Agenda and minutes

Apologies for absence were received from:-

John Adler                                Chief Executive, University Hospitals of

                                                    Leicester NHS Trust

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

                                                    Group

Andy Keeling                            Chief Operating Officer, Leicester City Council

Chief Supt Andy Lee              Head of Local Policing Directorate

Will Legge                                 Divisional Director,

Roz Lindridge                           Locality Director Central NHS England, Midlands

                                                    and East (Central England)

Dr Avi Prasad                           Co-Chair, Leicester City Clinical Commissioning

                                                    Group

Councillor Sarah Russell       Deputy City Mayor

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 might have in the business to be discussed at the meeting. No such declarations were made.

The Minutes of the previous meeting of the Board held on 17 August 2017 are attached and the Board is asked to confirm them as a correct record.

RESOLVED:

That the minutes of the previous meeting of the Board held on 17 August 2017 be confirmed as a correct record subject to the last line of paragraph a) in Minute No 87 being amended to read “to have extended access for all city registered patients”.

Tamsin Hooton and Jennifer Smith attended the meeting to present the LLR Winter Plan 2017-2018.

It was noted that the Plan was overseen by NHS England and had been submitted to them on 8 September 2017.  The Plan had been assured by the Local NHS Team and was currently awaiting a formal assurance from the National NHS England Team. The purpose of the Plan was to co-ordinate the health systems ability to response to increased demand for services from the public in seasonal winter periods and particularly to spikes in demand arising during that period.

The Plan was overseen locally by the A&E Delivery Board Chaired by John Adler assisted by a Winter Plan Sub-Group that brought together the different agencies involved.   As part of the planning process in preparing the lessons learned from the experiences of the previous winter period were reviewed to improve the resilience of the service for this winter.

The opening of the new Emergency Department was showing improved ambulance handover times.  The lost hours through ambulance crews waiting for patient handover had been reduced by over 80% which enabled the ambulance service to recycle those resources back into the system to enable EMAS to respond more rapidly to calls for assistance.

Changes had also been made in the community based urgent care services with a view to providing an enhanced clinical navigation process in conjunction with NHS 111 to introduced an enhance care triage assessment to signpost to book non-urgent patients into an alternative treatment in non-acute services settings.  Approximately 80% of patients seen by EMAS with a none emergency ambulance response were now receiving a different outcome from being conveyed to the acute hospital setting as a result of clinical navigation.  In addition 6—65% of ED referrals were also being treated in a different way as well. Demand was beginning to be moderated and attendances at the A&E Department were already showing a 2% reduction compared to the same period last year. This was also being supported by the 4 Health Care Hubs in the City and patients were being booked into these through the clinical navigation process where appropriate.

Work was continuing to build and develop elements of the Plan.  These included:-

·         The development of a flu and infectious disease plan across city.

·         Refining and refreshing the arrangements in relation to the need for a surgeon escalation within the plan co-ordinated by the CCG Team, so that there were clear actions at each level of pressure and that all partners were aware of the these actions at each level of escalation. 

·         The Plan also helped to manage the surge in demands and smooth out the peaks of demand for services.  There was a spike in demand for service on Mondays throughout the year and also after 2 days of Christmas and Bank Holidays which were exacerbated by the additional winter pressures.

·         A Passport Scheme, whereby patients identified as being at high risk of either attendance or admission to hospital, had a  ...  view the full minutes text for item 98.

Melanie Shilton, Communications Manager, Leicester City Clinical Commissioning Group will present the Winter Communications, Engagement and Marketing Plan 2017/18.

Melanie Shilton (Communications Manager, Corporate Affairs, Leicester City Clinical Commissioning Group) attended the meeting to present the report and respond to Members’ questions on the Communications and Engagement Plan.

The following comments were noted during the presentation:-

a)         Although the Plan was a collaborative LLR approach there were specific initiative that would be delivered in the City.  There was a strong collaborative approach across the LLR and all communications leads met fortnightly and would continue to do so throughout the winter to review the effectiveness of the arrangements.

b)         There were 5 key themes to the communications plan:-

1 Raising awareness of flu jab particularly with patients over 65 and those with long term conditions.  The plan was currently live and supporting GP practices to reach patients to have their flu jab.  One element was proactive telephone calls to patients identified as being at risk to encourage them to have their vaccinations.  There was some additional money available to support this for 8-10 practices in the city.

The national flu campaign would be launched later in the week and would focus on parents of young children, those with long term health conditions, pregnant women and BME communities.

2 Christmas Period The communications would be increased around the Christmas period encouraging people to contact the NHS 111 service which would then advise patients on the best service to use to get the appropriate level of health care for the patient’s needs e.g Pharmacy and GP practices where appropriate to relive the pressure on A&E Departments. In previous years patients who were unsure where service they could use to receive treatment had generally gone to A&E in the first instance.  The strategy aimed to reduce the spikes in demands at A&E department experienced in previous years.

3 Early help especially directed at the elderly who traditionally delayed getting care in the early stages which resulted in their condition deteriorating resulting in increased chances of being admitted to hospital.

4 Discharge Arrangements to encourage patients to return home with support if appropriate.

5 Care Homes were a key part of the health system and communications with care homes would be increased during the winter period to try and reduce hospital admissions.  Targeted communication had been successful with students in the City in the previous year

c) Specific initiatives in the City would include:-

·         Using all the free and owned channels of communications and relationships with key partners, including the Patient Participation Groups GP Practices and voluntary and community sector services.

·         A variety of toolkits would be shared widely and there would be pro-active outreach by attending community events.  This outreach had already been to all student fresher fairs.  The CCG arranged the contents displayed on the GP practice screens and this would be actively used to promote the Health Care Hubs, contacting the NHS 111service and the availability of flu jabs etc.  All channels of communications would be giving the same message to the public at the same time and  ...  view the full minutes text for item 99.

Chloe Leggat, Screening and Immunisation Co-ordinator (Leicestershire, Lincolnshire and Northamptonshire) Public Health England will make a presentation on Flu and Vaccination Programmes – Leicester City.

Chloe Leggat, Screening and Immunisation Co-ordinator, NHS England (Leicestershire, Lincolnshire and Northamptonshire) attended the meeting to give a presentation on the Flu and Vaccination Programmes for Leicester City.

During the presentation it was noted that:-

a)         The programme provided for flu vaccinations for a wide range of at risk groups which were listed in the report including everyone aged 6 months to 65 years with a serious medical condition, those groups with chronic long term respiratory, heart, kidney, liver and neurological diseases, diabetes, poorly functioning or absent spleen, weakened immunity systems and those classified as morbidly obese.

b)         The National uptake of flu vaccinations were generally lower in GP practices than in schools and the uptake was not as good in younger children.  The take up of the vaccination was outlined in detail in the presentation slides which had been circulated with the agenda.

c)         Barriers encountered in delivering the flu vaccinations included:-

·         Issues in obtaining school pupil data.

·         Myths that vaccination did not work or gave you the flu.

·         Recent increase in activity by anti-vaccine lobby and concerns that vaccine contained porcine gelatine.

·         There were some issues around poor performance and practice in GP practices and these were being addressed.  These issues included needle phobia, porcine gelatine concerns, myths, perceived as a minor illness, patient targeting and poor strain matching.

d)         LPT provided a school aged immunisation service with an uptake of over 50%.  Children who were absent from schools on the day the vaccinations were given a second offer or the option of going to specific pharmacies to get immunised.

e)         There were 102 schools in the city and 28,420 pupils were eligible for the vaccine and 46.6% of pupils had been vaccinated which was above the 40% rate need to provide an economic benefit.

f)          The uptake in some schools were very poor.  One school with 420 pupils on the school roll resulted in only 32 consents being given for the vaccination to be administered.  Reasons appeared to vary as one GP practice in the same catchment area as schools had an uptake of 45% as opposed to 15% in the schools in the area.  This was felt be a result of the GP practice being actively proactive n promoting the vaccinations.

g)         Some schools had cancelled vaccination sessions because they had Ofsted inspections at the time and work was ongoing with Ofsted who did encourage schools to participate in the vaccination programme as part of the inspection regime.

h)        Dialogue had been established with UHL to identify 2 year olds in the various risk groups and to co-ordinate arrangements for them to be vaccinated.  An SIT letter had been sent to 2 &3 year olds to improve the uptake of the vaccination programme and UHL maternity services and midwives were encouraged to give flu vaccinations alongside the scanning programme for expectant mothers.

i)          The H1N1 swine flu virus was still prevalent in India and a number of requests had been received from patients for  ...  view the full minutes text for item 100.

The Chair to invite questions from members of the public.

There were no questions from members of the public.

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

Thursday 7^th December 2017 – 10.30am

Monday 5^th February 2018 – 3.00pm

Monday 9^th April 2018 – 2.00pm

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. 

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

Thursday 7th December 2017 – 10.30am

Monday 5th February 2018 – 3.00pm

Monday 9th April 2018 – 2.00pm

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. 

There were no other items of Any Other Urgent Business.

The Chair declared the meeting closed at 4.22pm.