Agenda and minutes

There were no apologies for absence.

The Chair welcomed Councillor Whittle to the meeting. It was noted that Councillor Whittle was in attendance to ask questions under the Covid update item at the Chair’s discretion.

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 16 December 2020 are attached and the Commission is asked to confirm them as a correct record.

The Chair referred to an issue raised by a member of the public concerning the minutes.  It was noted as a matter of clarification that an image shown as part of a response during UHL consultation on the business case was purely an image and did not represent a structure to be built as part of the proposals.

The Chair also confirmed that the meeting recordings were held in a library on the Council’s website.

AGREED:

That the Minutes of the meeting of the Health and Wellbeing Scrutiny Commission held on 16 December 2020 be confirmed as a correct record, subject to the above clarification.

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.

The Monitoring Officer reported that no questions, representations and statements of case had been submitted in accordance with the Council’s procedures.

The Director of Public Health will provide a verbal update on the latest position.

The Director of Public Health gave a presentation, confirming the key messages as an update to the current Covid 19 pandemic situation.

It was reported the most recent data showed 27,000 confirmed positive tests with an infection rate at approximately 600.  This figure was falling but was considered to still be at a high level.  It was noted that data relating to the most vulnerable groups showed that the rate in children had stabilised, but there had been an increase in the 60 plus category.

In terms of hospital admissions, it was reported that these had been high since November 2020 and when countywide admissions were factored in for various conditions, the pressure on hospitals was exacerbated. 

Using information received from the UHL including city and county residents, there were 472 Covid patients, 1037 non-Covid patients and 199 unoccupied beds, which gave an 88% occupancy rate.

The data concerning mortality was confirmed, with 2929 deaths in 2020.  Averages on previous years, were around 2500.  It was also confirmed that 17% of deaths had a mention of Covid on certificates.  There had been 509 deaths within the past 28 days.  Charts were displayed within the presentation, which showed further detailed information of results, 7-day averages, age bands and hospital admissions. 

In concluding the presentation, details of the access to updated information as available on the Council’s website were provided.

The Director also confirmed that the new variant presented a significant impact as the predominant variant, with recent data showing that 64% of cases were new variant cases. 

It was emphasised that the situation was being monitored carefully and the key public health messages including social distancing, self-isolation, hand hygiene and ventilation remained important to reduce the rate.

The Chair invited Commission members to ask questions and the following points and responses were noted:

The scale of asymptomatic cases was clarified at a lower level than that reported recently, where data from the launch and rollout of the Fosse testing station could be used to identify trends.  The actual figures could be circulated separately but it was expected that there were around 5-10% of asymptomatic cases.

Lateral flow testing had presented challenges and concerns with potentially misleading results as some tests and results were not being administered or read by health professionals. Strong guidance and advice were given accordingly, including the need for repeated tests to be undertaken.  Concerns remained with negative test results being used as a means to enable rules and guidance to be ignored.

The effect on hospitals, their capacity and the morale of the workforce were significant.  The role of volunteers had increased, and staff were receiving vaccinations.  It was reported positively that the collaboration across local government, the voluntary and independent sectors and other partners had enhanced and the initiative to repeat this message had increased morale.

At this point, the Chair invited Councillor Whittle to ask his question, as recorded in the earlier item.

Councillor Whittle thanked the Chair for allowing the opportunity to address the  ...  view the full minutes text for item 27.

The CCGs submit two papers, which provide an update on the uptake of the flu vaccination programme 2020/21 with a focus on Leicester City and an update on the development of the National Covid-19 vaccination programme and progress across Leicester Leicestershire and Rutland.

The CCGs submitted two papers, which provided an update on the uptake of the flu vaccination programme 2020/21 with a focus on Leicester City and an update on the development of the National Covid-19 vaccination programme and progress across Leicester Leicestershire and Rutland.

In respect of the Flu Vaccination Programme the importance of maintaining a high vaccination coverage was highlighted, however the delivery of this year’s programme was more challenging because of the impact of Covid-19. 

The report provided an update on the uptake of the Leicester Leicestershire and Rutland flu vaccination programme 2020/21 with a focus on Leicester City, with data taken from the IMMFORM national database. It was noted that practice level data from IMMFORM could not be shared in the public domain due to licensing restrictions and this situation was being monitored.  Updates would be provided if and when available and appropriate to do so.

In respect of the Covid-19 Vaccination Programme the report provided an update on the development of the National Covid-19 vaccination programme and progress across Leicester Leicestershire and Rutland.

It was noted and recognised that the vaccination programme was extremely dynamic, and information would be updated as necessary in due course.  The report provided details of vaccination locations, priority groups, vaccine development and availability, spacing of doses, and delivery.

In terms of the next steps it was noted that Next Steps it was reported that a larger scale vaccination centre at the Peepul Centre was in progress and subject to regional and national sign off was due to go live in January 2021.  Other sites were being considered, including an additional Hospital Hub.  All would be subject to the strict requirements on infection control requirements, security, storage, and IT infrastructure.

In response to questions it was confirmed that the spacing of flu vaccinations and Covid vaccinations was currently one week, and the spacing between first and second Covid vaccinations was currently 3 months.  It was accepted that some people had received a second Covid dose, as this would have been arranged before the guidance was changed.

The initiative to launch a vaccination centre at the Peepul Centre was supported, and the need to encourage its use and monitor attendance was highlighted.

The Chair raised a point sent to him by a member of the public relating to predicted problems for individuals with residency, immigration or nationality issues who were not on GP lists.  It was also considered that those with mental health problems, the homeless and other vulnerable groups who would be in most need of the vaccine would not be referred. 

In response it was confirmed that GPs lists were being used as the primary process to offer vaccinations, however reassurance was provided that outreach work including liaison with Inclusion Health Care had been accelerated and updates could be provided at a later date.

The Vice-Chair also raised issues with the hard to reach communities and referred to negativity of the effectiveness of the vaccines being reported to him.  It  ...  view the full minutes text for item 28.

The Director of Public Health submits a report, which provides an overview of the health and social inequalities related to the Covid-19 pandemic.

The Director of Health submitted a report, which provided an overview of the health and social inequalities related to the covid-19 pandemic.

It was reported that analysis had been undertaken by Public Health England PHE in their 2020 report “Disparities in the risks and outcomes of Covid-19” which confirmed that older people, males, people from deprived backgrounds and people from BAME backgrounds were more likely to die with Covid-19.

The Director of Public Health reported that reasons for this inequity were complex and involved a combination of economic and social drivers such as lifestyle and behaviour.

It was noted that the additional health burden of Covid-19 is of particular concern locally given the diversity and deprivation experienced by the population of Leicester.

In conclusion of the presentation, it was reported that a defined programme of work was required to measure the specific impacts and to recommend mitigations to address inequalities and improve health equity going forward.

AGREED to:

1.    Note the content of the report 

2.    Support the ongoing programme of work to identify and address the impact of covid-19 on health and social inequalities across Leicester

3.    Receive an update on the inequality impact of Covid 19 on the local population

The Director of Finance’s report to Council, which will consider the City Mayor’s proposed budget for 2021/22 and medium-term projections up to 2024 is submitted for comment on public health items related to the portfolio of this scrutiny commission.

The Chair referred to the Director of Finance’s report, which considered the City Mayor’s proposed budget for 2021/22 and medium-term projections up to 2024.  The Commission was asked to make comment on the public health items relating to its portfolio. 

The Assistant City Mayor (Health) commented on key issues within the report, relating to the continued commitment to fund 0-19 services, although his had been put on hold due to recent Covid-19 implications and restrictions.  It was expected that consultation would be enhanced to allow the contract concerned to be extended.  The further ongoing commitments to mental health services and physical health services would also receive further investment which was welcomed.

In response to questions put by Commission members, it was confirmed that the budget for substance misuse was included in the Adults Services line in the budget.  In terms of the public health grant it was reported that not all of the expenditure related to the grant is included in the Health and Wellbeing budget line with some expenditure included in other budget lines. The Chair asked for confirmation that the grant was being treated in line with other external grants and this was confirmed to be the case.

In respect of the support to contraception and sexual health services a reduction in capacity including services offered by General Practitioners had caused a potential for longer-term concern following Covid-19. 

It was reported that other services had also experienced capacity issues exacerbated by Covid-19 and the situation was being monitored.

In conclusion the Chair referred to the poor quality of food offered in vending machine and food services at the Council’s Leisure Centres, commenting that the current arrangements were not suitable.

AGREED to:

1)    Welcome the commitment to the 0-19 service and to welcome the continued funding, with a monitoring report to be submitted at the appropriate time.

2)    Note that the capacity of the contraception and sexual health services and other services affected by Covid-19 continue to be monitored and a report be submitted in due course.

3)    Undertake a review of contracts for vending machines and other food services at the Council’s Leisure Centres.

The meeting closed at 8.05pm.