Agenda item

The Integrated Care Board (ICB) will give the Commission a verbal update covering lessons learned from last winter and the process being undertaken to develop this year's winter plans, including the key areas of focus and progress to date.

The Chief Medical Officer for the LLR Integrated Care Board introduced the item and presented an update on winter planning and system preparedness across Leicester City for winter 2026/27.

It was noted that:

·       Winter planning formed part of a year-round approach to managing system pressures, with increasing challenges also being experienced during periods of extreme weather during the summer months.

·       Learning from previous years had resulted in improved resilience across the system, strengthened partnership working and clearer escalation arrangements when pressures arose.

·       The NHS 10-Year Plan emphasised a shift towards neighbourhood and community-based care, with a focus on prevention and reducing avoidable hospital admissions.

·       Pre-transfer clinical assessment services enabled patients to be assessed by UHL and LPT services where appropriate, helping to avoid unnecessary admissions.

·       Partnership working with local authorities, adult social care and home care providers remained a key component of winter planning arrangements.

·       Pathways such as Same Day Emergency Care, Pharmacy First and community response services continued to provide alternatives to Accident and Emergency attendance and hospital admission.

·       A single point of access remained an important element of the urgent care offer, helping patients access the most appropriate service first time.

·       Vaccination programmes remained a key priority, including flu and RSV vaccinations, with targeted outreach activity planned to support uptake, particularly within the city and amongst priority groups.

·       Additional investment had been made to support vaccination delivery and improve protection against respiratory illness during the winter period.

·       Improving access to mental health support and maintaining workforce resilience across the system remained priorities.

·       Community hospital beds, virtual wards and enhanced community services would continue to support patient flow and reduce pressure on acute services.

·       Demand and capacity modelling had been undertaken to assess likely activity levels and identify additional capacity requirements during the winter period.

·       Public communications activity would focus on improving awareness of available healthcare services and promoting vaccination uptake.

The Commission heard that system-wide planning arrangements had involved all health and care partners, including local authorities, to ensure organisational plans complemented one another and formed part of a single LLR winter plan.

It was further noted that:

• Governance and escalation arrangements had been reviewed in preparation for winter.
• Local and regional winter planning exercises would be undertaken to stress test arrangements and identify any remaining risks.
• Surge and escalation plans had been modelled against a range of scenarios, including levels of demand beyond those experienced during a typical winter period.
• No significant risks had been identified at the present time, although planning assumptions and resilience arrangements would continue to be tested through the forthcoming exercises.
• Additional capacity had been identified across acute, community and primary care services to support anticipated demand.

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

• Members acknowledged that summer pressures were becoming increasingly significant and expressed disappointment that previous reporting had not included sufficient performance information and assurance measures.
• The Pharmacy First service was recognised as a positive development which had improved patient access to care and reduced pressure on other parts of the system.
• Workforce pressures remained a concern, particularly given the increasing impact of extreme weather conditions throughout the year.
• UHL intended to undertake a review of lessons learnt from summer pressures to inform future planning.
• Staff across the health and care system were commended for their work in responding to sustained demand pressures.
• Improvements had been achieved in ambulance handover performance, although challenges remained on periods of exceptionally high demand.
• Demand modelling was informed by historical activity levels, seasonal demand patterns and current growth trends.
• Historically, the first two weeks of January represented the most challenging period of the winter, with Mondays and Tuesdays continuing to experience the highest levels of demand.
• Activity during the winter period was currently forecast to range between approximately 950 and 1,050 attendances per day, with the highest recorded day during the previous winter having exceeded 1,050 attendances.
• Current modelling identified an approximate shortfall of 40 beds and this would continue to be tested through scenario planning exercises.
• Members sought assurances regarding the impact of access to GP appointments on Accident and Emergency attendances.
• It was acknowledged that supporting residents to access the most appropriate healthcare service remained a key priority across the system and that public communications would play an important role in achieving this.

AGREED:

1.    The Commission noted the update on Winter Pressures planning and preparedness across the Leicester, Leicestershire and Rutland health and care system.

2.    Members support the promotion of vaccination programmes and public awareness campaigns encouraging residents to access the most appropriate healthcare services.

3.    A further update on winter pressures, demand and system resilience be brought to the Commission at an appropriate point during the winter period.