Agenda and minutes

Scrutiny Board (Adults,Health & Active Lifestyles)
Tuesday, 23rd April, 2019 1.30 pm

Venue: Civic Hall, Leeds, LS1 1UR

Contact: Steven Courtney (0113) 37 88666  Email: steven.courtney@leeds.gov.uk

Items
No. Item

CO-OPTEE  Dr J Beal – Healthwatch Leeds

 

83.

Appeals Against Refusal of Inspection of Documents

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 Head of Governance Services at least 24 hours before the meeting).

Minutes:

There were no appeals.

 

84.

Exempt Information - Possible Exclusion of the Press and Public

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.

Minutes:

The agenda contained no exempt information.

 

85.

Late Items

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

 

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

Minutes:

No formal late items of business were added to the agenda however the Board was in receipt of the following supplementary documents:

a)  Agenda item 6 – minutes of the meeting held 2nd April 2019 (minute 88 refers).

b)  Agenda item 8 – supplementary information provided by Leeds Teaching Hospitals NHS Trust setting out current practice in relation to bereavement services (minute 91 refers).

c)  Agenda item 10 – supplementary information containing the Scrutiny Position Statement on Urgent Treatment Centres in Leeds in relation to the Board’s work programme (minute 93 refers)

 

86.

Declaration of Disclosable Pecuniary Interests

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.

Minutes:

There were no declarations of disclosable pecuniary interests.

 

87.

Apologies for Absence and Notification of Substitutes

To receive any apologies for absence and notification of substitutes.

Minutes:

Apologies for absence were received from Councillor S Lay with no substitute member attending.

 

88.

Minutes - 2 April 2019 pdf icon PDF 334 KB

To approve as a correct record the minutes of the meeting held on 2 April 2019. (To follow).

 

 

 

Minutes:

RESOLVED – That the minutes of the meeting held 2nd April 2019 be agreed as a correct record.

 

89.

Matters Arising

Minutes:

Homecare provision – A member of the Board requested an update on the implementation and impact of the two delegated decisions regarding (i) Payment during service user hospitalisation; and (ii) the Interim Homecare Service (previously referred to at the Rapid Response Service). The Chair reported that the Adults and Health Directorate had commenced a review of the current homecare contract framework in preparation for a new framework arrangement (in approximately two years). The Principal Scrutiny Adviser identified that an update on the areas identified could be incorporated into a broader report on the quality of services for adults and older people, currently scheduled for June 2019. This report would also include details of the Care Quality Commission inspection outcomes routinely reported to the Scrutiny Board.

 

90.

Overview of the NHS Long Term Plan pdf icon PDF 328 KB

To consider a report from the Director of Adults and Health that provides an overview of the NHS Long Term Plan and some of the initial implications for Leeds and the region.

 

 

 

Minutes:

The Director of Adults and Health submitted a report that provided an overview of the NHS Long Term Plan (the Plan) and some of the initial implications for Leeds and the region.

 

Tony Cooke, Chief Officer, Health Partnerships, attended the meeting and in presenting the report, highlighted the following key elements of focus in the Plan for the Boards consideration:

·  The Plan presented a real commitment to person centred care through the integration of health and care provision and a focus on care closer to a patient’s home.

·  The Plan indicated a shift away from competition in the provision of services – with an emphasis on collaboration and partnership working.

·  The uplift in NHS funding indicated in the Plan was welcomed; however the need to recognise the social and economic wider determinants of health as key drivers for a lifetime of good health was also acknowledged.

·  The Plan reflected the approach being adopted in Leeds; with a number of measures already in place to support health and care in the city, many of which were stronger and more established than those suggested in the Plan, such as the Neighbourhood Networks and strength based approach to social care.

·  Although the Plan referenced health inequalities, further focus on mental health and learning disabilities would be welcomed.

 

Members discussed a number of matters including:

 

Inequality – The need to retain focus on the links between health, housing and finance and inequality was not emphasised within the Plan.

 

Green Paper on Adult Social Care (ASC) - Publication of the Government’s Green Paper was still awaited. Concerns remained over the long-term and sustainable funding of ASC and associated governance arrangements

 

Local Care Partnerships – Discussion focussed on the level of consultation and engagement undertaken with Councillors so far and how their comments could inform the emerging LCPs. Additionally, Members requested details of the proposed governance arrangements and level of Member involvement in LCPs. The intention to present a report on arrangements for Local Care Partnerships to a future Executive Board meeting was noted.

 

Funding for Rough Sleepers – It was felt that the £30m national allocation was insufficient to meet nationwide needs.

 

Mental Health Crisis Point of Access – Noting the national target for provision by 2023/24, the Board highlighted the need for earlier provision in Leeds.

 

Consultation and engagement – The Board emphasised the importance of meaningful consultation with residents and patients in developing improvements in health and care provision.

 

Nursing and residential home care placements – A comment regarding patients receiving care in nursing and residential home care settings rather than at home highlighted that such placements were not referenced within the Plan.

 

RESOLVED -

a)  That the contents of the report providing an overview of the NHS Long Term Plan and the discussions at the meeting be noted.

b)  That it be noted that the Leeds Health and Wellbeing Board will continue to provide strategic leadership for the Leeds Health and Care Plan and as part of its refresh influence the development  ...  view the full minutes text for item 90.

91.

Bereavement Arrangements at Leeds Teaching Hospitals NHS Trust pdf icon PDF 144 KB

To consider a report from the Head of Governance and Scrutiny Support that summarise work undertaken associated with the bereavement arrangements at Leeds Teaching Hospitals NHS Trust (LTHT). It also introduces the fuller and more formal update from the Trust to help the Scrutiny Board set out its formal position by the end of the municipal year. 

 

Additional documents:

Minutes:

The Head of Governance and Scrutiny Support submitted a report summarising the work undertaken associated with the bereavement arrangements at Leeds Teaching Hospitals NHS Trust (LTHT). It also introduced a formal update from the Trust to help the Scrutiny Board set out its formal position on this issue before the end of the 2018/19 municipal year.

 

The report included at Appendix 1 a copy of a letter sent to LTHT by the Chair, Scrutiny Board Adults, Health and Active Lifestyles in December 2018 summarising the main issues of enquiry from the Board. The response of Leeds Teaching Hospitals NHS Trust which provided a position statement on bereavement services and current practice within LTHT had been provided as supplementary information prior to the meeting. 

 

The following were in attendance:

·  Mark Philpott – General Manager, Pathology Clinical Service Unit, Leeds Teaching Hospitals NHS Trust

·  Angie Craig – Assistant Director of Operations, Leeds Teaching Hospitals NHS Trust

·  Krystina Kozlowska – Head of Patient Experience, Leeds Teaching Hospitals NHS Trust

 

In presenting the report, the General Manager, Pathology Clinical Service Unit, and the Assistant Director of Operations, Leeds Teaching Hospitals NHS Trust (LTHT) provided a summary of progress since December 2018, including:

·  Information on arrangements for the release of a deceased patient out of hours, noting the need to ensure timely release of deceased patients to meet the cultural and religious requirements of communities, including the Jewish and Muslim communities.

·  Liaison between LTHT, the Registrars of Births, Deaths and Marriages and the Coroner for West Yorkshire to provide the timely release of bodies and access to non-invasive post mortem investigations in Leeds; alongside a consistency of approach to bereavement services across the West Yorkshire and Harrogate Health and Care Partnership footprint.

·  LTHT’s current benchmarking activity to review practice and compare performance against peers within the West Yorkshire Association of Acute Trusts and more widely.

 

Councillor M Iqbal, who stated he had over 20 years experience of providing support to many families during their time of bereavement, reported positively on his dealings with the Pathology Unit, Registrars and Coroner’s office.

 

Members discussed a number of matters including:

 

Non coroner reportable deaths in hours – Identified the need for consistency of approach to the timely completion of the Medical Certificate of Cause of Death and release of the deceased to an appointed funeral director. The Chair requested an update be provided to Board Members on obtaining MCCD’s.

 

Access to LTHT bereavement services – Mortuary and Bereavement Office opening times were reported to cause some difficulty to those families seeking to comply with cultural or religious funeral requirements or seeking to undertake a repatriation.

 

Support for the provision of non-invasive post-mortems – It was reported that one of the facilities based in Bradford had closed, which would impact on the availability of this service for Leeds residents. The Board supported the establishment of a non-invasive post mortem suite in Leeds and considered whether Leeds City Council could take a similar approach to the City of Bradford Council  ...  view the full minutes text for item 91.

92.

Chair's Update pdf icon PDF 209 KB

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

 

Minutes:

The Board received an informal update from the Chair on areas of work and activity undertaken since the previous Scrutiny Board meeting on 2nd April 2019, including:

 

Access to Dentistry – The Chair reported on discussions held at the West Yorkshire and Harrogate Joint Health Overview and Scrutiny Committee meeting on 8th April 2019 regarding the service changes implemented on 1st April 2019. The Chair reported the Joint Committee’s dissatisfaction with the amount of consultation and detail provided by NHS England. A request for the Board to further consider the new urgent dental care contracts, alongside the review of community dentistry in Leeds being undertaken by Leeds Community Healthcare NHS Trust and NHS England, was noted.

 

Vascular Services - The Chair reported that progress was being made to formalise the necessary mandatory joint health scrutiny arrangements for West Yorkshire and Harrogate in order to present a joint response to NHS England’s consultation plans on proposed changes to urgent vascular services.

 

Autism Accommodation – The closure of Ashlar House was reported; alongside arrangements to assess service user needs and provide suitable accommodation for the current residents. In response to a concern raised about sufficiency of provision of this type of accommodation and care in Leeds, it was reiterated that the needs of existing residents were being assessed in order to identify how and where those needs could be met in the future. The Board sought assurance that the closure would not result in a net reduction in provision across the city.

 

RESOLVED

(a)  That the contents of the informal report and the verbal update be noted and reflected in the development of the Board’s work schedule.

(b)  That further assurance regarding the closure of Ashlar House identified at the meeting, be sought on behalf of the Board.

 

(Councillor M Iqbal withdrew from the meeting for a short while during consideration of this item).

 

93.

Work Schedule pdf icon PDF 161 KB

To consider a summary of the Scrutiny Board’s work schedule for the 2018/19 municipal year and an outline work schedule for the successor Scrutiny Board in 2019/20.

 

Additional documents:

Minutes:

The Head of Governance and Scrutiny Support submitted a report which invited Members to consider the development of the Board’s work schedule for the 2018/19 municipal year, and suggestions for areas of focus for 2019/20. The Principal Scrutiny Adviser introduced the report and outlined the areas within the report and associated work schedule.

 

A summary of the work schedule for 2018/19 was attached as Appendix 1 with a copy of the minutes of the Executive Board meeting held 20th March attached as Appendix 2.

 

A draft schedule of planned meeting dates for the 2019/20 Municipal Year, including known items of scrutiny activity, was attached as appendix 3 for the Board’s consideration which was welcomed as a useful approach to the start of the new Municipal Year.

 

The proposed draft Scrutiny Statement on Urgent Treatment Centres in Leeds was also presented for consideration and approval. Two outstanding Board responses – a Position Statement on Mental Health Services and the Integrated Market Position Statement – would be shared with Board Members in due course and published subject to their agreement.

 

The Board noted the following matters raised during discussions:

 

Quality Accounts – The joint HealthWatch/Scrutiny Board meeting to formulate a joint comment to each NHS providers’ draft quality accounts was scheduled for 24th April 2019.

 

GPs issuing MCCD’s and contract renewals – In response to a comment on the issuing of MCCD’s out of hours and any provision within renewed GP contracts, the Chair agreed that this issue could be raised with the GP Federation. Additionally, progress on previous discussions on a proposal to train Residential and Nursing Care Home nursing staff to be responsible for signing MCCD’s at weekends would be pursued.

 

RESOLVED

(a)  That the 2018/19 work schedule be used as the basis for the Board’s contribution to the 2018/19 Annual Scrutiny Report to be presented to Council in July 2019. 

(b)  That the 2019/20 outline work schedule presented be agreed as the basis for the new municipal year, with the addition of the requests made during the meeting.

(c)  That the minutes of the Executive Board meeting held 20 March 2019 be noted.

(d)  That the draft Scrutiny Statement on Urgent Treatment Centres in Leeds be agreed.

(e)  That the draft position statements on Mental Health Services and the Integrated Market Position Statement be circulated outside of the meeting for comment and agreement.

(f)  That the arrangements to consider the draft Quality Accounts previously agreed by the Board be noted. 

 

94.

Date and Time of Next Meeting

Minutes:

RESOLVED – To note the next meeting is proposed as Tuesday 25th June 2019 at 1.30pm (with a pre-meeting for Board Members at 1.00 pm).

 

 

At the conclusion of the meeting, the Chair thanked all members of the Board for their contributions throughout the course of the year.

 

The meeting closed at 3:00pm.