Agenda and minutes

Apologies for absence were received from:

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

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

Andy Keeling, Chief Operating Officer,Leicester City Council

Chief Superintendent Andy Lee, Head of Local Policing Directorate, Leicestershire Police.

Sue Lock, Managing Director, Leicester City Clinical Commissioning Group

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

Trish Thompson, Locality Director Central NHS England – Midlands & East – (Central England)

Professor Martin Tobin, Professor of Genetic Epidemiology and Public Health and MRC Senior Clinical Fellow, University of Leicester.

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 declaration were made.

The Monitoring Officer to report that the Council appointed the following Members to the Board at its meeting on 14 July 2016:-

Councillors

Councillor Piara Clair Singh – Assistant City Mayor, Culture Leisure and Sport.

NHS Representatives

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

Dr Peter Miller, Chief Executive, Leicestershire Partnership NHS Trust

Healthwatch / Other Representatives

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

Steve Robinson-Day, Collaboration Manager, Leicestershire Fire and Rescue Service

A representative of the city’s sports community – to be appointed

A representative of the private sector/business/employers – to be appointed

In addition the Chair has also issued a standing invitation to the following to attend meetings as non-voting members of the Board.

Kaye Burnett, Chair, Better Care Together Programme

Toby Sanders, Senior Responsible Officer, Better Care Together Programme

Richard Henderson, Acting Chief Executive, East Midlands Ambulance Service NHS Trust

A representative of the Primary Care Sector – to be appointed.

The Local Policing Unit has also informed the Monitoring Officer that their representative on the Board is now Chief Superintendent Andy Lee, Head of Local Policing Directorate, following Chief Superintendent Sally Healy’s retirement.   Supt Kerry McLernon has also been nominated to attend the Board in Chief Superintendent Lee’s absence.

The revised Terms of Reference for the Board to reflect these changes are attached for information. 

The Board noted that the Council had made the following appointments to the Board at its meeting on 14 July 2016:-

Councillors

Councillor Piara Clair Singh – Assistant City Mayor, Culture Leisure and Sport.

NHS Representatives

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

Dr Peter Miller, Chief Executive, Leicestershire Partnership NHS Trust

Healthwatch / Other Representatives

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

Steve Robinson-Day, Collaboration Manager, Leicestershire Fire and Rescue Service

A representative of the city’s sports community – to be appointed

A representative of the private sector/business/employers – to be appointed

In addition the Chair has also issued a standing invitation to the following to attend meetings as non-voting members of the Board.

Kaye Burnett, Chair, Better Care Together Programme

Toby Sanders, Senior Responsible Officer, Better Care Together Programme

Richard Henderson, Acting Chief Executive, East Midlands Ambulance Service NHS Trust

A representative of the Primary Care Sector – to be appointed.

The Local Policing Unit had also informed the Monitoring Officer that their representative on the Board is now Chief Superintendent Andy Lee, Head of Local Policing Directorate, following Chief Superintendent Sally Healy’s retirement.   Supt Kerry McLernon has also been nominated to attend the Board in Chief Superintendent Lee’s absence.

The revised Terms of Reference for the Board reflecting these changes were received by the Board.

The Minutes of the previous meeting of the Board held on 6 June 2016 are attached and the Board is asked to confirm them as a correct record.

AGREED:

That the Minutes of the previous Board meeting held on 6 June be confirmed as a correct record.

NHS England to present a report on their proposals for the future provision of congenital heart disease services with particular reference to University Hospitals of Leicester NHS Trust.

Will Huxter, Senior Responsible Officer for the Congenital Heart Disease Review and Regional Director of Specialised Commissioning (London) and Christine Richardson from the local specialised commissioning team will attend the meeting to present the report.

Supporting Documents

A copy of the Deputy City Mayor’s letter to the Secretary of State on 13 July 2016 requesting the decision to be reviewed and reversed is attached at Appendix C1 (Page 33)

A copy of the decisions already taken by Leicester City Council and Leicestershire County Council on Children’s Heart Surgery at Glenfield Hospital following NHS England’s announcement are also attached at Appendix C2 (Page 35).

NHS England presented a report on their proposals for the future provision of congenital heart disease services with particular reference to University Hospitals of Leicester NHS Trust.

Will Huxter, Senior Responsible Officer for the Congenital Heart Disease (CHD) Implementation Programme and Regional Director of Specialised Commissioning (London), NHS England and Dr Geraldine Linehan, Regional Clinical Director, Midlands and East for Specialist Commissioning, NHS England, attended the meeting to present the report.

The Board also received a copy of the Deputy City Mayor’s letter to the Secretary of State on 13 July 2016 requesting the decision to be reviewed and reversed.  Copies of the decisions already taken by Leicester City Council and Leicestershire County Council on Children’s Heart Surgery at Glenfield Hospital following NHS England’s announcement had also been submitted for information.

The Chair welcomed the representatives of NHS England to the meeting, together with Mr E White CC, Chair of Leicestershire County Council’s Health and Wellbeing Board and Councillor V Dempster, Chair of the Leicester City Council’s Health and Wellbeing Scrutiny Commission.

The Chair invited members of the public to indicate if they would like to contribute to the discussion on this item and four members of the public asked to speak to the meeting.

Mr Huxter, NHS England, thanked the Chair for the opportunity to present the report and to set out the proposals for change and the basis upon which they had been made.  He was also keen, as the Senior Responsible Officer for congenital heart disease work across the country; to listen to the Board’s and the public’s questions and concerns and have the opportunity to address them.

He also introduced Dr Linehan Clinical Director for specialist commissioning for the Midlands and East region. Dr Linehan stated that she was a GP by training, not a specialist in Congenital Heart Disease (CHD); but did have an overall remit for quality of services in the region.

In presenting the report, Mr Huxter stated he wished to set out the context of the proposals and their rationale and then outline the next steps in the debate and consideration of the proposals.  During the presentation of the report he made the following comments:-

a)         NHS England had not made any final decision yet on Glenfield or any other providers of CHD.

b)         The proposals were based upon assessments of whether trusts currently met the standards or were likely to do so in the time frame set out in NHS England’s standards.

c)         NHS England were meeting University Hospitals of Leicester NHS Trust (UHL) on 16 September 2016 to discuss in detail their assessment and the trust’s response.

d)         There would be formal public consultation on the proposals later this year, and NHS England would want to come back to the area to talk to the Joint Health Overview Scrutiny Committee once the consultation was launched. 

e)         Much of the debate about CHD services was focused on the standards, their development and how they fitted in with the  ...  view the full minutes text for item 20.

Leicester City Clinical Commissioning Group to give a presentation on the challenges faced by primary care in the city and the plans being developed for a Primary Care Strategy to address these.  The strategy will be finalised once the local Sustainability and Transformation Plan is completed in September 2016, which is including work around general practice. In addition it will be informed by the Primary Care Summit which is being held on 9 September 2016.

Sarah Prema, Director Strategy and Implementation, Leicester City Clinical Commissioning Group, will attend the meeting to present the item.

Professor Farooqi, Co-Chair Leicester City Clinical Commissioning Group (CCG) and Sarah Prema, Director, Strategy and Implementation, (CCG) gave a presentation on the challenges faced by primary care in the city and the plans being developed for a Primary Care Strategy to address these.  The strategy would be finalised once the local Sustainability and Transformation Plan was completed in September 2016; which included work around general practice. In addition, it would be informed by the Primary Care Summit that had been organised for 9 September 2016.

During the presentation it was noted that:-

a)         The number of single handed practices in the City had decreased from 26 to 6 in recent years as a result of some GPs retiring and others merging with other practices.

b)         There were 59 practices in city of which 14 were training practices. The average list size of a practice was 6,531. This was slightly lower than the national average of 7,225.

c)         There were a large number of Alternative Provider Medical Services (APMS) contracts; 13 practices out of the total number of 59 practices in the City.  This was in contrast to the county area where there were no APMS contracts. This was an indicator of the difficulty in ensuring services in the City.

d)         More practices in Leicester were rated as good by the CQC compared to the England and Midlands and East averages.

e)         The number of primary sector consultations had increased continually over the last 13 years.  Applicants to GP training had dropped by 15% and in 2014 one in ten slots for new GP trainees remained vacant.  The number of unfilled GP posts nationally had quadrupled in the last 3 years.

f)          The average funding for a GP in the city was approximately 10% below the national average.

g)         The city had been divided into 4 Health Need Neighbourhoods to enable a locality delivery of primary and community care.  These would include extended hours provision, urgent care services (including diagnostics), community nursing and therapy services, social services, voluntary service, self-care and patient education.  The focus of the Health Need Neighbourhoods would be on prevention and mobilising community “assets” as well as the development of integrated teams to support patients with the most complex needs.

h)        The CCG were also developing a HUB within 2 Health Need Neighbourhoods to provide patients with access to wider services.  The strategy also included a number of initiatives (outlined in the presentation) to improve access to the services.

i)          There was raft of initiatives to improve the recruitment and retention of staff in primary care.  These were listed in full in the presentation.

j)          The 59 GP practices were delivered from 60 main premises and 12 branch sites.  There were a number of practices operating from converted houses and the CCG supported practices to apply to the NHS England Estates and Technology Fund and 5 developments to the fund were made in 2016.

k)         The CCG supported the development of Federations which supported practices  ...  view the full minutes text for item 21.

The Chair to invite questions from members of the public.

There were no questions from members of the public present at the meeting.

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

Monday 10th October 2016 – 3.00pm

Thursday 15th December 2016 – 5.00pm

Monday 6th February 2017 – 3.00pm

Monday 3rd April 2017 – 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. 

It was noted that future meetings of the Board would be held on the following dates:-

Monday 10th October 2016 – 3.00pm

Thursday 15th December 2016 – 5.00pm

Monday 6th February 2017 – 3.00pm

Monday 3rd April 2017 – 2.00pm

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

There were no items to be considered.

The Chair declared the meeting closed at 6.05pm