Agenda and minutes

Leicestershire, Leicester and Rutland Health Overview and Scrutiny Committee
Monday, 14 December 2020 10.00 am

Venue: Microsoft Teams video conferencing.

Contact: Euan Walters (0116 3052583)  Email: Euan.Walters@leics.gov.uk

Items
No. Item

22.

Minutes of the meeting held on 15 October 2020. pdf icon PDF 253 KB

Minutes:

The minutes of the meeting held on 15 October 2020 were taken as read, confirmed and signed.

 

 

23.

Question Time. pdf icon PDF 476 KB

A number of questions have been submitted by the public and the questions and answers will be published on the day of the meeting.

 

Additional documents:

Minutes:

The Chief Executive reported that 13 questions had been received under Standing Order 34.

 

1.           Question by Godfrey Jennings

 

In light of the Covid pandemic and limited awareness among the general public of the Better Hospitals for the Future consultation and that no community provision assurances have been given do you not think an extension of the consultation period should be considered?

 

Reply by the Chairman:

 

I have put this question to the Clinical Commissioning Groups and they have provided the following response:

 

“When looking at the current circumstances the world finds itself in, then in order to fulfil our duty and to continue to exercise our functions we have adapted our processes to achieve that objective. The use of technology to hold meetings, share information and promote the consultation has enabled a wider reach across communities.  This activity has been combined with off-line activities to reach communities not digitally enabled. We are able to measure the majority of our activities confidently.  This demonstrates that the vast majority of adults across Leicester, Leicestershire and Rutland will have had the opportunity to be aware of the proposals, often through multiple channels, and participate in the consultation process if they wish.

 

We are confident that our activities to date and the approach we have taken has allowed us to meet both our statutory and common law duties.  Therefore we see no reason to extend the consultation period, which will close on 21 December 2020.”

 

 

2.           Question by Glynn Cartwright, Melton Mowbray

 

I, along with many others, am deeply concerned that the UHL Acute and Maternity Reconfiguration consultation process itself contravenes the Gunning Principle of those being consulted having sufficient information to respond appropriately to what is being asked of them.

 

Given that the proposals signify a particular loss of services to the communities of Melton Mowbray and Rutland specifically and generally

to North East Leicestershire, East Leicestershire and South Nottinghamshire areas:

 

a)  What steps have been taken to ensure information has been adequately provided in these population groups, about which exact services are going to be lost, especially with those who are not able to access online meeting facilities or use the internet frequently?

 

Reply by the Chairman:

 

The NHS bodies involved in this decision-making process have been quite clear what acute services they intend to move, why and the impact of the change, which means the Gunning Principle referred to has been met.

 

NHS England and Improvement run a thorough assurance process on all service reconfiguration programmes which are undertaking public consultation and, throughout this process, the CCGs have been advised by Gerard Hanratty of Browne Jacobson, who is a solicitor specialising in public law and service reconfiguration advice for the NHS. This ensures the CCGs have been advised on their compliance with both their statutory duties and common law obligations, including those set out in the Gunning Principles.

 

When looking at the current circumstances the world finds itself in, then in order to fulfil their duty and to continue to exercise their functions the CCGs had to adapt their processes to achieve that objective.

 

The pandemic has shown how technology can be used to involve and engage the public on a range of issues. The CCGs have adapted and adopted new ways of working including the use of technology which has enabled them to reach more communities. This is in addition to off-line communications and engagement activities in order to reach people not digitally enabled. 

 

To reach people the CCGs have used a variety of both online and offline tools and techniques. These are set out elsewhere in the  ...  view the full minutes text for item 23.

24.

Questions asked by Members. pdf icon PDF 284 KB

Minutes:

The Chief Executive reported that three questions had been received under Standing Order 7.

 

1.           Question by Dr Terri Eynon CC:

 

I would like to ask about the closure of the hydrotherapy pool at LGH:

 

(a)        How many patients currently access the hydrotherapy pool at LGH?

Reply by Chairman:

 

118 patients per week, both children and adults

 

(b)    How is the hydrotherapy pool at LGH currently staffed?

 

Reply by Chairman:

 

Sessions are provided by UHL Physio Therapists and also used by LPT Therapy teams and external groups who staff independently with a lifeguard

 

(c)    How many patients do the CCG envisage accessing hydrotherapy under     the new arrangements?

 

Reply by Chairman:

 

This number is yet to be determined as the changes will not be implemented for a further 5 years, and would depend on where the pools are located.

 

(d)    How will the new hydrotherapy sessions be staffed?

 

Reply by Chairman:

 

Please see my answer to question b above.

 

 

(e)     Have the CCG already identified sites in the community?

 

Reply by the Chairman:

 

A mapping exercise identified 5 possible pools in Loughborough, Glenfield, Oakham and Stamford. The CCG is working with the One Public Estate Leisure Group to expand this offer over the next 5 years, with possible areas including Wigston and Harborough.  The feedback from the consultation will also be used to understand impact on people and may also identify other options for us to consider

 

(f) Where are these pools likely to be?

 

Reply by Chairman:

 

Please see the answer to question (e) above.

 

(g)    How can the CCG ensure these community pools are suitable for use   as hydrotherapy pools? Will they be warm enough? Will they have hoists?

 

Reply by Chairman:

 

There is clear guidance that must be complied with.  This includes:

 

·       Temperature – The pool should be heated between 32.3c – 36.0c;

·       Depth - approximately 1.0 – 1.2m at its deepest with steps down to each depth; not a sloping floor.

·       The pool must also have access to a hoist. 

 

(h)    How much investment will this require?

 

Reply by Chairman:

 

The expectation is that the pools will he hired for sessions, so no capital investment will be required. There will be a cost to the services for those who want to use them and this will be calculated at the appropriate time in the future.

 

(i)      How will hydrotherapy treatment integrate with community provision  after patients are discharged from hydrotherapy?

 

Reply by Chairman:

 

This is yet to be determined as part of a wider review of community based therapies. As now patients are signposted to local hydrotherapy/self-help groups and other forms of exercise e.g. exercise referral schemes.

 

(j)      How will this change lead to better outcomes for patients?

 

Reply by Chairman:

 

It should reduce travel time for patients, as they should be able to access pools closer to home. The evidence from the cardiac physio therapy pilot that provided patients with physio at Aylestone Leisure Centre rather than in the hospital setting, showed that the outcomes were improved because the patient continued to access the services at the leisure centre after they were discharged by the physio team, giving long-term health benefits. Therefore the planning for the hydrotherapy service will consider this model and possible wider health benefits.

 

 

2.           Question by Cllr Sam Harvey

 

Please confirm the following for the year 2019/2020:

 

(a)          The number of Rutland residents who delivered at St Mary’s Unit;

 

Reply by Chairman

 

14         

 

(b)     The number of Rutland residents who received post partum inpatient care in the ward at St Mary’s;

 

Reply by Chairman:

 

No Rutland residents received post-partum inpatient care in  ...  view the full minutes text for item 24.

25.

Urgent items.

Minutes:

There were no urgent items for consideration.

 

26.

Declarations of interest.

Minutes:

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting. No declarations were made.

 

27.

Presentation of Petitions.

Two petitions have been received in relation to St Mary’s Birthing Centre in Melton and these will be considered under Agenda item 7: UHL Acute and Maternity Reconfiguration Consultation: "Building Better Hospitals".

 

Minutes:

The Chairman reported that two petitions had been received under Standing Order 35 but as they were both in relation to St Mary’s Birth Centre in Melton they would be considered under Agenda item 7: UHL Acute and Maternity Reconfiguration Consultation: "Building Better Hospitals".

 

 

28.

UHL Acute and Maternity Reconfiguration Consultation: "Building Better Hospitals". pdf icon PDF 410 KB

Additional documents:

Minutes:

The Committee considered a joint report of University Hospitals of Leicester NHS Trust (UHL) and Leicester, Leicestershire and Rutland Clinical Commissioning Groups (LLR CCGs) regarding the consultation on the plans to reconfigure Leicester’s Hospitals known as ‘Building Better Hospitals for the Future’, with particular emphasis on the proposals for St Mary’s Birth Centre, Melton Mowbray. A copy of the report, marked ‘Agenda Item 7’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Andy Williams, Chief Executive, LLR CCGs, Richard Morris, Director of Operations and Corporate Affairs, Leicester City Clinical Commissioning Group (CCG), Sara Prema, Executive Director of Strategy and Planning, Leicester City CCG, Rebecca Brown, Acting Chief Executive, UHL, Mark Wightman, Director of Strategy and Communications, UHL, Ian Scudamore, Director of Women’s and Children’s Services, UHL,  Justin Hammond, Head of UHL Reconfiguration PMO, UHL, and Florence Cox, Community Midwifery Matron, UHL.

 

The Chairman reported that the following petitions had been received in relation to St Mary’s Birth Centre:

 

Keep St Mary's Birth Centre Melton Mowbray Open

 

St Mary's Birth Centre Melton Mowbray should be kept open because it provides gold standard maternity care both during and after birth. The unit is the only maternity unit in the county outside the City of Leicester and provides an important choice for expectant parents both from Melton and the rest of Leicestershire. It is the only unit in the County where mothers are attended by a midwife throughout labour, which is recommended by NICE. The excellent postnatal care received at the unit helps new families become more confident and have a better transition to parenthood.

 

This petition had 1,470 supporters at the time of consideration by the Committee.

 

 

Save St Mary's Birthing Centre

 

We firmly believe that Melton needs its Birthing Unit.  As a much loved, vital service, it forms an important piece of the jigsaw for women and their families requiring maternity care.  The unit gives pregnant mothers a choice in the ethos of care and being local it saves the long drive when in labour.  Furthermore, it provides wonderful after care, including support around breastfeeding and mothers mental health.  The larger hospitals simply don't have the resources for this.

If it closed there is also the risk of more pressure on midwives as more low risk mothers might choose to have home births instead of risking the journeyy to Leicester. Each home birth requires two midwives present and the question is will there be enough to go around.

Finally, the Birthing Unit not only needs to stay open but we call on it to be properly funded going forward.

This petition has been started by The Rutland and Melton Labour Party.

 

This petition had 3,499 supporters at the time of consideration by the Committee.

 

Both Petitions were presented by Ms. Helen Cliff. In presenting the Petitions Ms. Cliff emphasised that the supporters of the Petition resided in various locations across LLR not just Melton. She also raised concerns that NHS staff were not making pregnant mothers aware that the St Mary’s Birth Centre was an option or were deterring mothers from opting to give birth there.

 

Arising from discussions the following points were noted:

 

(i)     Members welcomed the proposed £450 million investment in Leicester’s Hospitals.

 

Consultation

 

(ii)         The format of the consultation was that the CCGs and UHL set out how they were minded to proceed and the public were asked whether any issues or alternatives had not been considered and whether the proposals disproportionately impacted a particular group or area. Whilst the CCGs and UHL were not looking for a majority of the public  ...  view the full minutes text for item 28.

29.

Covid-19 Vaccine in Leicester, Leicestershire and Rutland.

A verbal update will be provided by Caroline Trevithick, Chief Nurse and Executive Director of Nursing, Quality and Performance, West Leicestershire Clinical Commissioning Group.

Minutes:

The Committee received an oral update from Caroline Trevithick, Chief Nurse and Executive Director of Nursing, Quality and Performance, West Leicestershire Clinical Commissioning Group regarding the Covid-19 vaccination programme in Leicester, Leicestershire and Rutland (LLR).

 

Arising from the presentation the following points were noted:

 

(i)          The vaccination programme began in LLR on Saturday 12 December 2020 using Leicester General Hospital as the hospital hub. Prior to Leicester General Hospital being chosen as the hub consideration had been give to whether Leicester Racecourse was the best venue as there was a need for the venue to be suitable for both NHS staff and the general public to visit. Although the Racecourse was was not currently being used as a vaccination venue it could still become one in the future.

 

(ii)         The Pfizer vaccine was currently being used in LLR and initially vaccines were only being given to people over 80 years old and care home staff. However, it was important not to waste the vaccine and when all the people in those categories had been vaccinated the programme would be widened out to other people. Due to the way it was required to be stored the Pfizer vaccine was not as able to be taken out into communities as the Astra Zeneca vaccine which was still awaiting approval. It was planned that in the near future vaccinations would be able to be given more locally in places such as GP Practices. A schedule of the exact locations had not yet been published as care needed to be taken that the published information was accurate and would not be subject to change however a communications plan was in place. The public were advised not to contact their GP Practice regarding receiving the vaccine but to wait until the GP Practice contacted them. Clarification was awaited on whether it was safe for the Pfizer vaccine and the Astra Zeneca vaccine to be stored at the same venue and the answer to this question would have implications on which vaccination venues were chosen. There was a further reason for not yet publicising the venues of where the vaccine would be given and that was security concerns involving public disturbances at the venues and conversations were ongoing with the Police to ensure NHS colleagues were not put at risk.

 

(iii)       The CCG were aware that some of the population of LLR were eager to be vaccinated whereas others were concerned about side effects and did not wish to receive the vaccine. In order that the vaccine was not wasted conversations were being had with individuals to ensure that they were willing to commit to the vaccination programme before the vaccine was allocated to them. The Pfizer vaccine involved a two stage vaccination process therefore it was important that participants were willing to take part in both stages of the process.

 

(iv)       Once the vaccine was extended to wider categories of people the CCG intended to use local leaders and champions to encourage as many people in communities as possible to agree to be vaccinated.

 

(v)        It would be difficult for people in receipt of domiciliary care to travel to receive the vaccine therefore it was intended that their carers would receive the Pfizer vaccine in order to give them some protection until the Astra Zeneca vaccine was approved and ready to be taken into homes.

 

(vi)       Young people with learning disabilities were high on the priority list to receive the vaccine. Whilst categories of people such as the homeless and rough sleepers were not on the national list of priorities, conversations were taking place with  ...  view the full minutes text for item 29.

30.

Impact of Covid-19 on Dental Services in Leicestershire, Leicester and Rutland. pdf icon PDF 337 KB

Additional documents:

Minutes:

The Committee had been due to consider a report regarding the Impact of Covid-19 on Dental Services in Leicestershire, Leicester and Rutland, a copy of which, marked ‘Agenda Item 9’, is filed with these minutes. The Chairman reported that due to time constraints Thomas Bailey, Senior Commissioning Manager, NHS England and NHS Improvement – Midlands was no longer able to present this item.

 

RESOLVED:

 

That this agenda item be deferred to a future meeting of the Committee.

 

31.

East Midlands Ambulance Service Clinical Operating Model and Specialist Practitioners. pdf icon PDF 261 KB

Minutes:

The Committee had been due to consider a report of East Midlands Ambulance Service (EMAS) regarding their Clinical Operating Model and Specialist Practitioners. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.The Chairman reported that due to time constraints Russell Smalley, Service Delivery Manager, EMAS was no longer able to present this item.

 

RESOLVED:

 

That this agenda item be deferred to a future meeting of the Committee.

 

32.

Date of next meeting.

The next meeting of the Committee is scheduled to take place on Friday 5 March 2021 at 10:00am.

 

Minutes:

It was noted that the next meeting of the Committee was scheduled for 5 March 2021 at 10:00am however a meeting needed to be arranged in the intervening period to enable the Committee to consider the analysis of the Building Better Hospitals for Leicester consultation feedback.

 

RESOLVED:

 

That officers be requested to liaise with members regarding potential dates for a meeting to consider the Building Better Hospitals for Leicester consultation feedback.