Agenda and minutes

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

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

The following late information was submitted to the Board:

·  Agenda item 9 – Care Quality Commission Inspection Outcomes – Updated appendix 1 (minute no. 62 refers)

·  Agenda item 11 – The Adult Social Care Residential and Nursing Framework Contract (minute no. 64 refers)

The above information was not available at the time of agenda despatch but 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 Councillor G Hussain drew the Board’s attention to the fact that two close family members were employees within the local NHS.

To receive any apologies for absence and notification of substitutes.

Apologies for absence were submitted by Councillors Christine Macniven, Sandy Lay and Co-opted Member, Mr Richard Taylor (HealthWatch Leeds).

To confirm as a correct record, the minutes of the meeting held on 20 October 2015.

RESOLVED – That the minutes of the meeting held on 20 October 2015 be approved as a correct record.

Minute no. 43 – Chair’s Update

In relation to proposed changes to and/or mergers of local GP practices, the Chair reported that a response had been received from the local CCG advising that individual GP practices were responsible for determining the level of consultation undertaken with patient groups. 

Representatives from the CCG were in attendance and provided a brief summary of work undertaken, particularly in terms of communication and engagement.

The Chair advised that the above issues would be considered as part of the Board’s next working group session. 

In relation to Windmill Health Centre, the Chair advised that he had requested a meeting to seek a progress update and the outcome was to be reported back to the Board.

Minute no. 44 – Request for Scrutiny – Tobacco Investments

The Chair advised that he had referred some of the issues associated with the request for scrutiny to the West Yorkshire Joint Health Overview and Scrutiny Committee and the Scrutiny Board (Strategy and Resources).

To receive for information purposes the minutes of the Executive Board meeting held on 21 October 2015.

RESOLVED – That the minutes of the Executive Board meeting held on 21 October 2015, be noted.

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

The Chair provided a verbal update on some of the scrutiny activity since the October Board meeting.

The following updates were provided:

·  HealthWatch Leeds – The Board was advised that there had been productive discussions with HealthWatch Leeds regarding joint visits.  Further details to be provided in due course.

·  Richmond Medical Practice – There were concerns regarding the level of patients still registered at the practice.  NHS England had given notice that the practice would close and requested that patients registered at an alternative GP practice.  NHS England would then allocate patients to an alternative practice where they had not registered themselves. NHS England had agreed to provide a weekly update to the Scrutiny Board and Ward Members were being kept informed.

·  NHS England / CCG Co-commissioning – The Chair reported on recent information from NHS England / CCGs regarding the future arrangements for commissioning Primary Care.  The Chair suggested that the Board give this matter more formal consideration, including governance issues and managing conflicts of interests, at its December meeting.

·  Leeds and York Partnership Foundation Trust – The Chair reported on the recent announcement that the Chief Executive, Chris Bulter had resigned and was due to leave the organisation in December 2015. On behalf of the Board, the Chair thanked Chris for his hard work and positive contribution.

RESOLVED – That the Chair’s update be noted.

To consider a report from the Head of Scrutiny and Member Development presenting a summary of Care Quality Commission (CQC) inspection reports relating to Health and Social Care organisations within the Leeds boundary.

The Head of Scrutiny and Member Development submitted a report which presented a summary of Care Quality Commission (CQC) inspection reports relating to Health and Social Care organisations within the Leeds boundary.

The following information was appended to the report:

-  A summary of recent CQC Inspection Reports (an updated summary was presented at the meeting (minute 55 refers).

-  Adult Commissioning Briefing Note in relation to Adult Social Care Monitoring, 11 November 2015

-  CQC ‘Building on strong foundations – Shaping the future of health and care quality regulation’, October 2015

-  CQC consultation: Regulatory Fees – Have Your Say (November 2015).

The following representatives were in attendance:

-  Councillor Lisa Mulherin, Executive Member (Health, Wellbeing and Adults)

-  Cath Roff, Director of Adult Social Services

-  Mick Ward, Head of Commissioning, Adult Social Services

-  Mark Phillott, Head of Contracts, Business Development and Markets Management, Adult Social Services.

The Head of Contracts, Business Development and Markets Management presented a brief outline of the Adult Social Services briefing note in relation to monitoring service quality and quality assurance.

The key areas of discussion were:

·  Timescales for improvement and concern that approximately 50% of providers failed to improve following re-inspection.

·  Clarification regarding improvement work as part of monitoring and CQC reporting arrangements.

·  Concern about high levels of agency staff employed by some providers.  The Board was advised that levels of agency staff were monitored by CQC and Leeds City Council (LCC).

·  Recognising the work undertaken by Adult Social Services, but concern that more than 50% of providers had received a rating of ‘inadequate’ or ‘requires improvement’. 

·  Identifying trends and the development of training across the independent sector.

·  Concern about the proposed increases in registration fees outlined in the CQC consultation document.

·  Concern regarding the apparent disparity between the proposed regulatory fees for NHS hospital trust and independent hospitals.

·  Confirmation that the Adult Social Care directorate and Executive Member (Health, Wellbeing and Adults) were in the process of submitting its response to the CQC consultation in relation to Regulatory Fees.  It was suggested that the Scrutiny Board presented its response to the consultation document to the December Board meeting when representatives from CQC were expected to attend.

RESOLVED –

(a)  That the contents of the report and appendices be noted

(b)  That the Scrutiny Board presents its response to the consultation document at the December Board meeting.

(Councillor S Varley joined the meeting at 2.30pm during the consideration of this item.)

To consider a report from the Director of Adult Social Services outlining the main aspects of the consultation currently underway on charging for non-residential Adult Social Care services and inviting members of Scrutiny Board to provide comments as part of the consultation process.

The Director of Adult Social Services submitted a report which outlined the main aspects of the consultation underway on charging for non-residential Adult Social Care services and which invited the Board to provide comments as part of the consultation process.

The following information was appended to the report:

-  Standard rates for Adult Social Care Services

-  Financial Assessment Methodology

-  Consultation proposals – Changes to the Financial Assessment Methodology.

The following were in attendance:

-  Councillor Lisa Mulherin, Executive Board Member (Health, Wellbeing and Adults)

-  Cath Roff, Director of Adult Social Services

-  Mick Ward, Head of Commissioning, Adult Social Services

-  Ann Hill, Head of Finance, Adult Social Services.

The key areas of discussion were:

·  An acknowledgement of the severe financial pressures facing the service.

·  Clarification regarding the likely impact of the proposals, particularly for individuals required to pay an extra £50 or more per week for services.  The Board was advised that the impact was also dependent on whether a cap for services was applied (currently £250).

·  A comparison of charges applied by other West Yorkshire Councils, North Yorkshire County Council and City of York Council.  The Board was advised that two Councils had retained a cap for services (reported to be £380 and £420).

·  The level of additional income the proposals were likely to generate and the availability of a hardship fund.

·  Whether there was any cumulative impact on those most likely to be affected by the proposals.

·  Joint working with the independent sector to improve signposting to access services.

·  Confirmation that 550 consultation responses had been received to date.  The main concerns related to affordability and respondents being unclear about the likely impact of the proposals.

The Chair summarised the discussion and queried the timescales for decision-making and suggested the Board might give further consideration to the proposals following analysis of the consultation response and prior to the Executive Board’s decision.

RESOLVED –

(a)  That the Board notes the consultation underway on charging for non-residential Adult Social Care services

(b)  That a draft response to the consultation on charging for Non-Residential Adult Social Care Services be submitted to the Board’s next working group meeting.

To consider a report from the Director of Adult Social Services setting out details associated with the Adult Social Care Residential and Nursing Framework Contract.

(Report to follow)

The Head of Contracts and Business Development submitted a report which outlined the history of the Adult Social Care Residential and Nursing Framework Contract, how it was operating and proposals for the next phase of the commissioning process.

The following information was appended to the report:

-  Service Specification – Quality Standards Framework

-  Schedule of Fees 2014.

The following were in attendance:

-  Councillor Lisa Mulherin, Executive Member (Health, Wellbeing and Adults)

-  Cath Roff, Director of Adult Social Services

-  Mick Ward, Head of Commissioning, Adult Social Services

-  Mark Phillott, Head of Contracts, Business Development and Markets Management, Adult Social Services.

The Board briefly discussed the importance of monitoring providers to ensure they were financially robust.  The Board also considered the sanctions that could be applied.

RESOLVED – That the contents of the report and appendices be noted.

To consider a report from the Head of Scrutiny and Member Development introducing a verbal update from the Director of Public Health on the Council’s 2015/16 Public Health budget following publication of the Department of Health response to the consultation carried out earlier in the year.

The Head of Scrutiny and Member Development submitted a report which presented an update regarding the Public Health budget for 2015/16.

The following information was appended to the report:

-  Department of Health ‘Local authority public health grant allocations 2015/16 – Government response to public consultation on in-year savings and Equality and health inequalities analysis’, November 2015.

The following were in attendance:

-  Councillor Lisa Mulherin, Executive Board Member (Health, Wellbeing and Adults)

-  Ian Cameron, Director of Public Health

-  Doug Meeson, Chief Officer (Finance Services), Financial Management.

The key areas of discussion were:

·  An update on Public Health savings, particularly the cessation of planned activities, raising awareness campaigns and partnership opportunities.  The Board was advised that commissioned activity was unaffected and job losses were not anticipated at present.

·  Concern that following public consultation and despite the level of opposition to the original proposals, there had been no change to the original proposals.  The Board was reminded that LCC opposed the savings proposed and favoured option A, to ‘take a larger sum from local authorities above target’.

·  The degree to which alternative options had been considered in order to make the required level of ‘in-year’ savings for 2015/16, including the use of Council Reserves and/or generating savings in other areas of Council expenditure.

·  The need to balance resources across all Council directorates and service areas. 

RESOLVED – That the contents of the report and appendices be noted.

To consider a report from the Head of Scrutiny and Member Development that introduces a range of information relating to the development of general practice (GP services) in Leeds.

The Head of Scrutiny and Member Development submitted a report which presented information in relation to the development of general practice (GP services) in Leeds.

The following information was appended to the report:

-  Report of Clinical Commissioning Group (CCG) in relation to the development of Primary Care Services (General Practice), 24 November 2015

-  Details of all practices extended opening arrangements

-  Prime Minister’s Challenge Fund: Improving Access to General Practice, First Evaluation Report, October 2015

-  NHS Leeds West CCG – Enhancing Primary Care Access Scheme – Assurance Monitoring and Evaluation Update, July 2015.

The following were in attendance:

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

-  Gina Davy, Deputy Director of Commissioning, (Primary Care and Business Development), NHS Leeds North CCG

-  Matt Ward, Chief Operating Officer, NHS Leeds South and East CCG

-  Kirsty Turner, Associate Director of Primary Care, Leeds West CCG

-  Dr Nicola Hambridge, Vice Chair of Leeds Local Medical Committee.

The Board was advised that a Pharmacy Workshop was scheduled to take place on 1 December 2015.  Further details were to be forwarded to Board Members.

The key areas of discussion were:

·  Context around the NHS 5-Year Forward View.

·  The pressures and challenges associated with providing 7 day access to primary care (GP) service, including whether there was sufficient demand beyond 6-days.

·  The most significant pressure / challenge related to workforce recruitment and retention.

·  Developing work with partners and local practices around integration and making the most of collective resources.

·  The need to change the current service model for GP and potentially consider the funding model.

·  An increased use of technology and access to online services.

·  An update on the clinical pharmacist scheme, which enabled GPs to focus on more complex patient needs.

·  Concern about the longer-term sustainability of some proposals contained in the NHS Five Year Forward Plan.

·  Concern about patients unable to access non-urgent appointments.

·  Examples of practices working in partnership to deliver better outcomes for patients.

·  Concern about an insufficient number of healthcare professionals, particularly in parts of South and East Leeds.

·  The impact of new housing developments in terms of accessing a GP. 

·  The need to tackle missed appointments.

·  The importance of patient engagement and involvement, including the role of patient reference groups and development of the Patient Leader Programme.

The Chair summarised the discussion and was encouraged by the level on on-going and innovative work.  The Chair also confirmed there would be further discussion at the working group meeting in December and it would then be necessary to take stock of the discussions to date and any areas for recommendations. 

RESOLVED – That the contents of the report and appendices be noted.

(Councillor G Hussain left the meeting at 4.45pm during the consideration of this item.)

To consider a report from the Head of Scrutiny and Member Development that introduces a joint report from Leeds’ Clinical Commissioning Groups and Leeds Teaching Hospitals NHS Trust around Cancer Waiting Times and associated levels of performance against national targets.

The Head of Scrutiny and Member Development submitted a report which introduced a joint report from Leeds’ Clinical Commissioning Groups and Leeds Teaching Hospitals NHS Trust in relation to Cancer Waiting Times and associated levels of performance against national targets.

The following information was appended to the report:

-  Cancer performance data: Performance data for each of the Leeds CCGs against the National Waiting Times Standards, across all providers, and Leeds Teaching Hospitals NHS Trust (LTHT) performance across all commissioners.

The following were in attendance:

-  Sue Robins, Director of Commissioning, Strategy and Performance, NHS Leeds West Clinical Commissioning Group (CCG) – representing all Leeds’ CCGs

-  Angie Craig, Head of Performance, Leeds Teaching Hospitals NHS Trust.

The key areas of discussion were:

·  Raising awareness and developing patient understanding of symptoms.

·  Challenges associated with the 2 week wait from GP referral and the 62-day treatment target – particularly in relation to referrals from outside the Leeds area.

·  The importance to consider and track outcomes alongside timed targets.

·  Confirmation that a review of outcomes was reported by Cancer Strategy Board.

RESOLVED –

(a)  That the Board notes the current situation regarding cancer performance and monitoring and the progress made to deliver better outcomes and shorter wait times for both Leeds patients and other patients treated at Leeds Teaching Hospitals NHS Trust.

(b)  That a further report on cancer outcomes be presented to a future meeting.

(c)  That the report presented be submitted to the West Yorkshire Joint Health Overview and Scrutiny Committee for further consideration.

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

The Head of Scrutiny and Member Development submitted a report which invited Members to consider the Board’s work schedule for the 2015/16 municipal year.

Members were advised that a working group was taking place (2nd week in December) to consider progress in relation to Integrated Health and Social Care Teams.

A Pharmacy workshop session was taking place in December – details regarding this to be forwarded to Board Members.

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

Tuesday, 22 December 2015 at 2:00pm (pre-meeting for all Board members at 1:30pm)

Following a short discussion, members agreed to start future meetings 30 minutes earlier than currently scheduled (i.e. 1:30pm rather than 2:00pm).  As such, the next meeting would be:

Tuesday, 22 December 2015 at 1.30pm (pre-meeting for all Board Members at 1.00pm)

(The meeting concluded at 5.15pm)