Agenda and minutes

Apologies for absence were received from:-

John Adler                             Chief Executive, University Hospitals of Leicester NHS Trust

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

Phil Coyne                            Strategic Director City Development and Neighbourhoods, Leicester City Council

Steven Forbes                      Strategic Director of Social Care and Education, Leicester City Council

Mark Gregory                        General Manager, Leicestershire, East Midlands Ambulance Service NHS Trust

Roz Lindridge                       Locality Director Central NHS England – Midlands & East (Central England)

Chief Supt Andy Lee           Head of Local Policing Directorate, Leicestershire Police

Sue Lock                               Managing Director, Leicester City Clinical Commissioning Group

Dr Peter Miller                      Chief Executive, Leicestershire Partnership NHS Trust

Dr Avi Prasad                       Co-Chair, Leicester City 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 might 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 20 September 2018 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 20 September 2018 be confirmed as a correct record.

4.a)     Diabetes in Leicester                                              APPENDIX B

PAGE 11

To receive an Executive Summary report outlining the work being undertaken in Leicester to deliver initiatives to raise awareness, educate and train communities to deliver type 2 diabetes prevention and introduce lifestyle education programmes.

4.b)     Diabetes in Leicester and the Diabetes Delivery Group APPENDIX B1

                                                                                                              PAGE 13

To receive a presentation from Professor Azhar Farooqi, Co-Chair Leicester City Clinical Commission Group, on the work of the Diabetes Delivery Group.

4.c)      Leicester Changing Diabetes                                            APPENDIX B2

                                                                                                            PAGE 35

To receive a presentation from Melanie J Davies CBE on behalf of the Cities Changing Diabetes Group.

4.d)     The Chair will address the Board on the City-wide Diabetes Pledge.

Consideration was given to an Executive Summary report outlining the work being undertaken in Leicester to deliver initiatives to raise awareness, educate and train communities to deliver type 2 diabetes prevention and introduce lifestyle education programmes.

It was noted that diabetes was one of the most pressing health challenges of the decade. The Cities Changing Diabetes partnership has been developed as a platform for cross-disciplinary, cross sector collaboration.  Leicester, with its high prevalence of diabetes and ethnic diversity, was the 1st UK member of Cities Changing Diabetes.

The Leicester Changing Diabetes programme was intended to be inclusive of a range of community stakeholders and was being delivered through a series of projects/activities/initiatives/events that were all pertinent and tailored to the needs of individual or collaborating groups of stakeholders, yet all contributing to the delivery of the overarching flag ship mission.

The diabetes delivery group considered the whole of the patient’s journey in relation to diabetes from prevention, screening and early detection through to management of diabetes, education programmes and treatment of complications.

The local professional sports clubs, Leicester Changing Diabetes and Leicester City Council had formed the Strategic Alliance for Physical Activity. They had recently developed a pledge to commit to tackle diabetes across Leicester by continuing to be healthy role models for fans, supporting fans to make healthy lifestyle choices and working with key partners to provide accessible and inclusive community sessions.

RESOLVED:-

That the work and initiatives of the organisations above to tackle diabetes across the City be supported.

The Board received a presentation from Professor Azhar, Farooqi, Co-Chair Leicester City Clinical Commissioning Group on the work of the Diabetes Delivery Group.

During the presentation it was noted that:-

·         Approximately 30,000 people in Leicester were diagnosed with diabetes and a further 60,000 were at risk of diabetes.

·         Approximately 8.7% of the population in Leicester were either diagnosed with diabetes or were at risk of diabetes.  The rate was 3 times higher in BAME communities.

·         Diabetes shortened life expectancy; a person diagnosed with diabetes at age 60 years was likely to lose 4-5 years in life expectancy.  A person diagnosed at 40 years old could expect to lose 7 years of life expectancy.

·         Diabetes could be brought on by a wide range of factors including political and socio-economic conditions as well as medical conditions.

·         The national Diabetes Prevention Programme was designed to empower patients to take control of their condition and to reduce or prevent the onset of Type 2 diabetes in individuals at risk from developing diabetes. Leicester was one of the highest referrers into this scheme.  There was some initial evidence that it was having effect, especially in weight reduction.

·         Newly diagnosed Type 1 diabetes patients were referred to a 5 day structured training course to learn from experiences and shared group work.

·         Type 2 patients were also offered the opportunity to attend a 4 hour course designed to help people understand their condition and its effect on their body as well as make achievable changes to the food they eat in their daily life.  These courses were available across the whole LLR footprint. 

·         The CCG had invested in a primary care diabetes enhance service education programme for healthcare workers and it was considered that it was now one of the best diabetes trained workforces in the country with some staff attained degree level qualifications in diabetes.

·         This was already showing reductions in hospital admissions for patients with hyperglycaemia and diabetic ketoacidosis, reduced outpatient department referrals (50% less) and better achievement of 3 treatment target and care processes and an holistic One Stop care for patients. 

·         The youngest patient in Leicester diagnosed with type 2 diabetes was is 10 years old and was a reflection of obesity and lifestyles such less physical activity and junk food.

·         Approximately half of GP practices (mainly the larger ones) were signed up for the enhanced diabetes service and but work was progressing to provide embed specialist nurses in smaller practices.  It was hoped that by next summer all GP practices would offer enhanced services.  Each practice would advise patients of the enhanced service available and arrangements would be put in place to consult with hospital staff for the patient’s after care following discharge from hospital.

Members of the Board commented that:-

·         Public health programmes were escalating in being embedded in schools for healthy eating programmes. 36 school had signed up last year.  Schools were also engaged in keeping active and healthy programmes and positive outcomes were already being seen in some schools  ...  view the full minutes text for item 153.

The Board received a presentation from Melanie J Davies CBE on behalf of the Cities Changing Diabetes Group.

During the presentation is was noted that:-

·         The Cities Changing Diabetes Programme (CCDP) aimed to address the global problem and most pressing health challenge of the decade.   425m people globally had diabetes and this was projected to reach 629m by 2045.  The majority of people with diabetes lived in urban areas.

·         Leicester was the 1^st city to join the UK programme which was the first of its kind to create a platform partnership for cross-disciplinary and cross sector collaboration.  The programme aimed to map the problem in five ‘study cities’, share learning experiences with many cities around the world and act as a catalyst to meaningful action which could defeat the incidence of urban diabetes.

·         Leicester Changing Diabetes had been launched in May and was a true collaboration of sports organisations, faith centres and health organisations.  The initiative aimed to create a new paradigm for tackling diabetes involving all the partners and their services and initiatives to reduce the incidence of diabetes in the urban environment.

·         Leicester was the 1^st city in the world where the four elite sports teams for football, rugby union basketball and cricket had signed up to the initiative to work together with all the other partners.

·         Leicester was the only city to put up programme to look at Type 2 Diabetes in children.

·         The project focused on raising awareness, educating and training communities to deliver Type 2 diabetes prevention and lifestyle education in the City through school-based offerings, healthy food environments, community-based programmes and increasing the uptake and use of local amenities and services.

·          Research had shown that:-

o   There were higher number of cases of diabetes and obesity in Leicester where people lived within 500m of a fast food outlet; and

o   The prevalence of Type 2 diabetes in Leicester in neighbourhoods with a higher provision of green spaces was 5% lower than areas with the lowest green space provision.   

·         The work in Leicester was already receiving international recognition.

The Chair commented he was delighted the City Council was part of initiative and the benefits that have already been seen through the leverage of the partnerships with the professional sporting clubs in Leicester in promoting health and education of the issues.  This work had already highlighted a deficiency of services for the elderly population and there were now walking cricket, football and basketball initiatives to promote healthier lifestyles for the elderly.  He was also pleased to be attending a summit next month in Westminster.

Members of the commented that:-

·         That whilst fast food outlets and lower green spaces could be mapped and matched in social economic terms it was important to not drawn the wrong conclusion but recognise all factors involved as it may be that the issue was more linked to people’s financial opportunity to access both the food and the lifestyle that makes a difference.

·         The data around the prevalence of obesity  ...  view the full minutes text for item 154.

To receive a presentation on Social Value in Procurement from Councillor Danny Myers, Assistant City Mayor, Entrepreneurial Councils and Neil Bayliss, Head of Procurement, Leicester City Council.  (APPENDIX C1 – PAGE 71)

A copy of the Council’s Social Value Charter (APPENDIX C2 – PAGE 79) and Delivering Social Value for Leicester (a guide for suppliers and contractors) (APPENDIX C3 – PAGE 85) are also provided for Members information.

The Board received a presentation on Social Value in Procurement from Councillor Danny Myers, Assistant City Mayor, Entrepreneurial Councils, together with a copy of the Council’s Social Value Charter and Delivering Social Value for Leicester (a guide for suppliers and contractors).

During the presentation it was noted that:-

·         That the Council buys £360m of services from 5,800 businesses.  Over half what is bought is from suppliers in the city and county and two thirds of expenditure was spent in the city and county areas.

·         The challenge was to get more out of this spending power activity and use social value to work together with partners so that every public pound spent in the city benefits the city and gets all public voluntary and business sectors in the city working together to tackle the city’s problems. 

·         The aim of the initiative was to change a commercial activity to a commercial activity that has a civic element.  Social value within procurement aimed to provide additional benefits generated by a service beyond its primary purpose. 

·         The aim was for social gain to be added to contracts.  This was principle similar to when there is a large development, developers often contribute with a quota of affordable social housing or provide new roads and highways improvements or playgrounds and in some large schemes developers make a contribution to a new school.

·         Legislation in 2012 enabled the Council to pursue approach with services and since then apprenticeships have been secured, more services have been procured more locally and this principle has been broadly applied across the supply chains.

·         Although the legislation was laudable and had decent intent, it sadly coincided with austerity and public-sector budget cuts and reductions.

·         The principles of the social value charter had been translated into a guide that set out the Council’s priorities and ambitions and was aimed at those providing goods and services purchased by the Council and encouraged a change in relationships so suppliers appreciated there was a civic and social element to transactions.

·         The guide set out that the Council expected certain standards including applying the living wage, universally if possible, and that there were ethical environmental supply chains with none involving human slavery.

·         The guide encouraged an imaginative approach so that suppliers of services could offer social value which may not necessarily be immediately linked to the service being purchased.  Eg companies already had staff volunteering programmes and bulk buying arrangement that could benefit charities etc in the city.  They had back office systems which could provide work experience opportunities in finance and IT for young people to improve their skills.  Suppliers may also have mass transport arrangements for their workers which could be of benefit to others or they may have meeting space that could be offered to voluntary organisations to use.

·         It was recognised that some supply chains were not suited to this process as services purchased from overseas such as It etc did not allow much opportunity to interact with local economy.  However, there were  ...  view the full minutes text for item 155.

To receive a report Steven Forbes, Strategic Director Social Care and Education, Leicester City Council; outlining the process for completing the Autism Self-Assessment Framework 2018 across health and social care organisations.

Consideration was given to a report from the Strategic Director Social Care and Education, Leicester City Council; outlining the process for completing the Autism Self-Assessment Framework 2018 across health and social care organisations.

It was noted that further updates were still awaited before the Self-Assessment Framework could be submitted on 10 December 2019.  The feedback on the Self-Assessment Framework would be incorporated into the Strategic Delivery Plan of the Leicester, Leicestershire and Rutland (LLR) draft joint health and social care Autism Strategy (2019-2022) which was due proceed to consultation in January 2019.  The delivery of the LLR Strategy would be overseen by the LLR Autism Partnership Board.

In response to a question, it was confirmed that the template for the Self-Assessment Framework had been prescribed nationally.

RESOLVED:-

1)    That the submission of the Self-Assessment Framework be supported.

2)    That the final version of the Self-Assessment Framework be sent to Board members for comments and that the Chair be authorised to make any final amendments as a result of any comments received before it was submitted by the deadline of 10 December 2018.

Wayne Henderson, Inclusion Healthcare, will address the Board to ask whether it wishes to sign up to the Homelessness Charter and whether a formal pledge by the Board or individual Board members would be appropriate.

A copy of the Homelessness Charter (APPENDIX E1 - PAGE 153) and Pledge Form (APPENDIX E2 – PAGE 157) are attached for the Board’s information.

Wayne Henderson, Inclusion Healthcare, addressed the Board to ask whether it wished to sign up to the Homelessness Charter and whether a formal pledge by the Board or individual Board members would be appropriate.  The Board also received a copy of the Homelessness Charter and a Pledge Form.

During the presentation it was noted that:-

·         Increases in levels of homelessness were being experiencing nationally. 

·         It was fortunate in Leicester that there were many organisations, charity groups and individuals who wished to be involved and wanted to help addressing and reducing homelessness.  A number of businesses also wanted to be involved.

·         It had been identified that there was a lack of awareness and communication of what was available and being delivered to help the homeless and there were also instances of services being replicated and duplicated.

·         The challenge had been to bring organisations and groups together over the last 18 months and the Charter aimed to bring people to together to work more effectively in collaboration and partnership than could be achieved by working individually and to have a shared vision, with shared leadership and expertise and encourage all partners to pledge to be active in supporting the Charter.

·         The Charter had been launched jointly by Leicester Cathedral, the Police and Crime Commissioner and the City Mayor.

·         There were 5 work streams within the Charter and members of the Board were urged to pledge themselves to the Charter either as a Board or individual organisations.  The CCG, UHL and the LLP were asked to provide individuals to be members of the group driving the 5 work streams forward

The Director of Public Health commented that work was progressing to develop multi-issue initiatives under the umbrella of the Charter and these would be reported to future Board meetings. The City was fortunate to have a lot of resources available in the City to help the homelessness and it was important to co-ordinate resources to the best effect in reaching those most in need and providing intensive psychological support, especially the relatively small cohort that were known to the Police and health services.  St Mungos had been approached to see it they were able to assist in setting up a recovery college in the City aimed at helping the homeless to get back into work.

The Police and Crime Commissioner commented that the Police and City Council met regularly to discuss street lifestyle issues.   It was important for the homelessness issue to have momentum and efforts be kept going to address them.

It was also noted that the Young Peoples Council had put forward within their 7 area of work, children’s access to mental health and a day of action to focus on homelessness and how promote knowledge and provide information the support that was available.

RESOLVED:-

That all partners be encouraged to pledge their individual organisations to the Charter.

The Chair to invite questions from members of the public.

There were no questions from members of the public.

To note that the next meeting of the Board will be held on Thursday 28 February 2019 at 5.00pm.

Dates of meeting for the Board for 2018/19 will be determined at the Council’s Annual Meeting in May 2019.

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 Board noted that the next meeting of the Board would be held on Thursday 28 February 2019 at 5.00pm in Meeting Room G01 at City Hall unless stated otherwise on the agenda for the meeting.

The dates of meetings for the Board for 2018/19 will be determined at the Council’s Annual Meeting in May 2019.

The Chair reported that this would be the last meeting of Ruth Tennant as Director of Public Health before she took up her new post as Director of Public Health at Solihull Metropolitan Borough Council.  The Chair paid tribute to her work and contributions to public health in Leicester with both the Board and the Council and wished her well for the future.

There were no items of Any Other Urgent Business.

The Chair declared the meeting closed at 11.40 am.