Cllr Ramsay Ross submitted the following questions to the Scrutiny Committee:
1. LRI-A&E
What progress has been made on the issues of Staffing and Alternative Provision of Services and what further steps are envisaged for 2026:
Staffing:
· What reduction has there been in the number of agency and bank nursing staff between January 2024 and December 2025?
· What increase has there been in the number of consultant, middle and junior level medical staff between January 2024 and December 2025
· Staff sickness rates – what reduction has been achieved since 2024?
2. Alternative Provision, Utilisation and the Management of Flows:
· The use of NHS111 – Market Harborough and Rutland MH Urgent Care Clinics now require appointments, with no walk in provision (and the Corby Health Centre proposes to introduce similar measures).
· Is this approach to patient access consistent with addressing the CQC findings highlighting those LRI-A&E patients who either could not gain access to, or had not attempted to get a GP appointment or Out-of-Hours clinical appointment?
· Has the utilisation of facilities, such as the Merlyn Vaz Centre, increased since January 2024?
· What steps have been taken to address the level of demand for mental health provision?
3. The Role of Councils: The CQC noted that demand in A&E was higher than planned due to the increased length of stay for patients who could not be transferred to other hospital Depts, in part due to discharge rates (bed-blocking). It further noted that discharge rates were impacted by problems with provision of community care, support for people living with deprivation, and homelessness.
· Is the ICB content with those steps that have been taken by Councils since 2024 to address patient discharge issues and what further steps are required in 2026?
4. Ambulance Waiting Times and Utilisation of Services: East Midlands service response times have worsened in the period from August to October 2025, having been stable earlier in the year. What are the top three reasons for the recent change in service provision to December 2025?
· Out of Area Patient Discharge - the CQC noted the under-utilisation of the independent provider of patient transport services. Has this been addressed?
5. NHS Dentistry Provision Crises
In December 2024 there were c. 8000 foreign qualified dentists on the waiting list to take the two-part General Dental Council (GDC) overseas registration exam. In 2025 there were 350, or 4% of such dentists, who took the GDC exams. What specific written representations has the LLR-ICB made over the past 2 years, concerning the rapid accreditation of these dentists?
Cllr Haq submitted the following questions:
1. Please could we have an update on the creation of a Maggie’s Cancer Centre in Leicester, why is this taking so long ?
2. Why are the people of Leicester, Leicestershire and Rutland losing out on the world leading Cancer treatment and Support?
Minutes:
Cllr Ramsay Ross submitted the following questions to the Scrutiny Committee:
1. LRI-A&E
What progress has been made on the issues of Staffing and Alternative
Provision of Services and what further steps are envisaged for 2026:
Staffing:
• What reduction has there been in the number of agency and bank
nursing staff between January 2024 and December 2025?
• What increase has there been in the number of consultant, middle
and junior level medical staff between January 2024 and December
2025
• Staff sickness rates – what reduction has been achieved since 2024?
The following response was provided:
What reduction has there been in the number of agency and bank nursing staff in ED between January 2024 and December 2025?
There has been a 45% reduction in bank and agency usage in ED from January 2024 to December 2025.
What increase has there been in the number of consultant, middle and junior level medical staff in ED between January 2024 and December 2025.
University Hospitals of Leicester NHS Trust has appointed four additional consultants in the adult emergency department and two additional consultants in the children’s emergency department. There has been no change in the number of middle?grade or junior doctors during this period.
Staff sickness rates in ED – what reduction has been achieved since 2024?
Staff sickness rates in the emergency department have reduced overall since January 2024, from 5.25% to 4.72%, representing a decrease of 0.53 percentage points.
2. Alternative Provision, Utilisation and the Management of Flows:
• The use of NHS111 – Market Harborough and Rutland MH Urgent
Care Clinics now require appointments, with no walk in provision
(and the Corby Health Centre proposes to introduce similar
measures).
• Is this approach to patient access consistent with addressing the
CQC findings highlighting those LRI-A&E patients who either could
not gain access to, or had not attempted to get a GP appointment or
Out-of-Hours clinical appointment?
• Has the utilisation of facilities, such as the Merlyn Vaz Centre,
increased since January 2024?
• What steps have been taken to address the level of demand for
mental health provision?
The following response was provided:
On 1 April 2026, new same-day appointments were introduced in Leicestershire during evenings, weekends and bank holidays. Patients may be offered one of the new appointments, when they contact NHS 111 with an urgent health need. A small number of appointments are also available via GP practices and patients who go to the emergency department for minor health problems may also get an appointment booked for them. All appointments are with a GP, are 15 minutes long and take place at one of eight locations. It is an appointment-only service and replaces what were known as extended access appointments and taking place from urgent care centres in Enderby, Coalville, Hinckley, Lutterworth, Market Harborough and Melton Mowbray.
The minor injury units in Melton and Market Harborough and the urgent treatment centres at Loughborough, Oadby and Merlyn Vaz can all continue to be used on a walk-in basis.
Also on 1 April 2026, the Rutland Minor Illness and Injury service opened at Rutland Memorial Hospital, replacing the previous urgent care centre and minor injury unit. This is mainly an appointment-based service, with appointments available through NHS 111 and GP practice. Initially, a small number of walk-in appointments are available for minor injuries only.
Both of these new services are making it easier for people to get help quickly for urgent but non-life threatening health problems and support the NHS aim of matching each patient to the right level of care, from the right health professional, in the right part of the NHS, first time - known as Right Care, Right Place.
By asking people to contact NHS 111 or their GP practice when they have an urgent health problem helps ensure the NHS makes best use of all the available appointment options, including at GP practices, pharmacies under the Pharmacy First scheme, urgent treatment centres or the new same-day appointments described above. The approach reduces the number of places people need to contact and avoids unnecessary waits or trips to services that may not be suitable.
In addition, the NHS has increased the number of appointments overall:
• Since mid?2024, Pharmacy First referrals have more than doubled to over 4,000 per month and referral rates per 1,000 population have risen across most primary care networks (PCNs). The latest year statistics for 2025 show the growth of referrals per 100,000 patients is the best in England.
• Total number of General Practice appointments offered in LLR for Apr-Feb (latest month’s data) was 7,328,852, representing a 1.68% increase from the same period in 24/25 and an additional 120,826 appointments.
• Over 35,000 of the new Leicestershire same-day appointments are available annually representing a 1.9% increase compared to the previous extended access/urgent care model
Recognising the right care, right place approach, demand for urgent treatment centres has been relatively stable since January 2024, but with fluctuations though winter depending on the timing of the flu season. If demand exceeds capacity, the provider is able to flex their workforce to manage patient flow and avoid the need to pass patients onto further care pathways.
Mental health care follows a similar approach to ensure patients are treated in the right place for their needs. For urgent mental health matters, patients are encouraged to call NHS 111 and choose the mental health option. They will go through to the Central Access Point where a mental health call taker will triage their needs. They may arrange for a mental health professional to speak to them, advise them to go to the Mental Health Urgent Care Hub at the Bradgate Unit, or advise on more local support available such as a mental health Neighbourhood Café.
3. The Role of Councils: The CQC noted that demand in A&E was higher
than planned due to the increased length of stay for patients who could
not be transferred to other hospital Depts, in part due to discharge rates
(bed-blocking). It further noted that discharge rates were impacted by
problems with provision of community care, support for people living with
deprivation, and homelessness.
• Is the ICB content with those steps that have been taken by Councils
since 2024 to address patient discharge issues and what further
steps are required in 2026?
The following response was provided:
The ICB works in close partnership with local authority colleagues and wider system partners across Leicester, Leicestershire and Rutland to support timely and effective discharge from hospital. We recognise that discharge is a shared system responsibility, requiring coordinated action across health, social care, housing, and voluntary sector partners.
Since the 2024 CQC report, there has been clear and evidenced progress across the system. This includes the strengthening of intermediate care services, with increased capacity to support discharge and admission avoidance, alongside more responsive pathways to support patients presenting through the Emergency Department. These improvements reflect a collective focus across partners to enhance patient flow and reduce delays.
Local authorities have contributed to this progress, including taking action to address housing-related barriers to discharge through the introduction of additional temporary accommodation for individuals who are medically fit but require short-term housing solutions. This has been supported by wider system changes to improve coordination and oversight of discharge pathways.
Recent CQC inspections with local authorities has recognised improvements in discharge arrangements, reflecting a more coordinated and effective system-wide approach.
Looking ahead, discharge remains a priority across all partners. Local authorities have set out plans for 2026/27 to continue strengthening community-based provision and support individuals, alongside ongoing work across the NHS and system partners to further improve discharge processes and patient flow.
The ICB is assured that appropriate steps have been taken since 2024, and that there is a clear and shared commitment across the system to continue building on this progress.
4. Ambulance Waiting Times and Utilisation of Services: East Midlands
service response times have worsened in the period from August to
October 2025, having been stable earlier in the year. What are the top
three reasons for the recent change in service provision to December
2025?
• Out of Area Patient Discharge - the CQC noted the under
utilisation of the independent provider of patient transport
services. Has this been addressed?
The following response was provided:
The CQC report states that the ICB-contracted patient transport service was not available for out of area patients.
Each ICB is responsible for arranging patient transport for its own patients. The responsibility for arranging repatriation for out of area patients is decided between ICBs on a case-by-case basis, depending on the hospital where the patient is currently located and where they need to go.
5. NHS Dentistry Provision Crises
In December 2024 there were c. 8000 foreign qualified dentists on the
waiting list to take the two-part General Dental Council (GDC) overseas
registration exam. In 2025 there were 350, or 4% of such dentists, who
took the GDC exams. What specific written representations has the
LLR-ICB made over the past 2 years, concerning the rapid accreditation
of these dentists?
The following response was provided:
The ICB is not able to verify the specific figure cited regarding “8,000 foreign?qualified dentists on the waiting list” for the General Dental Council (GDC) Overseas Registration Examination, as this data is held nationally by the GDC and NHS England.
Over the past two years, NHS Leicester, Leicestershire and Rutland ICB has not made formal written representations directly to the GDC regarding the rapid accreditation of overseas?qualified dentists. Responsibility for professional regulation, examination capacity and accreditation processes sits nationally rather than with ICBs.
The ICB has, however, contributed to this issue through NHS England regional and national channels, including workforce and dental commissioning forums, and by supporting national work led by the Office of the Chief Dental Officer for England and the British Dental Association with the GDC. Nationally, ORE examination capacity was increased in 2024, with a further expansion announced by NHS England in March 2026.
Locally, the ICB has focused on measures within its remit, including supporting streamlined supervised practice arrangements for overseas dentists entering NHS primary care and participating in the NHS England Dental Recruitment Incentive Scheme.
For further detail on accreditation processes or national correspondence, NHS England and the General Dental Council would be the appropriate bodies to approach.
Cllr Ramsey raised the following additional questions, that would be picked up outside of the meeting.
1. Alternative Provision, Utilisation and Management of Flows, Can utilisation data for Minor Injury (ideally) and Urgent Treatment Centres (certainly) be provided on a rolling monthly basis, alongside LRI A&E data, to support wider “public messaging” on the proper use of LRI A&E services and the understanding of Cllrs?
2. From the Integrated Care Journal of 14th April 26 Cheshire East have initiated and Early intervention programme for frail and vulnerable residents which has resulted in a sharp fall in emergency admissions for this patient group. Is there such a programme within LLR?
3. Noted that there are over 35000 new appointments via the new Leicestershire same day appointments, ,representing a 1.9% increase. What are the equivalent figures for the City and Rutland?
4. Independent provider of patient transport services confirmation that there is no issue with LLR utilisation of this service?
5. NHS Dentistry Provision confirmation that the LLR-ICB has made no such representations to NHS nationally/Govt on the issue raised in the question?
Cllr Haq submitted the following questions:
1. Please could we have an update on the creation of a Maggie’s Cancer
Centre in Leicester, why is this taking so long ?
The following response was provided:
2. Why are the people of Leicester, Leicestershire and Rutland losing out
on the world leading Cancer treatment and Support?
The following response was provided:
Cancer waiting times
What the LLR system is proud of in 2025/26