Agenda and minutes

There were no apologies for absence.

The Chair referred to the principal item of business as the reconfiguration proposals, and advised he intended to structure the item under themes.  He asked that members of the public’s questions would be taken out of order and submit supplementary questions relating to each theme.

Questions from Mr Ambrose Musiyiwa were received and in his absence, it was noted that written answers would be provided prior to the next meeting.

Members are asked to declare any interests they may have in the business on the agenda.

There were no declarations of interest.

The minutes of the meeting held on 6 October 2020 are attached and the Commission is asked to confirm them as a correct record.

AGREED:

That the Minutes of the meeting of the Commission held on 6 October 2020 be confirmed as a correct record.

The Monitoring Officer to report on the receipt of any petitions submitted in accordance with the Council’s procedures.

The Monitoring Officer reported that no petitions had been submitted in accordance with the Council’s procedures.

The Monitoring Officer to report on the receipt of any questions, representations and statements of case submitted in accordance with the Council’s procedures.

Eight Questions have been received in respect of the reconfiguration consultation and are listed at that item later on the Agenda.

The following Questions have also been received from Mr Ambrose Musiyiwa:

Question 1

In the Health and Wellbeing Scrutiny Commission of Thursday, 30/01/2020, Cllr Melissa March reported that in 2017 she was asked to produce a passport or another form of ID before she could be allowed to access maternity care. (See item 7 here):

www.cabinet.leicester.gov.uk:8071/ieListDocuments.aspx?CId=737&MId=9470&Ver=4)

The response from the UHL NHS Trust was that they did this because they were trialling overseas visitors’ policies in different settings. The Trust also indicated the trials have been taking place as recently as the 18 months leading up to January 2020.

Can the UHL NHS Trust produce the ethics, risk and impact assessments that were done before and after the passport and ID checks?

How long did/has the UHL NHS Trust been conducting these checks? How many of these checks have been conducted? Who has been conducting them, when, where and how? 

What effect have the checks had on GP surgeries, hospitals and on patients and people who use the NHS?

Are the checks still going on? What does the UHL NHS Trust do with the information they collect(ed) through these checks? What effect do/have these actions had on the patients and people affected?

It is important that the hospital answer these questions and produce the ethics, risk and impact assessments because passport and ID checks are associated with borders and border control. Depending on what passport they hold or do not hold, some people can breeze through borders while others experience borders as places of extreme and sometimes lethal violence.

Question 2

Information on the Leicester City Council website says, in 2012/14, rates of stillbirth and perinatal and infant deaths in Leicester were higher than the national average 

https://www.leicester.gov.uk/your-council/policies-plans-and-strategies/public-health/data-reports-information/jsna/cyp-jsna/pre-birth-to-antenatal/

Similarly, the Leicester, Leicestershire and Rutland Child Death Reviews (2011/12 to 2016/17) reports that child deaths in Leicester are higher than the national average 

https://lrsb.org.uk/uploads/llr-child-death-review-analysis.pdf

Appendix B (especially pages 10 and 11) of the minutes of the Health and Wellbeing Scrutiny Commission of 30/01/2020 hints at these issues when it emphasises initiatives and measures that have been put in place to reduce child mortality - but, at the same time, does not say how many stillbirths and perinatal and infant deaths have been or are occurring Leicester or explain why these deaths are happening. 

In the Health and Wellbeing Scrutiny Commission meeting of 30/01/2020, the chair asked the UHL NHS Trust for statistics and reports on the deaths. 

Did the Trust provide the reports?  

The Monitoring Officer reported that eight Questions had been received in respect of the reconfiguration consultation and in consultation with the Chair these had been listed for consideration at that item.

The Chief Executive Officer of the Clinical Commissioning Groups in Leicester, Leicestershire And Rutland submits a report at Appendix B titled:

‘Building Better Hospitals for The Future’

The report responds to questions previously raised by the Commission on the plans to reconfigure Leicester’s hospitals in order to build better hospitals for the future for the population of Leicester, Leicestershire and Rutland.  

Eight questions have been received in relation to this item as attached at Appendix C. 

Responses to those questions will be provided by the UHL/CCGs prior to the meeting.

The Chair referred to his comments made at the earlier item “Chair’s Announcements” where it had been explained that discussion on this item would be structured into themes.

The Chair invited Andy Williams, Chief Executive Officer of the Clinical Commissioning Groups (CCG) in Leicester, Leicestershire And Rutland to address the Commission and submit the report at “Building Better Hospitals for The Future’”.  The report responded to questions previously raised by the Commission on the plans to reconfigure Leicester’s hospitals.

As recorded in the previous item, eight questions had been received and responses to those questions had been be provided by the University Hospitals of Leicester (UHL)/CCGs prior to the meeting.  It was noted that those public questions would be considered out of order listed in the agenda, and that supplementary questions following the written responses would be allowed.

The Chair further referred to the discussion at the Joint Health Overview Scrutiny Committee (HOSC) meeting held on 14 December 2020 and commented that this reinforced the need to consider the issues in the following themes:

a) UHL reconfiguration consultation

Sally Ruane was invited to address the Commission and ask her supplementary question following the written response received.  

She asked for details on how many residents had requested copies of the consultation document, how many had engaged in the process, and what affect this had on staff time and resources, including the how much the consultation had cost.

It was suggested that a written response be forwarded by the CCG via Richard Morris, Director of Operations and Corporate Affairs, NHS Leicester City CCG.

The Vice Chair commented on the consultation process and welcomed the use of social media; however, it was considered that there remained some hard to reach sections of communities in the city that had not engaged in the consultation.  

This was recognised by the CCG and it was confirmed that multi-language information had been offered and various other methods of reaching all ethnicity and geographical groups across the city’s demographic had been undertaken.  

It was reported that engagement with voluntary services groups to encourage responses to the consultation included: the South Asian Health Association, Age UK, the Council of Faiths, other Faith leaders across the city, the LGBT Centre, Project Polska, Sharma Womens Centre, and the Somali Development Services.

In respect of the data submitted at the recent Joint HOSC meeting, the Chair asked for clarification of the numbers of responses already received as this seemed unfeasibly high.  It was agreed that details of the analysis from Google Analytics could be provided to the scrutiny commission.

b) Maternity Services

Robert Ball was invited to address the Commission and ask a supplementary question following the written response received.  

He commented that there were risks to proposing that all hospital births would be in one building, given likely increased pressure and congestion on the road network.  It was also noted that this issue had not been included on the risk register associated with the reconfiguration plans.

Brenda Worrall was invited to  ...  view the full minutes text for item 17.

The Director of Public Health will provide a verbal update regarding latest trends/numbers/contact tracing/information on lateral flow tests.

NHS partners will provide a verbal update regarding the Covid-19 vaccination programme.

A further update will be provided on the progress of the flu vaccination programme.

The Chair opened the item and asked for specific developments on priority areas of protection rates and tiers, lateral flow, and progress with the vaccination programme.

The Director of Public Health provided headline key messages.  In terms of infection rates, the city had been in the highest region for some time, however rates had recently fallen, and the current rate was 255 per 100,000.  It was noted that in context, some weeks ago the rate was 438.  In broader context Leicester currently stood at around the 58^th highest area, due to the increase in rates in the south and east coast.  It was confirmed that there would be further updates in due course.

As figures were now plateauing since the first spike it was reported that currently at 8% of testes were positive, showing a fall.  It was clarified that although this was initially significant regionally, the rate was below that in London but higher than the average for both the East and West Midlands. 

In respect of the lateral flow and devices it was noted that the door to door testing activity was continuing, utilising tests that were well known with high specificity and lateral flow.  It was reported that some press reports stating that results would be received within an hour had caused concern and had been treated with caution.  It was clarified that from the public health viewpoint, the tests were not seen as reliable as PCR tests, so could only be used to give a good indication, with encouragement for a repeat test.  Details of the testing centre at Fosse were confirmed.

In relation to vaccinations, it had been emphasised that it was the responsibility of the NHS and the Council only offered its support to the track and trace and contact tracing initiatives.  The system therefore had limitations and the current vaccine was fragile due to the constraints of its storage and transportation.  It was noted that a further AstraZeneca option was being developed and details would be known soon.

The Chair thanked the Director for the update and then opened the debate to questions.

Councillor Sangster asked how many of the city’s population had been tested and what was considered a low rate of infection.

In response it was estimated that over 130,000 people had been tested and the exact figures would be supplied separately.  It was noted that the original lockdown had been called after a recording of 135 per 100,000, therefore a figure below that could be considered as low.  At present the national figure was 184 per 100,000 taken as an average and the city was 255.  It was confirmed that Government meetings were ongoing to look at future tiers and announcements would be made shortly.

Councillor Sangster also commented that there was some reluctance in the health service for staff to take the current vaccine.  She asked what as a Council we could do in response and how could support the broader community.

The Director advised that some misinformation  ...  view the full minutes text for item 18.

A Scrutiny Review Document is attached titled:

‘The experience of black people working in health services in Leicester and Leicestershire’.

The Commission is recommended to adopt the Review following discussion of its rationale and purpose.

The Scrutiny Review Scoping Document titled; “The experience of black people working in health services in Leicester and Leicestershire” was presented, for endorsement.

In terms of the rationale it was reported that the recent Black Lives Matter movement together with the disproportionate effect COVID19 has had on ethnic minority groups, specifically people of Black heritage, had highlighted the inequalities Black people face in their day to day lives.

Whilst nationally the NHS had set up the NHS Race and Health Observatory and has the Workforce Race Equality Standard (WRES), Commission would like to explore the picture locally. This would consider any the employment trajectories, outcomes as well as the disciplinary practices experienced by black people while working across the health sector in Leicester and Leicestershire.

The Vice Chair suggested that in respect of the gathering of evidence there was a need to include carers and pharmacists and any other relevant contributors.  This suggestion was accepted by the Commission.

AGREED:
That the rationale of the Scoping Document be approved.

The meeting closed at 8.00 pm.