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.)

There were no late items, however the Chair admitted to the agenda additional information provided since the agenda’s publication.  This information was relevant to agenda items 7 and 8 (‘Provision of Renal Services’ and ‘Provision of Dermatology Services’) and had been circulated to Members.

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.

In respect of Agenda Item 7 ‘Provision of Renal Services’ (Minute No. 44 refers), Councillor Chapman declared a personal interest as her daughter-in-law worked for the health care provider and was about to start work on one of the renal wards.

To receive any apologies for absence.

Apologies for absence were submitted on behalf of Mr E Mack (Co-opted Member), and Councillors Yeadon and Congreve.

To receive and approve the minutes of the previous meeting held on 20^th October 2009.

RESOLVED – That the minutes of the meeting held on 20^th October 2009 be confirmed as a correct record.

To consider the attached report of the Head of Scrutiny and Member Development presenting the Scrutiny Board (Health) with additional information to assist members to consider current proposals associated with the provision of renal services (dialysis) across the Trust, particularly in terms of provision at Leeds General Infirmary (LGI).

The Head of Scrutiny and Member Development submitted a report providing Members with additional information to assist in the consideration of current proposals associated with the provision of renal services (dialysis) across the Trust, particularly in terms of provision at Leeds General Infirmary (LGI).

The report also presented the draft Yorkshire and The Humber Renal Strategy (2009 – 2014) for consideration and comment.

Appended to the report was the following information:

·  Position Statement: Proposed Renal Services Provision at Leeds General Infirmary – 29 July 2009 (Appendix 1)

·  Renal Services: Provision at LGI – Follow-up Questions – (Appendix 2)

·  Leeds Teaching Hospitals NHS Trust (LTHT) Response to Scrutiny Board Health follow-up questions on Renal Services provision at LGI (Appendix 3)

·  Draft Yorkshire and the Humber Renal Network Strategy for Renal Services 2009-2014 (Appendix 4)

Previously accepted as additional information under Agenda Item 3 (Minute No.40 refers) was a written submission from the Kidney Patients Association (LGI).

The Chair welcomed to the meeting, Frank Griffiths from the Kidney Patients Association (LGI), to outline the patients’ position on the proposed changes to renal provision at LGI.  Gloria Black, a kidney dialysis patient since 1996, was also invited to address the Board on her first hand experiences of undergoing dialysis at Seacroft.

Mr Griffiths submitted an apology from Paul Taylor of the Kidney Patients Association (St. James’) and read out a letter from Mr Taylor which endorsed everything that the KPA (LGI) were saying and supported their campaign to get renal services at the LGI fully reinstated.

Mr Griffiths then summarised the written submission from the KPA (LGI).  At issue was the way the LTHT had planned and provided care for patients with Chronic Kidney Disease.  He referred to a paper dated 29^th April 2009  from the National Kidney Federation (NKF) which provided a definition of a ‘patient centred service’, advice on how a site should be chosen and the other hospital services and departments that should be easily accessible to kidney patients.  The KPA was concerned that these recommendations were not being followed in Leeds.

Mr Griffith raised particular concerns about the Seacroft unit being described as a ‘Main Dialysis Unit’ by the Trust, although it did not have the service standards required by a main unit as defined in the aforementioned NKF paper.  Mr Griffiths later went on to expand on this issue and explained about co-morbidities, that is when a patient had more than one complaint for which they needed treatment, such as cardiology, neurology, eurology and diabetes – questioning how these services could be accessed at the main dialysis unit at Seacroft.

The NKF paper also defined holistic care and there was concern that the guidance on treating kidney patients holistically was not being met in Leeds.  The Seacroft unit had not been built for that purpose, doctors were not available on a regular basis there and neither was psychological support, faith  ...  view the full minutes text for item 44.

To consider the attached report of the Head of Scrutiny and Member Development presenting the Scrutiny Board (Health) with a range of information to assist members to consider current developments associated with the provision of dermatology services, particularly in terms of inpatient provision on ward 43 at Leeds General Infirmary.

The Head of Scrutiny and Member Development submitted a report providing Members with a range of information to assist in the consideration of current developments associated with the provision of dermatology services, particularly in terms of inpatient provision on ward 43 at Leeds General Infirmary (LGI).

Appended to the report was the following information:

·  The response from Leeds Teaching Hospitals NHS Trust (LTHT) to the letter sent by the Chair of the Scrutiny Board (Health) requesting information and seeking clarification on various matters (Appendix 1).

·  Examples of communications sent by a range of stakeholders to LTHT (Appendices 2 and 3).

The Chair advised that the Scrutiny Board only became aware of potential changes in the provision of dermatology services, particularly in terms of inpatient provision on ward 43 at LGI, in early October when two separate requests for the proposals to be examined in more detail had been received from patients and the British Association of Dermatologists (BAD).

The Chair welcomed to the meeting:

·  Tania von Hospenthal, Business  Manager (Clinical  Advisory Unit) – British Association of Dermatologists (BAD)

·  Victor Boughton – Dermatology Patient Representative, and

·  Mohammed Patel – Dermatology Patient

Apologies had also been received from Andrew Langford, Chief Executive, Skin Care Campaign, who had provided a written submission and from Mark Goodfield, President of the British Association of Dermatologists.

The Board heard that one of the main concerns of BAD was the consultation process; that staff and patients should be consulted before any decision to move ward 43 was made.  BAD had written to the Chief Executive but had not yet received a response. They were also concerned that if the ward was to be moved, that it should remain as a dedicated unit and not be part of a larger ward.

The Dermatology Patient Representative summarised the comments received from patients and which had been accepted by the Board as additional information.  He outlined the anxieties of the patients if the ward became part of a larger ward; that the patients’ conditions would become worse due to stress unless the correct level of privacy and highly skilled nursing care was provided.  There were concerns about:

·  Contracting infections on open wards;

·  The availability of baths or showers – which were a necessary part of the daily treatment; 

·  The potential need for having to travel between different hospital sites for associated treatments, and the increased stress for patients this may cause;

·  The level of consultation with staff and patients.

Mr Patel, a dermatology patient on ward 43, then addressed the Board from a sufferer’s perspective and explained the effect on himself if ward 43 was to be moved and became part of another ward.  One of his main concerns was that the current high level of service would not be maintained outside of a dedicated ward for skin patients.

The Chair thanked the previous speakers for their views and then welcomed the following officers to the meeting to present the report and respond  ...  view the full minutes text for item 45.

To consider the attached report of the Head of Scrutiny and Member Development presenting the Scrutiny Board (Health) with a range of information on the consultation being undertaken by Leeds Teaching Hospitals NHS Trust about its application to become an NHS Foundation Trust as well as seeking the views of the Board on the consultation plan and on the actual application itself.

The Head of Scrutiny and Member Development submitted a report providing the Board with a range of information on the consultation being undertaken by Leeds Teaching Hospitals NHS Trust (LTHT) about its application to become an NHS Foundation Trust and seeking Members’ views on the consultation plan presented and on the application itself.

Appended to the report was the following information:

·  The consultation document (Appendix 1)

·  The Trust’s consultation plan (Appendix 2)

·  A list of more detailed information relating to specific consultation events (Appendix 3)

The Chair welcomed Ruth Holt, Chief Nurse, Leeds Teaching Hospitals NHS Trust, to the meeting to present the report and respond to any specific questions identified by the Board.

In summary, Members made the following comments and raised the following questions:

·  Clarification of the geographical boundaries and whether the LTHT would be reconsidering the proposed boundaries, perhaps to coincide with the Council’s well established Area Committee structure.

·  Clarification on the proposed arrangements for recruiting members and appointing governors for a Foundation Trust .

·  Based on recent events, the Scrutiny Board was concerned that LTHT was not demonstrating an appropriate level of patient involvement and engagement.  It was felt that this did not complement  LTHT’s desire for achieving Foundation Trust status.

·  Clarification as to how residents living in outer areas would feel motivated to become members of the new Leeds Foundation Trust, if they currently accessed healthcare services in other areas, eg Harrogate and York hospitals. 

·  Clarification of how much it would cost to operate the new arrangements for Foundation Trust status.

·  The need to raise the profile and continue to emphasise the importance of the governor role to motivate members of the public to become fully engaged with the Foundation Trust process, in both the short and longer-term.

·  Clarification of the day to day operations of the new Foundation Trust and future relationship with Monitor, the Strategic Health Authority and  the Secretary of State for Health.

·  Clarification as to whether establishing Foundation Trust status was appropriate, at this present time: particularly when considering the current challenges facing the Trust around reconfiguring services etc.

·  Clarification of how the LTHT would potentially change their specialisms and the need for the Board to be kept up to date with any subsequent developments. 

·  Clarification as to whom was the ultimate decision maker within this process.

·  The need for the Board to recognise the importance of this issue and to play a major part in the democratic process, as a ‘critical friend’, and for LTHT to listen to the Board’s views.

The Chief Nurse responded to the issues raised, further outlining the work being undertaken by the Trust in this regard, and agreed to explore a number of the issues raised by the Board.

RESOLVED –

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

(b)  That the Principal Scrutiny Adviser be requested to prepare a draft consultation response, summarising the comments made by the Scrutiny Board, for submission to the Leeds Teaching Hospitals NHS Trust  ...  view the full minutes text for item 46.

To consider the attached report of the Head of Scrutiny and Member Development presenting the Scrutiny Board with a joint health scrutiny protocol for the Yorkshire and the Humber region for members to consider and agree.  The protocol would form the basis for any joint scrutiny between the constituent local authorities within the region.

The Head of Scrutiny and Member Development submitted a report on the joint health scrutiny protocol for the Yorkshire and the Humber region.  The draft protocol was attached to the report for Members’ consideration and agreement.

Steven Courtney, Principal Scrutiny Adviser, presented the report and advised the meeting that, to date 9 local authorities out of a possible 15, had now signed up to the protocol for the Yorkshire and the Humber Councils Joint Health Scrutiny Committee.

RESOLVED –

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

(b)  That the draft attached protocol be agreed in accordance with the report now submitted.

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 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.

Attached to the report was the following information:

·  Scrutiny Board (Health) Work Programme 2009/10 – updated November 2009 (Appendix 1)

·  Minutes of the Executive Board meetings held on 14^th October and 4^th November 2009 (Appendix 2)

Steven Courtney, Principal Scrutiny Adviser, presented the report and stated that a provisional meeting of the Health Proposals Working Group had been arranged for Wednesday 3^rd December 2009 at 3.30pm.  This was an open invitation for all Board Members.

Specific discussion ensued on the Leeds Teaching Hospitals Trust’s presentation on their application to become an NHS Foundation Trust.

RESOLVED –

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

(b)  That the Work Programme be agreed.

(c)  That in view of the importance and public interest in this matter, a Working Group be established to discuss and propose the Board’s consultation submission in relation to Leeds Teaching Hospitals NHS Trust proposals for achieving Foundation Trust status. 

To note that the next meeting of the Board will be held on 15^th December 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 15^th December 2009 at 10.00am with a pre-meeting for Board Members at 9.30am.

The meeting concluded at 2:40 pm.