The Public Health and Health Integration Scrutiny Commission met on Tuesday 28 April 2026 to discuss a range of critical public health issues. Key topics included the concerningly high infant mortality rate in Leicester, an update on the LLR Child Death Overview Panel's annual report, and a review of rheumatology services.

Reducing Infant Mortality in Leicester

The Commission received a report detailing the critical situation regarding infant mortality in Leicester, which has the second-highest rate in England. Between 2022 and 2024, there were 105 infant deaths, resulting in a rate of 7.9 per 1,000 live births, significantly higher than the England average of 4.2. The report highlighted that neonatal deaths (under 28 days) account for 70-80% of all infant deaths in the city and that rates are higher for infants of Black or Black British ethnicity, followed by Asian or Asian British ethnicity, compared to White infants.

The Public Health team, in collaboration with the Integrated Care Board (ICB), Leicestershire Public Health, NHS England, and the Office for Health Improvements and Disparities (OHID), has been working to identify areas for improvement. This has involved insights gathered from 12 focus groups and 5 interviews with stakeholders, leading to a Call to Action workshop with over 40 participants. Four key themes emerged: targeting risk and reducing inequalities, ensuring consistent, high-quality, and accessible support, fostering trusted relationships and community-led support, and improving joined-up systems, information, and intelligence. Action plans are currently being developed, with delivery of top priorities set to begin in the summer. The Commission was asked to recognise the gravity of the situation, support the ongoing work, and champion existing initiatives, such as the Bumps to Babies programme, the use of the Safer Sleeping Risk Assessment Tool, successful smoking cessation programmes, and healthy weight initiatives. The report also noted emerging themes around overseas IVF conceptions and late booking of antenatal appointments, particularly among Black women.

LLR Child Death Overview Panel Annual Report 2024/25

The Commission reviewed the Leicester, Leicestershire and Rutland (LLR) Child Death Overview Panel (CDOP) Annual Report for 2024/25. The report detailed that 92 notifications of child deaths were received, an increase from the previous year. Of these, 27% met the criteria for a Joint Agency Response. The report highlighted that 77% of child deaths occurred in hospital, with 20% occurring at home.

A significant focus of the report was on contributory and modifiable factors that could help reduce future child deaths. The top six modifiable factors identified were: smoking in pregnancy, unhealthy weight in pregnancy, household exposure to cigarette smoke, poor communication between agencies, guidelines or policies not being followed, and missed signs of deterioration. The report also detailed local learning from service provision, noting that 25% of completed case reviews had modifiable factors related to service provision. The Commission was presented with recommendations for 2025/26, including promoting breastfeeding, auditing the Safer Sleeping Risk Assessment Tool, increasing resources to tackle smoking in pregnancy, and promoting healthy weight. Further recommendations included improving communication between agencies, ensuring staff are empowered to recognise and escalate risk, and fostering a culture of openness and learning. The report also emphasised the importance of sharing best practice in end-of-life care and ensuring children and young people with a learning disability have an allocated lead medical consultant. National learning from the National Child Mortality Database (NCMD) reports on deaths of children with learning disabilities, autistic children, and deaths due to asthma or anaphylaxis was also presented.

Rheumatology Services Update

The Commission received an update on Rheumatology Services in Leicester from University Hospitals Leicester (UHL). While the transcript does not provide specific details of the update, it indicates that this was a key agenda item. Discussions touched upon the challenges of consultant vacancies and the need for a team of consultants rather than a single one. There was also mention of efforts to secure funding for additional consultants and allied health professionals, including specialist nurses and physiotherapists, to manage the workload. The conversation also touched upon the increasing number of referrals from primary care, with suggestions that some could be avoided through better triage. The complexity of conditions like fibromyalgia and the role of rheumatology in their management were also discussed, with an acknowledgement that guidelines from bodies like the British Society for Rheumatology (BSR) and the Royal College of Physicians (RCP) do not typically involve rheumatologists for fibromyalgia.

Health Protection

The Director of Public Health provided a verbal update on health protection matters. Key points included an increase in Measles, Mumps, and Rubella (MMR) second dose uptake, making Leicester higher than many comparator areas. There was also an increase in Flu and Covid vaccination uptake, though specific figures were not yet available. The HPV school vaccination programme had seen increased uptake, potentially due to a new consent form. The report noted that long-term organisational changes within the ICB and the future structure of the team responsible for immunisation and screening were yet to be determined. A TB action plan had been refreshed with a new plan and risk register. Regarding a Meningitis outbreak in Kent, it was noted that while it was an unusually large outbreak, new cases were not evident and it appeared well-contained. Suspected cases in Leicester had not been confirmed as Meningitis. The discussion also covered Meningitis B vaccination, which is currently only given to babies, and the ACWY vaccine offered to school children. The UK Health Security Agency and the Joint Committee on Vaccination and Immunisation were considering the cost-effectiveness of including the MenB vaccine in the school-aged schedule. Leicester's vaccination rates for Meningitis B were around 90% for one-year-olds and 86% for two-year-olds, while school-age uptake for the ACWY vaccine was just under 50%. Campaigns were being run to raise awareness, and community wellbeing champions and radio publicity were being utilised. Members recommended that the Commission write to the Secretary of State for Health and Social Care to request more funding for the vaccination programme in the city.

Work Programme

The Commission considered its work programme for the upcoming year. It was suggested that NHS Dentistry be considered at the next meeting, with a report on this topic having been delayed. A report on palliative care, including information on LOROS Hospice, and a Winter Plan Debrief were also proposed for future discussion.