Agenda and minutes

To identify items which have been admitted to the agenda by the Chair for consideration.

(The special circumstances shall be specified in the minutes.)

The following late information was submitted to the Board:

-  Agenda item 9 – Adults and Health Regulated Services Quality Account – CQC press statement: State of Care Services report.

The above information was not available at the time of agenda despatch, but was subsequently made available on the Council’s website.

To disclose or draw attention to any disclosable pecuniary interests for the purposes of Section 31 of the Localism Act 2011 and paragraphs 13-16 of the Members’ Code of Conduct.

There were no disclosable pecuniary interests declared to the meeting.

To receive any apologies for absence and notification of substitutes.

Apologies for absence were submitted by Councillors J Pryor and D Ragan.

To approve as a correct record the minutes of the meeting held on 5September 2017.

RESOLVED – That the minutes of the meeting held on 5 September 2017 be approved as a correct record.

Minute No. 36 – Work Schedule – September 2017

In relation to the Board’s recommendation regarding contributions from the CCG partnership to the future commissioning Neighbourhood Networks, it was noted that a briefing note had been provided to Board Members which advised that due to the separate funding arrangements for ‘running costs’ and ‘programme (commissioning) activity’ the CCG partnership would not be in a position to pursue the previous recommendation of the Scrutiny Board.

While accepting the additional information on funding arrangements and the impact this had on the Board’s previous recommendation, the Board acknowledged that the Council remained in discussion with the CCG Partnership regarding the funding of Neighbourhood Networks. 

The Board noted that as part of this partnership approach to commissioning, funding for Neighbourhood Networks, alongside a range of other third sector funding/ activity, formed part of a 'long list' of funding options/business cases that the CCG Partnership would be considering over the next few months.

The Board expressed its desire to ensure that Neighbourhood Networks were adequately funded to reflect the full range of activity undertaken, with financial contributions from all appropriate partners.

The Board also agreed to invite the CCG Partnership to share details of its long list of funding options/ business cases, to allow the Scrutiny Board an opportunity to consider and comment on outline priorities and help inform CCG Partnership longer-term funding decisions.

To consider, for information purposes, the draft minutes from the Executive Board meeting held on 20 September 2017, as they relate to the remit of the Scrutiny Board.

RESOLVED – That the minutes of the Executive Board meeting held on 20 September 2017, be noted.

To receive an update from the Chair on specific scrutiny activity since the previous Board meeting, not specifically included elsewhere on the agenda.

The Chair provided a verbal update on recent scrutiny activity that had not been included elsewhere on the agenda.

The key points were:

·  An update on working group meetings held on 29 September 2017 and 5 October 2017.  It was advised that the next round of working group meetings were planned for January 2018.

·  Attendance at Leeds Teaching Hospital Trust (LTHT) AGM on 27 September 2017.

·  Involvement with issues associated with the West Yorkshire and Harrogate STP and work of the Joint Health Overview and Scrutiny Committee (West Yorkshire).

·  An update on NHS England’s consultation on Gender Identity Services, and the approach taken to increase awareness and encourage contributions to the consultation.  The Board was reminded that the consultation closed on 16 October 2017.

The Board welcomed the update and expressed its satisfaction with the Chair’s approach for dealing with NHS England’s consultation on Gender Identity Services.

RESOLVED – That the Chair’s update be noted.

To consider a report from the Head of Governance and Scrutiny Support introducing the Adults and Health Regulated Services Quality Account considered by Executive Board at its meeting on 20 September 2017. 

The Head of Governance and Scrutiny Support submitted a report which presented the Adults and Health Regulated Services Quality Account for Leeds, considered by Executive Board at its meeting on 20 September 2017.

The following were in attendance:

-  Councillor Rebecca Charlwood (Executive Member for Health, Wellbeing and Adults)

-  Mick Ward (Interim Deputy Director, Integrated Commissioning – Adults and Health).

The key areas of discussion were:

Members also welcomed (to her first meeting of the Scrutiny Board) Caroline Baria – the recently appointed Deputy Director Integrated Commissioning, Adults and Health. 

The Executive Board member and Interim Deputy Director introduced the report and highlighted a number of matters, including:

·  Improvement in the proportion (53%) of older people’s independent care home providers rated as ‘good’.

·  Concern regarding the proportion (41%) of older people’s nursing care providers rated as ‘good’.

·  81% of care homes for working aged adults rated as ‘good’.

·  Mainly positive feedback (and improvements) identified through the domiciliary care survey undertaken by HealthWatch Leeds.

The Scrutiny Board considered the information presented and discussed a number of areas, including:

·  The relative performance of Leeds services rated as ‘good’ when compared to other local authority areas.

·  Areas for improvement in people’s experience of care, as evidenced by the survey work undertaken by HealthWatch Leeds.

·  Concern that 50% (approx.) of care home providers for older people had failed to improve at the point of re-inspection.

·  Concern around the overall ratings of those domiciliary care providers contracted to the Council.

·  The complexities around ensuring consistency of high quality care.

·  The responsibilities of local authorities to support private sector care providers.

·  The number of domiciliary care providers delivering services to ‘self-funders’ and therefore not reflected in the report. 

RESOLVED – That the contents of the report and appendices be noted.

To consider a report from the Head of Governance and Scrutiny Support that introduces an update on the implementation of Phase 3 of the Better Lives Strategy, as presented to the Executive Board on 20 September 2017.

The Head of Governance and Scrutiny Support submitted a report which introduced an update on the implementation of Phase 3 of the Better Lives Strategy, as presented to the Executive Board on 20 September 2017.

The following were in attendance:

-  Councillor Rebecca Charlwood (Executive Member for Health, Wellbeing and Adults)

-  Mick Ward (Interim Deputy Director, Integrated Commissioning – Adults and Health).

The Executive Board member and Interim Deputy Director introduced the report and provided a summary of the main issues.

The Scrutiny Board considered the information presented and discussed a number of areas, including:

·  Confirmation that the outstanding issues identified in the report had been addressed / resolved.

·  The reassurance around mortality levels during the period of decommissioning.

·  Acknowledgement that the decommissioning of care homes and day centres had been achieved without any compulsory redundancies; and the positive staff response.

·  The planned development and implementation of an intermediate care facility in November 2017 – including recruitment of staff.

·  The impact / implications of the Council’s ‘Early Leavers Initiative’ scheme and the current recruitment process (identified above).

RESOLVED – That the Board notes the update on the implementation of Phase 3 of the Better Lives Strategy, as presented to the Executive Board on 20 September 2017.

To consider a report from the Head of Governance and Scrutiny Support that introduces an update from Leeds CCG Partnerships on the current delivery of primary care (GP) services across the City.

The Head of Governance and Scrutiny Support submitted a report which introduced an update from Leeds CCG Partnerships on the current delivery of primary care (GP) services across the City.

The following were in attendance:

-  Kirsty Turner – Associate Director (Primary Care), Leeds Clinical Commissioning Groups Partnership

-  Gaynor Connor – Associate Director (Primary Care and New Models of Care), Leeds Clinical Commissioning Groups Partnership.

The Board received a short PowerPoint presentation on the ‘NHS England GP Forward View’.

Highlighted that the combined objective of the various workstreams was to ensure resilient and sustainable primary care (GP) services across Leeds, the Associate Directors introduced the report, which included the following details:

·  A range of information on the current positon / delivery of primary care (GP) services in Leeds.

·  Workforce matters.

·  GP Access.

·  Estate developments.

The report also provided a summary of CQC inspection outcomes.

The Scrutiny Board considered the information presented and discussed a number of areas, including:

·  The potential impact on the patient populations of ‘smaller’ GP surgeries that may be at greater risk of closure.

·  The need for more detailed metrics / demographic information around current GP provision and the overall workforce profile across Leeds.

·  Development of digital initiatives and associated training / skills enhancement for GPs and allied professionals.

·  The implications associated with an increased emphasis on ‘self-care’.

·  Issues associated with the recruitment and retention of GPs, including flexible working, different employment models and employment practice.

·  Concern that workforce and extended access targets may be overly ambitious.

During the discussion it was suggested that the Scrutiny Board should also seek the input from representatives of the Local Medical Committee (LMC) and Local Pharmaceutical Committee (LPC) in order to obtain additional perspectives on the issues outlined in the report and discussed at the meeting. 

RESOLVED –

(a)  That the information presented and discussed at the meeting be noted.

(b)  That more detailed metrics / demographic information be provided to a future meeting of the Board, that expands on the information provided around the current GP provision and the overall workforce profile across Leeds.

(c)  That suitable representatives from the Local Medical Committee (LMC) and the Local Pharmaceutical Committee (LPC) be invited to attend a future meeting of the Board to provide additional perspectives on the issues outlined in the report and discussed at the meeting.

(Councillor J Chapman left the meeting at 2.45pm during the consideration of this item.)

To consider a report from the Head of Governance and Scrutiny Support introducing Department of Health response in relation to the concerns raised by the Scrutiny Board regarding NHS Blood and Transplant’s closure of the Blood Donor Centre in Seacroft. 

The Head of Governance and Scrutiny Support submitted a report which introduced the Department of Health response in relation to concerns raised by the Scrutiny Board regarding NHS Blood and Transplant’s closure of the Blood Donor Centre in Seacroft.

Details of the Scrutiny Board’s letter and associated enclosures together with the Department of Health response (dated 5 September) were appended to the report.

The Scrutiny Board considered the information presented and discussed a number of potential actions, including:

·  Seeking confirmation from NHS Blood and Transplant on the specific improvements made to its communications with Health Overview and Scrutiny Committees about planned changes in local areas.

·  Requesting details from NHS Blood and Transplant on its work and proposals to attract more blood donors from priority groups;

·  Highlighting the Board’s concerns regarding the general implications of the Department of Health response in relation to ‘Special Health Authorities’ to the relevant local Member of Parliament.

·  Referring the matter and the Board’s concerns to the Parliamentary Select Committee for Health.

RESOLVED –

(a)  That NHS Blood and Transplant be asked to provide details of:

i.  Proposals to attract more blood donors from priority groups.

ii.  Improvements made to its communications processes in order to advise Health Overview and Scrutiny Committees about planned changes in local areas.

(b)  That, on behalf of the Scrutiny Board, the Chair highlights the concerns of the Board with the relevant local Member of Parliament; particularly the general implications associated with the Department of Health’s comments in relation to ‘Special Health Authorities’.

(c)  That the concerns identified by the Board also be referred to the Parliamentary Select Committee for Health.

To consider the Scrutiny Board’s work schedule for the 2017/18 municipal year.

The Head of Governance and Scrutiny Support submitted a report which invited Members to consider the Board’s work schedule for the 2017/18 municipal year.

The Board referred to its earlier discussion around the delivery of GP services in Leeds (minute 47 refers) and agreed an additional working group meeting should be convened to consider the additional information and inputs identified at the meeting.

RESOLVED –

(a)  That, subject to any routine scheduling decisions by the Chair, and the issues detailed above, the Board’s outline work schedule be approved.

(b)  That a GP services working group meeting should be convened to consider the additional information and inputs identified at the meeting (minute 47 refers).

Tuesday, 14 November 2017 at 1:30pm (pre-meeting for all members of the Scrutiny Board at 1:00pm).

Tuesday, 14 November 2017 at 1.00pm (pre-meeting for all members of the Scrutiny Board at 12.30pm).

The earlier start times (from those detailed on the published agenda) were specifically noted and agreed by the Board.

(The meeting concluded at 3.45pm)