Agenda and draft minutes

Scrutiny Board (Adults,Health & Active Lifestyles)
Tuesday, 23rd July, 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-opted Member present - Dr J Beal

17.

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.

 

 

18.

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:

There were no exempt items.

 

 

19.

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:

There were no formal late items. However, the following supplementary information was distributed to at the beginning of the meeting in relation to Item 8 NHS Integrated Quality and Performance Report:

 

-  NHS Integrated Quality and Performance Report April 2019

 

 

20.

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.

 

 

21.

Apologies for Absence and Notification of Substitutes

To receive any apologies for absence and notification of substitutes.

Minutes:

Apologies for absence were received from Councillors C Anderson, C Knight and A Smart.

 

Councillor S Firth was in attendance as a substitute for Councillor C Anderson.

 

 

22.

Minutes - 25 June 2019 pdf icon PDF 324 KB

To approve as a correct record the minutes of the meeting held on 25 June 2019.

 

Minutes:

RESOLVED – That the draft minutes of the meeting held on 25th June 2019 be agreed as an accurate record.

 

Matters arising

 

In relation to Item 10, Dr Beal notified Members of a recent New York Times article titled ‘The 5G health hazard that isn’t’, which explained how an inaccurate recording of data has been misused to support claims that 5G is harmful to public health. Dr Beal urged interested parties to read the article.

 

The Chair thanked Dr Beal for drawing this to the attention of the Board; which supported the view of the Board when considering the related request for scrutiny.

 

 

23.

Request for Scrutiny - Inquiry into Endometriosis pdf icon PDF 298 KB

To consider a report from the Head of Democratic Services presenting a request for scrutiny, alongside some background information to help inform the Board’s consideration.

 

Additional documents:

Minutes:

The Head of Governance and Scrutiny Support submitted a report that presented a request for scrutiny, alongside some background information to help inform the Board’s consideration.

 

The following were in attendance:

 

-  Councillor Jonathan Pryor, Executive Member for Learning, Skills and Employment

-  Councillor Matthew Robinson

-  Tim Taylor, Head of Public Health (Localities & Primary Care), Adults and Health Directorate

 

The request for Scrutiny was submitted as follows:

 

‘To consider an inquiry into endometriosis, how easy it is to be diagnosed and how accessible support is across the city for women of different ages and backgrounds.’

 

The Executive Member for Learning, Skills and Employment presented the request for Scrutiny to the Board, informing Members of ongoing work to introduce free sanitary products to schools and community hubs, which uncovered the need for more support and understanding in relation to women’s reproductive issues and conditions such as Endometriosis.

Councillor Robinson informed the Board that he had been in contact with Endometriosis Support Sisters, a Leeds-based support group for Endometriosis, who had shared some women’s experiences in Leeds in relation to diagnosis, as well as support and treatment. Councillor Robinson noted in particular the impact of misdiagnosis on the mental health of those who suffer from the condition.

 

The Head of Public Health (Localities & Primary Care) informed Members that Endometriosis affects 10-20k women in Leeds, of which, 5-30% experience a severe form, which can have a large impact on their lives.

 

Members of the Scrutiny Board were also advised of the recently published report, ‘The State of Women’s Health in Leeds’ (March 2019), which included a specific section on reproductive health and identified a number of recommendations for health partners. Specific reference was made to Endometriosis within the reproductive health section of the report. 

 

Members felt that the issue required attention, however it was agreed that focus on women’s reproductive issues as a broader issue would be a more suitable approach than to focus exclusively on Endometriosis.

 

RESOLVED –

 

a)  That the contents of the report, along with Members comments, be noted;

b)  That an extraordinary meeting of the Board be arranged to focus on issues relating to women’s reproductive health;

c)  That the Endometriosis Support Sisters be invited to contribute to the meeting.

 

Councillor Iqbal left the meeting briefly during discussion of this item at 13:35 and returned at 13:55.

 

 

24.

NHS Integrated Performance Report pdf icon PDF 157 KB

To consider a report from the Head of Democratic Services introducing the NHS Integrated Performance Report and any specific matter highlighted by individual local NHS Trusts. 

 

 

Additional documents:

Minutes:

Head of Democratic Services submitted a report introducing the NHS Integrated Quality and Performance Report (IQPR) and any specific matter highlighted by individual local NHS Trusts.

 

The following was appended to the report:

 

-  IQPR February 2019

-  IQPR April 2019

 

The following were in attendance:

 

-  Sue Robins, Director of Operational Delivery, NHS Leeds CCG

-  Sam Prince, Executive Director of Operations, Leeds Community Healthcare (LCH)  NHS Trust

-  SajAzeb, Assistant Director of Operations, Leeds Teaching Hospitals NHS Trust (LTHT)

 

The Chair noted her disappointment that a representative of Leeds and York Partnership Foundation Trust (LYPFT) was not in attendance.

 

The Director of Operational Delivery (NHS Leeds CCG) introduced the report. Representatives from both of the NHS Trusts provided Members with further information regarding some of the main pressures, along with supporting action plans in place.

 

Members discussed a number of matters, including:

 

·  Data reporting style. Members commented that it would be useful to be provided with the increase or decrease in patient numbers in relation to each performance indicator, as an addition to the ’direction of travel’ arrows.

·  Independent sector. In response to a query, Members were informed that the independent sector are only commissioned for overflow and patient access purposes when internal providers are unavailable. Following the meeting, further information regarding patients who have accessed care via the independent sector would be provided to the Board.

·  Impact of public health campaigns. Members were informed that sudden increases of referrals for cancer screenings are often as a result of national public health campaigns, and significantly impact waiting times.

·  Indicators relating to care for those with learning difficulties. Members were informed that the figure only includes a very small cohort of patients, and as a result small changes are reflected significantly within percentages.

·  New contract for primary care mental health services. It was announced that Leeds Community Healthcare had been awarded the new contract for primary care mental health services, effective from November 2019. The Executive Director of Operations for LCH informed Members of a recent screening week to better understand the needs of the population and address therapy sites, and that each Local Care Partnership area would include two main sites for delivering services in partnership with a number of third sector organisations.

·  Comparative information. Members requested comparative information for other core cities with similar NHS Trusts be included in future reports across the range of performance measures presented.

 

 

RESOLVED – That the contents of the report, along with Members comments, be noted and actioned accordingly.

 

Councillor Lay left the meeting at 2pm during discussion of this item, and returned at 3.05pm.

 

 

25.

Leeds Dementia Strategy pdf icon PDF 121 KB

To consider a report from the Director of Adults and Health introducing Leeds Dementia Strategy.

Additional documents:

Minutes:

The Director of Adults and Health submitted a report introducing Leeds Dementia Strategy.

 

The following documents were appended to the report:

 

-  Progress and next steps

-  Equality, Diversity, Cohesion and Integration Screening

 

The following were in attendance:

 

-  Caroline Baria, Deputy Director Integrated Commissioning, Adults and Health

-  Tim Sanders, Commissioning Manager, Dementia, NHS Leeds Clinical Commissioning Group / Adults and Health

-  Kashif Ahmed, Head of Commissioning (Mental Health & Learning Disabilities), NHS Leeds Clinical Commissioning Group

 

The Deputy Director for Integrated Commissioning introduced the report. It was highlighting that the development of the Dementia Strategy was taking place alongside the development of the overall Leeds Mental Health Strategy.  It was reported that the development of the Leeds Mental Health Strategy would be presented to a future meeting of the Scrutiny Board.

 

The Commissioning Manager delivered a short presentation summarising the key elements of the Dementia Strategy.  .

 

Members discussed a number of matters, including:

 

·  Pathways for diagnosis and support. Members were informed that the online offer for diagnosis and support was currently undergoing improvement, and further work to develop pathways is taking place in partnership with universities and third sector organisations.

·  Insight from carers. Members were pleased to hear that consultation with Carers Leeds had taken place throughout the development of the strategy.

·  Respite care provision. Members were advised of the increased funding of the ‘Carers Breaks’ service, reflecting the change of focus towards supporting carers  providing intensive care, alongside the use of direct payments to help service uses match services to their needs.

·  The role of Neighbourhood Networks. Members were informed that Neighbourhood Networks work closely with dementia sufferers to support them to remain active, and to provide carers with respite. Members expressed concerns around the stability of funding, however were informed that the Neighbourhood Networks received annual recurrent funding directly from the CCG.

 

RESOLVED –

 

a)  That the contents of the report, along with Members comments, be noted;

b)  That the Board’s support for the development of the proposed strategy be noted.

 

 

26.

Mental Health Services for Adults and Older People in Wetherby pdf icon PDF 174 KB

To consider a report from the Head of Democratic Services introducing a range of information regarding proposed changes to Mental Health Services for Adults and Older People in Wetherby and the planned public / service user engagement activity.

 

Additional documents:

Minutes:

The Head of Democratic Services submitted a report that introduced a range of information regarding proposed changes to Mental Health Services for Adults and Older People in Wetherby and the planned public / service user engagement activity.

 

The following documents were appended to the report:

 

-  Developing mental health services for adults and older people in Harrogate and Rural District – Summary

-  Joint Health Overview and Scrutiny Committee for North Yorkshire County Council, City of York Council and Leeds City Council

-  Engagement Plan – Developing Mental Health Services in Harrogate and Wetherby

 

The following were in attendance:

 

-  Caroline Baria, Deputy Director Integrated Commissioning, Adults and Health

-  Kashif Ahmed, Head of Commissioning (Mental Health & Learning Disabilities), NHS Leeds Clinical Commissioning Group

-  Paul-Andrew Knox, Locality Manager, Tees, Esk and Wear Valley NHS Foundation Trust

-  Paul Hogarth, Locality Manager, Tees, Esk and Wear Valley NHS Foundation Trust

 

The Principal Scrutiny Adviser set out the proposals for service change, and the Head of Commissioning (Leeds CCG) provided more detail around the planned engagement and consultation.

 

Members discussed a number of matters, including:

 

·  Access to inpatient beds. The Chair commented that the proposals did not clearly set out that inpatient facilities in Harrogate would be closed, and that inpatient services would be relocated to York. CCG representatives noted that the proposed increase of community provision was intended to prevent admissions.

·  Transport considerations. Members felt that the proposals would have significant impact on families travelling to visit inpatients, if the closest inpatient facilities were provided in York. Members noted that many patients and their families are likely to be elderly, and that the distance to the proposed facilities, the level of access and associated costs were not acceptable.

·  Meeting Mental Health crisis needs. A member of the Scrutiny Board expressed significant concern about the proposals and questioned whether the proposals would meet the mental health crisis needs for the population of Wetherby and the affected surrounding areas.  Leeds CCG reported that challenges for community mental health services formed part of a national issue relating to mental health needs.

·  Alternative provision in Leeds. Members highlighted the need for the engagement activity to understand patient / public views around accessing in-patient services elsewhere (i.e. in Leeds) and queried whether Leeds and York Partnership Foundation NHS Trust (LYPFT) had sufficient capacity to meet the projected needs for service users in Wetherby and surrounding areas. Members were informed that this would create further pressure for LYPFT but Leeds CCG would work with both trusts to embed patient choice as part of the future arrangements.

·  Level of change. The Chair deemed ‘Level 3 – Significant Change’ as set out in the engagement plan to be incorrect for the purposes of the consultation, and considered ‘Level 4 – Major Change’ to be more appropriate. Members also expressed concern that the service change would affect a larger population than was originally reported, and therefore encouraged the CCG to contact other relevant local ward Members as part of  ...  view the full minutes text for item 26.

27.

Financial Performance - Adults and Health pdf icon PDF 220 KB

To consider a report from the Head of Democratic Services introducing the Council’s financial outturn position for 2018/19, specifically related to the Adults and Health Directorate.

 

 

 

Additional documents:

Minutes:

The Head of Democratic Services submitted a report that introduced the Council’s financial outturn position for 2018/19, specifically related to the Adults and Health Directorate.

 

The following were in attendance:

 

-  Caroline Baria, Deputy Director Integrated Commissioning, Adults and Health

-  Steve Hume, Chief Officer Resources and Strategy, Adults and Health

-  John Crowther, Head of Finance, Resources and Housing

 

The Chief Officer for Resources and Strategy introduced the report and highlighted some of the main challenges and expectations for the year, within a context of uncertainty for recurrent and non-recurrent funding.

 

RESOLVED – That the contents of the report be noted.

 

 

28.

Chair's Update pdf icon PDF 240 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.

 

Additional documents:

Minutes:

The Head of Governance and Scrutiny Support submitted a report that provided an opportunity for the Chair of the Scrutiny Board to outline some areas of work and activity since the previous Scrutiny Board meeting in June 2019.

 

The Chair provided an update to the Board regarding a number of matters, including:

 

·  Outcomes of public engagement and next steps around Urgent Treatment Centres in Leeds;

·  Notice of the contract award for the new primary care mental health contact in Leeds, as per conversations earlier in the meeting, awarded to a consortium led by Leeds Community Healthcare NHS Trust;

·  An overview of the discussions at Leeds Local Medical Committee meeting held 5th July 2019;

·  Notice of the suspension of Local Authority funded placements at a Nursing Care Home and Residential Care Home in Leeds, details of which were not made publically available due to commercial sensitivities;

·  Notification that a meeting between the Chair and Emma Wilson (NHS England) had been arranged for 25th July 2019 to discuss dentistry, as Emma was unable to attend the dedicated item at the previous meeting of the Board. Members would be provided with an update at the next Board meeting.

 

RESOLVED – That the contents of the report and the verbal update be noted and reflected in the development of the Board’s work schedule.

 

 

29.

Work Schedule pdf icon PDF 241 KB

To consider the Scrutiny Board’s work schedule for the 2019/20 municipal year.

 

Additional documents:

Minutes:

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

 

RESOLVED – That the outline work schedule presented, with the addition of the requests made during the meeting, be agreed.

 

 

30.

Date and Time of Next Meeting

Tuesday, 17 September 2019 at 1:30pm (pre-meeting for all Board Members at 1:00pm).

 

Minutes:

Tuesday, 17 September 2019 at 1:30pm (pre-meeting for all Board Members at 1:00pm).

 

The meeting ended at 4:55 pm.