Agenda and minutes

The Chair welcomed everyone to the November meeting of the Scrutiny Board (Health). In particular, he also welcomed Councillor G Latty who had replaced Councillor M Lobley on the Board.

The Chair agreed to accept the following documents as supplementary information (Agenda Item 7)(Minute 52 refers):

• Letter from UNISON
• NHS Leeds briefing note on Transforming Community Services
• List of NHS Leeds Community Healthcare services

The documents were not available at the time of the agenda despatch, but were made available on the Council’s Internet site following the Board meeting.

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 J Illingworth declared a personal interest in his capacity as having a small involvement in relation to the teaching budget (Agenda Item 8) (Minute 53 refers).

To receive any apologies for absence and notification of substitutes.

An apology for absence was submitted on behalf of Councillor E Taylor.

To confirm as a correct record the minutes of the meeting held on 26^th October 2010.

RESOLVED – That the minutes of the meeting held on 26^th October 2010 be confirmed as a correct record.

a)  Provision of Dermatology Services - Update (Minute 40 refers)

Councillor G Kirkland referred to a recent Board Members visit to the new in-patient Dermatology Ward at Chapel Allerton Hospital.. He briefly outlined the following matters with regards to the new ward:

·  subject to the alterations outlined during the visit, the ward appeared adequate for delivering in-patient dermatology services

·  access difficulties from patients living in North West Outer Leeds and limited car parking provision on site, which are likely to be exacerbated with the transfer of out-patient facilities and increased number of appointments

·  some noise nuisance caused by the MR machine

·  access to other specialisms for in-patient dermatology patients

Following a brief discussion, the Chair, on behalf of the Board, agreed to write to the Leeds Teaching Hospital NHS Trust (LTHT) raising the above issues and to seek reassurances around the continued engagement and involvement  of the Leeds Dermatology prior to the Board re-visiting this issue in January 2011.

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 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 (Appendix 1 refers)
• Review of Children’s Heart Surgery Services in England: an update (Appendix 2 refers)
• Executive Board Minutes of a meeting held 3^rd November 2010 (Appendix 3 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.

At the request of the Chair, Councillor J Illingworth raised a number of issues and concerns around  the importance of health issues for planning policy and development control. Making specific reference to the recent Leeds Girl’s High School planning application, suggesting that the outcome from the planning application/ appeal process could become a test case that significantly influences how  the Council improves health outcomes in the most disadvantaged areas of Leeds.

The Board’s Principal Scrutiny Adviser responded and stated that, whilst there was a legitimate role for Scrutiny to examine how the City Council measures the impact of its policies and actions on health, current legislation dictated that Scrutiny Boards cannot scrutinise individual decisions of Plans Panels.

He made reference to the Scrutiny Board’s inquiry published in May 2010, which examined the role of the Council and it’s partners in promoting good public health. In that report, specific reference was made to the Council’s planning policy/ framework and its impact on health, resulting in specific recommendations in this area being put forward. At the December Board meeting, Members would be monitoring progress around the implementation of all the recommendations detailed in the report and clearly, this would provide the opportunity for Board Members to examine progress in this area in more detail.  

Following a brief discussion, the Board agreed to discuss this issue further under the ‘Recommendation Tracking’ item at the next meeting to be held on 21st December 2010.

RESOLVED-

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

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

  with the report now submitted.

c)  That the Board’s work programme be updated as follows:

·  Children’s Cardiac Surgery Services – National Review (December 2010)

·  Health and Wellbeing Plan (January 2011)

d)  That in relation to the referral of the issue regarding Health Service Direct Discharge into Residential Care by the Scrutiny Board (Adult Social Care) at their meeting held on 10^th November 2010, the Board’s Principal Scrutiny Adviser be requested to incorporate this issue within the Board’s quarterly performance report.

To consider a report of the Head of Scrutiny and Member Development updating the meeting regarding developments towards delivering a future organisational structure for Leeds Community Health Care.

The Head of Scrutiny and Member Development submitted a report updating the meeting regarding developments towards delivering a future organisational structure for Leeds Community Health Care.

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

• UNISON Leeds Community Health deputation to Council – September 2010
• Deputation to Council – UNISON Leeds Community Health regarding NHS Leeds and Social Enterprise – Report of the Director of Adult Social Services – Executive Board – 3^rd November 2010
• Leeds Community Health Services: Foundation Trust Status - Letter addressed to Linda Pollard, Chair, NHS Leeds dated 22^nd October 2010

In addition to the above documents, further supplementary information was circulated to assist the Board in their deliberations (Minute 46 refers).

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

• Matt Ward (Associate Director of Commissioning) – NHS Leeds
• Neil Ferguson (Provider Development Manager) – NHS Yorkshire & 

  the Humber

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

  Services

• Angela Gabriel, UNISON

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

• Confirmation about the need to move forward, with confidence, on a process within an agreed timescale
• Clarification from a patients perspective in relation to the proposals for a Social Enterprise compared to a Foundation Trust
• Confirmation of the process involved in achieving a preferred NHS Trust model prior to becoming a Foundation Trust
• Clarification sought about the wider strategic options and service delivery
• Confirmation that patients would not be inconvenienced during the transition arrangements
• Clarification sought about how Patient and Public involvement would fit into a Foundation Trust, together with the specific role of carers/patients
• Clarification sought about the representation/configuration of the NHS Leeds Board and how equal status would be achieved
• Clarification about the appointment process for Executive/Non-Executive functions and how the Council could contribute to this process

(In response to this specific issue, the Associate Director of Commissioning, NHS Leeds responded and agreed to supply the Board with more detail on the options/processes via the Board’s Principal Scrutiny Adviser)

RESOLVED-

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

b)  That the Board notes the updated position and details of progress towards delivering a future organisational structure for Leeds Community Healthcare Services and;

c)  That the Board’s Principal Scrutiny Adviser be requested to draft a letter, on behalf of the Chair, to Linda Pollard, Chair, NHS Leeds,  conveying the Board’s support to the recent position outlined by the Leader of Leeds City Council in Leeds Community Health Services move towards achieving Community Foundation Trust status.

To consider a report of the Head of Scrutiny and Member Development  on the introduction of a range of inputs to help provide the Board with an overview of local development and progress against the proposals set out in the White Paper ‘Equity and excellence: Liberating the NHS’ which sets out key proposals for change and reform.

Referring to Minute 29 of the meeting held on 21^st September 2010, the Head of Scrutiny and Member Development submitted a report on the introduction of a range of inputs to help provide the Board with an overview of local development and progress against the proposals set out in the White Paper ‘Equity and excellence: Liberating the NHS’ which sets out key proposals for change and reform.

The following representatives 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:

• Philomena Corrigan (Executive Director of Strategy and

  Commissioning) – NHS Leeds

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

  Services

In brief summary, the main points highlighted and discussed were:

• The commissioning process; including, for example, how something similar to the Vascular Service Review would be implemented and the National Commissioning Board’s role in the budget setting process
• Complexities around Leeds Teaching Hospital NHS Trust’s funding streams, which may lead to multiple commissioning arrangements/ agreements
• GP consortia; how they would be monitored in terms of patient care and details of the number of unaligned GP practices
• Issues around ensuring equity within and between GP consortia across the City
• GPs likely to become more accountable in terms of commissioning decisions
• Acknowledgment that the White Paper proposals were likely to have a significant impact within the Council and clarification of how this impact was being communicated to officers and Councillors
• Confirmation that Elected Members would be involved within the pre/post changes
• Confirmation that the Health and Well Being Board would have a pivotal role and would need to have robust conversations with the new consortia
• The future role and importance of the City’s Joint Strategic Needs Assessment, particularly in view of the Council’s future role in health promotion
• The role of ‘Health Watch’ and how carers/people would be engaged within the future arrangements
• Clarification sought around the composition of the Officer Group assigned to address the White Paper proposals; who received papers for meetings and the need for Elected Member representation at this level (The Deputy Director, Adult Social Services responded and agreed to provide a detailed note on this issue for circulation to Board Members via the Principal Scrutiny Adviser)

RESOLVED-

a)  That the contents of the report, including the update on local developments aimed at addressing the vision for the NHS, as detailed in the proposals set out in the recent White Paper, be received and noted and;

b)  That this Board notes that a further report on the overall update on the proposed NHS reforms, alongside the governments response to the issues raised as part of the consultation process, would be submitted to the Board meeting on 25^th January 2011.

To consider a report of the Head of Scrutiny and Member Development presenting the Board with details of the proposed changes to Vascular Services across the Yorkshire and Humber Region, with particular reference to the likely implications for service users in Leeds.

The Head of Scrutiny and Member Development submitted a report presenting the Board with details of the proposed changes to Vascular Services across the Yorkshire and Humber Region, with particular reference to the likely implications for service users in Leeds.

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

• Yorkshire and Humber Vascular Services Review – Formal Public Consultation – Letter from the Assistant Director of Commissioning – NHS Yorkshire and the Humber Specialised Commissioning Group dated 26^th October 2010
• Consultation on proposals to improve vascular services in Yorkshire and the Humber

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

• Philomena Corrigan (Executive Director of Strategy and 

  Commissioning) – NHS Leeds

• Pia Clinton-Tarestad (Assistant Director of Commissioning –

   Specialised Services) – Yorkshire and Humber Specialised 

  Commissioning Group

The Assistant Director of Commissioning – Specialised Services outlined the proposed services changes to Vascular Services and the potential impact on patients in Leeds. In brief summary, the main points highlighted and discussed were:

• Similar review of Vascular Services being undertaken in other regions
• The proposed service changes were supported clinically across the region
• Leeds Teaching Hospitals NHS Trust currently met the desired service standards in terms of access, medical cover and patient outcomes:  As such the proposals were low risk for Leeds.
• Capacity issues were perceived as minimal – up to 700 additional admissions for LTHT with steady patient numbers predicted for future years
• The review was expected to be cost neutral with no loss of services or likely disruption to the workforce arising from the proposed changes: However, there was an anticipated change in emphasis in terms of medical staff, due to less invasive surgical procedures
• Clarification about the Private Sector provision for vascular services and the number of procedures carried out in percentage terms
• Confirmation that Leeds LINk would be involved in the consultation process

RESOLVED-

a)  That this Board notes the details of proposed changes to Vascular Services across the Yorkshire and Humber region, with particular reference to the likely implications for service users in Leeds and;

b)  That, in consultation with the Chair, the Board’s Principal Scrutiny Adviser be requested to draft a response, on behalf of the Board, conveying the Board’s support to the proposals to improve vascular services in Yorkshire and the Humber.

(Councillor A Hussain left the meeting at 12.15pm during discussion of the above item)

To note that the next meeting of the Scrutiny Board will be held on Tuesday 21^st December 2010 at 10.00am in the Civic Hall, Leeds (Pre meeting for Board Members at 9.30am)

Thursday 21^st December 2010 at 2.00pm (Pre-meeting for Board Members at 1.30 pm).

(The meeting concluded at 12.25 pm)