Agenda and minutes

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).

There were no appeals.

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.

There was 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.

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 declarations.

To receive any apologies for absence and notification of substitutes.

Apologies for absence were submitted on behalf of Councillors C Knight, S Lay and D Ragan.

To approve as a correct record the minutes of the meeting held on 7 January 2020.

RESOLVED – That the minutes of the meeting held on 7 January 2020 be confirmed as a correct record.

To consider a report from the Head of Democratic Services introducing the proposed reconfiguration of maternity and neonatal services in Leeds; alongside details of the associated public consultation.

The report of the Head of Democratic Services introduced the proposed reconfiguration of maternity and neonatal services in Leeds alongside details of the associated public consultation.

Appendices to the report gave an overview of Maternity and Neonatal Services in Leeds and introduced the proposals for the reconfiguration of services.

The following were in attendance for this item:

·  Dr Kelly Cohen, Consultant in Fetal Medicine and Obstetrics & Clinical Director, Women's CSU (Leeds Teaching Hospitals NHS Trust)

·  Dr Hannah Shore, Lead Clinician Neonatal Service (Leeds Teaching Hospitals NHS Trust)

·  Dr Jane Mischenko, Lead Strategic Commissioner: Children & Maternity Care, (NHS Leeds Clinical Commissioning Group)

·  Sarah Halstead, Senior Service Specialist (NHS England Specialised Commissioning)

·  Shak Rafiq, Communications Manager (NHS Leeds Clinical Commissioning Group)

The Board was shown a short video presentation with regard to the proposed reconfiguration of Maternity and Neonatal Services in Leeds.

The following was highlighted:

·  Midwifery led care had been highlighted as an issue from the Maternity Strategy and the proposed reconfiguration of services aimed to deliver this.  There was clear evidence in the benefits of the proposals.

·  Existing maternity arrangements at St James and LGI were virtually identical with different neonatal services.  This caused problems with having to transfer babies between the sites and also mothers being separated from babies where neonatal care was required.

In response to questions from the Board, the following was discussed:

·  Public consultation had been undertaken due to the significance of the proposed changes.

·  There had been recent changes to services at St James’s which had had a positive impact.  This had involved some pre-term deliveries being referred to LGI.

·  Impact on families when babies are transferred between the two hospital sites.

·  There were workforce challenges due to the size of the delivery unit at St James’s and the need to have doctors and nurses on stand by.

·  The trust worked closely with other trusts including Harrogate to provide neo-natal care and how the trusts can work better together.

·  The consultation process had included targeting hard to reach communities through Voluntary Action Leeds, other community groups and those with English as a second language.  Translators had been available at drop in events.

·  Mental health and emotional wellbeing had been an important part of the Maternity Strategy and there were pathways for perinatal mental health care.

·  Provision of bereavement services – there was co-ordination between in house teams and external services.  There was also support available for fathers.

·  Timescales and forthcoming consultations events.

Members of the Board were invited to visit the sites.

The Chair thanked those in attendance for their attendance and presentation.

RESOLVED – That the report and accompanying information be noted along with the associated key activities and timescales.

To consider a report from the Head of Democratic Services introducing a Leeds Teaching Hospitals NHS Trust report on access to services, particularly related to dermatology and spinal surgery services; alongside the latest Integrated Quality and Performance Report (January 2020) and an overview of the West Yorkshire Association of Acute Trusts (WYATT). 

The report of the Head of Democratic Services introduced a Leeds Teaching Hospitals NHS Trust report on access to services, particularly related to dermatology and spinal surgery services alongside the latest Integrated Quality and Performance Report (January 2020) and an overview of the West Yorkshire Association of Acute Trusts (WYATT).

The following were appended to the report:

-  Leeds Teaching Hospital Trust’s Integrated Quality and Performance Report

-  West Yorkshire Association of Acute Trusts Annual Report 2018/19.

The following were in attendance for this item:

·  Julian Hartley, Chief Executive (Leeds Teaching Hospitals NHS Trust)

·  Clare Smith, Director of Operations (Leeds Teaching Hospitals NHS Trust)

·  Matt Graham, WYAAT Programme Director.(Leeds Teaching Hospitals NHS Trust)

·  Helen Lewis, Interim Director of Commissioning, Acute, Mental Health and Learning Disability Services (NHS Leeds Clinical Commissioning Group)

An overview was given of access to Dermatology Services.  The following was highlighted:

·  Services were based at Chapel Allerton hospital.  81% of patients were commissioned by Leeds CCG with 11% coming from Calderdale.

·  There had been an increase in waiting times over the past 18 to 24 months with increased referrals from Calderdale putting pressure on the delivery of the service.  There had been a response with the provision of additional clinics and work was ongoing with Calderdale to address this.

·  Patients were taken on a clinical needs order and then chronological order.

·  Waiting times were currently around 11 weeks.

In response to questions, the following was discussed:

·  There was no problem with recruitment and there had been innovative practices including the use of tele-dermatology.

·  It was a challenge at a West Yorkshire level to meet capacity and demand and a network was being developed across West Yorkshire.

·  WYAAT held a monthly meeting to discuss key pressure areas.  There had been difficulties in Calderdale as they had been unable to recruit consultant dermatologists.

·  Concern that Leeds were having to take more patients from other areas and this affected treatment for Leeds residents.  It was reported that there were challenges across West Yorkshire and nationally.  Consideration was being given to demand and workforce issues and how these could be managed.

An overview was given of access to Spinal Surgery Services.  The following was highlighted:

·  Spinal services in Leeds were tertiary and covered West Yorkshire and Harrogate.

·  Most of the work was based at LGI with some out-clinics at Wharfedale.

·  There had been 52 patients waiting for spinal surgery across West Yorkshire over the 52 week waiting list target; 15 of these patients coming from Leeds.  This had reduced over the past two years with considerable improvement over the past year.

·  Reference was made to the ‘Getting it Right First Time Program’ which enabled efficiencies in the service.

In response to questions from the Board, the following was discussed:

·  Patients who had been waiting for longer periods had less clinically urgent cases than others.

·  Challenges facing the service – allocation of resources; complexity of cases often with other health issues and the impact of this on the wider service.  ...  view the full minutes text for item 91.

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

The report of the Head of Democratic Services provided an opportunity to formally outline some of the areas of work and activity of the Chair since the previous Board meeting in January 2020.

·  Co-Chaired HealthWatch Leeds event on Mental Health Crisis across Leeds.  An interactive event with a number of different table discussions that involved a range of stakeholders including NHS commissioners, NHS Mental Health Service Providers, Third Sector organisations, GPs and service users.

·  An update on the mandatory Joint Health Scrutiny Committee considering proposals to reconfigure specialist vascular services.   A further meeting of the Joint Committee was scheduled for 24 February 2020.

·  An outline of a meeting with Leeds Local Medical Committee scheduled for 21 February 2020; which would pick up on the work being undertaken on supporting Nursing Care Homes supporting GP services (particularly Out of Hours Service) in certifying expected deaths.

·  Outline of a recent pre-planning meeting around the East Leeds Extension Southern and Middle Quadrants and the engagement of the NHS in likely impacts and planning for the future.  Arrangements were being put in place for further discussions. 

RESOLVED – That the report be noted.

To consider the Scrutiny Board’s work schedule for the 2018/19 municipal year.

The report of the Head of Democratic Services invited Members to consider the Board’s work schedule for the remainder of the 2019/20 Municipal Year.

A copy of the outline work schedule and Executive Board minutes were appended to the report.

The Principal Scrutiny Adviser presented the report.  The following was highlighted:

·  Additional meetings for Adults Safeguarding and Public Consultation on Reconfiguration of Maternity/Neo-Natal Services.

·  Additional meeting to be arranged regarding the Leisure Centre referral.

RESOLVED – That the repot and Board’s work schedule for the remainder of the 2019/20 Municipal Year be noted.

The next meeting is scheduled for Tuesday, 31 March 2020 at 1:30pm (with a pre-meeting for all members of the Scrutiny Board at 1:00pm).

To note the additional meetings scheduled for:

·  21 April 2020

·  19 May 2020

(Both meetings to be held on Tuesday at 1.30 pm. (With a pre-meeting for Board Members at 1.00 pm))

Tuesday, 31 March 2020 at 1.30 p.m.

(Pre-meeting for all Board Members at 1.00 p.m.)