Agenda and minutes

The Chair opened the meeting and welcomed everyone in attendance.

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 agreed to accept the following late and supplementary information for consideration at the meeting:

·  Better Care Fund – Developing Proposals in Leeds: Outline of draft proposals (minute 85 refers)

·  Work Schedule: Revised draft Work Schedule (minute 87 refers)

The above documents were not available at the time of the agenda despatch, but had been made available to the public on the Council’s website in advance of the meeting. Copies of the papers were also made available at the meeting.

To disclose or draw attention to any disclosable pecuniary interests for the purposes of Section 31 of the Localism Act 2011 and paragraphs 13-16 of the Members’ Code of Conduct.

There were no disclosable pecuniary interests declared to the meeting.

To receive any apologies for absence and notification of substitutes.

The following apologies for absence had been received and were reported to the Scrutiny Board. 

·  Apologies from Councillor Christine Towler with Councillor Neil Walshaw attending as a substitute.

It was also noted that Councillor James Lewis had been delayed due to a prior engagement, but would join the meeting as soon as possible.

To confirm as a correct record, the minutes of the meeting held on 18 December 2013.

In considering the minutes from the previous meeting, the following points were raised:

Progress report on Adult Social Care Better Lives Programme (minute 75 refers)

·  It was confirmed that a report on a proposed staff-led mutual for the provision of Learning Disability Community Support service was scheduled to be presented to the Executive Board at its meeting on 14 February 2014.  The Scrutiny Board may wish to consider any proposals presented for consultation in more detail.

RESOLVED –

(a)  That the minutes of the meeting held on 18 December 2013 be approved as a correct record.

(b)  That, following the outcome of the Executive Board meeting in February 2014, further consideration be given to any proposals for a staff-led mutual for the provision of Learning Disability Community Support service. 

To consider a report from the Head of Scrutiny and Member Development presenting a briefing note to the Scrutiny Board in relation to the provision of General Practice (GP) and Walk-in Services at Shakespeare Medical Practice.

The Head of Scrutiny and Member Development submitted a report that introduced a briefing note from Leeds North Clinical Commissioning Group relating to the provision of GP and Walk-in services at Shakespeare Medical Practice and the decision of Care UK not to enter into an extended agreement for the continuing provision of services. 

The following representatives were in attendance to help the Scrutiny Board consider the information presented:

·  Nigel Grey (Chief Officer – Leeds North Clinical Commissioning Group)

·  Kathryn Hilliam (Head of Primary Care – NHS England (West Yorkshire Area Team)

In addressing the Scrutiny Board, the following points were made (in addition to the briefing note provided):

·  A longer notice period setting out Care UK’s position would have been preferable, however the notice provided was in line with the contractual conditions.

·  To ensure the continuity of services, a restricted competitive process was proceeding that included the submission of ‘expressions of interest’ from prospective service providers.

·  A new provider would be in place by 2 March 2014.

·  NHS England (West Yorkshire Area Team) and Leeds North CCG were working collaboratively, which had included producing an updated service specification and an opportunity to consider associated performance indicators.

The Scrutiny Board discussed the report and the details highlighted at the meeting.  A number of matters were raised, including:

·  Performance levels of Care UK during the duration of the contract and the potential impact of any imposed financial penalties for failing to deliver against specific performance measures.

·  Timescales for commencing negotiations with Care UK around the continuation of services beyond 1 March 2014 and Care UK’s notification to exit the contract.

·  Following recent structural changes to the NHS (post 1 April 2013), the implications of different aspects of the existing contract being held by different parts of the NHS – i.e. GP services being the responsibility of NHS England (West Yorkshire Area Team) and Walk-in services being the responsibility of local CCGs.

·  The costs of the process to the NHS in Leeds.

·  Any patterns in service access from across the City.

The Chair thanked those in attendance for their contribution to the discussion and looked forward to a further update at the next Scrutiny Board meeting.  The Chair also reiterated the Scrutiny Board’s desire to consider issues around ‘lesson’s learned’, alongside other issues raised during the Scrutiny Board’s recent consideration of the closure of the Woodlands Surgery.

RESOLVED –

(a)  To note the information presented and discussed at the meeting.

(b)  That a scoping meeting be convened with appropriate NHS representatives to consider the Scrutiny Board’s consideration of general matters relating to the development of Primary Care services in Leeds and, in particular, any specific matters in relation to:

(i)  The closure of Woodlands GP Surgery (considered at the meeting in November 2013)

(ii)  The provision of General Practice (GP) and Walk-in Services at Shakespeare Medical Practice.

(Councillor James Lewis joined the meeting at 1:50pm during the Scrutiny Board’s consideration of this item.)

To consider a report from the Head of Scrutiny and Member Development presenting an update on the financial position and progress towards the requirements of the Better Care Fund in Leeds since the final guidance was released on 20 December 2013.

The Head of Scrutiny and Member Development submitted a report that introduced a report presented to Leeds’ Health and Wellbeing Board presenting an update on the financial position and progress towards the requirements of the Better Care Fund in Leeds, since the final guidance was released on 20 December 2013.

As agreed earlier in the meeting (minute 80 refers) an outline of the draft proposals was also presented and considered by the Scrutiny Board.

The following representatives were in attendance to help the Scrutiny Board consider the information presented:

·  Dennis Holmes (Deputy Director (Adult Social Services) – Leeds City Council)

·  Steve Hume (Chief Officer Resources and Strategy (Adult Social Services) – Leeds City Council)

·  Matt Ward (Chief Operating Officer – Leeds South and East Clinical Commissioning Group)

The Deputy Director of Adult Social Services introduced the report and made the following points:

·  The Better Care Fund had previously been referred to as the Integration Transformation Fund.

·  There was a national requirement to submit draft proposals to NHS England (NHSE) and the Local Government Association (LGA) by 14 February 2014.  The current iteration of the draft proposals was now presented to the Scrutiny Board for consideration.

·  A final submission of proposals would need to be submitted to NHSE/ LGA by 4 April 2014.

·  The £55M allocation to the Better Care Fund in Leeds represented the minimum level of funding.  Potentially, the fund could include the entire commissioning budgets from Adult Social Service and Clinical Commissioning Groups (CCGs) – some £1.5 billion.

In light of the particularly short timescales involved, the Deputy Director also expressed his thanks and appreciation for the hard work and continued commitment of officers across the Council and local CCGs in drafting the proposals. 

The Scrutiny Board discussed the report and the details highlighted at the meeting.  A number of matters were raised, including:

·  The current draft proposals only included schemes aimed at adults/ older people. There appeared to be no proposed schemes that specifically included mental health services or services to the under 25s. 

·  Concerns associated with the lead-in times for preventative services to generate the savings necessary in acute care – particularly in light of the Better Care Fund aimed at delivering results (in terms of better patient outcomes and financial savings) within 12-18 months.

·  With 2014/15 identified as a ‘shadow year’, plans to consult on the draft proposals and undertake meaningful equality impact assessments.

·  Flexibilities associated with commissioning acute care through funding mechanisms other than ‘tariff’.

·  The alignment between the Better Care Fund proposals and Leeds’ Health and Wellbeing Strategy.

The Chair thanked those in attendance and looked forward to receiving further details around the proposals and subsequent progress/ achievements in due course.

RESOLVED –

(a)  To note the information presented and discussed at the meeting.

(b)  The need to consult service users on draft proposals and undertake meaningful equality impact assessments be highlighted to Leeds’ Health and Wellbeing Board.

(c)  To consider a further update on the draft proposals at the next meeting of  ...  view the full minutes text for item 85.

To consider a report from the Head of Scrutiny and Member Development presenting the Director of Public Health Annual Report 2013.

The Head of Scrutiny and Member Development submitted a report that introduced the Director of Public Health Annual Report 2013, which had been submitted to the Executive Board at its meeting on 18 December 2013. 

Ian Cameron, Leeds City Council’s Director of Public Health was in attendance to introduce the report and contribute to the Scrutiny Board consideration of the information presented. 

By way of introduction, the Director of Public Health made the following points:

·  Under the Health & Social Care Act 2012, it was a specific duty of the Director of Public Health to produce an Annual Report on the health of the population.

·  A number of previous reports had been produced, during the time when the Director of Public Health role was part of the former Primary Care Trust.

·  Following the recent health reforms, the 2013 report represented the first report for Leeds since the public health duties had been transferred to local authorities.

·  The main focus of the report was around health protection and it sought to compare and contrast the similarities and differences since the birth of public health in Leeds between 1866 and 1877.

The Scrutiny Board discussed the report and the details highlighted at the meeting.  A number of matters were raised and discussed, including:

·  The responsibilities for local councillors under the new public health duties bestowed on local authorities.

·  The dispersal of responsibilities around health protection across the new health landscape.

·  Initial confusion around roles and responsibilities arising from the changes to the health landscape.

·  The level of public health funding/ allocated budget, with Leeds being below target in terms of its level of funding.

·  Concern regarding the timing of any announcement around the 2015/16 budget, which would not be known until December 2014.

·  The role and position of public health in relation to a range of matters / responsibilities of the Council – in particular planning and housing quality.

·  The role of school nurses in public health and the potential impact of academies and free schools.

The Chair thanked the Director of Public Health for his attendance and contribution to the meeting.

RESOLVED – To note the report as presented and the issues discussed at the meeting.

(Councillor James Lewis left the meeting at 3:00pm during the Scrutiny Board’s consideration of this item.)

To consider a report from the Head of Scrutiny and Member Development presenting the Scrutiny Board’s work schedule for the remainder of the municipal year, 2013/14.

The Head of Scrutiny and Member Development submitted a report that presented the current draft iteration of Scrutiny Board’s work schedule for 2013/14.

The report reminded the Scrutiny Board of the themes it had initially identified to form the broad direction of its work programme for 2013/14, in addition to additional areas where the Scrutiny Board had agreed to undertake further work around the following areas. 

As agreed earlier in the meeting (minute 80 refers) a revised draft work schedule was also presented and considered by the Scrutiny Board.

The Principal Scrutiny Adviser outlined that while work was on-going to translate all the issues identified by the Scrutiny Board into a work schedule for the current year, this was proving increasingly difficult due to the number of additional matters that had been raised during the course of the year. 

As such, the Principal Scrutiny Adviser proposed that the Scrutiny Board should consider its work programme over a longer period of time (i.e. beyond the current municipal year), while acknowledging that priorities may change post May 2014.  It was reported that this might usefully include agreeing to delete or defer specific matters previously included in the work programme. 

The Scrutiny Board discussed the report and information highlighted at the meeting.  A number of specific points were made, including:

·  A proposal that the following items and associated activity be removed from the Board’s work schedule for the current year (2013/14):

Ø  Quality Accounts’ and ‘Health Service Developments’ working groups;

Ø  Request for scrutiny – Men’s Health;

Ø  Request for Scrutiny – Children’s epilepsy surgery;

Ø  Information flows/ data sharing.

·  Proposals to incorporate the following areas / items into the work schedule for the current year (2013/14):

Ø  To hold a dedicated meeting focusing on mental health;

Ø  To hold a scoping meeting with NHS England and CCG representatives around Primary Care (during February / March 2014);

Ø  To review the partnership arrangements of the Health and Wellbeing Board through a working group meeting in April 2013 (date to be agreed/ confirmed);

Ø  To request a report on the proposals to review homecare provision in Leeds, including timescales and the proposed approach, in order to specifically consider the role of the Scrutiny Board.

·  To consider convening an additional Scrutiny Board meeting in May 2014.

·  To consider current trends in patient referral patterns in Leeds across each CCG.

RESOLVED –

(a)  To note the information presented and discussed at the meeting. 

(b)  Subject to the issues discussed during consideration of this item, the revised draft work schedule as presented be agreed.

Friday, 28 February 2014 at 10.00am (Pre-meeting for Board Members at 9.30am)

Friday, 28 February 2014, commencing at 10:00am (with a pre-meeting for Board Members at 9:30am).

(The meeting concluded at 3:50pm)