Agenda and minutes

The minutes of the meeting held on 18 January 2023 were taken as read, confirmed and signed.

The Chief Executive reported that no questions had been received under Standing Order 34.

The Chief Executive reported that no questions had been received under Standing Order 7(3) and 7(5).

There were no urgent items for consideration.

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

Mrs. M. E. Newton CC declared a Non-Registrable Interest in agenda item 9: Health Performance as she had two close relatives that worked for the NHS.

There were no declarations of the party whip in accordance with Overview and Scrutiny Procedure Rule 16.

The Chief Executive reported that no petitions had been received under Standing Order 35.

The Committee considered a report of the Director of Public Health which provided an update on the existing Domestic Energy Efficiency Retrofit Programme (DEER) and plans to extend the scheme. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)           There were 32,496 households in Leicestershire in fuel poverty and it was anticipated that approximately 300 houses would receive measures under the DEER Programme. In response to a concern raised by a member that this was a very small percentage of the homes that needed support it was explained that there was a finite amount of funding available, there were conditions to the funding and the County Council was doing as much as it could with what was available. Were there to be more money available or less conditions regarding what it could be spent on then the department would consider other options for improving homes.

(ii)         In February 2022, the County Council had offered to act as a consortium lead, pooling the district funding and hosting a project delivery team. All districts except Oadby and Wigston Borough Council agreed to support the consortium approach. Oadby and Wigston Borough Council were working with the Midlands Net Zero Hub and had delivered measures to 27 properties.

(iii)        The Charnwood area had 132 households confirmed as eligible which was far higher than the other Districts in Leicestershire and yet the target was to retrofit only 14 of those houses. In response to a question as to why the target was so low it was explained that when asked whether they wished to take part in the scheme Charnwood had initially said no as they did not feel they had the capacity to deliver the scheme. However, Charnwood had now received some funding as a result of underspend from other areas and asked to be included in future funding rounds.

(iv)       In response to a question about how the impact of the scheme was measured it was explained that the funding came from the new Department for Energy Security and Net Zero, and the main outcomes were around energy consumption. However, the Public Health department was interested in wider outcomes particularly relating to health and so remained in touch with the households after the retrofitting had been completed and carried out customer satisfaction surveys to obtain feedback. Carrying out evaluation cost money and given that there were conditions to the funding it could not be spent on a bespoke monitoring system. With regards to monitoring health impacts of the scheme the results could take a lot longer to become apparent.

(v)         A member asked whether there was a decrease in the energy bills of those homes that had been retrofitted and in response it was explained that for many homes there was a decrease but the precise amount depended on the exact retrofitting measures that had been delivered to that particular household. The variability of energy prices also had an impact on bills. 

(vi)       The current phase of funding combined phase 3 of Local Authority Delivery (LAD) scheme and the first round of Home Upgrade Grant (HUG) funding. It was agreed that the figures for the earlier funding rounds would be provided to members after the meeting.

(vii)      A member suggested that it would be useful to know how many properties in Leicestershire sat within the different energy bands.

RESOLVED:

That the Domestic Energy Efficiency Retrofit Programme and plans to extend the scheme be welcomed.

The Committee considered a joint report of the Chief Executive and the Integrated Care System Performance Service which provided an update on health and care system performance based on the available data in January 2023 and focused in particular on cancer performance and recovery. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

The Committee welcomed to the meeting for this item Hannah Hutchinson, Assistant Director of Performance & Quality Improvement, Leicester, Leicestershire and Rutland Integrated Care Board (ICB), Helen Mather, Associate Director of Elective Care, Cancer and Diagnostics at the ICB, Jon Melbourne, Chief Operating Officer, University Hospitals of Leicester NHS Trust (UHL), and Alison Buteux, Senior Performance Manager, Midlands and Lancashire Commissioning Support Unit.

Arising from discussions the following points were noted:

(i)           The number of patients waiting over 104 weeks for elective treatment had reduced steadily each month for the previous six consecutive months. The peak of 1,063 patients in January 2022 decreased so that at the end of December 2022 there were 67 Leicestershire and Rutland patients waiting over 104 weeks, at a number of different Acute providers. There was a target that the number of 104 week waiters would be zero by the end of March 2023 and the number of 65 week waiters would be zero by March 2024.

(ii)         The dementia diagnosis rate was currently 60.7% and the target was 66.7%.

(iii)        Accident & Emergency Departments had a target to admit, transfer or discharge patients within 4 hours of their arrival. As of January 2023 57% of patients arriving at Leicester Royal Infirmary met this target and the national target for 2023/24 was to reach 76% compliance.

(iv)       At the end of December 2022 10,836 patients were waiting over 52 weeks from referral to treatment. There was a target that this figure be zero by March 2025.

(v)         In December 2022 45% of patients referred for cancer treatment were seen within 62 days. A trajectory had been set that fewer than 517 patients would be seen after more than 62 days by the end of March 2023 and in 2024 this would improve further with a target currently being agreed.

(vi)       With regards to patients that were seen within two weeks of an urgent GP referral for suspected cancer the position as of November 2022 was 88.3%. Of those patients 90% were found not to have cancer but this still meant that they had a medical problem of some kind that needed dealing with.

(vii)      Whilst some Trusts were able to achieve their performance targets earlier than the national trajectory it was not expected that this would be the case in Leicestershire due to the challenges faced.

(viii)    There was a new cancer leadership team both within the system and within UHL. The Trust was working with the national improvement support team to improve the processes and practices around cancer.

(ix)       It was important to get the governance of the cancer system right and some of the recent improvements had been as a result of improvements in governance.

(x)         There were concerns that during the Covid-19 pandemic patients had not been seeking medical advice when ordinarily they would have and this meant cancers were not detected early and as a result patients that were now being seen were more likely to have stage 4 cancers than stage 1 or 2 therefore requiring more invasive treatment. More data and modelling was required to fully understand the scale of this issue.

(xi)       Members raised concerns that historically cancer referral rates rose approximately 25% every three years and noted that this was partly  ...  view the full minutes text for item 58.

The Committee considered a report of the Director of Public Health which provided an update on the new Teen Health Service: 11-19 which was formerly part of the Healthy Child Programme. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

Arising from discussions the following points were made:

(i)           Reassurance was given that during the transfer of the 11-19 service from Leicestershire Partnership NHS Trust to it being integrated within Leicestershire County Council Children’s and Families Wellbeing Service the service provided was not reduced and it did not fail to support any children.

(ii)         The model for the new service was different to what was in place previously and was more focused on public health and prevention elements. The service was able to be reactive to emerging issues such as substance misuse and gender/sexual identity. Individuals that came forward for help were allocated a support worker but the service was trying to be proactive and so carried out group sessions and drop-in sessions. One member of staff who had oversight of all the work was medically qualified but the other staff had been recruited based on their ability to work with young people.

(iii)        The Teen Health Service: 11-19 differed from the Local Area Co-ordinator scheme in that it was designed for young people. The reason it was called the teen service when it did not just deal with teens was that the views of service users had been taken into account when deciding what to name it.

(iv)       The Public Health department intended to carry out more work to tackle the issue of young people vaping. The Trading Standards department at Leicestershire County Council were already working on this problem.

(v)         In response to a question about how the department tackled the use of nitrous oxide it was agreed that further information would be provided to members after the meeting.

RESOLVED:

That the update on the Teen Health Service: 11-19 be noted.

The next meeting of the Committee is scheduled to take place on Wednesday 14 June 2023 at 2.00pm.

RESOLVED:

It was noted that the next meeting of the Committee would be held on 14 June 2023 at 2.00pm.