The Public Health and Health Integration Scrutiny Commission met on Tuesday 28 April 2026 to discuss several 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 verbal update on health protection matters.

Reducing Infant Mortality in Leicester

The Commission received an update on the significant issue of 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, compared to the England average of 4.2 per 1,000 live births. This rate is not only higher than Leicestershire but also shows an increasing trend. Neonatal deaths (under 28 days) account for 70-80% of all infant deaths in Leicester and are significantly higher than national and regional averages.

The report highlighted that the infant mortality rate is particularly high among Black or Black British ethnicity infants, more than double that of white infants. Asian or Asian British infants also have a higher death rate than white infants. Key contributory factors identified that could be modified to reduce future deaths include smoking in pregnancy, unhealthy weight in pregnancy, household exposure to cigarette smoke, poor communication between agencies, failure to follow guidelines or policies, and missed signs of deterioration.

To address this, a multi-phase approach involving insights, a conference, and action plans is underway, with input from various partners including the Integrated Care Board (ICB), Leicestershire Public Health team, NHS England, and the Office for Health Improvements and Disparities (OHID). A Call to Action workshop brought together over 40 participants to develop solutions focused on four themes: 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 expected to begin in the summer.

The Commission was also updated on existing work aligned with Child Death Overview Panel (CDOP) recommendations, including the Bumps to Babies programme, the use of the Safer Sleeping Risk Assessment Tool, successful smoking cessation initiatives, and efforts to promote healthy weight before and during pregnancy. Additional work is being undertaken on overseas IVF conceptions and late bookings for antenatal care, particularly among Black women and birthing people.

The Commission was asked to recognise the gravity of the situation, support the ongoing work to address infant mortality, and champion the existing positive initiatives.

LLR Child Death Overview Panel Annual Report 2024/25

The Commission received a presentation on the LLR Child Death Overview Panel (CDOP) Annual Report for 2024/25. The report detailed the work of the panel in reviewing child deaths across Leicester, Leicestershire, and Rutland to understand how and why children die, with the aim of identifying trends and areas for improvement.

Key findings from the report indicated 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 majority of deaths occurred in hospital (77%), with 20% occurring at home.

The report highlighted significant contributory factors to child deaths, with factors intrinsic to the child being present in 99% of cases. Factors in the family or social environment were identified in 39% of cases, and factors in service provision in 30% of cases. Modifiable factors, which could be addressed through interventions, were identified in 46% of LLR cases, a figure slightly higher than the England average. The most frequent modifiable factors included smoking in pregnancy, high maternal BMI, household smoking, poor communication between agencies, and failure to follow guidelines or policies.

The report also detailed local learning from excellence, noting that in 60% of cases, good or excellent aspects of service delivery were recorded. These included advanced care planning, communication and teamwork between agencies, and end-of-life care planning.

Thematic learning focused on infant mortality, sudden unexplained infant deaths, and deaths of children with a learning disability. For infant mortality, the report noted that Leicester's rate is significantly higher than Leicestershire and England, with an increasing trend. The report also highlighted national learning from NCMD reports on deaths of children with learning disabilities and autistic children, and deaths due to asthma or anaphylaxis.

The CDOP has made several recommendations for 2025/26, including promoting breastfeeding, safer sleeping practices, reducing smoking in pregnancy, promoting healthy weight, improving service provision, sharing best practices in end-of-life care, and ensuring children with learning disabilities have care passports and are on GP registers.

Health Protection

The Director of Public Health provided a verbal update on health protection matters. While specific details of this update were not extensively documented in the provided transcripts, it is understood to have covered general health protection issues relevant to the commission's remit.

Work Programme

The Commission reviewed its work programme for the upcoming year. It was noted that NHS Dentistry would be considered at a future meeting, along with a report on palliative care, including information on LOROS Hospice, and a debrief on the Winter Plan. The Commission also discussed potential future items, including a deeper look into winter pressures and ambulance wait times, GP access, and updates on various public health initiatives.