Agenda and minutes

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

In particular, the Chair welcomed Councillor Judith Chapman (Chair, Scrutiny Board (Children and Families)), specifically attending in relation to the mental health framework (minute no. 32 refers) and the provision of mental health services and support for children and young people (minute no. 33 refers).

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

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

There were no late items; however members of the Scrutiny Board received a set of presentation in relation to Leeds’ Mental Health Framework (minute no. 32 refers). The presentation did not provide any new/ additional information and summarised the information already presented in the report. 

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 agenda item 9, Child and Adolescent Mental Health Services (CAMHS), Mr J Beal drew the Board’s attention to the fact that a close family member was a CAMHS practitioner.  As this was not a pecuniary interest, Mr J Beal remained in the meeting for that part of the discussion (minute no. 33 refers). 

To receive any apologies for absence and notification of substitutes.

There were no apologies for absence and no substitute members were in attendance.

To confirm as a correct record, the minutes of the meeting held on 30 September 2014.  To follow.

RESOLVED – The draft minutes from the meeting held on 30 September 2014 be deferred until the next meeting (25 November 2014).

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 previous Scrutiny Board meeting.

The Head of Scrutiny and Member Development submitted a report that provided an outline of the Chair’s activity since the Board’s meeting in September 2014. 

The Chair provided a verbal report at the meeting, drawing particular attention to the discussions / activity around the following matters:

·  Work of the Joint Health Overview and Scrutiny Committee (JHOSC) – particularly relating to the new congenital heart disease (CHD) review;

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

·  Meeting a range of stakeholders in relation to Swillington GP Surgery; and,

·  The availability of healthy food options at health care establishments across the City.

Members discussed the information provided, in particular the availability of healthy food options at health care establishments across the City – and requested an overall position statement.  Members also suggested this should be extended to include Leeds City Council Sports establishments. 

Progress against previous matters highlighted at the Scrutiny Board was also discussed – in particular issues associated with the release of deceased relatives to aid timely burials across the Muslim community 

RESOLVED –

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

(b)  To request an overall position statement in relation to the availability and provision of healthy food options at health care establishments across the City.

(c)  To expand the request in (b) above, to include Leeds City Council Sports establishments.

To receive a report from the Head of Scrutiny and Member Development introducing a summary paper in relation to Leeds’ Mental Health Framework (2014-2017).

The Head of Scrutiny and Member Development submitted a report introducing a summary paper in relation to Leeds’ Mental Health Framework (2014 – 2017). 

The following representatives were in attendance:

·  Liane Langdon (Director of Commissioning and Strategic Development) – NHS Leeds North CCG

·  Jane Williams (Strategic Commissioning Lead – Mental Health) – NHS Leeds North CCG

·  Victoria Eaton (Consultant in Public Health) – Leeds City Council

·  Mick Ward (Head of Commissioning (Adult Social Care) – Leeds City Council)

The Director of Commissioning and Strategic Development gave a brief outline of the report and the process for developing the draft framework to date.  As part of the introduction, a number of points were highlighted, including:

·  The role of the Mental Health Partnership Board in developing the draft framework.

·  One of the aims of the Mental Health Framework was to help inform the transformation over the coming 12 months.

·  A significant challenge was around parity of esteem between mental health and physical needs/ care.

·  Recent planning guidance from NHS England had identified ‘parity of esteem’ in relation to mental health services.  In response, contracts were being developed to include clauses to ensure NHS service providers adopted the principles of parity of esteem.

Members of the Scrutiny Board reflected on the details presented and raised a number of specific matters, including:

·  The mental health needs (including transition) of Children and Young People insufficiently reflected in the framework;

·  Leeds Mental Health Needs Assessment highlighted that 50% of mental health issues occur before 14 years of age.

·  Partnership arrangements and associated governance.

·  Wider determinants / contributors of mental ill-health.

·  Despite an increased focus on improving mental health, demand for services appeared to be rising.

·  Current baseline information in order to help identify the direction of travel and impact of the Mental Health Framework sometime in the future.

·  Relationships with Community Committees and identified priority areas.

·  Personalised health budgets – specifically in relation to helping to address mental health needs.

·  The work and role of Third Sector organisations.

·  Waiting times for diagnosis and treatment, including how these related/ compared to physical health needs.

·  Prevalence of mental ill-health across different communities.

·  The likely reduction in the bed-base to reflect the shift in the model of care (i.e. a greater focus of recovery and rehabilitation).

·  How Leeds’ draft framework reflected the detail of the ‘Closing the Gap’ report (published January 2014). 

Through the discussion and responses provided, members identified a range of additional information to be provided, including:

·  A copy of the ‘Whole Life Course’ (covering children and adults), presented to the Health and Wellbeing Board.

·  Details of the Mental Health Partnership Board and its associated governance arrangements.

·  Details of current performance (including referral / waiting times) associated with mental health service provision.

·  Associated action plans to support the delivery of the Leeds Mental Health Framework and specifically reflecting the requirements of the ‘Closing the Gap’ report (published in January 2014).

RESOLVED –

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

(b)  ...  view the full minutes text for item 32.

To receive a report from the Head of Scrutiny and Member Development introducing a summary paper in relation to Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TaMHS). 

The Head of Scrutiny and Member Development submitted a report introducing a summary paper in relation to Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TaMHS).

The following representatives were in attendance:

·  Matt Ward (Chief Operating Officer) – NHS Leeds South & East CCG

·  Jane Mischenko (Commissioning Lead – Children and Maternity Services) – NHS Leeds CCGs

·  Paul Bollom (Head of Commissioning and Market Management) - Children's Services, Leeds City Council

Those in attendance gave a brief introduction and outline of the report.  As part of the introduction, a number of points were highlighted, including:

·  There were significant concerns about access to CAMHS, nationally.  This was also reflected regionally and locally.

·  There was a level of unmet demand for services, which was reflected by feedback from stakeholders.

·  A review of service provision had recently started and this was the highest priority area for Children’s Commissioning. The report and recommendations to be reported to the Integrated Commissioning Executive (ICE) by March 2015.

·  Support and services for children were provided through a mixture of provision.

·  There was a complexity to the commissioning and provision of services, but recognition that changes are needed around access to emotional and mental health services.

·  There were a number of challenges, including:

Ø  Providing the same level of access to services for children and young people, when compared to services for adults.

Ø  The need for early interventions and support, i.e. upstreaming services.

Ø  Significant demand and capacity issues.

Ø  Recognition that the review may not resolve all the current issues. 

·  The use of seed-funding to support Targeted Mental Health in Schools (TaMHS) was seen as a particular strength in Leeds.

·  The review would seek to build on current strengths and consider the challenges facing the City.  The review would include:

Ø  Refreshing the local health needs assessment (currently 2 years old), with the backdrop of the national prevalence information being based on 2004 data and updated national prevalence information unlikely to be available until 2016/17.

Ø  Modelling current patient flows across the system.

Ø  Benchmarking activity, looking at key performance data such as activity, waiting times, turnover etc.

Members of the Scrutiny Board reflected on the details presented and raised a number of specific matters, including:

·  The need for a clearer overall spending/ funding analysis across CAMHS and TaMHS, including the different tiers of provision.

·  Saddened that, excluding dementia, 50% of mental illnesses in adult life start before age 15 and 75% by age 18. There appeared to be a clear need to focus on early interventions and appropriate access to such services. 

·  The involvement of children and families in the design of services was crucial.

·  Notwithstanding attempts to understand local needs, concern in relation to, what appeared to be, out of date national prevalence data.

·  Concern there may be inconsistent TaMHS provision across the City due to different arrangements and priorities within school clusters.  The Scrutiny Board should reflect on the School Clusters enquiry report  ...  view the full minutes text for item 33.

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 Mental Health and the provision of Child and Adolescent Mental Health Services (CAMHS) in Leeds.

Members discussed the issues presented in the report and raised a number of matters at the meeting, including:

·  The Director of Public Health’s Annual Report and requested that this be presented to the Scrutiny Board for consideration (including progress on previous reports/ recommendations).

·  Equality Impact Assessments associated with the provision of mental health services in Leeds.

·  The ‘Due North’ report highlighted in the minutes from the Executive Board meeting held on 15 November 2014.  The Scrutiny Board noted the referral to the Health and Wellbeing Board and requested the outcome of such consideration be reported to a future meeting of the Scrutiny Board.

·  Members noted that, earlier that morning, NHS England had published the final two reports following the temporary suspension of children’s cardiac surgery services at Leeds Teaching Hospitals NHS Trust in March/ April 2013. 

RESOLVED –

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

(b)  To amend the work schedule presented to reflect the discussion and outcomes of the meeting.

Tuesday, 25 November 2014 at 10.00am in the Civic Hall, Leeds (Pre-meeting for all Board Members at 9.30am)

Tuesday, 25 November 2014 at 10:00am (with a pre-meeting for members of the Scrutiny Board from 9:30am).

(The meeting concluded at 12:10pm)