Agenda and minutes

The Chair opened the meeting and welcomed those in attendance. 

The Chair reminded all those in attendance of the Council’s Third Party Recording code of practice, copies of which were available at the meeting. 

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 powers under Section 100B(4)(b) of the Local

Government Act 1972, the Chair agreed to accept the following late information:

Leeds and York Partnership NHS Foundation Trust: Care Quality Commission Inspection and Associated Action Plans – Supplementary Information (Minute 90 refers)

·  Trust action plans.

Scrutiny Inquiry: Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TAMHS) – Supplementary Information (Minute 91 refers)

·  The report and recommendations presented and agreed at the Integrated Commissioning Executive (ICE) meeting on 17 March 2015.

·  Additional information following concerns raised by Leeds Local Medical Committee (LMC) regarding Targeted Mental Health in Schools (TaMHS) services in Leeds.

·  Extracts from the ‘Future in Mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing’ report, including the Executive Summary and key proposals.

Work Schedule – Supplementary Information (Minute 92 refers)

·  Draft minutes from the Executive Board meeting – 18 March 2015

Investing in Specialised Commissioning – Public Consultation – Additional Agenda Item (Minute 89 refers)

The above information was not available at the time of agenda despatch and was subsequently made available on the Council’s website.

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. 

However, in relation to the item on Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TAMHS),  Dr Beal drew members’ attention to the fact that his daughter was currently employed in the delivery of Leeds CAMHS services (minute 91 refers).

To receive any apologies for absence and notification of substitutes.

Apologies for absence were received and recorded on behalf of Councillor S Varley and Councillor G Hussain.

No substitute members were in attendance at the meeting. 

To confirm as a correct record, the minutes of the meeting held on 24 February 2015.

(Minutes to follow)

RESOLVED – To defer consideration of the draft minutes to a future meeting of the Scrutiny Board. 

To consider areas of work and activity of the Chair of the Scrutiny Board since the Scrutiny Board meetings in February 2014

The Head of Scrutiny and Member Development submitted a report that provided an outline of the Chair’s activity since the Board’s meetings in January 2015. 

The Chair provided a verbal update at the meeting and invited members of eth Scrutiny Board to raise any specific matters for further discussion. 

No specific issues were raised, however Members thanked the Chair for the update and agreed to maintain a continued overview of the issues dealt with outside the formal Board meetings.

RESOLVED –

(a)  To note the report and update provided at the meeting.

(b)  To maintain a continued overview of the issues dealt with outside the formal Board meetings.

The Head of Scrutiny and Member Development submitted a report introducing NHS England’s public consultation associated with the future investment in specialised services.

The following representatives were in attendance:

·  Moira Dumma (Commissioning Operations Director (Yorkshire & the Humber)) – NHS England (North)

·  Matt Day (Consultant in Public Health, Specialised Commissioning) – NHS England (North)

·  Phil Corrigan (Chief Executive) – NHS Leeds West Clinical Commissioning Group

·  Dave Berridge (Medical Director (Operations & International Partnerships) / Consultant Vascular Surgeon) – Leeds Teaching Hospitals NHS Trust

·  Jenny Ehrhardt (Associate Director of Finance) – Leeds Teaching Hospitals NHS Trust

The Commissioning Operations Director and Consultant in Public Health (Specialised Commissioning) introduced the item and outlined NHS England’s national consultation process associated with future investment and prioritisation in specialised commissioning.  It was highlighted that commissioning decisions are made on a national basis, however there was a shift (or at least a desire to move) towards a ‘co-commissioning’ model between NHS England and local Clinical Commissioning Groups. 

Representatives from Leeds Teaching Hospitals NHS Trust also addressed the Board and other issues highlighted as part of the instruction included:

·  An outline of the current decision-making processes in relation to specialised services and the role of Clinical Reference Groups (CRGs).

·  The potential need to control ‘aspirational’ aspects of some CRGs.

·  Substantial financial pressures on specialised services – particularly as new advances in treatment and technologies become available.

·  Potential future decisions around prioritisation and/or decommissioning of some services/ treatments.

·  Concerns that specialised services were becoming ‘unaffordable’.

·  The potential effects on other ‘mainstream’ services when considering future funding of specialised services.

The Scrutiny Board considered the information provided and discussed a number of issues raised at the meeting, including:

·  Issues associated with the availability of ‘evidence’ when considering specialised services.

·  Whether the issues under consideration related to ‘quality of services’ or ‘funding’.

·  Consideration of the ‘rarity of medical conditions’ being a health inequality and how this might be reflected in future prioritisation discussions.

·  The process for administering Individual Funding Requests (IFRs).

·  Issues associated with knowing ‘when to intervene’.

·  Financial implications for providers of specialised services and the process for payments – including historical differentials in the level of tariff payments between providers.

·  The implications on the infrastructure of other hospitals services with shared facilities across specialised areas.

On conclusion of the item, the Chair thanked those present for their attendance and contribution to the discussion. 

RESOLVED – To develop and submit a robust consultation response on behalf of the Scrutiny Board. 

To receive action plans from Leeds and York Partnership NHS Foundation Trust (LYPFT) in response to the findings and recommendations arising from the Care Quality Commission’s (CQC) recent inspection of services at the Trust

The Head of Scrutiny and Member Development submitted a report introducing the action plans from leeds and York Partnership NHS Foundation Trust in response to the findings and recommendations arising from the recent Care Quality Commission inspection of services.

The following representatives were in attendance:

·  Chris Butler (Chief Executive – Leeds and York Partnership NHS Foundation Trust)

·  Jill Copeland (Chief Operating Officer and Deputy Chief Executive) – Leeds and York Partnership NHS Foundation Trust

·  Anthony Deery (Interim Director of Nursing and Quality – Leeds and York Partnership NHS Foundation Trust)

·  Nigel Gray (Chief Officer) – NHS Leeds North CCG

The Chief Executive of Leeds and York Partnership NHS Foundation Trust (LYPFT) addressed the Scrutiny Board and outlined the information presented. It was confirmed that both the Care Quality Commission (CQC) and Monitor had ‘signed-off’ the Trust’s action plan.  An implementation team within the Trust was taking forward and monitoring progress of the agreed actions. 

The Scrutiny Board considered the information provided and discussed a number of issues raised at the meeting, including:

·  Changes in the delivery model of services, in particular current ‘in-patient’ services.

·  Identified potential ligature points and risk assessment training for staff.

·  Assurance sought around actions ‘due for completion’ but not yet completed.

·  Assurance from commissioners around the quality of services provided.

·  The Trust’s relationship with other partners, including the police.

On conclusion of the item, the Chair thanked those present for their attendance and contribution to the discussion.  The Chair also congratulated the Trust on the clarity and format of its action plan.

RESOLVED –

(a)  To note the information and action plans presented.

(b)  To consider a further update at a future meeting in the new municipal year. 

To receive a range of additional information in relation to Child and Adolescent Mental Health Services and Targeted Mental Health in Schools

The Head of Scrutiny and Member Development submitted a report introducing further information in relation to the Board’s inquiry into Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TAMHS). 

The following representatives were in attendance:

·  Joe Krasinski (Lead Emotional Wellbeing and Mental Health Consultant & TaMHS Project Manager) – Leeds City Council

·  Ruth Gordon (Project Manager for Children and Maternity Services) – Leeds CCGs

The TaMHS Project Manager outlined the evidence paper submitted to the meeting.

The Project Manager for Children and Maternity Services presented and introduced the report and recommendations presented to the Integrated Commissioning Executive (ICE).  It was confirmed that:

·  All eleven (11) recommendations had been agreed by ICE.

·  Implementation was now moving forward – with a particular focus on having an established ‘single point of access’ by September 2015.

·  Despite the recommendations, demand for services was still likely to outstrip supply by a ratio of 4:1 

The Scrutiny Board considered the information provided and discussed a number of issues raised at the meeting, including:

·  Communication issues across the system to enable the delivery of a ‘single point of access’.

·  Any likely improvements on waiting times and the availability of interim support.

·  The capacity, capability and quality of service between different school clusters across the City.

·  Easing transition between children’s and adult services.

·  Concerns around the prevalence data (2004) being outdated.

·   The potential variability of services across the City.

On conclusion of the item, the Chair thanked those present for their attendance and contribution to the discussion. 

RESOLVED –

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

(b)  To consider the information provided in order to inform the Board’s final inquiry report and associated recommendations.

(Councillor G Latty left the meeting at 11:55am during consideration of the above item.)

(Councillor J Lewis left the meeting at 12:00noon during consideration of the above item.)

(Councillor S Lay left the meeting at 12:05pm during consideration of the above item.)

To consider the progress and ongoing development of the Scrutiny Board’s work schedule for the current municipal year

The Head of Scrutiny and Member Development submitted a report setting out the progress and ongoing development of the Scrutiny Board’s work schedule for the current municipal year.

The Principal Scrutiny Adviser gave a brief introduction to the report and set out the proposed areas of discussion at the remaining meetings of the current municipal year.  Specific matters highlighted to the Scrutiny Board, included:

·  Forthcoming Care Quality Commission (CQC) inspection reports for Leeds Community Healthcare NHS Trust and Yorkshire Ambulance Service NHS Trust. 

·  Progress of the Board’s Adult Social Care Working Group and consideration of the Future Provision of Homecare across the City. 

RESOLVED –

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

(b)  The Principal Scrutiny Adviser, in consultation with the Chair, amends the work schedule as necessary and to reflect the discussion at the meeting. 

Tuesday, 21 April 2015 at 10.00am in the Civic Hall, Leeds (Pre-meeting for all Board Members at 9.30am)

Tuesday, 21 April 2015 at 10:00am (with a pre-meeting for members of the Scrutiny Board from 9:30am).

The Chair thanked all those in attendance for their contribution to the Scrutiny Board’s discussion and closed the meeting. 

(The meeting concluded at 12:15pm)