Agenda and minutes

The Chair opened the meeting by welcoming all those present and invited formal introductions.

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.

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 the following matters were brought to the attention of the Scrutiny Board for information:

• Councillor B Selby highlighted he was Chair of Leeds’ Community Equipment Partnership. 

Councillor B Selby remained present for the duration of the meeting.

To receive any apologies for absence and notification of substitutes.

Apologies for absence and notifications of substitutes were reported as follows:

·  Councillor B Flynn – no substitute member attending

·  Councillor G Hussain – Councillor R Grahame attending as a substitute member

·  Councillor C Macniven – Councillor M Iqbal attending as a substitute member

·  Councillor S Varley – no substitute member attending

·  Dr John Beal – HealthWatch Leeds

To confirm as a correct record, the minutes of the Scrutiny Board (Adult Social Services, Public Health, NHS) meeting held on 23 June 2015.

The draft minutes from the previous meeting held on 23 June 2015 were presented for consideration. 

The following matters arising were highlighted at the meeting:

·  Minute 7 – co-opted members. The Chair advised the Scrutiny Board of the notification that Mr Richard Taylor had been nominated as HealthWatch Leeds’ 2^nd non-voting co-optee to sit on the Board.  It was noted that Mr Taylor was unable to attend the meeting.

·  Minute 9 – Health Service Developments Working Group.  The Chair advised the Scrutiny Board that the Working Group was likely to meet in mid-August.

RESOLVED –

(a)  That the matters arising highlighted at the meeting be noted.

(b)  That the minutes of the Scrutiny Board (Adult Social Services, Public Health, NHS) meeting held on 23 June 2015, be approved as an accurate and correct record.

To receive for information purposes the minutes of the Health and Wellbeing Board meeting held on 10 June 2015.

The minutes of the Health and Wellbeing Board meeting held on 10 June 2015 were presented for consideration. 

The following matters arising were highlighted and briefly discussed at the meeting:

·  Minute 10 – Health and Social Care winter pressures in Leeds: building a resilient system.

The potential relevance to the Scrutiny Board’s work around Integrated Health and Social Care Teams was highlighted.

·  Minute 12 – Leeds Joint Strategic Needs Assessment (JSNA) 2015 Draft Executive Summary: Cross Cutting Themes. 

The Chair highlighted and queried how the City’s planned expansion in housing would be reflected in JSNA process.

RESOLVED – That the minutes of the Health and Wellbeing Board meeting held on 10 June 2015 and the matters highlighted at the meeting be noted.

To receive for information purposes the minutes of the Executive Board meetings held on 24 June and 15 July 2015.

The minutes from the Executive Board meetings held on 24 June 2015 and 15 July 2015 were presented for consideration. 

RESOLVED – That the minutes from the Executive Board meetings held on 24 June 2015 and 15 July 2015 be noted.

To receive an update from the Chair on scrutiny activity, not specifically included on the agenda, since the previous Board meeting.

The Chair presented a verbal update on the scrutiny activity since the June meeting not otherwise included on the Board’s meeting agenda.  In particular, the Chair raised the following matters:

·  The new Congenital Heart Disease (CHD) review outcome – making reference to the NHS England Board decision, the Chair paid tribute to previous Chairs and members involved in raising public awareness of previous proposals, resulting in a reconsideration of the previous decision.  The Chair confirmed that the new CHD review was now entering its implementation phase and it was intended that the Joint Health Overview and Scrutiny Committee (JHOSC) for Yorkshire and the Humber would maintain an overview of progress and future plans. 

·  The recent announcement of Urgent Care Vanguards – including West Yorkshire.  The Chair planned to seek a briefing from local Clinical Commissioning Groups on the scheme and any local implications.

·  The continued delay in the announcement of the Care Quality Commission (CQC) inspection outcome for Yorkshire Ambulance Service NHS Trust.  The inspection took place in January 2015, yet the outcome and judgement had not been reported.  The Chair proposed to write to the CQC for an explanation and to seek assurance around the inspection process. 

·  The reported dispute between Leeds and York Partnership NHS  Foundation Trust (LYPFT) and the Vale of York Clinical Commissioning Group regarding the procurement process for services in York.  The Chair proposed to contact the necessary bodies involved to be fully briefed on the matters reported in the local media. 

RESOLVED – That the verbal update provided at the meeting be noted and any actions proposed by the Chair be agreed.

NB   Councillor S Lay joined the meeting at 2:15pm during consideration of this item.

To receive a joint report from the Director of Adult Social Services and the Executive Director of Operations at Leeds Community Healthcare NHS Trust regarding the establishment and operation of the integrated health and social care teams across the City.

The Director of Adult Social Services and the Executive Director of Operations at Leeds Community Healthcare NHS Trust submitted a joint report regarding the establishment and operation of the integrated health and social care teams across the City.

The following representatives were in attendance during consideration of this item:

·  Councillor Lisa Mulherin – Executive Member for Health, Wellbeing and Adults

·  Cath Roff (Director of Adult Social Services) – Adult Social Services, Leeds Council

·  Shona McFarlane (Chief Officer (Access and Care Delivery)) – Adult Social Services, Leeds Council

·  Kim Adams (Programme Manager (Health Integration)) –  Adult Social Services, Leeds Council

·   Paul Morrin (Director of Integration) – Leeds Community Healthcare NHS Trust

The Director of Adult Social Services gave a brief introduction of the report detailing the 2/3 year journey around integrated health and social care teams across the City and the future challenges, including:

·  Developing and implementing an integrated performance management framework.

·  Making best use of existing and/or new estate.

·  Working with different information technology (IT) systems and infrastructure.

·  Combining joint working with primary care and mental health services.

The Scrutiny Board discussed the information presented in the report and outlined at the meeting, raising a number of issues, including:

·  The impact of organisational culture within a change programme.

·  Issues around making the best use of existing and/or new estate and the potential link to the Council’s development of Community Hubs.

·  The specific involvement of GPs as part of the integrated approach.

·  The membership and role of the Integration Programme Board, along with the need for a clearer outline of future actions and associated timescales.

·  The use of flexible solutions to meet the needs of different areas of the City.

·  The relationship between the outcomes framework and an integrated performance management framework.

·  Joint working around hospital discharges, re-ablement and service planning (including winter pressures). 

RESOLVED –

(a)  That the progress and next steps outlined in the report – with particular reference to the achievements to date, the identified actions required around estates, performance and the future plans, be noted.

(b)  That, in conjunction with the Chair, the Principal Scrutiny Adviser works to scope the Boards inquiry around the work of the City’s integrated health and social care teams.

To consider the formal response to the previous Board’s inquiry report and recommendations into the provision of emotional wellbeing and mental health support services for children and young people in Leeds.

The Principal Scrutiny Adviser submitted a report that summarised the previous Board’s inquiry into the Provision of Emotional Wellbeing and Mental Health Support Services for Children and Young People in Leeds.  The report also introduced commissioners’ initial response to the report and recommendations.

The following representatives were in attendance during consideration of this item:

·  Councillor Lisa Mulherin – Executive Member for Health, Wellbeing and Adults

·  Jane Mischenko (Commissioning Lead (Children & Maternity Services)) –NHS Leeds Clinical Commissioning Groups

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

The Commissioning Lead (Children & Maternity Services) addressed the Board and gave further background relevant to the commissioning and scrutiny reviews.  It was also highlighted that some of the detail of the improvement plan was reliant upon national guidance – initially expected in June 2015, but now anticipated in mid-August 2015.

The Scrutiny Board discussed the response to the inquiry recommendations, raising a number of issues, including:

·  Access to services and the level of need across the City.

·  Funding requirements in the longer-term.

·  Raising awareness and elected member training.

·  Transitional arrangements from services for children to adult services.

·  Availability of support for parents and carers.

·  The importance of continuing to hear the voice of service users and other stakeholders – including practitioners.

·  Concern regarding the certainty of the response provided – in particular around timescales.

RESOLVED –

(a)   That the progress outlined in the response and discussed at the meeting be noted.

(b)   That the initial response is reviewed and firmer timescales agreed.

(c)   That the outcome of the review (in (b) above) be reflected in the Scrutiny Board’s future work programme.

NB Councillor S Bentley joined the meeting at 3:00pm as consideration of this

item commenced.

To consider a report from the Head of Scrutiny and Member Development introducing the Maternity Strategy for Leeds (2015-2020).

The Principal Scrutiny Adviser submitted a report that introduced Leeds Maternity Strategy (2015-2020) and an accompanying briefing note.  A statement provided on behalf of the Director of Public Health was also submitted to the Scrutiny Board.

The following representatives were in attendance during consideration of this item:

·  Councillor Lisa Mulherin – Executive Member for Health, Wellbeing and Adults

·   Jane Mischenko (Commissioning Lead (Children & Maternity Services)) –NHS Leeds Clinical Commissioning Groups

·  Ian Cameron (Director of Public Health) – Public Health, Leeds City Council

The Commissioning Lead (Children & Maternity Services) introduced the item and presented the background in developing the strategy, including the maternity health needs assessment produced in 2014.  As part of the introduction, the following matters were highlighted:

·  The current birth rate in Leeds had stabilised around 10,000 births per year.

·  The strategy had been informed by:

o  An examination of available evidence and the current policies.

o  The involvement of traditionally ‘hard to reach’ groups.

·  The strategy was expressed in terms of nine (9) key priorities, with a programme plan to underpin the strategy under development.

The Scrutiny Board discussed the strategy and the matters highlighted at the meeting, raising a number of issues, including:

·  The relevance of the strategy in relation to giving every child in Leeds the best start, and the universal / targeted services approach.

·   Specific reference to fathers and partners as part of the strategy.

·  The relative importance of each of the priority areas within the strategy.

·  The lack of any reference to the availability and use of resources (or funding) as part of the strategy.

·  The proposal to present the strategy to the Health and Wellbeing Board in September 2015.

RESOLVED –

(a)   That the Maternity Strategy for Leeds (2015-2020) and the matters discussed at the meeting be noted.

(b)   That a progress update be provided to the Scrutiny Board in line with the Scrutiny Board’s work schedule.

NBCouncillor C Anderson left the meeting at 3:55pm during consideration of

this item.

At the conclusion of this item the meeting was briefly adjourned at 4:15pm.  The meeting recommenced at 4:25pm.

To receive a report from the Director of Public Health introducing the Leeds Children and Young People Oral Health Promotion Draft Plan 2015-2019.

The Director of Public Health submitted a report that introduced the draft Leeds Children and Young People Oral health Promotion Plan.  The draft plan outlined a preventative programme from 0-19 that aimed to ensure every child in the city has good oral health.

The following representatives were in attendance during consideration of this item:

·  Ian Cameron (Director of Public Health) – Public Health, Leeds City Council

·  Steph Jorysz (Advanced Health Improvement Specialist) – Leeds City Council

·  Jackie Moores (Advanced Health Improvement Specialist) – Leeds City Council

The Advanced Health Improvement Specialist introduced the item and presented the background in developing the oral health plan, alongside some of the key issues identified.  As part of the introduction, the following matters were specifically highlighted:

·  The Vision, Outcome and Objectives of the plan were summarised in the ‘plan on a page’ – presented at Appendix A.

·  Levels of tooth decay among children and young people in Leeds were worse than the England average.

·  Inequalities across Leeds were also significant.

·  The oral health of children and young people in Leeds was comparable to other core cities and slightly below average when compared to statistical neighbours.

The Scrutiny Board discussed the draft plan and the matters highlighted at the meeting, raising a number of issues, including:

·  Significant concern at the levels of tooth decay and relative poor oral health among children and young people in Leeds.

·  The need to use all available channels to raise awareness of the levels of tooth decay and relative poor oral health among children and young people in Leeds.

·  Suggestions to increase awareness through the Schools Forum, School Clusters, School Governors, the Youth Parliament and the Children’s Services Scrutiny Board.

·  Raising awareness while not seeking to apportion blame for the levels of tooth decay and relative poor oral health among children and young people in Leeds.

·  Issues associated with the fluoridation of the local water supplies with the aim of improving oral health.

·   Consistency of dental practice, specifically in relation to the use and application of fluoride varnish.

·  The role of NHS England in commissioning preventative dental treatments in relation to children and young people.

·  Work of the oral health promotion team.

RESOLVED –

(a)  That the draft Leeds Children and Young People Oral health Promotion Plan and the associated matters discussed at the meeting be noted.

(b)  That the suggestions for raising awareness discussed at the meeting be progressed appropriately.

(c)  That a 6-month progress update be provided and incorporated within the Scrutiny Board’s work schedule.

NB   Councillor A Hussain left the meeting at 4:45pm and Councillor S Bentley

left the meeting at 4:50pm, during consideration of this item.

To receive an update from the Director of Public Health on the Council’s 2015/16 Public Health budget, following the recent Treasury announcement about a proposed £200M in-year reduction across England.

The Principal Scrutiny Adviser submitted a brief report introducing a briefing note from the Director of Public Health regarding a proposed £200M in-year saving requirement across local authority public health expenditure across England. 

Dr Ian Cameron (Director of Public Health) was in attendance during consideration of this item. 

The Director of Public Health gave an introduction and confirmed that consultation around how the savings target would be achieved/ implemented had not yet been received but was expected to be imminent.

It was highlighted that should the savings target be achieved on a simple percentage share basis, Leeds contribution was likely to be around £2.8M during 2015/16. 

The Scrutiny Board discussed the information presented in the report and the update provided at the meeting.  Members raised a number of concerns, including:

·  The difficulties associated with achieving new savings targets in-year – i.e. once annual budgets had already been agreed.

·  The potential impacts on agreed contracts.

·  The timing and likely nature of the consultation.

·  The likely impact on other areas and both commissioner and provider organisations within the local health and social care economy.

RESOLVED –

(a)  That the information presented be noted.

(b)  That the Scrutiny Board maintains an overview of the consultation process – contributing where appropriate.

(c)  That, following the outcome of the consultation process, the Scrutiny Board considers its future role around local implementation.

NB Councillor R Grahame left the meeting at 4:55pm during consideration of

this item.

To consider a report from the Head of Scrutiny and Member Development introducing the Scrutiny Board’s outline work schedule for 2015/16.

The Principal Scrutiny Adviser provided a report that introduced a draft work schedule for the remainder of the municipal year.

The Chair advised the Board that the draft work schedule captured a number of the areas highlighted and discussed at the Board’s initial meeting in June 2015 and he was keen to involve members of the public in the Board’s work – particularly in relation to more detailed inquiries. Members of the Board agreed with this approach.

Councillor B Selby raised the matter of the practical implications and financial impact on Adult Social Services of a recent court judgement in relation to ‘Deprivation of Liberty’ processes, and recommended a report be presented to the Scrutiny Board in order to raise awareness of the issues and implications. 

The Chair made reference to a number of potential work areas highlighted by Councillor B Flynn (who was unable to attend the meeting).  It was felt that a number of matters identified could be incorporated into the existing draft work schedule, including Leeds Teaching Hospitals NHS Trust progress against recommendations from the Care Quality Commission inspection in 2014, and cancer wait times.  However, the Board would not have capacity to consider ‘whistleblowing’ as a specific work area.

RESOLVED – That, subject to any necessary adjustments arising from discussions at the meeting, the Board’s work schedule (as presented) be agreed.

Tuesday, 8 September 2015 at 12.30pm (pre-meeting for all Board Members at 12 noon)

Tuesday, 8 September 2015 at 12:30pm (pre meeting for all Board Members at 12:00noon)

(The meeting concluded at 5:05pm)