Agenda and minutes

The Chair welcomed everyone to the September meeting, and particularly Councillor Hollingsworth who was attending for the first time as he had recently been appointed to the Board in place of Councillor Rhodes-Clayton.

The Chair also welcomed as an observer Tracy Wallis, Scrutiny Officer for the City of York.

To declare any personal/prejudicial interests for the purpose of Section 81 (3) of the Local Government Act 2000 and paragraphs 8 to 12 of the Members Code of Conduct.

Councillor Dobson declared a personal interest in respect of Agenda Item 8 ‘KPMG Health Inequalities Report’  (Minute No. 29 refers) in his capacity as a member of Leeds Initiative - Healthy Leeds Partnership.

(Councillor Kirkland declared a personal interest later in the meeting under Minute No. 28.)

To receive any apologies for absence.

Apologies for absence were submitted on behalf of Councillors Yeadon, Iqbal and Wadsworth.  The Chair advised that Councillor Wadsworth had been recently appointed to the Board in place of Councillor Latty.

To receive and approve the minutes of the previous meeting held on 28^th July 2009.

The Minutes were agreed as a correct record although it was noted that one Member of the Board did not consider that the minutes reflected the depth of concern that Members felt with regard to the provision of renal services in Leeds.

RESOLVED – That the minutes of the meeting held on 28^th July 2009 be confirmed as a correct record.

To consider the attached report of the Head of Scrutiny and Member Development inviting each local NHS Trust to provide a quarterly update on priority areas.

The Head of Scrutiny and Member Development submitted a report outlining for Members previously identified priority areas for each local NHS Trust for the current year and explaining that each of the Trusts had been invited to attend the meeting to provide an update on progress against these priority areas.

The following representatives from local NHS Trusts were welcomed to the meeting:

·  Beverley Bryant (Executive Director of Performance, Improvement and Delivery) – NHS Leeds, and

·  Chris Butler (Chief Executive) – Leeds Partnerships NHS Foundation Trust (LPFT).

Sylvia Craven (Director of Planning) – Leeds Teaching Hospitals NHS Trust (LTHT) joined the meeting later during the consideration of this item.

The representatives reported on progress against the key issues and priorities as outlined in the report and responded to queries and comments from the Board.

In brief summary, the issues raised with the Executive Director of Performance, Improvement and Delivery (NHS Leeds) were:

·  Exercising Choice  - concern was expressed by Members that the choice element had been removed for patients where services were being concentrated in one centre:

Members were advised that it was recognised that it was necessary to have an open debate with the public as to where services were to be placed.

·  Dentistry Services – approval was expressed that there were proposals to increase the number of NHS dentists but concern that the Trust was putting obstacles in the way of a particular group of dentists who were trying to set up a practice in Otley:

Officers could not comment on the specific example given but Members were advised that although many dentists left the NHS in 2006,  they were now returning from private practice.  Contracts had gone out to tender and it was important to ensure equity in the contracts. The north west of the city had experienced particular problems but a Helpline had been set up to assist patients find an NHS dentist.

·  Dentistry services and short-term contracts:

Members were advised that an additional 28,000 NHS dental places for patients had been secured.  20,000 of these were permanent places and 8,000 were short-term places.  It was intended to convert the short-term places to permanent arrangements through either current or alternative providers.  It was agreed to establish whether patients of dentists working under short-term arrangements  would be told of the potential short-term nature of their place and provide this information to the Board.

·  Dentistry and disabled access:

With regard to disabled access to practices being a condition in the new contracts, Members were advised that it was a requirement that any new dentist premises met the minimum standards.  It was not known however how may existing practices were fully compliant with DDA legislation and officers agreed to provide this information to the Board.

·  Patient Choice of three GP Practices and how this might impact on hospital admissions:

Members were advised that it was believed that choice of GP was an important right for the individual.  Accident and Emergency services were under pressure  ...  view the full minutes text for item 28.

To consider the attached report of the Head of Scrutiny and Member Development attaching the report of the Director of Adult Social Services to the Corporate Governance and Audit Committee on 29^th July 2009.

The Head of Scrutiny and Member Development submitted a report presenting Members with the KPMG report on Health Inequalities (June 2009) which provided an assessment of how the Council and NHS Leeds were addressing health inequalities across the city.  Also attached was the report of the Director of Adult Social Services to the Corporate Governance and Audit Committee (29^th July 2009) which included the response to the recommendations contained within the KPMG report.

The Chair welcomed the following officers to address any questions identified by the Board:

·  John England (Deputy Director – Partnerships and Organisational Effectiveness) – Leeds City Council, Adult Social Services, and

·  Brenda Fullard (Head of Healthy Living and Inequalities) – NHS Leeds.

Members were advised that Leeds City Council and NHS Leeds were working together on a detailed action plan to address the recommendations made in the KPMG report and this would be presented to the Executive Board in December 2009.

Officers advised the Board of the key issues brought out in the annual Public Health Report and the challenges that faced the Council and NHS Leeds to reduce health inequalities.  These were in brief:

·  Reducing smoking levels.

·  Locality commissioning.

·  A programme management approach relating to:

o  Increasing the number of people coming through GP surgeries for health checks,

o  Infant mortality,

o  Excessive winter deaths,

o  Healthy living services.

·  Joint working and a partnership approach to reducing cardiovascular deaths and levels of obesity.

·  Reducing alcohol related hospital admissions.

·  Maintaining investments with the voluntary sector as an interface between services and disadvantaged groups.

·  Strengthening the need for staff to be accountable for delivering targets.

·  Encouraging hard to reach groups to access services.

·  Considering the impact of the recession on health and well being across the City.

Officers also advised that it was a relatively short period of time that health inequalities had been included on the Council agenda but inroads were being made in terms of Council services recognising the contribution that they could make to address these issues.

In brief summary, the main issues raised by Members were:

·  That health inequalities were a manifestation of other inequalities in society.

·  Alcohol excess and promotions - the restrictions that local authorities had in terms of licensing laws and the need to press the Government for change. 

Members were advised that it was an infringement of a bar’s license if their staff served alcohol to people that were already drunk.

·  High levels of obesity.

·  Air pollutants eg high pollen and sulphur dioxide levels created under certain weather conditions which resulted in hospital admissions due to respiratory problems.

·  Recreation provision in the inner city - the importance of protecting playing fields and ensuring that planning regulations and legislation were robust.

·  Addressing the life expectancy gap between the highest area of the city (Adel and Wharfedale) and the lowest (City and Hunslet):

–  the affects of pollution from the many major roads and motorways in the south of the city on people suffering from respiratory problems,

–  the  ...  view the full minutes text for item 29.

To consider the attached report of the Head of Scrutiny and Member Development presenting the joint performance report from NHS Leeds and Leeds City Council which provides an overview of progress against key improvement indicators relevant to the Board at Quarter 1, 2009/10.

The Head of Scrutiny and Member Development submitted a joint report from NHS Leeds and Leeds City Council providing an overview of progress against key improvement priorities and performance indicators relevant to the Board at Quarter 1, 2009/10.

The following officers were welcomed to the meeting to address any specific questions identified by the Board:

·  Graham Brown (Performance Manager) – NHS Leeds, and

·  John England (Deputy Director – Partnerships and Organisational Effectiveness) – Leeds City Council, Adult Social Services.

The issue of concerns regarding the data quality of NI 70 (Reduce emergency hospital admissions caused by injury to children) was raised by Members.  Members were advised that this was a fairly new indicator and the data was to be available via the central Government Data Hub, but it had not been made available when it was promised.

The Board agreed to ask the Director of Children’s Services to respond to the Board’s concerns on the quality of the data of NI 70.

RESOLVED –

(a)  That the contents of the report and appendices be noted.

(b)  That the Director of Children’s Services be requested to respond to the Board’s concerns to the quality of the data of NI 70: Reduce emergency hospital admissions caused by injury to children.

To consider the attached report of the Head of Scrutiny and Member Development presenting the formal response to the recommendations presented in the Board’s Scrutiny Inquiry report.

The Head of Scrutiny and Member Development submitted a report attaching the formal response by the Director of Children’s Services to the Executive Board on 22^nd July 2009 to the recommendations presented in the Scrutiny Inquiry report: ‘Improving Sexual Health Among Young People (April 2009)’.

Also attached to the report was the Ministerial Report presenting the outcome of the March 2009 review by the Teenage Pregnancy National Support Team.

Steven Courtney, Principal Scrutiny Advisor, advised Members that the Executive Board approved the proposed responses to the previous Scrutiny Board (Health)’s recommendations, as contained within the report of the Director of Children’s Services and that the progress of each recommendation would be monitored in future quarterly recommendation tracking reports to the Board.

The following Officers were welcomed to the meeting to respond to any questions identified by the Board:

·  Paul Bollom, Priority Outcome Commissioner (Leeds City Council, Children’s Services), and

·  Keira Swift, Teenage Pregnancy Co-ordinator (Leeds City Council, Children’s Services).

In brief summary, Members raised the following issues:

·  That YSHAG (Young Sexual Health Action Group) should be consulted on the response – The Chair referred to the proposed inquiry into the role of the Council and its partners in promoting good public health which was to be considered under the next agenda item and where under Session 1 it was proposed to consider issues associated with improving sexual health and reducing the level of teenage pregnancies.

The Priority Outcome Commissioner advised that his was a new post and assured the Board that young people would be involved in setting up strategic commissioning.

The Teenage Pregnancy Co-ordinator advised that workshops had been held recently which had proved very useful.

·  Teenage Pregnancy – Concern was expressed that this data (NI 112: Teenage pregnancy rates) was 18 months out of date, that it was therefore difficult to monitor progress and that the targets should be challenged as unachievable. 

Members were also keen that officers should adopt the good practice of other local authorities such as Derby, which had greatly reduced teenage pregnancy rates.

Officers advised that it was a national target to reduce teenage pregnancy rates to 22.7 per 1,000 girls aged 15 to 17 by 2010 and agreed that it was worth investigating national as well as European best practice to reduce rates.

RESOLVED –

(a)  That the contents of the report and appendices be noted.

(b)  That the issues raised above be further scrutinised in the Board’s proposed Inquiry into the role of the Council and its partners in promoting good public health, subject to Members agreeing to hold this Inquiry and agreeing the terms of reference (see Minute No. 32).

To consider the attached report of the Head of Scrutiny and Member Development presenting the Board’s current outline work programme for the remainder of the current municipal year, for the Board to consider, amend and agree as appropriate.

The Head of Scrutiny and Member Development submitted a report presenting an outline work programme for the Board to consider, amend and agree as appropriate.

Appended to the report were copies of the following documents for the

information/comment of the Board:-

•   Draft Terms of Reference for a Scrutiny Board (Health) Inquiry into the role of the Council and its partners in promoting good public health (Appendix 1 refers) with the associated inquiry selection criteria pro-forma (Appendix 2).

•   Scrutiny Board (Health) - Draft Work Programme 2009/2010 (Appendix 3).

•   Scrutiny Board (Health) – Health Proposals Working Group Terms of Reference (Appendix 4).

•   Minutes of the Executive Board meetings held on 22^nd July and 26^th August 2009 (Appendices 5 and 6).

The Chair advised Members that the Board were being requested to reconsider their decision at their meeting on 30^th June 2009 not to re-establish the Health Proposals Working Group.  The was due to subsequent discussions with officials at NHS Leeds revealing the degree to which the working group had provided a useful vehicle to keep members of the Scrutiny Board appraised of developments across local NHS Trusts.  As such, the previously proposed terms of reference were attached to the report for Members’ reconsideration.

Following discussion, Members agreed to reinstate the Health Proposals Working Group.  With regard to membership of the working group, it was agreed that there would be a core membership of Councillors Dobson and Chapman and that all other members of the Board would attend whenever possible.

With reference to the Executive Board Minutes of 26^th August 2009 and the Council’s proposal to establish barbecue areas on Woodhouse Moor, a Member of the Scrutiny Board raised the issue of whether respiratory conditions were affected by barbecue smoke.  

Following discussion it was agreed to seek advice from NHS Leeds regarding the impact of air pollutants, such as barbecue smoke and emissions caused by road traffic and power stations, on people with respiratory difficulties. 

RESOLVED –

(a)  That the contents of the report and appendices be noted.

(b)  That the draft terms of reference for the Inquiry into the role of the Council and its partners in promoting good public health (Appendix 1) and the associated inquiry selection criteria pro-forma (Appendix 2) be agreed in lieu of the previously agreed terms of reference for a scrutiny inquiry solely around alcohol related harm.

(c)  That the outline work programme, as attached at Appendix 3 to the report, be agreed.

(d)  That the Health Proposals Working Group be re-established in line with the draft terms of reference as attached at Appendix 4 to the report, and that there would be a core membership of Councillors Dobson and Chapman, with other Members of the Board attending whenever possible.

(e)  That NHS Leeds be requested to provide advice on the impact of air pollutants, such as barbecue smoke and emissions caused by road traffic and power stations, on people with respiratory difficulties, in order for the Board to  ...  view the full minutes text for item 32.

To note that the next meeting of the Board will be held on 20^th October 2009 at 10.00am with a pre-meeting for Board Members at 9.30am.

Noted that the next meeting of the Board would be held on Tuesday 20th October 2009 at 10.00am, with a pre-meeting for Board Members at 9.30am.

The meeting concluded at 12.40pm.