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.)

In accordance with his powers under Section 100B(4)(b) of the Local Government Act 1972, the Chair admitted to the agenda the following late reports and supplementary information relating to the following agenda items:-

Agenda Item 8 – Foundation Trust Costs – Summary Briefing.

Agenda Item 9 – Renal Services in Leeds – Report following the Leeds Teaching Hospitals Trust Board on 20 May 2010.

Agenda Item 10 – Copy of the Scrutiny Board’s proposed final Inquiry Report into Promoting Good Public Health, together with the advice and comments of the Directors and Chief Officers in respect of the Board’s recommendations.

Agenda Item 11 – Copy of the Chair’s Summary to preface the Board’s contribution to the composite Annual Scrutiny Report for submission to Council.

None of the above documents had been available at the time of the agenda despatch.

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 Chapman declared a personal interest in relation to Agenda Items 9 and 10 in respect of a relative who worked in the health care sector.

To confirm as a correct record the minutes of the meeting held on 16^th March 2010.

RESOLVED – That the minutes of the meeting held on 16^th March 2010 be confirmed as a correct record.

To consider the draft quality account submissions for LTHT and LPFT. Including assurance statements from NHS Leeds.

Further to Minute No. 66, 26^th January 2010, the Head of Scrutiny and Member Development submitted for the Board’s consideration and comment the draft 2009/10 Quality Account Reports of the Leeds Teaching Hospitals NHS Trust (LTHT) and Leeds Partnership Foundations Trust (LPFT).

In attendance at the meeting, and responding to Members’ queries and comments, were:-

-  Guy Musson, Deputy Chief Executive, LPFT

-  Julia Roper, Quality Improvement Manager, LTHT

In brief summary, the main areas of discussion were:-

·  A current lack of targets in respect of the LPFT document.

It was explained that this was the first full year of producing the statutory Quality Accounts and there was currently no baseline data for comparison purposes.  However, the point was acknowledged and the Board could expect to see targets in future years.

·  The current dual monitoring and assessment arrangements, involving both the official Monitor and the Care Quality Commission, and the slightly different assessment regimes involved.  It was to be hoped that, possibly, these arrangements might be rationalised in the future.

·  The numbers and percentage of re-admissions of patients within 28 days of discharge and some of the reasons underlying the statistics.

·  A suggestion that when the Quality Accounts were published, they should be supplemented by a glossary explaining the various acronyms used, and a simplified bullet point summary of each document.

·  The LTHT report referred to accessibility, and the view was expressed  that this should apply equally to information and not just service provision.  Whilst understanding the need for some patient confidentiality, it was felt to be important to keep close relatives and carers informed of developments.

·  Reference was made to the Board’s previously expressed and continuing concerns regarding the present consultation methods of LTHT, e.g. the lack of meaningful consultation on the issue of the provision of renal services at Leeds General Information (LGI).  It was suggested that some sort of reflection on this issue on the part of the LTHT should, perhaps, be included in the Quality Account Statement.

·  Recognising and responding to acutely ill patients – reference was made to efforts to embed, locally, national best practice in this area.

RESOLVED –

a)  That the officers be thanked for their attendance and the manner in which they have responded to Members’ queries and comments.

b)  That the Principal Scrutiny Adviser, in consultation with the Chair, prepare and circulate to Board Members a draft Board Submission on the Quality Accounts for submission to both LPHT and LTHT.

To consider the outcome of the consultation exercise (including key messages and any emerging issues), the next steps, associated timescales and anticipated costs of administering any new arrangements.

Further to Minute No. 65, 26^th January 2010, the Board received an update on the progress of the public consultation exercise regarding LTHT’s proposal to achieve Foundation Trust status.

Ross Langford, Head of Communications, LTHT, was in attendance at the meeting and responded to Members’ queries and comments.  In brief summary the main issues discussed were:-

·  Ross Langford outlined some of the agreed changes as a result of the consultation to date.  The more significant ones were an increase in the number of Elected Governors, from 21 to 23, and the Appointed Governors, from 9 to 11, making a revised total of 40 Governors.  It had also been agreed to amend the proposed constituency boundaries from 9 to 10, and these would be aligned with Council Area Committee boundaries.

·  Many of the Scrutiny Board’s subsequent comments and concerns reflected the main concerns identified in the overall public consultation exercise, in particular :-

·  The costs of implementing Foundation Trust status and the resultant bureaucracy;

·  A lack of clarity regarding any perceived direct benefit for patients; and

·  The cost of the consultation exercise and whether it was real or cosmetic.

Members requested comparative figures for the current administration costs of LTHT and the estimated costs of the new arrangements.

·  Concern was also expressed regarding current communication and consultation difficulties between LTHT and its patients and, to an extent, the Scrutiny Board (Health), and whether the new arrangements would actually improve those areas.

·  Whilst Members accepted the principles which lay behind the exercise, and that democracy came at a price, overall they remained to be convinced, and would require further details regarding costs, how the proposals would work in reality, especially the LTHT Board/Board of Governors arrangements/relationships, and the perceived benefits to front-line services.

RESOLVED –

a)  That, subject to the above comments and requests for further information, the progress report be received and noted.

b)  That Ross Langford be thanked for attending the meeting and the manner in which he has responded to Members’ queries and comments, and he be invited to update the Board again at a future meeting.

(NB:  Councillor Yeadon left the meeting at 11.02 am, during the consideration of this item.)

Further to the Board’s previous consideration of this issue, to consider the outcome of the LTHT Board Meeting scheduled to take place on 20^th May 2010 and any subsequent actions of the Board.

Further to minute 85, 16^th March 2010, the Head of Scrutiny and Member Development submitted a report advising the Board that, at its meeting held on 20^th May 2010, the LTHT Board had decided not to proceed with the development of a renal haemodialysis unit at LGI.

In summary, the Scrutiny Board remained extremely concerned and unhappy at the decision, the rejection of its own finding and recommendations, and at what it regarded as wholly inadequate consultation and supporting evidence on the part of LTHT.

The Scrutiny Board considered the options now available to it, in particular taking into account the advice of the Head of Scrutiny and Member Development contained in paragraph 4.3 of his report regarding referrals to the Secretary of State for Health.

RESOLVED – (a) That further to the full Council resolution on 21^st April 2010, the decision of LTHT not to provide a satellite renal dialysis unit at LGI be  formally referred to the Secretary of State for Health, on the basis of the decision not being in the interest of the local health services.

(b) That, as part of the formal referral, the Principal Scrutiny Advisor prepares and circulates a brief statement setting out the Board’s concerns regarding the recent Trust Board decision.

To agree the Board’s final Inquiry Report and recommendations.

The Board considered its proposed final Inquiry Report, together with the comments and advice of Directors and chief Officers regarding the proposals.

RESOLVED – That, subject to the acceptance of the advice from the Director of Adult Social Services in respect of Recommendations 4 and 7, the Board’s proposed final Inquiry report be approved and published.

To agree the Board’s contribution to the composite Annual Scrutiny Report.

RESOLVED – That the Board’s proposed contribution to the composite Annual Scrutiny Report be approved, as updated to reflect decisions taken at today’s meeting.

To receive any apologies for absence.

The Chair thanked Members, present and past, and officers for their contributions to the work of the Board during what had been a challenging year in which the Board had tackled some significant issues in a meaningful way.

In particular, he paid tribute, endorsed by the Board, to the tremendous work performed by Steven Courtney, Principal Scrutiny Adviser, on the Board’s behalf.