Agenda and minutes

Public Health and Health Integration Scrutiny Commission - Tuesday, 21 January 2025 5:30 pm

Venue: Meeting Rooms G.01 and G.02, Ground Floor, City Hall, 115 Charles Street, Leicester, LE1 1FZ

Contact: Katie Jordan, Senior Governance Officer, email:  katie.jordan@leicester.gov.uk  Kirsty Wootton, Senior Governance Services Officer, email:  kirsty.wootton@leicester.gov.uk

Media

Items
No. Item

95.

Welcome and Apologies for Absence

To issue a welcome to those present, and to confirm if there are any apologies for absence.

 

Additional documents:

Minutes:

Apologies for absence were received from Councillor Joannou.

96.

Declarations of Interests

Members will be asked to declare any interests they may have in the business to be discussed.

 

Additional documents:

Minutes:

The Chair asked members of the commission to declare any interests in the proceedings for which there were none.

97.

Minutes of the Previous Meeting pdf icon PDF 149 KB

The minutes of the meeting of the Public Health and Health Integration Scrutiny Commission held on 5th November 2024 have been circulated, and Members will be asked to confirm them as a correct record.

 

Additional documents:

Minutes:

The Chair noted that the minutes of the previous meeting held on 5 November 2024 were included within the agenda pack and asked members to confirm that they could be agreed as an accurate account. 

 

 

AGREED:

 

·       Members confirmed that the minutes for the meeting on 5 November 2024 were a correct record.

98.

Chairs Announcements

The Chair is invited to make any announcements as they see fit.

Additional documents:

Minutes:

The Chair announced that Councillor Joannou had taken the Membership place of Councillor Westley and that Deputy City Mayor, Councillor Russell was leaving her role. The Chair thanked Councillor Russell for her contributions to the Public Health and Health Integration Scrutiny Commission, as well as her work elsewhere in the Council.

99.

Questions, Representations and Statements of Case

Any questions, representations and statements of case submitted in accordance with the Council’s procedures will be reported.

 

Additional documents:

Minutes:

It was noted that none had been received.

100.

Petitions

Any petitions received in accordance with Council procedures will be reported.

 

Additional documents:

Minutes:

It was noted that none had been received.

101.

Health Protection Update

The Director of Public Health will provide the Commission with a verbal update.

Additional documents:

Minutes:

The Director of Public Health gave a verbal update of the latest position of health protection, and it was noted that:

·       There had been high levels of norovirus across the country which had meant some extra precautions had been taken, particularly in care homes to isolate residents coming out of hospital. The numbers have now reduced.

·       There had been a scabies outbreak in a care home, but there were no further cases.

·       Uptake of the flu vaccination had been particularly poor in schools. Work was ongoing to promote update and procurement was in process for a new contract.

·       The uptake of covid vaccinations was lower than the previous year.

·       Leicester was still the local authority with the highest rates of TB. Regular cases were still being reported but these had remained evenly spread throughout the year.

·       Work  on TB rates was ongoing, including a dedicated steering group, a strategy and a detailed action plan to address the rates.

·       A business case had been put to the Integrated Care Board for the University Hospitals Leicester TB service.

·       There was still stigma attached to TB, particularly in certain communities so work was needed to address this barrier.

·       The cases of whooping cough had reduced consistently in Leicester. The County Council were leading the response as they  had experienced higher rates of whooping cough.

·       Last year saw a high peak in cases of measles. This had been addressed through exemplary partnership working. The success had not made them complacent however as measles is hugely contagious. 

·       There was reduced concern around covid, but there was concern around covid vaccination rates as they are much lower in Leicester City than in the county.

·       The low vaccination rates were likely due to the public being fatigued by vaccination messages.

·       H5N1 Bird Flu pandemic exercise was planned for April 2025. There had been no human-to-human transmissions to date but the Local Resilience Forum had planned the exercise to ensure they were prepared for the worst case.

·       There had been 1 new case of M-Pox, but none had been in the City. Despite this, work was ongoing with sexual health providers to ensure awareness.

·       A key priority of the Health and Wellbeing Board was childhood vaccinations. The HPV vaccine was key in this as uptake had been so low in the city. More work was needed in communities to encourage uptake.

 

In response to questions and comments from Members, it was noted that:

 

·       The uptake rates for HPV vaccinations were around 50% for girls and considerably less for boys.

·       The Deputy City Mayor commented that there had been increased discussion around vaccines since Covid with more people becoming less inclined to have them. Since this, Public Health campaigns had been a bigger challenge.

·       The evidence for the HPV vaccines effectiveness was incredibly strong.

·       Work was needed to understand what would make a difference for school age vaccinations, including the unpicking of myths which are a huge threat to herd immunity and are often hard to combat.

·       Teachers  ...  view the full minutes text for item 101.

102.

Systems Pressures Update

The Integrated Care Board will provide the Commission with an update on System Pressures.

Additional documents:

Minutes:

The Integrated Care Board (ICB) gave a verbal update to the Commission on System Pressures. It was noted that:

 

  • The City had faced a Quademic, particularly in children and elderly patients. With high numbers of the common cold, flu, covid pressures and norovirus.
  • The data demonstrated that all Health Care settings had been under pressure.
  • A knock-on effect and additional pressures were faced due to the flooding and this had put a strain on the Ambulance Service.
  • Additional services had been put into place to support the winter pressures. This included:

-      Extra appointments in primary care.

-      Increased opening hours of urgent treatment centres and increased number of available appointments.

-      Ambulances taking patients to A&E and same day emergency care, enabling patients to be seen by the correct service without waiting in the emergency department.

-      The Same Day Emergency Frailty Service was now live.

-      Work had taken place with Derbyshire Health United to help manage the ambulance stack for category 3 and 4 calls, to manage them with a different disposition.

-      Increases to the number of community hospital beds.

-      Working with colleagues to try and promote the vaccination service. Low levels of uptake had added to the overall pressures with more patients in hospital with respiratory and viral infections that could have been prevented, had they been vaccinated.

-      The Respiratory Syncytial Virus (RSV) vaccination programme had been launched for patients over 75 this year. It’s hard to see the data at this stage, however, it is hopeful this will help ease pressures going forward.

  • Plans were currently under way to help support the NHS through next winters pressures and to reduce overall waiting times across the service.

 

As part of discussions following the update it was noted that:

  • An additional clinical navigation system was in place for 111 calls to make sure patients get in the right disposition and reviews were in place to ensure calls were getting to the right place, at the right time.
  • From a General Practice point of view, all GPs as part of the post graduate qualification have to train in paediatrics either through hospital training or through their general practice training.
  • The Merlin Vaz and Oadby Walk-In Centre are both available for walk in patients. When at full capacity, patients are booked in to those centres and are streaming away from A&E. On occasion when they are full, they may temporally stop walk in patients.
  • The Central Access point was now in place for all patients across Leicester, Leicestershire and Rutland (LLR) seeking Mental Health support. Patients can phone the line and get immediate help either on the phone, face to face or if they are known to the service the can go straight in to existing services they have previously attended. Very few waits had been observed in LLRs, compared to regional colleagues. LLR have one of the lowest rates of patients who wait a significant amount of time in Health Services for  ...  view the full minutes text for item 102.

103.

General Fund Budget Proposals 2025/26 pdf icon PDF 620 KB

The Director of Finance submits a draft report proposing the General Fund

Revenue Budget for 2025/26.

Additional documents:

Minutes:

The Head of Finance presented the Revenue Budget 2025/26 and it was noted that:

·       The budget had gone to each scrutiny commission, ahead of Full Council in February.

·       The financial outlook faced by the council was the most severe we’ve known.

·       Some authorities have issued Section 114 notices. The budget strategy has aimed to avoid this and ensure financial sustainability until at least 2027/28.

·       Due to a decade of austerity, many services had already been cut so the scope for savings had been reduced dramatically.

·       Modest funding had been provided by Government to help fund statutory services, but they have stated there is no magic wand to address local government funding.

·       The details of the Public Health grant for 2025/26 had yet to be released.

·       The council’s financial strategy had 5 strands:

1. Releasing one-off funds totalling £110m to buy time.

2. Reducing the approved capital programme by £13m

3. Selling non-residential properties to secure an additional £60m.

4. Constraining growth in those statutory services under pressure.

5. Making ongoing savings of £20m per year in the revenue budget – these can be found in the agenda pack for each area but does not include Children’s, Adult Social Care or Public Health.

·       There may be further pressures created, and with one-off savings being used it was essential that there would be ongoing savings.

 

In response to comments and questions from Members, it was noted that:

 

·       It was disappointing the Public Health figures are not available for this commission.

·       It was important that other areas which may have an impact on aspects of Public Health had been considered such as budget proposals for the built environment or Adult Social Care.

·       As part of this, health partners reassured Members that pathways had been considered so that provision would not change and ensure no gaps are created by changes in the budget.

AGREED:

·       The Commission noted the report.

 

104.

GP Access pdf icon PDF 202 KB

The Integrated Care Board will provide the Commission with an update on Leicester, Leicestershire and Rutland Integrated Care Board’s progress to date in delivery of the 24/25 Primary Care Access Recovery Plan.

 

Additional documents:

Minutes:

The Senior Integration and Transformation Manager presented the report. It was noted that:

 

·       In April 2024 NHS England (NHSE) published the delivery plan for recovering access to primary care

·       The delivery plan had set out key deliverable actions for Leicester, Leicestershire and Rutland (LLR) Integrated Care Board (ICB) to implement during 2024-25. The key determinant of this delivery plan was to tackle the 8am rush, improve access in primary care, reduce bureaucracy, improve primary and secondary care interface and support primary care to move towards digital systems.

·       In Leicester, 1.8 million appointments had been provided for the year up to October 2024. In October, 267552 appointments had been provided, which was a 16% increase on the previous year. With an overall 9% increase on appointments compared to the previous year. Around 70% of those appointments were face to face.

·       This time last year Community Pharmacy and Pharmacy First was launched. 81 out of 82 City pharmacies were participating in that programme. Work had been taking place to engage the remaining pharmacy to the programme.

·       Up until November 2024, there were 13257 referrals in to the community Pharmacy First Programme in the city.

·       Out of the GP practices in the city, 39 out of 51 actively engage in that programme. The progressive was good, but further work still needed to be completed with the remaining GP surgeries.

·       A 100% of city practices now had Cloud Based Telephony installed, work was still required to improve the service.

·       The usage of the NHS app had increased to 1.4m people, which was an increase of 89%. Not everyone in Leicester City has access to online technology, but it was clear that those who do were utilising it as 41% of people were using the app for repeat prescriptions.

·       90% of appointments were now being delivered within 2 weeks, a 4% improvement on the previous year.

·       December 2024 was the first month of the additional GP appointments being available and 5 care providers were delivering those on behalf of the city, with 72% utilisation of the appointments.

·       Work force needed to deliver the increases and it had been challenging, however small improvements were now visible.

·       The Cities registered patient to GP ratio was 3262 patients per whole time equivalent GP in December 2024. January 2025 figures showed we are now 2829 registered patients per whole time equivalent GP. Work would continue to improve the figures to be at least in line with the regional average of 2266 patients.

·       GPs primary work was in practice, but general practice had modernised over recent years additional roles have come into place as a primary care network footprint. City practices have recruited fully to these roles with no gaps at present. These roles included;  65.6 Clinical Pharmacists, 40.5 Care Coordinators, 14.7 GP Assistants and 14.4 Pharmacy Technicians and 13.8 Advanced Nurse and Clinical Practitioners.

 

In response to comments and questions from Members, it was noted that:

 

·       The current data available from the NHS app was basic. Access was now  ...  view the full minutes text for item 104.

105.

Smoking and Vaping pdf icon PDF 391 KB

The Director of Public Health submits a report to update the Commission on the action being taken to reduce smoking rates.

Additional documents:

Minutes:

The Deputy Director of Public Health presented the report and it was noted that:

·       Smoking remained one of the leading causes of premature death and preventable ill health.

·       14.6% of residents smoked which was higher than the national average. This figure had increased as the Health and Wellbeing Survey that was due soon showed that around 16% now smoked.

·       There were higher rates of smoking in disadvantaged areas of the city.

·       Ethnicity had an impact on likelihood of people starting to smoke.

·       Chewing tobacco and shisha use had higher levels of use here than other areas of the country. However, the percentage was small compared to that of cigarette use.

·       Targeted groups were children and young people, those who had mental illnesses, those who were pregnant and those who were in social housing.

·       Smoking was more likely to continue if the habit began at a younger age.

·       3.5% of young people smoked in Leicester, which was lower than the national average.

·       Those who had long term mental health conditions were more likely to smoke, and were smoking more heavily. This was one of the key reasons that those with mental health conditions had higher mortality rates than the general population.

·       Smoking during pregnancy has a detrimental impact on the development and outcomes. 7.4% of pregnant mothers were smoking at the time of delivery, this was lower than the national average.

·       Herbal smoking was considered safer by some; however it still contains dangerous chemicals.

·       The Tobacco and Vapes bill was at the committee stage.

·       Disposable vapes were to be banned from 1st June 2025. It was hoped that this would have a fairly quick impact on the rise in numbers of young people vaping.

·       It was being considered how to make vapes less attractive to children.

·       Licensing was being considered for tobacco sales to make smoking less accessible.

·       The definition of a smoke free population was less than 5% of the population smoking.

·       The Leicestershire Partnership Trust had become a smoke free trust in January 2023.

·       Support was being given to foster carers, so they were confident to model positive health behaviours to young people.

·       Housing officers had been given training around smoking cessation so that they would be able to have conversations and signpost tenants.

·       There had been work with Turning Point to help staff provide cessation support.

·       A new marketing campaign had been scheduled for April to target the areas of the city where there were the highest levels of smoking.

·       LiveWell had been the integrated lifestyle service offering smoking cessation services.

·       There had been 1633 people going through the service in 2022/23. Data from the last year was not available due to a new system being in place.

·       57% quit smoking after 4 weeks which was better than the national average.

·       There was confidence the service was reaching the most disadvantaged communities.

·       More government funding had been made available for smoking cessation services for the next 5 years. This was to allow more quit attempts by providing  ...  view the full minutes text for item 105.

106.

Work Programme pdf icon PDF 126 KB

Members of the Commission will be asked to consider the work programme and make suggestions for additional items as it considers necessary.

 

Additional documents:

Minutes:

The Chair noted that the topics noted in the items would be added to the work programme.

 

107.

Any Other Urgent Business

Additional documents:

Minutes:

There being no further business, the meeting closed at 20.16.