Agenda item

The Committee considered a report of the Integrated Care Board regarding the plans in place to manage health system pressures across Leicester, Leicestershire and Rutland (LLR) over winter 2025/26. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Professor Nils Sanganee, Chief Medical Officer, Integrated Care Board, Sarah Smith, Head of Emergency Care, Integrated Care Board, Sarah Taylor, Deputy Chief Operating Officer, University Hospitals of Leicester NHS Trust, and Jean Knight, Managing Director, Leicestershire Partnership NHS Trust.

 

Arising from discussions the following points were noted:

 

(i)           Each year Integrated Care Board’s were asked by NHS England to submit a Winter Plan to ensure the health and care system was fully prepared to manage the increased pressures that typically arose during the winter months (October to March). For Leicestershire plans were in place to deal with expected surges in demand and also ‘supersurges’ where the demand was higher than expected. This year NHS England had asked for more detail about the plans and modelling of different scenarios. NHS England also required health systems to test the plans they had in place for managing winter pressures. In LLR a local test event was taking place on 11 September 2025 and a regional stress testing event was taking place on 17 September 2025.

 

(ii)         Monitoring was taking place of the winter in the southern hemisphere to see what lessons could be learnt and implemented for the UK winter.

 

(iii)        In response to a question from the Chair as to whether the NHS still had spare wards which could be used in the winter it was explained that this was no longer the case due to financial challenges as beds were very expensive. There was no spare capacity at Leicester Royal Infirmary. However, as part of the acute community plan the first floor of the Preston Lodge community rehabilitation unit could be used during the winter.

 

(iv)       In response to concerns raised by members about ambulance wait times outside the Leicester Royal Infirmary Emergency Department, it was acknowledged that this was still a problem but emphasised that significant improvements had been made. The 45 minute handover target was challenging to meet but was being met some of the time and needed to be met more consistently. Work was taking place to improve flow through the hospital. Ambulance response times had improved and EMAS staff were treating more patients at the scene rather than conveying them to hospital. Patients were also being given more treatment advice over the telephone. This all helped reduce demand at the Emergency Department.

 

(v)         There was a comprehensive communications campaign in place to ensure patients went to the most appropriate place for treatment over the winter and did not attend the Emergency Department unnecessarily. However, the public did not always pay attention to health messaging until they needed treatment therefore it could be difficult to get the message across.

 

(vi)       In response to a question from a member, it was explained that opening another Emergency Department in Leicestershire was not a realistic option because the department would need a resus department and specialist children’s facilities to accompany it which were only available at Leicester Royal Infirmary. There were, however, plans to build an additional Urgent Treatment Centre. Data indicated that this was the type of facility needed in LLR rather than an additional Emergency Department.

 

(vii)      It was reported that a regular theme of feedback from patients that Healthwatch had engaged with was unsafe discharge from hospital. In response it was acknowledged that this was an area that could be improved and more work needed to be carried out to ensure that the transfer of information from hospital to community services was timely and accurate and that the medication the patient needed was available when they left hospital.

 

(viii)    Loughborough Community Hospital had x-ray facilities so patients did not need to travel to the main hospitals if they just needed an x-ray. Members raised concerns about patients that did not reside near Loughborough particularly those in south Leicestershire. There was a lack of public transport from south Leicestershire into the city centre.

 

(ix)       There was usually an increase in respiratory problems over the winter. The NHS was no longer focusing on Covid-19 and less testing for it was taking place. However, Covid-19 disproportionately affected frail and vulnerable people therefore these high-risk cohorts still needed to be vaccinated. If they were vaccinated for Covid-19 they were far less likely to require admitting to a hospital.

 

(x)         A comprehensive vaccination strategy was in place for Leicestershire. Vaccine uptake was generally good in the county area of Leicestershire. Further work was needed to take place to improve vaccination uptake in some groups particularly children and social care staff. The flu vaccine was only available for pre-school children and children with particular health conditions such as asthma and diabetes. A vaccine would only be given to a child if parental consent had been received, though if the child was resisting the procedure the clinician may have to make a decision not to administer the vaccine, even if parental consent had been given.

 

(xi)       The Management Team at Leicestershire County Council had held discussions regarding how to increase vaccine take-up amongst staff, and options had been considered to encourage more people to get vaccinated including holding clinics at County Council buildings and offering vouchers.

 

(xii)      A member queried whether vaccine hesitancy due to safety concerns about previous vaccines, such as MMR, was an issue. In response it was explained that whilst there were now less concerns amongst the public about vaccine safety, vaccination rates had dropped since the Covid-19 pandemic had ended which was of concern. This was not necessarily thought to be due to safety concerns.

 

(xiii)    In response to concerns raised that the vaccination clinics would have a negative impact on the day-to-day primary care work reassurance was given that the work streams were kept separate. Weekend working and enhanced access (GP Practices open later in the evenings) meant that there was capacity for both. Efforts were also being made to encourage people to book their vaccinations in advance so the demand could be managed better.

 

(xiv)    A member raised concerns about the supply of vaccines to south Leicestershire. In response it was explained that vaccine supplies were based on the previous year’s levels plus expected growth. In the past there had been issues with supply from the manufacturers of the vaccine but this had improved significantly as planning had improved.

 

(xv)     The slides appended to the report referred to a group of people known as “Healthcare – ESR” that were receiving vaccines. It was explained that this related to those NHS staff on the Electronic Staff Record which was used to manage the HR and payroll for NHS employees.

 

RESOLVED:

 

That the plans in place to manage winter pressures be noted.