Agenda item

The Committee considered a report of the Leicester, Leicestershire and Rutland (LLR) Health System which provided an update on the elective care recovery progress for the patients of LLR. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

The Committee welcomed to the meeting for this item Siobhan Favier, Deputy Chief Operating Officer, UHL and John Melbourne, Chief Operating Officer, UHL.

Arising from discussions the following points were noted:

(i)           UHL had the 10th largest Referral to Treatment (RTT) waiting list nationally, based on September 2023 published data. UHL had seen a reduction in the overall waiting list since the start of the year (April 23 117,318), which was in contrast to national trends, and UHL was on track to achieve the waiting list target within the operational plan of 103,000 by the end of March 2024. The Committee welcomed this improvement though noted that the population of Leicester, Leicestershire and Rutland was approximately 1.1 million people, therefore a significant proportion of the population was on the waiting list.

(ii)         A patient could be counted on the list more than once if they were waiting for more than one treatment. Patients who had already received treatment and were awaiting an annual review were counted on a separate non-RTT waiting list.

(iii)        UHL had used the private sector to help reduce the waiting list, but use of the private sector was now decreasing. Care had been taken to ensure that the private sector offered value for money.

(iv)       UHL was implementing a Patient Initiated Follow-Up (PIFU) scheme where patients were able to initiate a follow-up appointment when they needed one, based on their symptoms and individual circumstances, rather than having a set timescale for follow-up appointments. However, PIFU was not suitable for all specialties/medical conditions and not suitable for all patients. Members raised concerns that PIFU could give an advantage to those patients that were more proactive in seeking appointments. In response it was explained that less confident patients did not have to be placed on the PIFU scheme. Reassurance was given that the Director of Health Equality and Inclusion at UHL was involved in the scheme to ensure patients were not disadvantaged. Further reassurance was given that PIFU was patient and clinician led, and management were not setting any targets. It was, however, noted that the best way to reduce inequalities in relation to appointments was to reduce the waiting list.

(v)         UHL was taking part in the Getting It Right First Time (GIRFT) national programme designed to improve the treatment and care of patients. This work included tackling health inequalities.

(vi)       Concerns were raised about cancer waiting times and specifically prostate cancer. In response it was explained that there had been a sustained improvement in the numbers of cancer patients waiting more than 62 days from referral to treatment. The specific data for prostate cancer could be provided after the meeting.

(vii)      A member raised concerns that the size of the waiting list was deterring patients from coming forward for treatment. In response UHL acknowledged these concerns and stressed the importance of good and regular communication with patients and GP Practices around waiting lists. It was noted that both UHL and GP Practices were involved in the Planned Care Partnership so discussions on the issue could take place in that forum. The best way to build trust in the service was to reduce the waiting list.

(viii)    UHL was making greater use of Day Case appointments where patients were not required to stay at the hospital overnight and could return home when the procedure was completed. Clinical evidence demonstrated that Day Case appointments resulted in better outcomes for patients including better recovery.

(ix)       The second phase of the East Midlands Planned Care Centre (refurbishment of the Brandon Unit) was due to be complete by December 2024. Recruitment was taking place to prepare for that.

(x)         In response to a question from a member about the Hinckley Community Diagnostics Centre and specifically delays in obtaining planning permission, reassurance was given that the project remained on track to be complete in January 2025.

RESOLVED:

(a)        That the contents of the report be welcomed;

(b)        That officers be requested to provide further updates on elective care, PIFU and health inequalities to a future meeting of the Committee.