Agenda item

To consider updates on good practice and innovation from organisations represented on the Board relating to a number of health and wellbeing issues.

Updates on good practice and innovation from organisations represented on the Board relating to a number of health and wellbeing issues were received.

These included:-

Leicester Partnership NHS Trust

·         Supporting people with long term cardio-respiratory conditions through the Covid-19 period, within restricted face to face contact due to IPC guidance in healthcare settings through providing Covid virtual wards for long term conditions management.

·         Divert as many patients as possible from A&E to increase their capacity to deal with the start of the Covid-19 pandemic by establishing and developing a urgent mental health care hub.

·         Improve the gap in the engagement of children and young people in reviewing and co-designing services through the application of ‘youth proofing services’ in the LPT Youth Advisory Board.

Police

·         Throughout Covid, there have been an increased demand on Emergency and Mental Health services, with often first-time presentation of a Mental Health illness, through the Police and Mental Health Proactive Triage Car to ensure the correct pathfinder / service.

·         Increase in Mental Health demand with limited referral pathways / reduction in face to face contact by other services during Covid-19 such as a transfer to telephone support.  The Proactive Vulnerability Engagement Team (PAVE), however continued to complete face to face visits were this was considered necessary.

·         PAVE jointly visited vulnerable residents with one of the local police neighbourhood officers to identify individuals that may require additional support and referrals to look at alternative way to reduce demand and resolve some of the key neighbourhood concerns expeditiously with multiagency approach.

University of Leicester

·         Identification of those who might be at greatest risk of infection or adverse outcomes, particularly among healthcare workers from black and minority ethnic backgrounds through :-

o   A project led by Prof Kamlesh Khunti (Director of Centre for Ethnic Health Research and member of SAGE) and Dr Manish Pareek (Associate Clinical Professor in Infectious Diseases).

o   Played pivotal role in bringing to light the disproportionate impact of COVID-19 on those from black, Asian and minority ethnic communities.

o   £2.1M government funding (UKRI and NIHR) for UK-REACH study into ethnicity and COVID-19 outcomes in healthcare workers.

o   Working with 30,000+ clinical and non-clinical members of NHS staff to determine their COVID risk based on analysis of health care records.

o   One of the outcomes was a new Risk Reduction Framework for NHS staff to better protect NHS workforce and maximise ability of NHS to deal with pandemic pressures.

o   Lack of easily accessible patient-focused information aimed at individuals who have had and were recovering from COVID-19 infection.  Need for clear advice on how to manage the physical, emotional and psychological effects through a on line

Voluntary Action Leicester

·         Enabling effective support for vulnerable service users with Learning Disability during Covid restrictions through providing Covid safe support in person and via online connections through.

·         Volunteer support for the Covid vaccination programme in recruiting 2,700 volunteers.  VAL continued to recruit, co-ordinate and deploy volunteers across 36 sites which was likely to be for the remainder of the year.

Leicester City Clinical Commissioning Group

·         GP’s had fed back that the template itself was not helpful and with the pressures of COVID, the number of patients receiving a cancer care review had fell from 74% prior to Covid to 15% between September and December 2020, detrimentally impacting patient care.  Clinical teams worked with management teams to rewrite the template in February 2020 and staff had on-line meetings with 80 clinician attendees.  By March 31 2021 the patients having a cancer care review had risen to 67%.

·         The increase in numbers of COVID patients had put the CDU at the Glenfield hospital under considerable pressure, with overcrowding,  staff exhaustion and increasing admissions.  Both UHL and LPT had implemented a virtual ward model for ‘front door’ activity as well COVID admissions this had reduced patient readmission rates by 51%.

·         144 COVID-19 patients had been discharged after a hospital admission with remote monitoring at home. To date, only 5 of these patients had been readmitted.

·         NHSE expectation that at least 67% of 14+ LD patients with receive an AHC.  2019/20 LLR achieved 54%. As at Q1 2019/20, LLR had achieved just 5.1%.  Changes to support and a funded post enabled the rate for people with a LD having an annual health check to be increased to 71% by March 2021.

·         Approximately 4,500 patients across LLR had been offered but declined a COVID vaccination.  Data analysis suggested that high proportion of were with BAME population or lived in deprived areas of LLR.  A pilot initiative was developed with GP clinicians calling patients and this resulted in 69% booking a vaccine, 19% wanted more time ot consider and 9% still declined.

·         Reducing the numbers of parents calling out of hours or presenting at A & E with children who have symptoms that could be managed at home through a Zoom call to schools and a webinar with parents.

·         High ED attendance and variable admission behaviours for frail patients had been supported by providing Community Response Service (CRS) and the Integrated Crisis Response Service (ICRS) being present and staff from CRS and ICRS would work with the Therapy Team and with the Emergency Floor Discharge Practitioners (EFDP’s) on ED.  This had enabled to identify patients that could be diverted from the ED to other appropriate pathways as early as possible.  It had also shared key information in terms of the key interventions already in place for people and increase the knowledge awareness of community services especially around Home First offers across LLR.

·         Introduction of the Community Pharmacy Consultation Service pathway to reduce appointments in GP practices  to enable them to focus on patients most in need of GP services.

·         Joint assessment and provision of assistive technology to prevent falls and keep people at home independently and safely to reduce the need for elderly acute care.

Healthwatch

·         Working with UHL to reduce the time patients were waiting in discharge lounges to get their medication.

·         Established ‘BME Connect’ – a  platform for communities to come together to talk about the issues that matter the most to them. This unique project began looking into mainstream methods of marketing and communication and its impact, influence, and connectivity to BME community settings.

The Chair welcomed the updates from member organisations and felt that this demonstrated the response to Covid issues across the whole of the system and that fully supported the approach to learning from each other and this item had clearly highlighted and demonstrated the good practice being delivered.

The Chair also commented that these updates reinforced both health and wellbeing and that it should be clearly seen in the City that there was parity for mental and physical health in service delivery and considerations.  The updates also showed that services were making most differences to those less able.

RESOLVED:             The reports from partner organisations were welcomed and future updates of good practices would be welcomed.