbeing.

­   Conversations were made with individuals from SystmOne via GP Surgeries and recording all notes on the progress and type of contact made.

­   Due to the number of non-engagements an initial letter was produced. It was found that the reading age in the area meant that sometimes the letters were not understood. So it was broken down into tailored engagement methods included letters adapted for local reading age, with short sentences, limited information visuals and the key message being to get in touch.

­   No timescale was decided for how long they would try to contact the patient, rather as much time that the patient needed to get on their journey.

­   Contact was recorded on a templated entry, to capture the different support that was being provided.

­   Check ins were taking place with Leicester City Councils Adult Social Care and usage of their Liquid Logic System to assess notes and understand what other workers were involved in their care to avoid duplication and manage timely  ...  view the full minutes text for item 128.

The Deputy Chief Nurse at University Hospitals Leicester has submitted a report providing an overview of current care standards. The report highlights the actions being taken to drive improvements and outlines the tools in place to support and assure quality of care.

UHL Quality Care Standards submitted a report to highlight the current position of actions being taken to continuously improve the position. It was noted that:

·       A new quality assurance framework was being rolled out across the whole organisation to understand the areas requiring support where the standards fell below the expected target. New tools were developed to ensure recording and visibility foe patients cared for in temporary escalation spaces (TES), during times of escalation across the system. This includes care for patients receiving care on ambulances, awaiting transfer into the Emergency Department.

·       It was explained that rising pressures in emergency care formed the context for understanding the challenges in maintaining quality standards.

·       Data showed that emergency department (ED) attendances continued to increase, with no signs of reduction. As a result, performance against the national four-hour standard had been impacted.

·       UHL was operating at approximately 60% compliance with the four-hour standard, compared to a national average of around 100 trusts, placing the trust below expected performance levels.

·       The ED was becoming increasingly busy, with delays in patient transfers contributing to ambulance handover challenges. Approximately 30% of ambulance arrivals were experiencing extended waiting times outside the department.

·       In response, the Trust had expanded urgent treatment capacity, increased alternative pathways, and made changes to the ED footprint.

·       It was noted that a requirement to respond to ambulance releases within 45 minutes had added pressure to maintain rapid patient flow, further compounding complexity.

·       Hospital-acquired pressure ulcers had previously placed UHL as an outlier nationally. While new equipment and beds had been introduced, early rollout lacked sufficient staff training. Improvements had since been made, although further work remained.

·       Specialist services, which had been paused during the COVID-19 pandemic, had now returned to ward settings to support care. It was also highlighted that some patients arrived with pre-existing pressure ulcers, which were not always recorded in time due to early system constraints.

·       85% of patients were now being seen within the agreed timeframe, which had positively impacted pressure rates.

·       Falls in hospital remained a key challenge, particularly among patients with dementia or delirium. The unfamiliar hospital environment increased risk, and additional specialist care was being introduced.

·       A business case had been approved for sensor mats that alert staff when patients attempt to move, aiming to reduce the incidence of falls.

·       The Trust was using a quality platform called MEG to monitor nursing metrics, including screening and care planning. Some red and amber ratings were noted, indicating areas for improvement. Nursing assessments were expected to be completed within six hours.

·       A quality improvement framework known as the LEAF (Leicestershire Excellence Assurance Framework) had been introduced in the previous year. This tool assessed ward performance based on 12 standards covering quality, safety, efficiency, patient and staff experience, with measurable metrics.

LEAF is structured around 5 key pillars:

­   Quality & Safety

­   Efficiency

­   Patient Experience

­   Staff Experience

­   Improving

·       These pillars are further defined by 12 standards and underpinned by 69 measurable metrics

·       LEAF had been rolled  ...  view the full minutes text for item 129.

The Senior Intelligence Manager, Leicester City Council submits an update to the Health and Wellbeing Board on the Pharmaceutical Needs Assessment.

Public Health submitted a report on the Pharmaceutical Needs Assessment 2025 for a approval to proceed to statutory consultation. It was noted that:

·       Health and Wellbeing boards have a statutory duty to complete a Pharmaceutical Needs Assessment (PNA) every 3 years to assess current and future pharmaceutical services within their area. It is used to inform planning and commissioning of pharmacy services and to inform decision making in response to applications made to provide a new pharmacy.

Legislation specifies that the document must include:

­   A statement of necessary services to meet current needs.

­   Services required to meet future demand or current needs not currently provided.

­   Recommendations to secure improvements or better access, now and in the future.

­   Additional contextual and supporting information.

·       Slides accompanying the report provided further detail on the required content and methodology.

·       There was a noted higher concentration of pharmacies in certain areas of the city.

·       Leicester currently had 83 pharmacies, equating to approximately 2.2 pharmacies per 10,000 residents.

·       All pharmacies were required to open for a minimum of 40 hours per week, with five pharmacies open for 100 hours.

·       While all pharmacies offered essential services, there was variation in the provision of advanced services, which could require patients to travel further for specific support.

·       The analysis included a pharmacy in Evington that had since closed, as the closure occurred after the data collection period.

·       Recommendations considered equity of access and explored how to encourage pharmacies to open in areas with lower provision.

·       Digital literacy and its impact on service access was also highlighted, alongside the role of pharmacies in broader commissioning strategies.

·       It was proposed that any new policy or funding changes be reviewed and reported to the Health and Wellbeing Board (HWB), with an annual update to be provided.

·       The statutory consultation period would run for 60 days, and subject to approval, the final version would be signed off and published in October.

In discussions with Members, the following was noted:

·       It was noted that the consultation should consider both city and county perspectives, reflecting the needs of individual communities and the pharmacies that serve them.

·       Members highlighted the importance of exploring different consultation models beyond reliance on surveys, suggesting task groups and varied engagement methods to ensure wider participation and ensure the assessment was fit for purpose.

·       The importance of ensuring accessibility was emphasised, particularly in addressing why some individuals attend A&E despite pharmacies being well-placed to provide support.

·       Gaps in provision across the city were acknowledged, and collaborative work with NHS England and other partners was underway to address them.

·       It was noted that a significant proportion of ICB costs related to prescribing, and questions were raised around opportunities to tackle medication waste and improve compliance, including clarity on where responsibility for this lay.

·       Members commented that all pharmacies offered a medicine return service, which could help reduce waste if better utilised.

·       The link between social prescribing and medication use was discussed. It was suggested that supporting people  ...  view the full minutes text for item 130.

An update on the Quarter 3 data for the Better Care Fund.

(This document will be circulated to members via email)

This item is minuted under item 6.

An overview of the Leicester City Gambling Harms Needs Assessment, outlining the health needs of the local population, the existing support services, and recommendations for further action to address identified needs

Katherine McVicar, Public Health, Leicester City Council submitted a report on the Gambling Harms Needs Assessment. They were joined by Annie Ashton, a Leicester Resident who had been campaigning for stricter gambling regulations following the death of her husband Luke Ashton.

The Chair welcomed Annie and noted the importance and value of having individuals share personal stories with an academic board.

It was noted that:

·       Annie shared that she had lost her husband, Luke, to gambling-related suicide in 2021 in Leicester.

·       The gambling operator had been listed as an interested party and appeared on the death certificate.

·       Following the inquest, gambling had been included in the local suicide prevention strategy a historic step given the complexity of suicide.

·       Annie had since been involved in work relating to gambling harm prevention, including contributions to changes in clinical codes of practice.

·       Katherine thanked Annie for attending and for highlighting the real harms of gambling.

·       An overview of previous work completed around 18 months earlier was presented, this had not previously been shared with the Health and Wellbeing Board.

·       It was noted that 54% of the population had gambled at least once a year, around 40% excluding the lottery.

·       Problem gambling had affected approximately 0.4% of the population, with 0.3% at risk and 7% indirectly affected.

·       When applied to Leicester’s population, this equated to roughly 1,500 cases of gambling harm, 14,000 problem gamblers, and 26,000 indirectly affected individuals.

·       Gambling had been linked to numerous harms including debt, poor mental health, and suicide.

·       Leicester had a higher than average population of young people, people from deprived backgrounds, and ethnic minorities  all factors increasing vulnerability to gambling harm.

·       Gamble Aware data had illustrated the demographics engaging with support services, which had aligned with comparator areas despite small numbers.

·       A map had shown the accessibility of gambling premises, which were more concentrated in the city centre and deprived areas.

·       Leicester had been identified as one of the highest areas for problem gambling but with low levels of support service uptake.

·       Three support services were currently available, including one NHS service accepting referrals across the East Midlands.

Recommendations from the needs assessment included:

­   Developing a local strategy to address gambling harms through collaboration.

­   Improving data collection and screening for those at risk.

­   Increasing training, signposting, and public education especially targeting children and families.

­   Influencing advertising and licensing regulations to protect the public.

­   The work was in its early stages and stakeholders were being engaged.

­   Support from the Health and Wellbeing Board was requested to take the work forward.

It discussions with Members, the following was noted:

·       Members stated that Annie’s contribution had a strong impact and thanked her for attending.

·       Annie highlighted that 44% of people were in a high-risk gambling category and criticised the limited scope of Gamble Aware, noting it was funded by the gambling industry. She cited more recent Gambling Commission analysis suggesting the problem was far greater.

·       Members noted they had attended an online webinar with Leicestershire  ...  view the full minutes text for item 132.

To note that meetings have been arranged for the following dates in 2025/2026 which were submitted to the Annual Council in May 2025.  Please add these dates to your diaries.  Diary appointments will be sent to Board Members.

Thursday 25 September 2025 – 9.30am

Thursday 4 December 2025 – 9.30am

Thursday 5 March 2026 – 9.30am

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

The dates of future meetings were noted by board members.

The Chair noted that many organisations had failed to send a representative or apologies despite the statutory status of the Health and Wellbeing Board. Attendance was now a consistent concern.

The meeting was declared closed at 12.28.