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 additional late items, however the followings details were provided as supplementary information:

-  Leeds City Council consultation response/ submission (minute 33 refers)

-  Revised Appendix 1: Summary of recent CQC inspection outcomes (minute 34 refers)

-  Details of correspondence from the Care Quality Commission (CQC) (minute 34 refers)

-  Leeds Local Medical Committee (LMC) – GP survey results (minute 35 refers)

The above details were not available at the time of agenda despatch, but were pertinent to the areas under discussion 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, however the following matters were brought to the attention of the Scrutiny Board for information:

-  Councillor G Hussain outlined that two close family members were employees within the local NHS.

Councillor G Hussain remained present for the duration of the meeting.

To receive any apologies for absence and notification of substitutes.

An apology for absence was submitted by Dr Richard Taylor, HealthWatch Leeds.

To confirm as a correct record the minutes of the Scrutiny Board (Adult Social Services, Public Health, NHS) meeting held on 28 July 2015.

The draft minutes from the previous meeting held on 28 July 2015 were presented for consideration. 

The Principal Scrutiny Adviser provided a verbal update on the actions arising from the meeting and associated progress.

In terms of accuracy, Councillor G Hussain highlighted an error under Minute 13 (Declarations of Disclosable Pecuniary Interest) and requested this to be corrected. 

RESOLVED –

(a)  That the verbal update and associated progress outlined at the meeting be noted.

(b)  That, subject to the necessary amendment highlighted at the meeting,  the minutes of the Scrutiny Board (Adult Social Services, Public Health, NHS) meeting held on 28 July 2015, be approved as an accurate and correct record.

To receive an update from the Chair on any scrutiny activity since the previous Board meeting that is not specifically included elsewhere on the agenda.

The Chair presented a verbal update on the scrutiny activity since the previous Board meeting in July 2015, and not otherwise included on the Board’s meeting agenda.  In particular, the Chair raised the following matters:

·  Progress against issues identified at the previous meeting, in particular Children’s Oral Health, Leeds Maternity Strategy and Public Health budgetary issues.

·  Details discussed at the recent meeting with representatives from Leeds Local Medical Committee (LMC).

·  Discussions held with representatives from Leeds and York Partnership NHS Foundation Trust (LYPFT) regarding concerns in relation to procurement practices and the proposed response from Monitor (the regulator). The Chair proposed to raise concerns with the appropriate body on behalf of the Scrutiny Board.

·  The forthcoming meeting of West Yorkshire Health Scrutiny Chairs, which would consider progress of the ‘Healthy Futures’ Programme across West Yorkshire and an update around the West Yorkshire Urgent Care Vanguard – recently announced. 

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

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

To consider an update from the Director of Public Health regarding the Council’s 2015/16 Public Health budget and response to the recent Department of Health consultation.

The Head of Scrutiny and Member Development submitted a report to introduce a further update from the Director of Public Health regarding the Public Health budget for 2015/16.

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

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

Apologies from Councillor Lisa Mulherin (Executive Member for Health, Wellbeing and Adults) were reported at the meeting. 

The Director of Public Health gave a brief update following the details presented to the Board at its July meeting, including:

·  Consultation was launched on 31 July 2015 and ran until 28 August 2015. It remained unclear when the Department of Health would make a formal announcement or decision.

·  As expected, the consultation focused on how to implement the overall £200M savings across England.

·  The Department of Health’s preferred option was a blanket 6.2% reduction across all relevant local authority areas.

·  A 6.2% reduction was the working assumption being used when considering possible reductions.  This equated to £2.8M in Leeds, across an overall budget of £45M.

·  The Council’s Public Health budget remained approximately £6M below the target level based on the Department of Health’s assessment of need.

·  Work on potential options to achieve the assumed budget savings continued, with proposals likely to be reported to the Executive Board later in September 2015.

·  Current considerations focused on targeting non-recurrent expenditure in 2015/16.

The Chair addressed the Board and highlighted concern regarding both the timing of the Department of Health consultation and its duration.  The Chair also confirmed that given the very short consultation period, he had submitted a consultation response on behalf of the Board, which had been shared with members at the time of submission.

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

·  Likely implications for the general public and the potential longer-term impact on the health gap across the City.

·  The likely impact on NHS services in the longer-term.

·  The potential impact of the likely budget reductions on the voluntary and community sector (the Third sector) in Leeds.

·  Concern regarding the potential direction of travel for public health funding in the future.

The Chair summarised the discussions and invited the Director of Public Health to consider how to involve the Scrutiny Board prior to any decisions being made, and to keep the Scrutiny Board updated on any developments.

RESOLVED –

(a)  That the details presented in the report and highlighted at the meeting be noted.

(b)  That, the Director of Public Health continues to keep the Scrutiny Board updated on developments as work progresses and considers how to involve the Scrutiny Board in considering how the savings are to be achieved.

(Councillor B Selby joined the meeting at 1.25pm and Dr J Beal at 1:30pm during the consideration of this item.)

To consider a report from the Head of Scrutiny and Member Development summarising Care Quality Commission inspection reports published since the Board meeting in July 2015.

The Head of Scrutiny and Member Development submitted a report that provided details of recently reported Care Quality Commission inspection outcomes for health and social care providers across Leeds.

The following representatives were in attendance:

-  Dr Wendy Barker (Deputy Director of Nursing) – NHS England (North) – Yorkshire and Humber sub-region

-  Ged McCann (Senior Supplier Manager) – Specialised Commissioning Group, NHS England (North)

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

-  Albert Chelliah (Group Operations Director) – Inmind Healthcare Group

-  David Ramage (Hospital Director (Waterloo Manor Independent Hospital)) – Inmind Healthcare Group.

It was noted that Mr Jonathan Hepworth (Inspection Manager) from the Care Quality Commission had been invited to attend the meeting for this discussion, but was unable to attend due to a prior engagement and had formally sent his apologies. 

In introducing the report, the Principal Scrutiny Adviser drew the Board’s attention to the updated Appendix 1, which was circulated at the meeting.  This had been updated to include some additional inspection outcomes published since the publication of the agenda. The Chair confirmed the intention was to provide the Board with an overview and ‘snapshot’ of recent inspection outcomes for consideration. 

The Chief Officer (Access and Care Delivery) highlighted that the Care Quality Commission (CQC) had recently changed its inspection methodology, which was considered to be much more robust.  It was also highlighted that regular monthly meetings between Adult Social Services and the CQC, provided opportunities to share intelligence and any particular areas of concern.  This helped inform the CQC’s risk-based approach for inspection plans and scheduling. It was anticipated that over time, future overview reports will provide a more balanced service quality landscape in Leeds.

The Board’s attention was also drawn to two specific inspection reports included with the agenda, in relation to Yorkshire Ambulance Service NHS Trust and Waterloo Manor Independent Hospital.

Yorkshire Ambulance Service NHS Trust

The Principal Scrutiny Adviser advised the Board that, given the large geographical covered by the Trust, it had been agreed that Wakefield Council’s Health Overview and Scrutiny Committee would oversee improvement planning against the recommendations and monitor progress.  Health Scrutiny Chairs from other relevant authorities would be invited to participate at appropriate meetings.  Members of the Scrutiny Board were invited to highlight any particular matters to be raised in such discussions.

Waterloo Manor Independent Hospital

The Chair invited those present to comment on the CQC inspection report that had judged service provision at the hospital to be ‘inadequate’ overall and across each of the five domains within the inspection process. A number of comments were made, including:

·  NHS England (NHSE) had been working with the provider at Waterloo Manor since February/ March 2014 when concerns had originally emerged.

·  NHSE had been surprised by the recent CQC inspection outcome, which took place in February 2015 and was reported in August 2015.

·   Following the inspection in February 2015, NHSE confirmed admissions had been suspended and a review of all  ...  view the full minutes text for item 33.

To consider a report from the Head of Scrutiny and Member Development introducing a range of information to inform the Board’s Primary Care inquiry.

The Head of Scrutiny and Member Development submitted a report that presented a range of information relating to the Scrutiny Board’s inquiry around Primary Care. 

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

-  Brian Hughes (Locality Director for West Yorkshire) – NHS England (North) – Yorkshire and Humber sub-region

-  Kathryn Hilliam (Head of Co-Commissioning) – NHS England (North) – Yorkshire and Humber sub-region

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

-  Adam Brannen (Head of Regeneration) – City Development, Leeds City Council

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

Councillor P Truswell, Chair of the Scrutiny Board (City Development) was also in attendance.

The Locality Director for West Yorkshire addressed the Board and confirmed the principals outlined in the previous report (November 2014) remained relevant and the principal aims for primary care in Leeds and across West Yorkshire were:

·  Sustaining and improving the quality of services

·  Improving the patient experience.

·  Driving integrated care (where appropriate).

·  Creating a sustainable workforce: This being particularly relevant in the context of the development and redevelopment of particular areas of the City.

The Head of Commissioning (NHS England) and Chief Operating Officer (NHS Leeds South & East CCG) confirmed that primary care, and in particular general practice, faced significant challenges and the current landscape was likely to be significantly different within 5-years.  Some of the specific points included:

·  Significant challenges around the workforce, finances and access to services.  As a result, it was likely that:

Ø  GPs would have to work together (across larger footprints);

Ø  Current ways of working would need to adapt, including access routes to primary care and management of long term conditions.

Ø  There would be a need to examine different funding models – which was currently based on a core contract (£s/ head) and additional incentivised activity.

·  Current pilots across England examining different ways of working, but new models of care would be needed.  Such changes might include:

Ø  Federations or mergers of GP practices – thus reducing back office pressures.

Ø  Focusing on specialisms with GP practices.

Ø  Establishing extended access schemes (existing pilot in Leeds West CCG are currently being evaluated).

Ø  Considering the suitability and availability of estate / premises.

Ø  Providing more GP trainee places.

Ø  Patient access and experience significantly influenced by capacity, capability and quality of all local primary care services (not just GPs). 

The Head of Regeneration confirmed the engagement of the local NHS in the planning process, stating an iterative approach was adopted around planning services to reflect housing growth and development. Reference was also made to the availability of supplementary planning guidance to assist the ‘Good Place Making’ responsibilities and role of the Council.  Further reference was made to the recently launched NHS England and Public Health England ‘Healthy New Towns’ initiative. 

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

·  The need  ...  view the full minutes text for item 34.

To consider a report from the Head of Scrutiny and Member Development introducing the Scrutiny Board’s work schedule for the remainder of the current municipal year, 2015/16.

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

The Chair advised the Board that the updated work schedule reflected previous discussions while taking account of details associated with scheduling items for the remainder of the municipal year.

RESOLVED – That, subject to any on-going scheduling decisions, the Board’s work schedule as presented be agreed.

Tuesday, 20^th October 2015 at 2pm (pre-meeting for all Board Members at 1.30pm)

Tuesday, 20 October 2015 at 2:00pm (pre meeting for all Board Members at 1:30pm)

(The meeting concluded at 3:25pm)