Agenda and minutes

The Chair welcomed all present to the meeting and noted that, due to the General Election scheduled for 12^th December 2019, the meeting fell within the pre-election period.  While noting the normal business of Local Authorities, the NHS and decision makers continues during this period, the Chair referenced the Code of Recommended Practice on Local Authority Publicity and Care during periods of heightened sensitivity; and directed Members of the Joint Committee to Section 33 of the Code, which stated:

“Local authorities should pay particular regard to the legislation governing publicity during the period of heightened sensitivity before elections and referendums. . . . It may be necessary to suspend the hosting of material produced by third parties, or to close public forums during this period to avoid breaching any legal restrictions.”

With these details in mind, the Joint Committee considered and agreed a motion to suspend the “Public Statements” agenda item.

Former Councillor M Walton

Councillor Smaje reported that former Councillor Molly Walton had recently passed away. Councillor Walton had previously championed health scrutiny and in her capacity as Chair of Health Scrutiny in Kirklees, she had been involved in previous Joint Health Scrutiny arrangements.  The Joint Committee shared recollections of former Councillor Walton and expressed their sadness at her passing; extending condolences and best wishes to all her family and friends.

To consider any appeals in accordance with Procedure Rule 25* of the Access to Information Procedure Rules (in the event of an Appeal the press and public will be excluded).

(*In accordance with Procedure Rule 25, notice of an appeal must be received in writing by the Chief Democratic Services Officer at least 24 hours before the meeting.)

There were no appeals against the refusal of inspection of documents.

1  To highlight reports or appendices which officers have identified as containing exempt information, and where officers consider that the public interest in maintaining the exemption outweighs the public interest in disclosing the information, for the reasons outlined in the report.

2  To consider whether or not to accept the officers recommendation in respect of the above information.

3  If so, to formally pass the following resolution:-

  RESOLVED – That the press and public be excluded from the meeting during consideration of the following parts of the agenda designated as containing exempt information on the grounds that it is likely, in view of the nature of the business to be transacted or the nature of the proceedings, that if members of the press and public were present there would be disclosure to them of exempt information, as follows:

  No exempt items have been identified on this agenda.

The agenda contained no exempt information.

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 of business.

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.

No declarations of disclosable pecuniary interests were made.

To receive any apologies for absence and notification of substitutes.

Apologies for absence were received from:

·  Councillor S Baines (Calderdale Council)

·  Councillor J Clark (North Yorkshire County Council)

·  Councillor N Griffiths (Kirklees Council)

There were no substitute members in attendance. 

Additionally, Councillor Smaje reported the resignation of Councillor N Griffiths from the Joint Committee. As such, the position was currently vacant and a nomination from Kirklees Council would be made in due course.

Having noted the implications of the Code of Recommended Practice on Local Authority Publicity and Care during periods of heightened sensitivity (minute 15 above refers) the Joint Committee agreed to withdraw this item from the agenda.

RESOLVED – To withdraw this item from the agenda.

To confirm as a correct record, the minutes of the meeting held on 10 September 2019.

The Joint Committee noted a request to amend Minute No.10 West Yorkshire and Harrogate Health and Care Partnership Draft 5 Year Strategy to read as follows:

·  ‘When addressing the first section of the NHS Long Term Plan on primary care networks, the Strategy should reflect community care…’

RESOLVED – That, subject to the amendment to Minute 10 outlined above, the minutes of the previous meeting held 10^th September 2019 be agreed as a correct record.

To consider a report from Leeds City Council’s Head of Democratic Services introducing an update around the West Yorkshire and Harrogate Health and Care Partnership acute care collaboration priority; the West Yorkshire Association of Acute Trusts (WYAAT) collaborative forum and the associated Committee in Common.

Further to minute 34 of the meeting held 5^th December 2018, the Joint Committee received a report from Leeds City Council’s Head of Democratic Services introducing an update from the West Yorkshire Association of Acute Trusts (WYAAT).

The report included the WYAAT Annual Report 2019 which provided an outline of progress made since December 2018 alongside the ‘Our Progress and Achievements during 2018/2019’ document. An extract of the Joint Committee minutes of the meeting held 5^th December 2018 was included for reference.

The following were in attendance to present the report and contribute to discussions:

-  Matt Graham – WYAAT Programme Director

-  Helen Barker – Chief Operating Officer, Community Health Foundation Trust

-  Debbie Graham – Head of Integration and Partnerships, Calderdale CCG

-  Matt Walsh – Chief Officer Calderdale Clinical Commissioning Group.

In introducing the report, the following matters were raised:

Dermatology Services

At its previous meeting on 10 September 2019, the Joint Committee had briefly considered concerns raised by dermatology patients regarding changes to services; and requested an update for early consideration.  A verbal update was provided at the meeting – specifically for the Calderdale and Huddersfield NHS Foundation Trust (CHFT) area.  The main points raised included:

·  A Community Dermatology Service had been commissioned and recently established to deal with primary care patients initially. The development of a new service model was dependant on recruitment to the second tier consultant led dermatology provision, which remained a challenge.

·  CHFT was keen to utilise the support available through the West Yorkshire and Harrogate Health and Care Partnership (WYH HCP) approach of using West Yorkshire wide resources.

·  In respect of waiting lists, data collected showed an increase in referrals from Calderdale to Leeds, with Calderdale patients amounting to 22% of overall waiting lists. Predominantly however, the demand in Leeds remained Leeds based. The Joint Committee welcomed the offer to share the data with Members.

·  A national review of dermatology services had identified 100+ consultant vacancies. WYAAT had therefore determined to recruit an additional consultant to the Leeds team with the intention for that post-holder to also deliver services to CHFT.

The Joint Committee additionally discussed the following matters:

·  The impact of previous service models on the uptake of training by potential consultant practioners as a factor in the deficit of consultants.

·  Concern that as Trusts struggle to recruit; services could be reconfigured and as a result, patients have to travel to the centralised service rather than practitioners delivering the service in areas of need. Alternatively, in those areas where staff do deliver service between Trusts, there was a need to assess any impact on the availability of clinical appointments at the substantive location. 

·  Acknowledgement that first point of contact practitioners were required to enable the service to balance the spread of specialist practioners across the Trusts to ensure that service needs are met.

·  The Joint Committee heard that the intended service model of making appointments to a Service Hub which would deliver across the WYH footprint would mirror  ...  view the full minutes text for item 23.

To consider a report from Leeds City Council’s Head of Democratic Services introducing a report from the West Yorkshire and Harrogate Health and Care Partnership regarding the Improving Planned Care Programme.

The Joint Committee received a report from Leeds City Council’s Head of Democratic Services introducing a report from the West Yorkshire and Harrogate Health and Care Partnership on the Improving Planned Care Programme.

The report included a copy of the West Yorkshire and Harrogate Improving Planned Care and Reducing Variation programme (Elective Care and Standardisation of Commissioning policies) at Appendix 1, which focussed on reducing the health inequalities evident across the West Yorkshire and Harrogate system and specifically clinical thresholds, clinical pathways and prescribing.

The following were in attendance to present the report and support discussions:

-  Dr Matt Walsh – Chief Officer, Calderdale Clinical Commissioning Group and Senior Responsible Officer, Improving Planned Care Programme

-  Catherine Thompson – Director, Improving Planned Care Programme

In presenting the report, the following work streams within the Programme and matters were highlighted:

·  Discussions on the complexities of culture, values, place and system within the Improving Planned Care (IPC) Programme were being held at ‘place’ level, however there was a desire for these to include the Joint Committee to provide assurance that the right discussions were being held.

·  The Joint Committee of CCGs provided governance for the workplan elements of the IPC Programme. The workplan currently covered 2 high volume services – Eye Care and Musculoskeletal. Standardised clinical policies had been established for both areas, such as commissioning policies and thresholds.

·  The Programme sought to create equitable care, service provision and access to services across WYH with fully evidenced high quality pathways. How to apply each pathway would be determined by place to shape the delivery of services.

In terms of Programme implementation, it was recognised that in some workstreams, such as workforce, WYH was the appropriate level, and not place. The Programme included a review of clinics to ensure best practice and efficiencies, and equity audits to better understand variations of practice and quality in cataract and knee/hip surgery. Consideration was also being given to the creation of a single prescribing committee.

In terms of workforce development, it was reported that funding had been secured to support the Eye Care Programme, as follows:

·  To establish 20 places for a first year cohort of ‘First Contact’ practitioners, the aim being to train 50 in total.

·  To provide enhanced skills training for 60 optometrists which will enable them to undertake ophthalmologist’s tasks

·  To provide training to create Advanced Practice Nurses to enable nurses to undertake some eye care tasks where there is evidence that it is safe for them to do so.

The Joint Committee considered and discussed a range of matters relating to the Improving Planned Care Programme, including:

Pathways – The Joint Committee sought information relating to the monitoring of pathway delivery, whether pathways already established within WYH had been reviewed and how they were delivered for local needs. A Joint Committee member provided the meeting with his personal experience of receiving care for the same issue at both regional and local level.

In response, the Joint Committee received assurance that the  ...  view the full minutes text for item 24.

To consider a report from Leeds City Council’s Head of Democratic Services presenting a further iteration of the West Yorkshire and Harrogate Health and Care Partnership draft five year strategy.

Further to minute 10 of the meeting held 10^th September 2019, Leeds City Council’s Head of Democratic Services submitted a further report which provided the Joint Committee with an opportunity to review the work undertaken by the West Yorkshire and Harrogate Health and Care Partnership on developing the Draft 5 Year Strategy. The first iteration of the Strategy was considered by the West Yorkshire and Harrogate Health and Care Partnership Board (WYH Partnership Board) meeting on 3^rd September 2019.

The Joint Committee noted that the final system narrative would be presented to the Partnership Board on 3^rd December 2019; however, despite being requested, an updated iteration of the draft 5 year strategy had not been made available to the Joint Committee for review.

The report included a brief update provided by the Partnership Director, outlining the development of the draft five year strategy and next steps. The first iteration of the draft strategy and accompanying presentation previously considered by the Joint Committee in September 2019 were also included within the report.

The following were in attendance to present the report and contribute to discussions:

-  Ian Holmes – Director, West Yorkshire and Harrogate Health and Care Partnership.

-  Rachael Loftus - Head of Regional Partnerships, Health Partnerships Team

In presenting the report, it was highlighted that the next draft of the 5 Year Strategy would be made public on 26^th November 2019 as part of the agenda papers for the Partnership Board meeting on 3^rd December 2019.

The Joint Committee considered and discussed a range of matters regarding the development of the 5 Year Strategy, including:

·  Concern that an updated iteration of the draft strategy, such as that submitted to NHS England on 27 September or 15 November, was not made available for the Joint Committee to review and receive assurance that comments made and issues raised at the September meeting had been addressed.

·  The Joint Committee noted the response that the version submitted to NHS E had included comments made by the Joint Committee and also local Health and Wellbeing Boards which had met by that date. The Joint Committee was advised that none of the Local Authority Leaders or Health and Wellbeing Board Chairs had seen the revised Strategy as yet; and those who were members of the WYH Partnership Board would receive a copy on 26^th November 2019

·  The technical process for the submission of the updated draft document, noting that comments from partners and interested parties had been received throughout the consultation process.

·  The implications of the General Election on 12^th December 2019, noting that, due to the guidance issued surrounding the pre-election period and decisions on future strategy, the WYH Partnership Board on 3^rd December 2019 may decide to postpone a decision on the 5 Year Strategy or to support the Strategy subject to the outcome of the election.

·  While noting that the draft strategy and its contents had predominantly been prepared by NHS partners, the Joint  ...  view the full minutes text for item 25.

To consider a report from Leeds City Council’s Head of Democratic Services presenting the Joint Committee’s future work programme.

The Joint Committee received a report from Leeds City Council’s Head of Democratic Services on the continuing development of the Joint Committee’s future work programme.

The Principal Scrutiny Adviser highlighted the challenges of establishing the work programme as the Joint Committee’s priorities and areas of interest changed throughout the year in response to emerging issues. The Principal Scrutiny Advisor also précised additional issues raised at this meeting as the basis for discussion.

The Joint Committee discussed the roles of and relationship between Health and Wellbeing Boards and Scrutiny Committees/ Boards at a local, place-based level.  

The Joint Committee also identified the following work areas for further consideration:

·  How to gain an oversight of service provider work programmes and link into the decision making group level such as the WYH Health and Care Partnership’s System Oversight and Assurance Group (SOAG);

·  How to raise the profile of the Joint Committee, particularly in terms of the overview function, with a view to seeking formal representation at the WYH Partnership Board.

RESOLVED –

a)  To note the report presented to the meeting and the contents of the discussions. 

b)  That the specific matters highlighted at the meeting be prioritised for consideration by the Joint Committee. 

The next meetings of the Joint Committee are currently scheduled as follows:

·  Tuesday, 18^th February 2020

·  Tuesday, 14^th April 2020

All meetings to start at 10:30 am (with pre-meeting for all members of the Joint Committee at 10:00 am) and are currently scheduled to be held at Leeds Civic Hall.

RESOLVED – To note the schedule of future meetings as

Tuesday 18^th February 2020

Tuesday 14^th April 2020

The formal meetings to commence at 10.30 am (with a pre-meeting for all members of the Joint committee at 10.00 am) to be held at the Civic Hall, Leeds.