Agenda and minutes

Apologies for absence were received from Councillor Halford and Councillor Westley (Heritage, Culture, Leisure and Sport Scrutiny Commission invitees).

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

The Chair declared an interest in Item 13 – Update on Integrated Sexual Health Services as a member of the Planning and Development Control Committee that had determined the planning application for the Sexual Heath Centre at the Haymarket. 

In accordance with the Council’s Code of Conduct the interest was not considered so significant that it was likely to prejudice the Chair’s judgement of the public interest.

The Chair was not therefore required to withdraw from the meeting during consideration and discussion on the item.

The minutes of the meeting held on 7 March 2018 have been circulated and the Commission will be asked to confirm them as a correct record.

AGREED:

That the minutes of the meeting of the Commission held on 7 March 2018 be confirmed as a correct record.

a)  “No. 5 Hill St”

The Chair referred to her recent visit to No 5 Hill St., where facilities were provided to assist people with alcohol and substance misuse problems.  It was noted that the visit had been very positive and the challenges concerning substance abuse and the increased use of psychoactive substances had been recognised.

b)  VAL and STP events

The Chair reported on visits made to a Voluntary Action LeicesterShire event and a separate STP event where it had been helpful to obtain the views of residents of the city.

c)  NHS 70^th Birthday Celebrations

The Chair read a statement recognising the 70^th Birthday of the NHS.  She commented on the launch of the NHS by the then Health Secretary Aneurin Bevan, which brought together the hugely ambitious plan to bring good healthcare that was free at the point of delivery.  Comment was made on the evolution of the NHS since that time and that the NHS was arguably one of Britain’s greatest organisations. 

Thanks were expressed to NHS colleagues for the hard work and care offered to the residents of the city in uncertain times.

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.

Members are asked to note the membership of the Commission as detailed on the front of the agenda.

The Commission noted its membership for the 2018/19 Municipal Year as follows:

Councillor Cutkelvin (Chair)

Councillor Fonseca (Vice-Chair)

Councillor Chaplin

Councillor Cleaver

Councillor Dr Moore

Councillor Pantling

Councillor Dr Sangster

Members are asked to note the dates of further meetings of the Health and Wellbeing Scrutiny Commission as detailed below:

23 August 2018

11 October 2018

29 November 2018

15 January 2019

12 March 2019

All meetings will commence at 5.30 pm.

The Commission noted the dates of meetings for the 2018/19 Municipal Year as follows:

5 July 2018

23 August 2018

11 October 2018

29 November 2018

5 January 2019

12 March 2019

Members are asked to note the Terms of Reference for the Health and Wellbeing Scrutiny Commission.

The Commission received and noted the Terms of Reference for Scrutiny Commissions.

The Director of Public Health submits a report that provides consultation feedback and final proposals on the Integrated Lifestyle Services.

Members are asked to:

·         Note the themes emerging from public consultation and their impact on the proposed model;

·         Note the associated savings to be achieved;

·         Note the risks associated with the implementation of this service and proposed mitigations; and

·         Feedback comments on the proposed model to the Executive.

Members of the Heritage, Culture, Leisure and Sport Scrutiny Commission have received an invitation to attend and participate in the consideration of this item.

The Chair advised that an invitation had been forwarded to members of the Heritage, Culture Leisure and Sport Scrutiny Commission for the discussion of the item and welcomed Councillors Bajaj and Gugnani to the meeting.

The Chair further advised that that revised legal and equality implications had been drafted to support the report submitted, copies of which were circulated to members.

The Director of Public Health submitted a report, which provided consultation feedback and final proposals for the Integrated Lifestyles Service.

It was noted that in February 2018, the Executive approved outline proposals to develop a new integrated lifestyle service, following a period of review and a number of reports on the service.  A period of public consultation had taken place which had been supported by focus groups specifically looking at areas of the proposal which it was felt would benefit from an in-depth insight.  The results of the public consultation were outlined in the report submitted and had formed the final proposals for the service.  The proposals had been endorsed by the Executive, pending the feedback from the Commission, with invited members of the Heritage, Culture, Leisure and Sport Scrutiny Commission.

Deputy City Mayor Councillor Clarke was invited to comment on the content of the report and made reference to the key emerging themes from the consultation, principally relating to the shift to the service having a single booking function.  It was noted that the new model would bring staff from a range of existing services to provide an enhanced single service.

The Chair welcomed the report and agreed with the principles outlined, but commented that further details would be required in due course to allow members to properly assess the impacts of the revised service.  Members supported this view and advised that more details and analysis of the results of the consultation were required.

The Deputy City Mayor Councillor Clarke reassured members that 1:1 support would remain for high risk groups, and in response to a comment informed the Commission that the sample of respondents in the consultation process was adequate and that other methods had been used to gain feedback.

The concerns in respect of the move to digital information were expressed, however it was noted that the enhanced use of technology had been positively received by service users.

In requesting a further report, it was accepted that information of alternative options and the reasons that they were not put forward should be explained in greater depth, together with more information on the methods of consultation and analysis of its actual impact.

It was AGREED to:

1)    Request that a further report be submitted to the next meeting of the Commission;

2)    Note the themes emerging from public consultation as reported to date and note their impact on the proposed model;

3)    Note the associated savings to be achieved;

4)    Note the risks associated with the implementation of the service and proposed mitigations; and

5)    Feedback the comments made to the Executive

The Commission will receive a report which provides an update on Phase Two of the work to create an Emergency Floor at the Leicester Royal Infirmary. Members are asked to comment on the report as they see fit.

The Chair welcomed and introduced Mark Wightman (LRI – Director of Strategy and Communications) and Richard Wong (LRI– Consultant in Care for the Elderly).

Mr Wightman submitted and presented the report, which provided an update on Phase 2 of the work to create an emergency floor at the LRI.

It was reported that the new emergency floor had been designed to meet the needs of patients and the recent completion of the move of all five acute assessment units next to the emergency department had created the emergency floor.

Dr Wong referred to the positive impact of the revised layout and made a particular comment on the improved hospital environment and move away from single event emergency care.  He advised that greater collaboration and corporate working of staff, specialist nurses and physicians had resulted since the implementation of phase 2 of the works.  It was recognised that the situation was evolving and difficulties in recruitment were reported and noted.

The Chair welcomed the report and commented on the improved patient flow data and outcomes.  Concern was expressed about the increased cost of the GP Assessment Unit (GPAU) and in response to the question the Commission was reassured that as the service was operated by acute physicians, the GPAU suffered from a misnomer in its definition and that improvements to patient care had been noted. 

A concern was raised as to whether the 20-minute waiting time permitted outside the Emergency Department was sufficient, as not everyone was brought to the hospital by ambulance. A Member asked for this waiting time to be reviewed.

In response to further questions it was confirmed that a review of signage, inclusion access to car parks and advice on the internal layout were being considered.  It was also confirmed that proposals for a new front entrance and external layout were being considered in the next phase of improvement works.

In this regard the improved patient flow had been recognised and the vast improvement in the performance data concerning ambulance waiting times was noted and welcomed.

In discussing the images provided of the acute medical unit and the acute frailty unit and dementia corridor (Memory Lane), the Commission welcomed the improvements and the Chair suggested a site visit for members to properly assess the improvements made.  Mr Wightman advised that a visit could be convened for members.

The decision to remove the former Chapel as part of the improvements was reiterated and members noted the significant opposition to the proposals when the plans were first submitted.  Mr Wightman commented on the positive response since works had commenced and advised that the new Chapel had been positively received by the Hospital Chaplain and multi-faith users.  It was confirmed that important historical windows and panels had been reused and relocated within the new provision.

In terms of the reported difficulties in recruiting nurses, the Commission commented on the need to increase advertisements of job opportunities at the site and at key sites elsewhere in the city.  The impact of  ...  view the full minutes text for item 11.

Sarah Prema, Director of Strategy and Implementation and Michelle Iliffe, Director of Finance, will be in attendance to present the Refresh of the 2017/18 and 2018/19 Operational Plan for the Leicester City Clinical Commissioning Group (CCG). NHS organisations are required to produce an Operational Plan as per the planning guidance issued by NHS England in February 2018.

 The Scrutiny Commission is asked to note and comment on the Refresh of the Operational Plan.

The national NHS Operational Planning and Contracting Guidance 2017-19 document can be found on the following link:

https://www.england.nhs.uk/wp-content/uploads/2016/09/NHS-operational-planning-guidance-201617-201819.pdf

A refresh of the above NHS Operational Planning Guidance can be found on the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/02/planning-guidance-18-19.pdf 

The Chair welcomed and introduced Sarah Prema (Leicester City CCG – Director of Strategy and Implementation and Michelle Iliffe (Leicester City CCG – Director of Finance).

The Chair referred to significant content within the report and particularly to the detailed information submitted in the full refresh document of the Operational Plan.  She advised members that in future, a separate briefing before the Commission’s meetings may be required to properly digest and assess detailed information, allowing proper scrutiny of the information by members.  It was accepted that training of new members of the Commission in the form of briefings prior to meetings could have been undertaken prior to the consideration of such items.

In submitting the report, reference was made to the key requirements of the revised planning guidance and it was explained that the document was a refresh only as the 2018/19 return, as it represented the second year of the agreed two-year plans and contracts.  The local actions to deliver the national priorities as set out in the operational plan document were explained and noted.

The Chair referred to the link to the guidance and suggested that any questions on the full document be forwarded by members individually, given the lengthy detail submitted.

In response to questions, the rationale for planning healthcare and the suggested lack of parity nationally with physical and mental illness was discussed and recognised.  It was considered that Leicester and Leicestershire offered enhanced diabetes services in comparison to similar cities nationally and it was suggested that a further report on this and the contractual issues concerning mental health services could be submitted to a future meeting of the Commission.    

In response to a question, it was noted that the Operational Plan refresh had been prepared prior to the Government’s recent decision to provide greater investment to NHS services.  It was confirmed that an update on the impact of the investment could be submitted later in the year.

It was AGREED to

1)    Note the refreshed Operational Plan for the Leicester City CCG and request a further report later in the year;

2)    That the enhanced Diabetes Service be added to the work programme; and

3)    That the Chair write to the CCG with further questions to be responded to prior to a future update.

The Director of Public Health will provide Members with an update on the new Integrated Sexual Health Services.

The Director of Public Health provided an update on the provision of integrated sexual health services within the Haymarket Shopping Centre.

It was reported that the procurement exercise had been completed and that the existing provider had been successful in renewing their contractual arrangements.  It was noted that the continuity of the service had been considered as a positive factor moving forwards with the new location of the service.

It was as confirmed that work continued with service users and young people to ensure discretion in the provision, including the site layout and entrance designs.

The Chair welcomed the update and requested that at an appropriate time, a written report be submitted to the Commission to describe the improved services.

In response to a question it was noted that the impact of the future hotel development and the issues concerning shared space were being considered.  It was confirmed that the service would deal with family planning, prevention and a wider range of services than sexual health, however it was suggested that the Executive be made aware of the Commission’s concerns in this respect.

It was AGREED to:

1)    Note the update and request a written report in due course;

2)    Inform the Executive of the Commission’s concerns relating to the design and layout of the entrance to the service, having regard to the shared space implications and the potential impact of the future hotel development.

The Scrutiny Policy Officer submits a document that outlines the Health and Wellbeing Scrutiny Commission’s Work Programme for 2018/19. The Commission is asked to consider the Programme and make comments and/or amendments as it considers necessary.

The Commission’s Work Programme was submitted and noted.

It was confirmed that a joint meeting will be convened with the Childrens, Young Peoples and Schools Scrutiny Commission, and the Adult Social Care Scrutiny Commission.  It was also reported that a joint meeting with the County and Rutland had been arranged for 4 September 2018 at 10.00am.

The Chair provided an update on the position of the Sustainability and Transformation Plan (STP) and stated that she would write to the Better Care Together Board and copy in the County and Rutland Councils about future expectations of the STP at scrutiny.

Members stated that they would welcome a briefing of the scrutiny that had occurred with regards to the Leicestershire Partnership NHS Trust prior to an item being brought to the meeting. It was agreed that this, along with a general explanation of the differences of Health scrutiny compared to other scrutiny commissions would be arranged for commission members.

The meeting closed at 8.30pm.