Agenda and minutes

Venue: Civic Hall, Leeds, LS1 1UR. View directions

Contact: Steven Courtney (0113) 24 74707  Email: steven.courtney@leeds.gov.uk

Items
No. Item

1.

Late Items

To identify items which have been admitted to the agenda by the Chair for consideration.

 

(The special circumstances shall be specified in the minutes.)

Minutes:

In accordance with his powers under Section 100B(4)(b) of the Local Government Act 1972, the Chair agreed to accept the following late information:

 

-  Minutes from the meetings held on 3 December 2012 and 10 April 2013 (Minute 4 refers)

-  Notes of the meeting between NHS England, the Local Government Association (LGA) and the Centre for Public Scrutiny (CfPS) – 27 August 2013 (Minute 6 refers).

-  Copy of the letter from Sir Bruce Keogh to Dr Tony Salmon – 30 August 2013 (Minute 6 refers).

-  Copy of the letter from Sir Bruce Keogh to Professor John Deanfield -– 30 August 2013 (Minute 6 refers). 

-  Copy of letter from Children’s Heart Surgery Fund to Bill McCarthy –12 September 2013 (Minute 6 refers).

 

The above documents were not available at the time of agenda despatch, but were subsequently made available on the Council’s website.

 

The Chair outlined that, following the committee’s previous meeting in April 2013, there had been three separate requests for copies of Sir Bruce Keogh’s e-mail correspondence at and around the time of the temporary suspension of children’s cardiac surgery services in Leeds. The intention had been to present and share such information with members of the joint committee; however non-redacted copies of the information requested had not been provided.

 

The Chair expressed his deep concern in this regard and stated his intention to continue to pursue this matter on behalf of the joint committee. 

 

2.

Declaration of Disclosable Pecuniary Interests

To disclose or draw attention to any disclosable pecuniary interests for the purposes of Section 31 of the Localism Act 2011 and paragraphs 13-18 of the Members’ Code of Conduct.

Minutes:

There were no declarations of disclosable pecuniary interests.

 

3.

Apologies for Absence and Notification of Substitutes

To receive any apologies for absence and notification of substitutes.

Minutes:

Apologies for absence were submitted on behalf of Councillors J Bromby,

D Brown, A McAllister and J Worton.

 

Councillor R Goldthorpe was in attendance as a substitute member for Councillor A McAllister.

 

4.

Minutes - 3 December 2012 and 10 April 2013

To confirm as a correct record, the minutes of the meetings held 3 December 2012 and 10 April 2013.

 

(Copies to follow)

Minutes:

RESOLVED – That the minutes of the meetings held on 3 December 2012 and 10 April 2013 be approved as correct records. 

 

5.

Safe and Sustainable Proposals for Children's Congenital Cardiac Services in England: Advice from the Independent Reconfiguration Panel (IRP) pdf icon PDF 66 KB

To receive and consider a report from the Head of Scrutiny and Member Development presenting the advice of the Independent Reconfiguration Panel (IRP) reported to the Secretary of State for Health on 30 April 2013. 

Additional documents:

Minutes:

The Head of Scrutiny and Member Development submitted a report that presented the advice from the Independent Reconfiguration Panel (IRP), following its review of the Safe and Sustainable Proposals for Children’s Congenital Cardiac Services in England.

 

It was outlined that the report had been submitted to the Secretary of State for Health on 30 April 2013 and subsequently made publicly available following the Secretary of State’s announcement on 12 June 2013.

 

It was reported that representatives from the IRP had been invited to attend the meeting to outline the report in more detail and address any questions from members of the joint committee.

 

It was reported that while it was customary to invite report authors to present reports to the joint committee, the IRP had advised such attendance would not fit comfortably with its terms of reference, set by the Secretary of State for Health. The submission of the IRP’s advice (on 30 April 2013) had effectively ended the IRP’s involvement in the matter and, as such, the invitation to attend had been declined. 

 

The Principal Scrutiny Adviser briefly introduced the report and subsequently invited member’s comments.

 

Members of the joint committee welcomed the IRP’s report and recommendations, noting the significant reference to the work of the joint committee and specific points raised in the reports published in October 2011 and November 2012.  The comments included the following points:

 

·  The Health Impact Assessment encapsulated the issues raised by the joint committee;

·  The statement regarding ‘flawed analysis’ was particularly welcomed;

·  The IRP’s report was refreshingly helpful;

·  Openness and transparency needed to be key characteristics of the new review – something that had been lacking;

·  Concern regarding the recruitment practices in establishing the various advisory bodies associated with the Safe and Sustainable Review and potential issues of bias;

·  It was important that the new review was subject to the same level of in-depth scrutiny.

 

While recognising the significant reference to the work of the joint committee within the IRP report, which reflected well on the efforts of members, the Chair expressed his regret that the referral to the Secretary of State for Health and the subsequent IRP report and recommendations, had become necessary parts of the former Safe and Sustainable review process. 

 

RESOLVED – To note the Independent Review Panel’s report and welcome the outcome of its review of the Safe and Sustainable process and proposals. 

 

6.

The new review of congenital heart services in England pdf icon PDF 59 KB

To receive and consider a report from the Head of Scrutiny and Member Development presenting details associated with the new review of congenital heart services in England.

Additional documents:

Minutes:

The Head of Scrutiny and Member Development submitted a report that sought to introduce and present a range of details associated with the new review of congenital heart services in England. 

 

The Principal Scrutiny Adviser introduced the report that confirmed NHS England as the responsible body for undertaking a national review of congenital heart services for both children and adults.  It was reported that the new review would consider the whole lifetime pathway of care for people with congenital heart disease (CHD) and aim to:

 

·  Achieve the best outcomes for all patients, not just lowest mortality but reduced disability and an improved opportunity for survivors to lead better lives.

·  Tackle variation so that services across the country consistently meet demanding performance standards and are able to offer resilient 24/7 care.

·  Achieve great patient experience, which includes how information is provided to patients and their families, considerations of access and support for families when they have to be away from home.

 

It reported that NHS England Board had established a committee (or sub-group) to provide formal governance for the new review work going forward.  The membership of that committee was reported as follows:

 

·  Sir Malcolm Grant (NHS England’s Board Chairman) – Chair

·  Margaret Casely-Hayford (Non-Executive Director)

·  Ed Smith (Non-Executive Director)

·  Sir Bruce Keogh (Medical Director)

·  Bill McCarthy (National Director for Policy)

 

A range of further information relevant to the new review was appended to the report, as follows:

 

·  A copy of the report setting out broad proposals for undertaking the new review, which was considered by the NHS England Board at its meeting on 18 July 2013.

·  Details provided by NHS England to the Secretary of State for Health, via a letter from the Chair of NHS England (dated 31 July 2013).

·  Notes from the first meeting of the Congenital Heart Disease (CHD) sub-group, held on 29 July 2013.

·  Notes from a series of different stakeholder meetings, as follows:

-  National charities and patient groups – 16 July 2013;

-  National clinical organisations – 16 July 2013;

-  Clinicians from surgical centres – 22 July 2013; and,

-  Local charities and patient groups – 7 August 2013.

 

Having been submitted earlier in the meeting (minute 1 refers) the following supplementary information was also considered:

 

-  Notes of the meeting between NHS England, the Local Government Association (LGA) and the Centre for Public Scrutiny (CfPS) – 27 August 2013.

-  Copy of the letter from Sir Bruce Keogh to Dr Tony Salmon – 30 August 2013.

-  Copy of the letter from Sir Bruce Keogh to Professor John Deanfield – 30 August 2013. 

-  Copy of letter from Children’s Heart Surgery Fund to Bill McCarthy –12 September 2013.

 

The following representatives were in attendance to address the joint committee and respond to appropriate questions:

 

-  John Holden, Systems Director (NHS England);

-  Sharon Cheng, Director (Children’s Heart Surgery Fund (CHSF)); and,

-  Lois Brown, Parent and member of Children’s Heart Surgery Fund.

 

In providing an introduction to the joint committee  ...  view the full minutes text for item 6.

7.

Children's Congenital Cardiac Surgery: Service provision at Leeds Teaching Hospitals NHS Trust pdf icon PDF 60 KB

To receive and consider a report from the Head of Scrutiny and Member Development providing an update on;

 

a)  The current provision of children’s heart surgery at Leeds Teaching Hospitals NHS Trust (LTHT); and,

b)  Progress of the subsequent phases of the review of quality of children’s heart surgery services at LTHT.

Additional documents:

Minutes:

The Head of Scrutiny and Member Development to provide an update on the current provision of children’s heart surgery at Leeds Teaching Hospitals NHS

Trust (LTHT) and the progress of the subsequent phases of the review of quality of children’s heart surgery services at LTHT.

 

The report reminded members of the matters relating to the temporary suspension of children’s heart surgery at Leeds Teaching Hospitals NHS Trust in late March 2013, as discussed at the joint committee’s previous meeting in April 2013.  Appended to the report, for completeness, were copies of the following reports (referred to at the meeting in April 2013):

 

-  Report of the External Review of Children’s Congenital Cardiac Surgery Service at Leeds Teaching Hospitals NHS Trust

-  Report from NICOR National Institute for Cardiovascular Outcomes Research (NICOR) following its investigation of mortality from Paediatric Cardiac Surgery in England 2009-12.

 

The following representative was in attendance to address the joint committee and respond to appropriate questions:

 

-  Andy Buck, Director – West Yorkshire Area Team (NHS England)

 

It was confirmed that since the temporary suspension and subsequent recommencement of children’s heart surgery at LTHT in March/ April 2013, a number of other activities had been taken forward.  These were summarised as follows:

 

·  Clinically led mortality review (April 2009 – 2013)

-  Covering all child deaths at LTHT within 30 days after undergoing heart surgery. 

-  The review had been completed and a draft report was being considered by NHS England and LTHT.

-  Whilst the report was still in draft form, that the review had found no major safety issues.

-  The review, in line with the vast majority of clinical audits in the NHS, some areas for improvement – which were likely to benefit other units performing children’s heart surgery.

 

·  Independent review of concerns/ complaints raised by parents and families

-  Review commissioned by NHS England – to be undertaken by Professor Pat Cantrill.

-  Professor Cantrill will meet with parents and families to listen to concerns and will subsequently draft a report for consideration by NHS England and LTHT.

-  Any necessary / additional actions will then be agreed.

 

·  Confirmation of any other outstanding issues requiring attention

 

It was reported that LTHT was taking proactive steps to ensure the provision of a safe, robust and high quality service.

 

The key points of the joint committee’s discussion included the following points:

 

·  Welcomed the report of no major safety issues at LTHT in its provision of children’s heart surgery.

·  Looked forward to the formal conclusion and reporting of NHS England’s investigation and associated learning points.

·  Some concern regarding timescales associated with NHS England’s investigations – which commenced in late March 2013,  with no target date for completion. 

·  Recent personnel changes at LTHT, including the appointment of a new Chief Executive, Medical Director, Nurse Director and additional surgeons.

·  Public perception around the movement / changes in personnel at LTHT and any relationship to the Trust’s stance/ position in relation to the Safe and Sustainable review.

 

RESOLVED  ...  view the full minutes text for item 7.

8.

Future of the Joint Health Overview and Scrutiny Committee (Yorkshire and the Humber) pdf icon PDF 61 KB

To receive and consider a report from the Head of Scrutiny and Member Development to consider the future role of the Joint Health Overview and Scrutiny Committee (Yorkshire and the Humber), as currently constituted.

Minutes:

The Head of Scrutiny and Member Development submitted a report that considered the future role of the Joint Health Overview and Scrutiny Committee (Yorkshire and the Humber), as currently constituted.

 

The Principal Scrutiny Adviser reminded Members that – in the absence of any standing Joint Health Overview and Scrutiny Committee (HOSC) arrangements in Yorkshire and the Humber – in March 2011, the Joint HOSC was established with a very clear and defined remit – i.e. to consider and respond to proposals arising from the Safe and Sustainable review of Children’s Congenital Cardiac Services in England. 

 

It had been reported and considered elsewhere on the agenda (minute 5 refers) that, on 12 June 2013, the announcement from the Secretary of State for Health had called a halt to the previous Safe and Sustainable review of Children’s Congenital Cardiac Services in England.  As such, it was noted that there was no legitimate scope for the Joint HOSC to continue in its current form

 

Furthermore, while details associated with the new review of congenital heart services in England had been presented and considered elsewhere on the agenda (minute 6 refers), it was also noted that currently there were no explicit NHS proposals to consider and/or pass comment on. 

 

It was noted that further legal advice had been sought and clarified that, while the terms of reference for the Joint HOSC would need to be revised to reflect the changed approach to reviewing services and, potentially, making future proposals – which may need approval from the constituent local authorities –  it would not be necessary to formally dissolve the committee.

 

Members discussed the report and information presented, making a number of comments, including:

 

·  The strength of joint scrutiny arrangements across Yorkshire and the Humber, vis-à-vis the Safe and Sustainable review and proposals, was clearly evident in the Secretary of State’s announcement in June 2013.

·  That the new review of congenital heart services in England would benefit from similar robust scrutiny arrangements as those in place for the Safe and Sustainable review.

·  General support for the current joint scrutiny arrangements (with revised/ appropriate terms of reference) continuing for the new review of congenital heart services in England.

·  Concern regarding the likely timescales for the new review and the processes necessary for agreeing revised terms of reference across fifteen constituent local authorities.

·  The need for a fair acceptance from those undertaking the new review (i.e. NHS England) that establishing joint health scrutiny arrangements could be a complex and time-consuming process that needed to be taken into account.

·  Recognising the need for broader political discussions, support, in principle, for establishing standing joint health scrutiny arrangements across Yorkshire and the Humber.

 

Summing up, the Chair reflected on the broad support for the work of the Joint HOSC to continue – insofar as it relates to the new review of congenital heart services in England, with appropriately revised terms of reference – alongside the need to facilitate broader political discussions associated with the potential establishment of any standing joint  ...  view the full minutes text for item 8.