Agenda and minutes

Apologies for absence were received from:

John Adler                             Chief Executive, University Hospitals of Leicester NHS Trust

Chief Supt Adam Street      Head of Local Policing Directorate, Leicestershire Police

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

Frances Shattock                 Director of Strategic Transformation, NHS England

Steven Forbes                      Strategic Director, Social Care and Education

Dr Peter Miller                      Chief Executive, Leicestershire Partnership NHS Trust

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

To note the membership of the Board for 2019/20 approved by the Council on 1 May 2019:-

City Councillors:

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 Danny Myers, Assistant City Mayor, Policy Delivery and Communications

City Council Officers:

Steven Forbes, Strategic Director of Social Care and Education

Ivan Browne, Director Public Health

2 Vacancies to be nominated by the Chief Operating Officer

NHS Representatives:

John Adler, Chief Executive, University Hospitals of Leicester NHS Trust

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

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

Frances Shattock, Director of Strategic Transformation, NHS England, Midlands & East (Central Midlands)

Healthwatch / Other Representatives:

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

Lord Willy Bach, Leicester, Leicestershire and Rutland Police and Crime Commissioner

Chief Superintendent, Adam Streets, Head of Local Policing Directorate, Leicestershire Police

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

STANDING INVITEE: (Not Board Member)

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

The Board noted its membership for 2019/20 as approved by the Council on 16 May 2019:-

City Councillors:

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 Danny Myers, Assistant City Mayor, Policy Delivery and Communications

City Council Officers:

Steven Forbes, Strategic Director of Social Care and Education

Ivan Browne, Director Public Health

2 Vacancies to be nominated by the Chief Operating Officer

NHS Representatives:

John Adler, Chief Executive, University Hospitals of Leicester NHS Trust

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

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

Frances Shattock, Director of Strategic Transformation, NHS England, Midlands & East (Central Midlands)

Healthwatch / Other Representatives:

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

Lord Willy Bach, Leicester, Leicestershire and Rutland Police and Crime Commissioner

Chief Superintendent, Adam Streets, Head of Local Policing Directorate, Leicestershire Police

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

STANDING INVITEE: (Not Board Member)

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

To note the Board’s Terms of Reference approved by the Annual Council on 16 May 2019.

The Board noted the Terms of Reference as approved by the Annual Council on 16 May 2019.

The Minutes of the previous meeting of the Board held on 28 February 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 Health and Wellbeing Board held on 28 February 2019 be confirmed as a correct record.

To note that the theme of the meeting is Healthy Places, one of the five themes within the Joint Health and Wellbeing Strategy.

The objectives of the theme are to:-

1)            Influence the environment to make healthier choice more accessible;

2)            Ensure decent homes are within the reach of all citizens;

3)            Improve air quality; and

4)            Develop and encourage healthy neighbourhoods and a sense of community.

The Board noted that the theme of the meeting was Healthy Places, which was one of the five themes within the Joint Health and Wellbeing Strategy.

Ivan Browne, Director of Public Health, Leicester City Council to present the Joint Health and Wellbeing Strategy setting out the health priorities for Leicester and providing details of the Board’s plans over the next five years.

The Board will be shown a short promotional video on the Strategy.

The Board is asked to pledge its commitment to the Strategy and Action Plan, contribute to the delivery and reporting on progress with the Strategy and Action Plan and Board Members are asked ot ensure that there is strategic alignment between the strategy and their own organisations commissioning plans.

Ivan Browne, the Director of Public Health presented the Joint Health and Wellbeing Strategy and Action Plan to the Board. As part of this, Members received a power-point presentation. This differed slightly to the version included in the agenda, and the amended version is attached to the back of these minutes.

The Chair introduced the Strategy and Action Plan commenting on the importance of looking at the wider determinants of health and taking a longer term rather than a short term view.

The Director of Public Health explained that in drawing up the Strategy, they wanted to make sure that there was an early and a real engagement with the public and partners. One of the themes that had emerged was the need to look at the wider determinants that contributed to people’s health and wellbeing.

The full consultation had resulted in 83 responses and showed that the majority of individuals welcomed the approach.  A recurring theme related to the use of green and open spaces and the need for an action relating to this, and environmental issues was emphasised. Concerns were also raised regarding the local environment and the proliferation of fast food outlets. In addition, comments were made that a greater emphasis was needed on people’s wellbeing and mental health. Members heard that the Board drove the Strategy and in turn, the Strategy drove the Action Plan.

The Director explained that the Action Plan was a live working document which would change over time. He asked all partners to pledge commitment to the Strategy and to contribute to the Action Plan. The Director also requested some strategic alignment; it was recognised that the different organisations had their own policies, but it was hoped that this Health and Wellbeing Strategy and Action Plan would be reflected in those individual policies.

Members welcomed the Strategy and Action Plan and comments were made that it brought a focus to the work.  The Deputy City Mayor for Social Care and Anti-Poverty commented that it had been a pleasure to be involved in the Strategy and commended the work that had taken place to engage with the Children’s Trust at an early stage.  As part of this, New College had their own Health and Wellbeing Strategy which linked into the City Strategy but focused on their school population and the issues that they could target. Members heard that New College had developed their own Strategy with the intention of rolling it out to other schools. Paul Hindson, Police and Crime Commissioner’s office stated that in terms of strategic alignment, there was a good opportunity to work together, as for the example the work in the Violence Reduction Unit was linked inexorably to health and wellbeing.

Comments were made that the Council were taking a holistic approach towards health and there were Executive Members on the Board to ensure that health and wellbeing was embedded across the Council. 

The Chair concluded the discussion and gave credit for the Strategy and Action Plan to the  ...  view the full minutes text for item 7.

Matthew Mace, Group Manager – Transport Strategy, Leicester City Council will give a presentation on the Air Quality Action Plan adopted by the Council in 2015.  The plan outlines the picture of Air Quality and states what the council are doing to improve Air Quality in Leicester through its action plan, which includes the Secretary of State for the Environment’s Direction for the council to achieve compliance with EU nitrogen dioxide objective levels “in the shortest possible time”.

The Board is asked to note the ambitions of the Air quality Action Plan and to consider how Members’ organisations can contribute to its delivery.

The Chair explained that there would be one presentation to include this item, and agenda items 9,10 and 11, and therefore all four items would be considered together.

Stuart Maxwell, City Transport Director delivered a combined presentation which related to the following:

·         The Air Quality Action Plan

·         Improving Air Quality in the City – Bus Retrofit Technology Project

·         Air Quality when walking and cycling

·         Sustainable travel – walking and cycling

A copy of this combined presentation is attached to the back of these minutes. 

The Chair thanked the City Transport Director for the presentation, commenting that it was very informative. During the ensuing discussion, a number of comments and queries were raised which included the following:

·      Mark Wightman, Director of Marketing and Communications, UHL commented that 5% of traffic on UK roads happened as a consequence of the NHS. This linked into the reconfiguration work that the UHL were carrying out, which included work to establish Primary Care Networks (PCNs) to provide health infrastructure closer to home and to prevent people from coming into hospitals unnecessarily. The PCNs would have a direct impact on the amount of traffic on the roads but also make it more convenient for people to receive treatment.  Mr Wightman added that issues around air quality was a very important aspect of the Health and Wellbeing Strategy and that the Board had an important role to play in its delivery.

·      The Chair commented that this was not just about the actions that the Council were taking, but also about the work that other organisations were undertaking to improve air quality. The Chair suggested that they might also bring presentations to the Board.

·      Most schools had issues with irresponsible parking outside their premises, and just a small amount of rain resulted in more people driving rather than walking to school.  The recent Clean Air Day event proved to be very successful and it was important to try to encourage people to think about their behaviour and use the car a bit less. The Director for Public Health added that many parents thought that they were doing their best for their child by taking them to school by car, but in reality, they were doing the opposite.

·      The majority of people who worked in the City, also lived in the City and had a small footprint. 33% of people who came into the City in the working day used buses and by providing more dedicated bus lanes, improving bus reliability and by providing more cycle lanes, air quality could be significantly improved.

·      A Member said that he believed prevention was better than cure and that nationally people didn’t exercise enough. There were many parks and gyms in the City and people could be guided as to how to use them. There was also a very good network of sports centres.

·      It was acknowledged that behavioural change was needed, and it was suggested that it would be useful to have a common approach with partners working together to achieve  ...  view the full minutes text for item 8.

Dr Jolanta Obszynska, Project Officer, Air Quality Systems, Leicester City Council will give a presentation on the Bus Retrofit Technology Project which result in over 200 buses being retrofitted with the abetment technology by 2020.  Four bus companies are involved in the project which has secured £4m of funding over the last 5 years.  The project will result in all buses operating within the Air Quality Management Area from 2020 below the Euro VI standard.

The Board is asked to note the bus retrofit project and the progress it has made in reducing NO2 in the City.

Consideration of this item of business took place under agenda Item 8, the Air Quality Action Plan and there was no further discussion on this item.

Hannah May, Transport Development Officer, Leicester City Council and Joshua Vande Hey, University of Leicester to give a presentation on a project aimed at understanding the level of exposure to NO2 Air Pollution: Walking, Cycling and Driving Journeys in Leicester. The presentation outlines the first of two phases of research, the second of which will take place in the summer. The data from both studies should contribute towards a robust evidence base for delivering public messaging.

The Board is asked to note the work undertaken so far and the intention to conduct a further study to support evidence-based messaging to the public on travel modes, and support the dissemination of public messaging developed with public health in Member’s own organisations.

Consideration of this item of business took place under agenda Item 8, the Air Quality Action Plan and there was no further discussion on this item.

Sally Slade, Cycling and Walking Team Leader, Leicester City Council to give a presentation on initiatives in the Walking & Cycling Team’s work programme which has largely been funded through successful bids ot the Department of Transport since 2011.  The work programme supports a number of local strategic priorities, referenced in the City Council’s actions plans, including those with a health & wellbeing focus

The Board is asked to note the ongoing work and to consider how Members’ own organisations can contribute to the walking and cycling targets by encouraging active travel and support the Walking & Cycling Team initiatives by sharing information on their work.

Consideration of this item of business took place under agenda Item 8, the Air Quality Action Plan and there was no further discussion on this item.

The Chair to invite questions from members of the public.

A member of the public said that the University Hospitals of Leicester, NHS Trust were planning to close the Leicester General Hospital (LGH) as an acute hospital and move a range of services from the LGH and the Glenfield to the Leicester Royal Infirmary (LRI). Local NHS leaders were refusing to share details of their plans with members of the public.  He said it was envisaged that this would bring more traffic on the ring road and increase air pollution.  He questioned whether Council Planners were working with the UHL to consider a potential increase in nitrogen dioxide and PM 2.5 pollution levels adjacent to the LRI, and if not when they would they do so.  

Further questions were asked as follows:

1)  Are the air pollution levels near the LRI compliant with the European                           Union’s air quality objectives for nitrogen dioxide?

2)  Do the PM 2.5 air pollution levels meet the World Health Organisation (WHO) guidelines? There were no Government standards for this.

3)  Where is the nearest monitoring station to the LRI, for monitoring nitrogen dioxide and PM 2.5 and are the air pollution records in the public domain and on the City Council website?

The following responses were given:

·      The Highway Authority would be consulted on this planning application when it was submitted to the Planning Service and officers would be looking at the highways issues raised.   

·      The closest air quality monitoring station to the LRI was on Vaughan Way where nitrogen dioxide and PM 10 levels were monitored. The Council exceeded nitrogen dioxide levels on the inner ring road.

·      Air quality information was published on the Council website.

·      There was one air quality station at the University of Leicester where PM.  levels were monitored. The annual average level was 11 and Council did not exceed the PM10 or PM2.5 levels.

·      The questioner had stated that there were no Government Standards for PM 2.5 levels, but this was incorrect.  The Council were obliged to follow the E.U. directive regarding air quality levels but were not obliged to adhere to the WHO guidelines.  Defra were looking into revising standards, but this still work in progress.

·      Acute hospitals wherever they were situated brought in a very considerable number of patients, but not all those patients needed an acute hospital. Part of the NHS Long Term plan was to reduce the reliance on acute hospitals.

·      The plans for the LGH, the Glenfield and the Children’s hospital at the LRI had been published so that people have been able to see what the plans looked like. It had been previously explained however that the UHL were not yet allowed to publish the 1600 page business case.

The Chair thanked the member of the public and the officers who had responded to the questions.

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

Thursday 19 September 2019 – 10.30am

Thursday 28 November 2019 – 10.30 am

Thursday 27 February 2020 – 10.30am

Thursday 30 April 2020 – 10.30 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.

Members noted that future meetings would be held on the following dates:

Thursday 19 September 2019 – 10.30am

Thursday 28 November 2019 – 10.30am

Thursday 27 February 2020 – 10.30am.

The meeting closed at 11.54 am.