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Agenda and minutes

Agenda and minutes

Venue: Meeting Room G.01, Ground Floor, City Hall, 115 Charles Street, Leicester, LE1 1FZ

Contact: Graham Carey, Tel 0116 4546356 or Internal 376356 

Items
No. Item

84.

APOLOGIES FOR ABSENCE

Minutes:

Apologies for absence were received from:-

 

John Adler                            Chief Executive, University Hospitals of Leicester

NHS Trust

 

Lord Willy Bach                    Leicester, Leicestershire and Rutland Police and

Crime Commissioner

 

Councillor Adam Clarke     Assistant City Mayor Energy and Sustainability,

                                                Leicester City Council

 

Andy Keeling                        Chief Operating Officer, Leicester City Council

 

Will Legge                             Divisional Director, east Midlands Ambulance

Service NHS Trust

 

Roz Lindridge                       Locality Director Central NHS England – Midlands

and East (Central England)

 

Sue Lock                               Managing Director, Leicester City Clinical

                                                Commissioning Group

 

Dr Peter Miller                       Chief Executive, Leicestershire Partnership NHS

Trust

 

Toby Sanders                       Senior Responsible Officer, Better Care Together

                                                Programme

 

Ruth Tennant                       Director of Public Health, Leicester City Council

85.

DECLARATIONS OF INTEREST

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

 

Minutes:

Members were asked to declare any interests they might have in the business to be discussed at the meeting. No such declarations were made.

86.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 111 KB

The Minutes of the previous meeting of the Board held on 19 June 2017 are attached and the Board is asked to confirm them as a correct record.

 

Minutes:

RESOLVED:

 

That the minutes of the previous meeting of the Board held on 17 August be conformed as a correct record subject to Councillor Osman’s title being amended to Assistant City Mayor, Strategic Partnerships and Change, Jill Smith being amended to Julie Smith and Professor Farooqi’s name being amended to Professor Azhar Farooqi.

87.

PRIMARY CARE STRATEGY AND GENERAL PRACTICE FORWARD VIEW pdf icon PDF 93 KB

Leicester City Clinical Commissioning Group to submit a report  detailing the approach to delivering the General Practice Forward View (GPFV) in Leicester City and how delivering this national work links to the development of the Sustainability and Transformation Plan delivery across Leicester, Leicestershire and Rutland.

Additional documents:

Minutes:

Leicester City Clinical Commissioning Group submitted a report detailing the approach to delivering the General Practice Forward View (GPFV) in Leicester City and how delivering this national work links to the development of the Sustainability and Transformation Plan delivery across Leicester, Leicestershire and Rutland.

 

Leicester City Clinical Commissioning Group submitted a report detailing the approach to delivering the General Practice Forward View (GPFV) in Leicester City and how delivering this national work links to the development of the Sustainability and Transformation Plan delivery across Leicester, Leicestershire and Rutland.

 

The Director of Operations and Corporate Affairs presented the report and the following comments were noted:-

 

a)         Access to primary care was still a concern to patients in the city and the CCG had met the national milestone of 50% of the public having access to week-end and evening GP appointments by March 2018.  The 3 hubs at Westcotes, Belgrave and Saffron had provided 1,300 extra appointments a week equivalent to an additional 135 hours.  The hubs were operating at 95% but there was a noticeable drop off in demand on Sunday afternoons.  The CCG were continuing to work with GPs to have extended access in all 59 practices.

 

b)         There was continued local recruitment for GPs which recently appointed 11 new GP.  The second phase of the recruitment in May had resulted in a further 4 new GPs and expressions of interest from others.  A further initiative to recruit from overseas based upon pilot scheme in Lincolnshire was planned.  There were 9 clinical pharmacists 9 working in GP practices. The local NHS England target was to recruit an additional 25 GPs in the city by 2020.  As 25% of GPs were currently over 55 years old, retention of existing GPs was also important.

 

c)         A toolkit looking at all models of care and case studies from elsewhere, was being developed.  A second edition of the toolkit was going live later in year but some practices were already moving forward.

 

d)         The CCG had re-invested more than £500k from existing funds to bring the base line for GP practices in Leicester up to and above the national minimum level of funding of £85 per patient.  It had also recycled approximately £2m of funding from within its existing budgets to provide additional funding for primary care services in Leicester.  £200k has also been made available for training in primary care. 

 

Following questions from Members the following response were received:-

 

a)         The Merlyn Vaz Centre had been a walk Centre for the last 8-9 years and had now been procured as 4th hub.  It would however be different  as it would offer a walk in facility and also a new pre-booked focus with the aim of increasing the pre- booked appointments.

 

b)         The CCG would aim to replace gaps in GPs services as and when established practices closed.  Some practices were currently understaffed, but the CCG had no powers to direct staffing levels in existing GP practices as  ...  view the full minutes text for item 87.

88.

HEALTH AND WELLBEING WORKSHOPS OVERVIEW pdf icon PDF 72 KB

The Director of Public Health submits a report that explains the purpose of the workshops, the key findings and how these will be applied to the draft strategy and future work.  The report will be supported by a presentation at the meeting.

Additional documents:

Minutes:

The Director of Public Health submitted a report that explained the purpose of the workshops, the key findings and how these would be applied to the draft strategy and future work.  The report was supported by a presentation.

 

It was noted that:

 

a)         The Health Start workshop was scheduled for September and others had already taken place.

 

b)         Increases in life expectancy had resulted in a significant gap between health life and life expectancy both nationally and in Leicester.  It was now estimated that males and females in Leicester could expect 20 years of not being in good health.  This was attributable to the increase in the inequalities of living a health life expectancy and more people living longer in poor health

 

c)         The outcomes of the Workshops that had already been held were summarised on the slides of the presentations which are attached to these minutes. 

 

d)         Due to the reducing budgets for public health it would be necessary to have a targeted approach in future.  Feedback supported continued working collectively across all health systems to avoid missing those most in need and them and causing stigma.  The community based approach would help to target whole families as opposed to individuals.

 

The Chair commented that the next Health and Wellbeing Strategy needed to be different from the current one as it needed to be more challenging and aspirational with the aim of bringing about improvements in health well beyond the 5 year life of the plan.  The challenges would be to how this could be done differently to achieve the aspirational aims within the limited resources that would be available.

 

Members commented that low physical activity often attributed to poor health, and whilst 1 in 5 were happy to participate in physical activity more was need to needed to address the cultural change to enable people to engage in more physical activities.   The City had quality open space and 33 open space gyms and initiatives to increase their usage were important.   The challenge was to reach those sections of community that don’t take regular exercise, such as those on low income, unemployed people and BME women.

 

RESOLVED:

 

That the report and the feedback from the workshops be received and welcomed and that these be fed into the revised draft strategy.  Members of the Board were also encouraged to submit comments and suggestions to shape the next Strategy.    

89.

LEICESTER CHILDREN and YOUNG PEOPLE'S HEALTH and WELLBEING SURVEY 2016 pdf icon PDF 96 KB

The Director of Public Health to submit a report on the Leicester Children and Young People’s Health and Wellbeing Survey 2016 that provides a cross-sectional snapshot of health and wellbeing issues for children and young people in the city.  A presentation will be made at the meeting.

Additional documents:

Minutes:

The Director of Public Health submitted a report on the Leicester Children and Young People’s Health and Wellbeing Survey 2016 that provided a cross-sectional snapshot of health and wellbeing issues for children and young people in the city.  A presentation was made at the meeting which had previously been circulated with agenda.

 

The results of the survey provided the views of approximately 3,000 children in years 6, 8 and 10.  The majority of those surveyed had generally expressed positive experiences.  The west of the city had poorer outcomes in health and education and differences had been observed in the risk factors.  It was felt the survey was a useful tool to triangulate data on risks and risks in specific groups.

 

The view was expressed that further thought needed to be given to how the survey results could be used proactively along other information that held since the more that data could be triangulated the more it helped to focus on groups that are at risk.   It was noticeable that 1in 5 children worried about having enough to eat and that also 1in 10 children were having takeaway meals on most days.  This indicated that some children were not getting sufficient nutrition to support growing bodies and minds and this could have a significant detrimental impact on the health system in 20 years’ time.   This needed to be addressed by all partner organisations on The Board.  It was felt that more resources were needed to There was concern that  there may not be sufficient or adequate resources needed to support families

 

The Chair commented that the survey provided real empirical date and was a valuable resource which the Board needed to use to the full in order to inform and redesign policies. 

 

The Deputy Director of Public Health stated that the results of the survey were available for everybody to use.  It provided a realistic picture of real experiences based upon a good sized sample.  There was significant amount of core data supporting the summary which could be broken down further should Board members find this useful.

 

RESOLVED:

 

The Board welcomed the report and survey results and supported the dissemination of the survey results to enable partner organisations to inform their own intitiatives.

90.

BETTER CARE FUND pdf icon PDF 101 KB

Leicester City Clinical Commissioning Group to submit a report on the Leicester City Better Care Fund 2017-19.

Additional documents:

Minutes:

Leicester City Clinical Commissioning Group submitted a report on the Leicester City Better Care Fund 2017-19.

 

It was noted that the draft was being submitted later than usual because the planning guidance and the requirement of the Better Care Fund were not issued until mid-July by NHS England and a submission date of 7 September 2017.  The draft narrative of the plan was contained in the current draft document narrative template and the final planning template had only recently been received since the Agenda was published and this was being completed.  Guidance was being drip fed to the CCG by NHS England and the Final Key Lines of Enquiry had only been received from NHS England earlier in the week and work was progressing to complete these.  The Plan, therefore, may change to reflect any additional information requested by NHS England before the formal submission date.  

 

The current draft had been prepared jointly by the CCG, the Council, partner organisations including UHL and LPT and Police and Fire Services and had recently been considered by the patient’s participation group for STP and had been largely supported. 

 

The plan was measured against a matrix of 5 indicators to ensure the efficacy of the Plan and these were:-

 

  • Non-elective Admissions
  • Delayed Transfer of Care in the acute and non-acute sites
  • |Admissions to residential care
  • Number of Patients at home 91 days after a hospital episode.

 

2 of the 5 matrix indicators had been achieved in 2016-17.  The non-elective admissions had been missed by 203 admissions previously 1000s achievement.  Delayed Transfer of Care had reduced significantly at the acute site and there were now few local authority attributed delays arising from previous initiatives taken under the better care together fund.  Work was progressing with health trusts to minimise delays in relation to mental health and learning disability facilities going forward.  The LLR A&E Delivery Board had addressed this issue and approved a plan to achieve the target by March 2018. 

 

The BCF Implementation Manager, NHS England (Midland and East) commented that she was a member of the Assurance Panel and felt the plan was well written and one of the better ones that had been received.  It was pleasing to see an increased focus on delayed care community settings and learning disabilities.  The links to housing needed strengthening as this was significant to peoples’ health and wellbeing.

 

The Healthwatch Chair expressed concerns at the other challenges in Chapter 2 of the draft and following the risk assessment received recently did not fit completely with the positive narrative and asked for assurances on these aspects.

 

In response it was noted that there had been a huge reduction in delayed transfer of care and non- elective surgery admissions which had reduced the number of 14-15 delayed transfers per week to the current level of 8-10.  This represented a 2.62% reduction in the number of patients in beds than the previous year which was considered to be a significant achievement.   Year on year reductions where  ...  view the full minutes text for item 90.

91.

QUESTIONS FROM MEMBERS OF THE PUBLIC

The Chair to invite questions from members of the public.

Minutes:

The Chair invited questions from members of the public.

 

The Vice Chair of Healthwatch asked of the documents that had been sent to Members of the Board after the agenda had been published could be made available to the public.

 

It was confirmed that these documents would be published with the minutes of the meeting.

92.

DATES OF FUTURE MEETINGS

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

 

Monday 9th October 2017 – 3.00pm

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. 

Minutes:

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

 

Monday 9th October 2017 – 3.00pm

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. 

93.

ANY OTHER URGENT BUSINESS

Minutes:

There were no items of Any Other Urgent Business.

94.

CLOSE OF MEETING

Minutes:

The Chair declared the meeting closed at 5.18pm.