Agenda and minutes

The Chair welcomed everyone to the September meeting of the Scrutiny Board (Health).

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 Chair informed the meeting that he had agreed to admit the following document to the agenda as a Late Item of business:-

Scrutiny Board (Health) Report on Promoting Good Public Health: the role of the Council and its Partners (May 2010) – Report of the Director of Adult Social Services and the Director of Public Health, NHS Leeds (Minute 31 refers).

The report in question was not available at the time of the agenda despatch and the timescales for responding to the recommendations were already outside those detailed in the Council’s Constitution. However, in order to help the Board fulfil its role in monitoring responses to its recommendations (and subsequent implementation) and to ensure that its work remained current, it was necessary for the Board to receive and consider this report before the next scheduled meeting in late October 2010.

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.

The following personal declarations were made:-

• Councillor E Taylor in her capacity as a nurse employed by Leeds Community Mental Health (Agenda Item 7) (Minute 30 refers)
• Councillor M Dobson in his capacity as Chair of the Leeds Initiative Healthy Leeds Partnership (Agenda Item 8) (Minute 29 refers)

To receive any apologies for absence and notification of substitutes.

Apologies for absence were submitted by Councillor A Hussain and Co-opted Member, Mr A Giles.  Notification had been received for Councillor G Hyde to substitute for Councillor Hussain.

To confirm as a correct record the minutes of the meeting held on 27^th July 2010.

RESOLVED – That the minutes of the meeting held on 27^th July 2010 be confirmed as a correct record.

a)  Joint Performance Report Year End 2009/10 (Minute 17 refers)

Councillor P Harrand made reference to the e mail circulated from Graham Brown, NHS Leeds dated 3^rd August 2010 clarifying the information in relation to mortality data. He raised his concerns that the statistics were not clear and following a brief discussion it was agreed to discuss this item further under Item 7 on the agenda relating to the Joint Performance Report – Quarter 1 2010/11.

Councillor J Illingworth raised the issue around the Board’s concerns with regard to the potential full consideration of the Leeds Girls High School planning application and enquired if a reply had been received from the Chair of Plans Panel (West).

The Board’s Principal Scrutiny Adviser responded and confirmed that a letter had been sent by Council S Armitage (as acting Chair) to Councillor N Taggart on this issue, but to date, and to the best of his knowledge, no reply had been received.

Following a brief discussion, the Board’s Principal Scrutiny Adviser agreed to follow up this issue with the Chief Planning Officer as a matter of urgency and to raise the public health and equality issues with a report back on progress at the next meeting in October 2010.

(Councillor J Matthews indicated that he was a Member of the Plans Panel (West) and could possibly be considering matters arising from the Leeds Girls High School item at a later date in that capacity.  He stated that he would remain in the meeting to listen to and take part in the discussion of this issue.  In order to avoid any perception of pre-determination, Councillor Matthews agreed that he would not be bound by any discussion taken at the meeting when issues from this matter came before Plans Panel (West) for determination, but would consider all representations and viewpoints presented at the planning meeting before reaching a conclusion based on the merits of the case).

To consider a report of the Head of Scrutiny Support and Member Development on Liberating the NHS White Paper and supporting consultations.

The Head of Scrutiny Support and Member Development submitted a report on the content of the Equity and Excellence: Liberating the NHS White Paper document and supporting consultations, together with the local implications. The Board was asked to determine the content of any consultation response and consider how to maintain an overview of progress and any subsequent implementation.

Appended to the report were copies of the following documents for the information/comment of the meeting:

·  Equity and Excellence: Liberating the NHS – White Paper -Executive summary (Appendix 1 refers);

·  Transparency in outcomes – a framework for the NHS - Executive summary (Appendix 2 refers);

·  Local democratic legitimacy in health - Full consultation document (Appendix 3 refers);

·  Commissioning for patients - Executive summary (Appendix 4 refers);

·  Regulating healthcare providers - Executive summary (Appendix 5 refers)

The following officers from NHS Leeds and Leeds City Council were in attendance to present the key issues highlighted in the report and to address any specific questions identified by the Scrutiny Board:

·  John England (Deputy Director) – Leeds City Council, Adult Social Services

·  Dr Simon Stockhill (Chair, Clinical Commissioning Executive) – NHS Leeds

The Board noted that apologies had been received from Christine Farrar (Policy Director – Health Improvement and Partnerships) – Leeds Initiative and Dr Bryan Power (GP consortia representative) – NHS Leeds.

At the request of the Chair, and from a local authority perspective, the Deputy Director, Adult Social Services outlined some of the key areas and likely  implications highlighted in the White Paper.  This included input from the Chair of the Clinical Commissioning Executive (NHS Leeds) around current GP consortia arrangements and likely implications of the current proposals.

Detailed discussion ensued, with the following issues being raised:

• Proposals to transfer to local councils the power/ responsibility to improve the health of the local population.
• Proposals to establish a national Public Health Service.
• Joint appointment of the Director of Public Health and potential transfer of current NHS services and staff to the Council.

(The Board noted that specific details in this area was likely to be available in a further White Paper around Public Health, expected in December 2010)

• Aspects of the Democratic Legitimacy consultation paper, including:

1.  A patient centred approach is strengthened by the proposals, with a shift away from a top-down approach to local determination;

2.  Establishment of the Health & Well Being Board, including proposed membership and transfer of Health Scrutiny statutory powers;

3.  Detailed supplementary guidance is not expected.

• 150,000 patients / 33 practices not part of any current GP consortia arrangements – with a large gap in the south of the City.
• Impact on commissioning arrangements including:

1.  Consistency across different areas of the City;

2.  Cross-border matters;

3.  Specialised services;

4.  Local authority commissioning.

• The importance of ensuring the delivery of high quality services during any transitional arrangements.
• Ensuring future models of delivery address the needs of Leeds residents / patients, recognising that such models may differ from other large cities and areas across England.
• The importance  ...  view the full minutes text for item 29.

To consider a joint report of Leeds City Council and the NHS Leeds  presenting performance information which summarised the progress against the joint council and NHS Leeds priorities as set out in the Leeds Strategic Plan, as well as key NHS Leeds priorities for first quarter of 2010/11.

Referring to Minute 17 of the meeting held on 27^th July 2010, a joint report of Leeds City Council and the NHS Leeds presenting performance information which summarised the progress against the joint council and NHS Leeds priorities as set out in the Leeds Strategic Plan, as well as key NHS Leeds priorities for first quarter of 2010/11.

Appended to the report were copies of the following documents for the information/comment of the meeting:

·  Action trackers for the high risk performance area from the Leeds Strategic Plan which were relevant to the Health Scrutiny Board.  This tracker included a contextual update as well as key performance indicator results (Appendix 1 refers);

·  Performance indicator report showing the Q1 result and predicted year end traffic lights for all key performance indicators aligned to the LSP which were relevant to the Health  Scrutiny Board as well as indicators relating to the key priorities for NHS Leeds (Appendix 2 refers);

·  An update on the outstanding PIs from the Q4 2009/10 which were not available at the time of the Q4 report or were not confirmed as validated results (Appendix 3 refers)

The following officers from NHS Leeds and Leeds City Council were in attendance to present the key issues highlighted in the report and to address any specific questions identified by the Scrutiny Board:

• Graham Brown (Performance Manager) – NHS Leeds
• Paul Bollom (Priority Commissioner) – Leeds City Council, Children’s Services
• Brenda Fullard (Head of Healthy Living and Health Inequalities) NHS Leeds

There was a full discussion around an overview of performance against key local health priorities relevant to the remit of the Scrutiny Board (Health) with specific reference to the consideration of performance in the areas of:

·  Teenage conception: and,

·  Premature mortality in deprived areas

To assist the Board with their deliberations, a copy of an e-mail from Graham Brown, NHS Leeds dated 3^rd August 2010 on mortality data was circulated for information/comment.

In summary, the main issues highlighted were as follows:

• The availability of general performance/ statistical data in terms of teenage conception and births in Leeds.
• Clarification of the difference between provisional/original data of births in Leeds.
• The importance of protecting and supporting young girls around teenage pregnancy.
• Clarification of the statutory rights of private providers in disclosing termination figures.
• The need to improve reporting arrangements to include more up to date performance information, including ‘proxy’ measures, to assist the Board in future deliberations.

(The Performance Manager responded and agreed to the Board’s request in this regard).

• Clarification of the procedure for standardising Mortality rates within local wards.
• The importance of communication between agencies around births/terminations and the need to consult with GP’s more effectively.
• Clarification of the 2008 Calendar Year and 2008-2009 Fiscal Year figures concerning the rates of teenage births against conceptions.

RESOLVED-

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

b)  That the Performance Manager (NHS) and the Deputy Director, Leeds City Council, Adult Social Services be requested to  ...  view the full minutes text for item 30.

A report of the Director of Adult Social Services and the Director of Public Health, NHS Leeds was submitted providing the Board with details of the recommendations from the recent Scrutiny Board (Health) inquiry into the role of the Council and its partners in promoting good public health and details how the Directors propose to respond to these.  The Board was asked to note and comment on the actions proposed.

Arising from discussions, the Board noted and welcomed that all ten of the recommendations had been agreed by both the Director of Public Health and the Director of Adult Social Care, incorporating input from other Directorates across the Council.

The Board’s Principal Scrutiny Adviser informed the meeting that the recommendations would be included with in the Board’s monitoring report which would give the Board a further opportunity to consider progress /  implementation of the recommendations at future meetings.

RESOLVED-

a)  That the contents of the report be noted.

b)  That this Board notes the actions underway to implement the recommendations from the Promoting Good Public Heath inquiry report, in accordance with the report submitted.

To consider a report of the Director of Leeds Initiative on progress with regards to the development and next steps in relation to the Vision for Leeds 2010 to 2030.

(This item was deferred until the next meeting on 26^th October 2010)

To receive and consider a report from the Head of Scrutiny and Member Development outlining the Scrutiny Board’s work programme for the remainder of the current municipal year.

The Head of Scrutiny and Member Development submitted a report outlining the Scrutiny Board’s updated work programme for the remainder of the current municipal year.

Appended to the report were copies of the following documents for the information/comment of the meeting:

• Scrutiny Board (Health) – Outline Work Programme 2010/11 – September 2010 (Appendix 1 refers)
• Safe and Sustainable – Children’s Heart Surgery: A Briefing (Appendix 2 refers)
• Executive Board minutes of the meeting held on 25^th August 2010 (Appendix 3 refers)
• Leeds LINk Work Plan 2010/11 (Appendix 4 refers)

The Board’s Principal Scrutiny Adviser presented the key issues highlighted in the report and addressed specific points of clarification identified by the Scrutiny Board, including a brief summary of the outcome and proposed recommendations arising from the Health Service Developments Working Group held on 14^th September 2010. The service changes and proposed levels of engagement were summarised as follows:

• Community Ophthalmology – level 3 (significant change)
• Community ENT Services – level 2 (minor change)
• Community Dental Services – level 3 (significant change)
• Community Dermatology Services – level 3 (significant change)
• Community Urology Services – level 3 (significant change)
• Stroke Care Services – level 2 (minor change)
• Reconfiguration of Community Intermediate Care – level 3 (significant change)
• Voluntary, Community and Faith Sector Review – level 3 (significant change)
• Community Neurology Services – level 3 (significant change)

It was further noted that the Board’s Principal Scrutiny Adviser would circulate a copy of the minutes of the meeting to Board Members for comment in due course.

The Chair made specific reference to the national review of Children’s Cardiac Surgery Services currently being undertaken and informed the meeting that he had written a letter, on behalf of the Board, on 20^th September 2010 to all Members of Parliament for Yorkshire and the Humber.  The letter sought to raise MP’s awareness of the review and the need to retain the current regional facilities provided in Leeds, and possibly an even a more enhanced role in any new model of delivery.

RESOLVED -

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

b)  That this Board notes the information presented at the meeting from 

  the Health Service Developments Working Group and agrees 

  the proposed level of engagement activity in relation to the identified

  service areas.

c)  That this Board notes the updated information presented in terms of the 

  Children’s Cardiac Surgery Services review and to the suggestion

  that the Board maintains a watching brief on this issue .

d)  That approval be given to the outline work programme in accordance

  with the report now submitted.

To note that the next meeting of the Scrutiny Board will be held on Tuesday 26^th October 2010 at 10.00am (Pre meeting for Board Members at 9.30am)

Tuesday 26^th October 2010 at 10.00am (Pre meeting for Board Members at 9.30am)

(The meeting concluded at 11.55am)