Agenda item

Health Performance and LLR Health System Governance and Design Group Update.


The Committee considered a joint report of the Chief Executive and the CCG Performance Service which provided an update on public health and Clinical Commissioning Group (CCG) performance in Leicestershire and Rutland based on the available data at the end of February 2021. The report also outlined the latest position on Leicester, Leicestershire and Rutland (LLR) Health System Governance, Structure and Design Group Formation. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.


The Committee welcomed to the meeting for this item Kate Allardyce Senior Performance Manager, NHS Midlands and Lancashire Commissioning Support Unit and Hannah Hutchinson, Assistant Director of Performance Improvement, Leicester City CCG.


Hannah Hutchinson gave a presentation regarding the Design Groups and system governance in Leicester, Leicestershire and Rutland. A copy of the presentation slides is filed with these minutes.


Arising from discussions the following points were noted:


Design Groups and System Governance


(i)          The Design Groups were part of the move towards an Integrated Care System (ICS) in LLR and a shadow ICS was to be in place from April 2021. The model would include three levels: System, Place and Neighbourhood. It was noted that the Neighbourhood level would comprise of areas with a population of 30,000 to 50,000 people but a member questioned whether that was too large an area to be described as a Neighbourhood and suggested most people consider their neighbourhood to be a much smaller area. Members welcomed the plans for the new system and supported the aims. 


(ii)         In response to a question from a member regarding where the Health Overview and Scrutiny Committee fitted into the governance structure it was agreed that further consideration would be given to this by the CCGs and a new diagram circulated.


(iii)       It needed to be ensured that each Primary Care Network had access to equipment such as electrocardiogram machines so that patients could undergo non-urgent procedures locally and that hospitals were reserved for patients with acute needs. Further work was being undertaken by the CCGs in this regard.


(iv)       There were a number of different ways the CCGs interacted with patients and the public including through Healthwatch and Patient Participation Groups and it was intended that once the ICS was in place meaningful conversations with patients would still take place. The CCGs offered to provide further details regarding public engagement to the Board after the meeting.


Public Health and CCG Performance


(v)        Since the performance report had been published cases of Covid-19 had reduced by 9% across Leicestershire. On 5 March 2021 the LLR SAGE Committee had downgraded the alert level from level 5 to level 4 and University Hospitals of Leicester NHS Trust had also set their alert level to 4.


(vi)       When the Covid-19 pandemic first began there had been a reduction in cancer referrals compared to the previous year however this reduction did not continue and referrals subsequently increased to a similar level to the previous year. As a result of the pandemic some cancer procedures were being carried out by private hospitals on behalf of the NHS. NHS England had asked CCGs to continue the contracts with the independent sector into the 2021/22 financial year as there was still work to do to catch up on the backlog. Whilst awaiting procedures the patients were being clinically reviewed and prioritised.


(vii)      Due to the nature of the ‘one year survival from all cancers’ metric the data took a long time to be reported. It was expected that the next set of data for that metric would be available in May 2021.


(viii)    With regards to the Improving Access to Psychological Therapies metric it was noted that extra training places for high intensity workers were being made available. In response to questions from a member it was agreed that further details and clarification regarding this would be provided to members after the meeting.


(ix)       Appendix 2: The CCG Performance Dashboard did not contain any data for the metric ‘Proportion of People with a learning disability on the GP register receiving an annual health check’ because Appendix 2 had been taken from NHS England’s national data source. However, locally the CCGs received data on a weekly basis regarding the proportion of people with learning disabilities receiving health checks.


(x)        It was noted that the percentage of adults classified as overweight or obese was high yet the percentage of physically active adults was also high and it was therefore questioned whether these two data sets were contradictory. The Director of Public Health stated he would give this issue further consideration but emphasised that diet also played a part in people’s weight. It was noted that the time period for both sets of data was 2018-19 therefore the Covid-19 pandemic and lockdown could not have impacted on the data.


(xi)       The data for ‘Breastfeeding prevalence at 6-8 weeks after birth’ was available but could not be published due to data quality issues. The data for ‘HIV late diagnosis’ was also available but could not be published because the numbers were so small that individuals could potentially be identified from the data.


(xii)      Members asked that future performance reports contain a glossary of commonly used phrases and acronyms in relation to the health and care system. It was also requested that when data was provided more information be provided to explain the context for example how Leicestershire compared to the rest of the country. It was suggested that the performance reports that were submitted to CCG Board meetings could also be forwarded to the Health Overview and Scrutiny Committee, though as they covered the whole of LLR the data would not be broken down into Leicestershire.




(a)        That the update regarding the Leicester, Leicestershire and Rutland Health System Governance, Structure and Design Group Formation be welcomed;


(b)        That the performance summary and issues identified be noted.


Supporting documents: