Agenda and minutes

The Chair welcomed everyone to the September meeting of the Scrutiny Board (Health and Well-Being and Adult Social Care). 

In particular, the Chair welcomed Dr John Beal to his first meeting of the Scrutiny Board.  It was noted that Dr Beal had been nominated as a non-voting co-opted member of the Scrutiny Board, representing HealthWatch Leeds.

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 Teaching Hospitals NHS Trust (LTHT) updated ‘SHOULD’ improve action plan (minute 21 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. 

To receive any apologies for absence and notification of substitutes.

An apology for absence was submitted by Councillor Lay.  No substitute members were in attendance. 

To confirm as a correct record, the minutes of the meeting held on 15 July 2014.

RESOLVED – That the minutes of the meeting held on 15 July 2014 be approved as a correct record.

To receive a report from the Head of Scrutiny and Member Development outlining some of the areas of work and activity of the Chair of the Scrutiny Board since the Scrutiny Board meeting in July 2014.

The Head of Scrutiny and Member Development submitted a report that provided an outline of activity undertaken since the Board’s meeting in July 2014, which included:

·  Commissioning of Specialised Services;

·  Developments in the commissioning/ provision of Children’s Epilepsy Surgery;

·  Commissioning arrangements on a West Yorkshire footprint – work of the 10 CC Group

·  Commissioning / provision of Personality Disorder Services in Leeds;

·  Discussions with Leeds Local Medical Committee (LMC);

·  Maternity Services provision in Leeds;

·  Care Ring services;

·  Work of the West Yorkshire Area Team (NHS England);

·  Forthcoming Care Quality Commission (CQC) inspections;

·  Work of the Joint Health Overview and Scrutiny Committee (JHOSC);

·  NHS England’s ongoing review of services Children’s Cardiac Surgery Services at LTHT (following the temporary suspension of services in March/ April 2013).

The Chair provided a verbal report at the meeting, drawing particular attention to the discussions with Leeds’ Local Medical Committee around GPs awareness and understanding of the Council’s Choice Based Lettings process. 

Members requested they be provided with details of Leeds’ Local Medical Committee. 

RESOLVED – To note the report and update provided at the meeting.

To consider a report from the Head of Scrutiny and Member Development presenting a summary of the outcome of the Care Quality Commission (CQC) hospital inspection of services provided by Leeds Teaching Hospitals NHS Trust (LTHT), alongside the Trusts associated action plans. 

The Head of Scrutiny and Member Development submitted a report that presented a summary of the outcome of the Care Quality Commission (CQC) hospital inspection of services provided by Leeds Teaching Hospitals NHS Trust (LTHT), alongside the Trust’s associated action plans. 

The following representatives were in attendance:

·  Professor Suzanne Hinchliffe –  Chief Nurse and Interim Chief Operating Officer, Leeds Teaching Hospitals NHS Trust

·  Craig Brigg –  Director of Quality, Leeds Teaching Hospitals NHS Trust

·  Russell Hart-Davies – Head of Quality, Leeds’ Clinical Commissioning Groups

The Chief Nurse and Director of Quality gave a brief outline of the inspection, publishing the reports and the process for developing the Trust’s action plan.  As part of the introduction, a number of points were highlighted, including:

·  The Trust felt the reports reflected the position of the organisation and had highlighted areas already identified by senior management.

·  The CQC reports did not present any ‘surprises’.

·  The CQC highlighted a number of areas the Trust ‘must’ improve and additional areas it ‘should’ improve.

·  The initial action plan to address the areas of improvement was briefly discussed at a Quality Summit meeting in July 2014.

·  Progress against the action plan was monitored through the Trust’s Quality Committee.  The Trust also met monthly with Clinical Commissioning Groups (CCGs) to review progress. It was also noted that NHS Trust Development Authority maintained overall oversight of progress.

Members of the Scrutiny Board reflected on the verbal introduction and discussed the details presented on the agenda.  Members raised a number of specific matters including:

·  Accountability of the current and previous members of the Trust Board.

·  Why earlier action had not been taken if the CQC report did not raise any ‘new’ issues / areas for improvement.

·  Confirmation of the processes for monitoring progress against the action plans – both internally and externally.

·  Noting with concern that of the 6 areas of assessment, the CQC had identified that 4 areas required improvement.

·  Given the Trust’s current financial position, the financial implications of addressing the areas for improvement – particularly in relation to staffing shortages.

·  Availability of suitably qualified staff and the Trust’s ability to attract high calibre individuals.

·  Concern around the staff training and low level of appraisals highlighted by the CQC.

·  Quality assurance roles and responsibilities (in general) across NHS/ health services in Leeds.

·  Concern that the flow of the improvement plans did not follow a similar format to that of the inspection reports and areas of assessment: Making it difficult to identify and track improvement activity against the original findings and areas of assessment.

In response, the Trust noted the comments made by the Scrutiny Board and outlined progress against the issues identified by the CQC and detailed within the Trust’s action plans.  The Trust also stated that the CQC’s overall ‘requires improvement’ assessment was comparable with other Teaching Hospitals in England and that the inspection had not identified any critical issues. 

The Scrutiny Board also discussed:

·  Issues associated with the release of deceased relatives to aid timely burials across  ...  view the full minutes text for item 21.

To receive a report from the Director of Adult Social Services presenting the Consultation, Engagement and Communication Strategy in respect of the Care Act (2014).

The Director of Adult Social Services submitted a report presenting the Consultation, Engagement and Communication Strategy in respect of the Care Act (2014).

The following representatives were in attendance:

·  Councillor Adam Ogilvie (Executive Board Member for Adult Social Services) – Leeds City Council

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

·  Sukhdev Dosanjh (Chief Officer, Adult Social Care Reforms) – Leeds City Council

The Executive Board Member and officers present gave a brief introduction to the report, highlighting a number of issues in relation to the Care Act (2014), including:

·  The Act represented the biggest change to the Adult Social Care landscape in 60 years. 

·  The Act placed the wellbeing of individuals at the heart of all activity.

·  The Act presented a series of challenges for the Council, with issues associated with carers representing a significant pressure.

·  National guidance was expected 13 October 2014 and consideration about ‘the Leeds offer’ was needed.

·  There was potentially a big risk associated with a significant increase in demand for services in the context of the current public sector financial environment. 

Members of the Scrutiny Board reflected on the verbal introduction and discussed the details presented on the agenda.  Members raised a number of specific matters including:

·  How to effectively engage/ communicate with service users across different communities.

·  Responsibilities regarding the needs of offenders. 

·  The pressures/ challenges faced by the Council in responding to the requirements of the Care Act 2014.

·  Concern about the timing of the release/ availability of national guidance in relation to the requirements of the Care Act 2014.

The Board requested that Councillor Ghulam Hussain be involved in discussions around engagement with communities.

RESOLVED –

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

(b)  To refer the matter, including monitoring of the proposed action plan, to the Adult Social Care Working Group. 

To receive a joint report from the Director of Adult Social Services and Chief Operating Officer, South and East CC, providing an update on progress on the Better Care Fund in Leeds to date.

The Head of Scrutiny and Member Development submitted a report providing an overview of how the national Better Care Fund (BCF) was being implemented in Leeds, including:

·  The context of plans for a sustainable health and social care system in the city;

·  The financial challenge facing the health and social care economy in Leeds;

·  Progress on implementation of the BCF since it was announced in 2013;

·  The individual BCF project areas;

·  The allocated budget and projected savings for each project;

·  The timescales and management / governance arrangements. 

The following representatives were in attendance:

·  Councillor Lisa Mulherin (Executive Board Member for Health and Wellbeing) – Leeds City Council

·  Councillor Adam Ogilvie (Executive Board Member for Adult Social Services) – Leeds City Council

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

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

The representative present gave a brief introduction to the report and information provided, reiterating the significant challenges posed across the health and social care landscape in Leeds.  There was also an acknowledgement of the significant work undertaken to date and genuine approach to partnership working to meet the challenges ahead.

Members of the Scrutiny Board reflected on the verbal introduction and discussed the details presented on the agenda.  Members raised a number of specific matters including:

·  Processes for managing and sharing financial risks across health and social care organisations in Leeds.

·  Governance arrangements and the respective roles of Leeds’ Health and Wellbeing Board and NHS England.

·  Queries about deliverability and whether or not the scheme would make a significant difference to service users.

·  Some concern that, predominantly, the proposals seemed an extension of existing schemes already underway.

·  The extent to which all GPs in Leeds were on board with the proposals.

·  Workforce issues associated with delivering 7-day, 24hr services.

RESOLVED –

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

(b)  That the respective roles of the Health and Wellbeing Board and the Scrutiny Board, insofar as they relate to the Better Care Fund, be subject to further discussions between the respective Chair of those Boards. 

(c)  That the outcome of those discussions (in (b) above) be reported to a future meeting of the Scrutiny Board. 

(Councillor James Lewis left the meeting at 12:10pm during consideration of this item)

To consider the Scrutiny Board’s work schedule for the 2014/15 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, which included a particular focus around the provision of Child and Adolescent Mental Health Services (CAMHS) in Leeds.

The report also outlined:

• Progress of the Scrutiny Board’s two working groups and outlined some proposed changes to provide the Board with greater flexibility and capacity. 

• Working arrangements with other Scrutiny Boards.

Members discussed the issues presented in the report and outlined at the meeting.

RESOLVED –

(a)  To note the content of the report and its appendices.

(b)  To establish the ‘Adult Social Care Working Group’, to cover general issues relating to Adult Social Care. 

(c)  To note that the work of the current ‘Homecare Working Group’ will form part of the activity undertaken by the ‘Adult Social care Working Group’ (referred to in (b) above). 

(d)  To nominate Councillor E Taylor as the Board’s representative on the Sport and Active Lifestyles Working Group, established by the Scrutiny Board (Sustainable Economy and Culture).

Tuesday, 28 October 2014 at 10.00am in the Civic Hall, Leeds (Pre-meeting for all Board Members at 9.30am)

RESOLVED – To note the date and time of the next meeting as Tuesday, 28 October 2014 at 10:00am (with a pre-meeting for members of the Scrutiny Board from 9:30am).

(The meeting concluded at 12:25pm)