Agenda item

To receive and consider the attached report of the Head of Scrutiny and Member Development.

John Lawlor, Chief Executive, NHS Leeds, to be in attendance.

The Head of Scrutiny and Member Development submitted a report on the local health economy – priorities for NHS Leeds.

The meeting noted that the new Chief Executive of NHS Leeds, Mr John Lawlor, formally came into post in January 2010. This meeting provided the first opportunity for the Scrutiny Board to discuss progress against the previously identified priorities and future issues likely to face the local health economy.

John Lawlor, Chief Executive, NHS Leeds was in attendance to provide a verbal overview of the local health economy and to address any associated observations and/or questions identified by the Board.

By way of introduction, Mr Lawlor outlined that, as part of the World Class Commissioning Programme, NHS Leeds was required to keep its strategic objectives under review and update its five-year strategy accordingly.  This process had commenced, resulting with the following draft objectives being identified:

• Keeping People Healthy
• Supporting Children and Families
• Supporting People with Long-term Conditions
• Commissioning Sustainable Services

Specific reference was also made to the following issues:

• The downward pressure on public sector finances, including the NHS.
• The need for continued focus on the reduction of health inequalities.
• Greater collaboration between NHS Leeds and Leeds City Council in terms of joint commissioning and joint provision of services.
• Designing and delivering services differently (intermediate care and dementia care services were identified as examples).
• Ensuring the delivery of high quality services.
• Ensuring that NHS Leeds was ‘fit for purpose (which will require management costs to be reduced by 30%).

A question and answer session followed, with Board Members making reference to a number of issues, including:-

• Greater collaboration between NHS Leeds and Leeds City Council and the possible pooling of resources

The Chief Executive responded and confirmed the need to consider arrangements for the  joint management of services and joint use of resources, including accommodation and other physical assets. It was highlighted that the collective budget of the Council and NHS Leeds was in the region of £3B (Council £1.7B and NHS Leeds £1.3B).  Therefore, wherever possible it was important to remove duplication across the respective organisations.

• Disabled access to dental facilities across the City

The Chief Executive advised Members that he was not in a position to advise the Scrutiny Board of any disabled access issues affect dental premises.  It was agreed that a written response would be provided in this regard.

• General health and well-being issues for mental health service users

The Chief Executive NHS Leeds confirmed there was a need for all NHS staff to consider the wider health needs of people that suffered mental ill-health, and the co-ordination of services was a key issue in this regard.  However, it was also confirmed that this continued to be a significant challenge for the NHS. 

• The implications for partnership working arising from the Council’s recent experiences  in relation to the Joint Service Centre in Kirkstall

The Chief Executive NHS Leeds acknowledged there were improvements to be made and lessons learned from the various processes associated with the Joint Service Centre in Kirkstall. It was confirmed that a report focusing on the lessons learned had recently been presented to the Scrutiny Board (City and Regional Partnerships).

• Clarification around the provision of community health care services

 The Chief Executive NHS Leeds confirmed that consideration was being given to  range of hospital based services that could be delivered in the community.  Key to this process was the involvement and engagement of clinicians to:

·  Promote and facilitate local solutions

·  Provide managerial / public assurances about the safety and quality of alternative services 

Reference was made to the recently introduced  Clinical Commissioning Executive, which would advise the Primary Care Trust Board prior to implementing any potential changes

• Clarification of how NHS Leeds would achieve a 30% reduction in management costs and any impact this may have on services

The Chief Executive NHS Leeds responded by making reference to a recent restructuring process which involved every vacancy being reviewed. It was outlined that working with and involving all staff would  be a key element and it was hoped that efficiencies could be made without the need for compulsory redundancies. The importance of protecting front line services was highlighted and re-emphasised as a key aim during this process.

It was noted that, of NHS Leeds’ £1.3B budget (previously outlined), around £20M was allocated to the operational or running costs of the PCT – representing 1.5% (approx.) of the total budget.

• Clarification of the arrangements for the Out of Hours service in Leeds

The Chief Executive NHS Leeds responded by outlining that the PCT was responsible for ensuring access to appropriate care on a 24/7 basis.  This included ensuring:

1. robust processes are in place to guarantee health care providers are fit to practice;
2. robust arrangements for the commissioning of quality Out of Hours services;
3. resources are targeted to help provide suitable access to Out of Hours services

RESOLVED-

a)  That the contents of the report, together with the verbal update provided at the meeting, be noted.

b)  That the Chief Executive (NHS Leeds) be invited to a future meeting of the Board to provide further updates, as appropriate.

(Councillor M Iqbal joined the meeting at 10.00am during consideration of this item)