Agenda and minutes

Apologies for absence were received from Councillors Cassidy, Osman and Palmer and Surinder Sharma and Karen Chauhan from Healthwatch Leicester.

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

Members were asked to declare any interests they may have in the business on the agenda.  No such declarations were received.

To note the membership of the Commission for the municipal year 2016/17.  This will be submitted for approval to the Annual Council meeting to be held on 19 May 2016 and it will be made available as soon as practicable after the Annual Council Meeting.

Members noted that the membership of the Commission for the 2016/17 municipal year that was submitted to the Annual Council meeting on 19 May 2016 as follows:-

Councillor Dempster – Chair

Councillor Fonseca – Vice-Chair

Councillor Cassidy

Councillor Chaplin

Councillor Cleaver

Councillor Sangster

Councillor Unsworth

1 unallocated Non-Grouped Place.

To note the Terms of Reference of the Commission to be approved by the Annual Council at its meeting on 19 May 2016.  These will be circulated as soon as practicably after the Annual Council Meeting.

Members noted the Terms of Reference for the Commission as approved by the Council at its Annual Meeting on 19 May 2016.

To note the dates for meetings of the Commission for the municipal year 2016/17.  These will be submitted for approval to the Annual Council meeting to be held on 19 May 2016 and they will be made available as soon as practicable after the Annual Council Meeting.

Members noted that meetings of the Commission would be held on the following dates during the municipal year 2016/17:-

Wednesday 25 May 2016 – 6.30pm - G01, City Hall

Thursday 30 June 2016 – 5.30pm - G01, City Hall

Wednesday 7 September 2016 – 5.30pm - G01, City Hall

Wednesday 9 November 2016 – 5.30pm - G01, City Hall

Wednesday 4 January 2017 – 5.30pm - G01, City Hall

Wednesday 8 March 2017 – 5.30pm - G01, City Hall

The minutes of the meeting held on 21 April 2016 have been circulated and the Commission will be asked to confirm them as a correct record.

The minutes can be found on the Council’s website at the following link:-

http://www.cabinet.leicester.gov.uk:8071/ieListDocuments.aspx?CId=737&MId=7015&Ver=4

RESOLVED:

that the minutes of the meeting held on 21 April 2016 be approved 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.

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

The Chair requested officers to consider allowing questions at meetings after the agenda had been published.  Members of the public were also advised to submit any questions to the Democratic Support Officer who would arrange for them to receive a written response.

The Chair commented that it was also intended to undertake joint scrutiny with the Children Young Peoples and Schools Scrutiny Commission on CAMHS and integration of Children’s 0-19 services during the next year.

There would also be joint scrutiny with Leicestershire and Rutland on the Better Care Together Programme during the consultation period to allow a joint response to be made in accordance with the Regulation 30 of The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013.

To receive a presentation from the Director of Public Health providing an overview of ‘A Picture of Health in Leicester City.’  The presentation is attached.

The Director of Public Health gave a presentation providing an overview of ‘A Picture of Health in Leicester City.’  The presentation had previously been circulated with the agenda.

During the presentation the following comments were noted:-

a)        There was now a considerable amount of data collected in the city for public health which helped to identify trends and target services.  The last Health and Wellbeing survey in the city had been conducted in September 2015.

b)         Child dental health had been the worst in the Country; but this had now improved by four places nationally in a short space of time due to the improvement plan introduced 2 years ago, though continued effort was needed.

c)         Life expectancy for people living in city was still below the national average for both men and women; but this has shown some signs of improvement in recent years.

d)         Generally people were living in good health until 58 years old and the challenge was to improve the length of time people lived in good health.  Life expectancy was worse in the more deprived areas of the city compared to the more affluent areas.

e)         Emergency hospital admission rates were higher in men, older ages and ethnic groups.

f)          People experiencing social isolation had higher levels of poor wellbeing and mental health.  Women had higher levels of poor mental health compared to men.

Following questions from members it was noted that:-

a)         The City had been divided into quarters for the purposes of the survey.  It was possible to use the data in the surveys to look at specific issues in greater detail, however the data could become unreliable if applied to ward level issues in some instances as the sample group in some wards may be too small for reliable statistical analysis.  Public Health England also provided detailed information at ward level based upon their detailed data.

b)         Teams working in Family and Children Centres had access to breast pumps, but introducing a loan system would help to improve breast feeding rate further.  

c)         Dentistry services were complicated to monitor as the services were commissioned by NHS England.   The information on the provision of private and NHS dental services in the city would be held by NHS England.

d)        Reductions in cancer and heart related diseases had already been observed in the city as a result of people benefiting from stopping smoking through the smoking cessation programme.

e)         Public Health Services would need to be increasingly targeted at areas of need in the future as pressures on budgets increased.  Data from the surveys would be an essential part of the decision making process.

f)         The data from the health surveys was an open resource and was used widely within the local health economy to shape service provision.  For example, the CCG used the data in planning GP services in the city.

g)         GPs prescribed approximately 2,000 people a year for physical activities with leisure centres.  It had been recognised that success rates             improved  ...  view the full minutes text for item 9.

To receive a presentation from the Programme Director, Better Care Together providing an overview and update of the Better Care Together Programme.

The Programme Director, Better Care Together gave a presentation providing an overview and update of the Better Care Together Programme (BCT).

During the presentation the following comments were noted:-

a)         That the timetable for consultation on Better Care Together had been delayed further due to requirement for 42 national health areas to provide  Local Health System Sustainability and Transformation Plansunder  ‘The Delivering the Forward View – NHS Planning Guidance  2016/17– 2020/21’ issued in December 2015.  This required placed based health providers to create an ambitious local blueprint for accelerating its implementation of the Forward View.  These Sustainability and Transformation Plans (STPs) would cover the period between October 2016and March 2021, and would be subject to formal assessment in July 2016 following submission in June 2016.

b)         The Guidance had been published jointly by NHS England, NHS Improvement (Monitor and the NHS Trust Development Authority), Care Quality Commission (CQC), Health Education England (HEE), National Institute of Health and Care Excellence (NICE), Public Health England(PHE).  The guidance asked the NHS to spend the next six months delivering core access, quality and financial standards while planning properly for the next five years.

c)         The local health area covered Leicester, Leicestershire and Rutland and whilst the Better Care Together pre consultation Business Case had been reviewed favourably by the NHS Review Panel they had asked for further details on finance, capital and capacity. 

d)         NHS England had issued advice that as the BCT was a part of the STP, it would not be possible to proceed with consultation on BCT until the STP had been formally approved.  This meant that the Business Case required amendment and it was therefore available for public consideration at this time.

e)         A letter had been sent to NHS England expressing the need to move forward locally on the BCT and this could be shared with the Commission members.

f)          The delay to the consultation, however, only delayed changes to services that required public consultation, such as the University Hospitals of Leicester NHS Trust’s proposals to reduce acute care from 3 sites to 2, which involved the significant shift of services from the General Hospital Site to the LRI and Glenfield Hospital sites.  It would also affect the proposals for the Maternity Services and the Women’s Hospital at the LRI.  These services were also subject to capital finance approvals before proceeding.

g)         Some changes to services could still go ahead as these were operational changes which did not require statutory consultation. These included the Integrated Community Support Services and Review of services for people with mental health conditions and learning difficulties.

Following questions from members it was noted that:-

a)         Any planned transfer of patient care from the acute sector to community hospitals and the social care sector would not occur until service plans were in place in these sectors.

b)         The provision of hospital beds at home was not suitable in all cases and would only happen if this was the patient’s preferred option  ...  view the full minutes text for item 10.

To receive a service brief and position statement on CAMHS from the Leicestershire Partnership NHS Trust (LPT).

Professor Adrian Childs, Chief Nurse and Deputy Chief Executive of the Leicestershire Partnership NHS Trust (LPT). Presented a report which gave a service brief and position statement on the Child and Adolescent Mental Health Services (CAMHS).

It was noted that:-

a)         The data in the report related solely to the city and excluded the costs for Leicestershire and Rutland.

b)         The 10 bed CAMHS Impatient Service unit was based temporarily at Coalville Community Hospital was commissioned by NHS England as it provided a regional service for not only Leicester, Leicestershire and Rutland but also Derbyshire, Lincolnshire and Nottinghamshire.

c)         Planning for a permanent site for the service was being delayed until the outcomes of the ‘Future in Mind’ review process was known as this could have an impact upon the number of in-patient beds to be provide.  Planning for a permanent site would also require capital finance approvals.  When the final commissioning requirements were known, there would be consultation on the proposals.

d)         Following previous concerns at the number of children and young waiting for an appointment for over 13 weeks, extra resources had been directed to address the issue.  In November 2015 the waiting list was 250 and this had been reduced to the current level of 43.  The remaining 43 cases had been booked appointments for assessment by the end of June.

e)         Other improvements to the service included:-

·         Providing a single point of access through care navigators to help families, carers and children to work through the health care system to receive help and treatment.

·         There was a Focus on ‘Evolving Minds’ and the service was working with young people to seek their views on how they would like access the service to get information on issues that were of concern to them.  Smart phone applications and the website were being developed to enable direct access for young people.

·         School nurses worked closely with CAMHS so children can contact the School Nurse service through an ‘app’.  The response to any enquiry was provided by a qualified nurse.  This had resulted in providing help issues such as bullying and eating disorders at an earlier stage, as children were more comfortable in communicating with an ‘app’ than talking to an adult.

Following comments from Members, the Chief Nurse and Deputy Chief Executive stated that:-

a)         Whilst it was recognised that the views of the children involved with the service were important, this had to be balanced with the views of their parents and carers which was often at variance with the views expressed by the children.

b)         The service recognises the importance of other services views and input they can bring to add to the service.  School nurses, in particular play an important part in identifying issues by holding discussion groups in schools and seeking the views of how young people would want the service to operate.

c)         The majority of schools are engaged with school nurses who will work closely with the teacher of the children and young  ...  view the full minutes text for item 11.

To receive an update on the Anchor Recovery Hub.

The Director of Public Health gave a verbal update on the current position in relation to the Anchor Recovery Hub.  It was noted that a short list of properties were currently being considered and would be considered by the Executive in due course.

AGREED:

That a further report be submitted to the Commission on the options that have been considered for the Anchor Centre.

The Scrutiny Policy Officer submits a document that outlines the Health and Wellbeing Scrutiny Commission’s Work Programme for 2014/15.  The Commission is asked to consider the Programme and make comments and/or amendments as it considers necessary.

The Scrutiny Support Officer submitted a document that outlined the Health and Wellbeing Scrutiny Commission’s Work Programme for 2014/15.

The Chair referred to the EMAS CQC Report and stated that EMAS had invited representatives of all local authorities in their operational area to a meeting on 6 July 2016 in Nottingham.  The Chair and the Scrutiny Policy Officer would be attending the meeting and the Chair requested that a member of the Commission also attend.

AGREED:

            That the Work Programme be noted.

The meeting closed at 9.10 pm.