Agenda item

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

The Director for Public Health gave an overview and presentation of the latest position of health protection issues in Leicester including Bowel Cancer Screening, TB, Measles, COVID-19 AND a vaccination summary. It was noted that:

• The Director outlined the role of public health in outbreak control, screening and vaccination promotion, working alongside the ICB and NHS England.
• Health Protection relied heavily on partnership work and relationships. The three areas of health protection are:

1.    Communicable disease control

­   Outbreak control (e.g. measles, TB, diarrhoea)

­   Screening and immunisation

­   Infection prevention control

2.    Emergency preparedness and planning

3.    Environmental health

Annual work highlights

• Outbreak control

­   Bed bugs IMT

­   Bed bugs look back exercise

­   Community measles outbreak

­   TB

­   Scabies

­   Respiratory infections in care homes

• Infection prevention control

­   IPC audit of all care and nursing homes

­   Urinary tract infection quality improvement

­   NICE guideline development

­   Safe discharge guidelines

• Screening & immunisations

­   Cervical cancer elimination strategy

­   HPV school vaccination

­   Childhood immunisations

­   Community engagement

­   Evaluation of LIST project

• TB

­   HNA final draft

­   LLR TB strategy development

­   ICB business case

­   Information sessions to multiple community groups and GP practices

•  Monthly health protection CPD sessions for all staff.

• The importance of community infection prevention was highlighted, with a shared responsibility across systems, particularly in care home settings.
• Broader health protection work continued throughout the year, with a strong focus on pandemic preparedness, building on lessons learned from COVID-19. This included ongoing exercises to ensure systems are equipped for future public health emergencies.
• Environmental health and trading standards played a key role, particularly in relation to food safety and managing outbreaks. This included incidents such as bed bugs in care homes, measles, TB, flu, and COVID-19.
• Specific cases were highlighted, including one involving an individual with autism and recurring urinary tract infections, which contributed to wider work on infection reduction in care settings. This work aligned with NICE guidance and included efforts to improve care quality and discharge procedures.
• Screening responsibilities lie with the ICB and NHS, but public health continued to support efforts to improve uptake, particularly around HPV and childhood immunisations. There had been an increased focus on engaging with communities to build trust and confidence in vaccination programmes, both locally and nationally.
• An update was provided on TB, a health needs assessment and strategy were ongoing, with work focusing on identifying and supporting individuals with dormant TB. Leicester remained involved in the regional TB control group and the LLR TB strategy group, with efforts aimed at increasing visibility and consistency across the programme.
• Care home discharge notifications were also discussed, with the recent measles outbreak used as a positive example of effective partnership working. Nearly 600 MMR vaccinations were delivered during the outbreak, and no new measles cases had been reported since last summer. While MMR uptake had dipped in recent years, some recent improvement was noted.
• The HPV school vaccination programme continued, with visits to secondary schools taking place.
• In terms of wider screening, bowel cancer remained a priority. Although work to increase uptake had been ongoing since 2015, Leicester's rates still fell below the national average, with just over 50% of eligible individuals taking part. Many were still presenting with late-stage symptoms, highlighting the need for early detection. Materials had been made more accessible, and a champions programme was being developed to help improve awareness.
• To further support uptake, GP practices with the lowest screening rates were being identified, with plans to share colour-coded data slides as part of the wider approach.
• Flu vaccine uptake remained lower than desired, but it was emphasised that there was no cause for concern or panic at this time.

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

• A question was raised about the size of the Public Health team at Leicester City Council and how it compared to similar local authorities.
• It was confirmed that the team was relatively small but high quality, with a small increase in the Public Health grant. Strengthening capacity was a priority, particularly in areas such as vaccination and screening rates.
• Approximately 130 staff were part of the wider Public Health Division including the Live Well service, which has expanded in recent years.
• It was noted that comparisons were usually made with other cities that had similar levels of deprivation. Factors such as poverty, inequality, diversity, and travel patterns in and out of Leicester were all relevant in interpreting public health data.
• Interest was expressed in bowel cancer screening, particularly regarding practices with high rates of non-attendance. It appeared that two such practices were located in opposite areas of the city.
• A full report on this area of work was offered for a future meeting, with reference to new partnership work involving the ICB and NHS England. It was noted that the data was complex, with factors such as deprivation and the role of GP practices contributing to uptake levels.
• Cultural considerations were acknowledged, with ongoing work to produce translated materials and to involve community organisations in promoting screening.
• It was confirmed that local engagement was already underway, including community-led sessions where residents were taken to hospital to learn about screening and dispel myths. These sessions targeted a range of individuals, including taxi drivers and community leaders, and included demonstrations of the bowel screening kits.
• Concern was raised about the number of stage 4 bowel cancer diagnoses, despite the availability of tools such as FIT tests. The issue was particularly prevalent among older men, and questions were asked about what more could be done. A full report was recommended to explore this further, along with an overview of the work already underway.
• Personal experiences were shared, including barriers such as language and the difficulty of contacting GP practices for support. Suggestions were made to have local champions who could provide guidance in the community, particularly when screening kits were sent out. A local helpline and community contacts that could help guide residents through the process, particularly where language barriers existed.
• It was acknowledged that NHS England currently held responsibility for this work, and there were ongoing concerns about the current service specification. There was a need to ensure that future arrangements, supported by the ICB, would be an improvement.
• The value of targeted, roaming outreach teams was highlighted as an effective approach.
• It was noted that low screening uptake was not always due to hesitancy, but often because people had not received their invitations. The NHS App was mentioned as an alternative access route.
• Some members of the group shared that the screening kits themselves could be confusing, and there was a need to simplify instructions.
• Positive examples were shared of healthcare professionals creating instructional videos in different languages, which had helped make the process more accessible and understandable.

AGREED:

1.    The Commission notes the report.

2.    An item on bowel screening and cancer to be added to the work programme.

3.    Governance services to circulate the slides shared at the meeting to members.