Agenda and minutes

The Chair welcomed everyone to the March meeting of the Scrutiny Board (Health and Well-being and Adult Social Care).

He informed the Board that this represented the final Scrutiny Board meeting before Leeds Local Involvement Network would cease to exist as the new structural arrangements for the NHS and wider Health economy come into force on 1^st April 2013.

On behalf of all members of the Scrutiny Board, the Chair thanked co-opted members Joy Fisher and Betty Smithson, in their capacity as representatives of Leeds LINK ,for their valuable contributions to the Board over a number of years.

The Board agreed the both Joy Fisher and Betty Smithson should continue as co-opted members on the Board, as general patient / service user representatives, for the remainder of the 2012/13 municipal year.

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 disclosable pecuniary interests declared to the meeting, however, in relation to the item entitled, ‘Charges for Non-Residential Adult Social Care Services’, Councillor S Varley drew the Board’s attention to the fact that she was a Member of the Cross Party Board for the Charging Review.  Joy Fisher and Emma Stewart also drew the Board’s attention to their roles on the Service Expert Advisory Group involved in the review process.  (Minute 98 refers). 

To receive any apologies for absence and notification of substitutes.

Apologies for absence were received on behalf of Councillor T Murray and Betty Smithson, Leeds LINk.

Notification had been received for Councillor C Gruen to substitute for Councillor T Murray.

To confirm as a correct record, the minutes of the meeting held on 20^th February 2013.

(Copy to follow)

The Principal Scrutiny Adviser informed the meeting that the minutes of the previous meeting held on 20^th February 2013 were not available.  He apologised for this omission and it was noted that a copy would be submitted to the next meeting for approval.

To receive and consider a report from the Director of Adult Social Services informing the Scrutiny Board of the outcomes of the stakeholder consultation and engagement on the Adult Social Care charging review for non-residential services.

The Director of Adult Social Services submitted a report informing the Scrutiny Board of the outcomes of the stakeholder consultation and engagement on the Adult Social Care charging review for non-residential services.

Appended to the report were copies of the following documents for the information/comment of the meeting:

• Adult Social Care – Charging Review for Non-Residential Services 2012/13 – Report on the Consultation and Engagement – March 2013
• Adult Social Care – Charging for Non-Residential Services Feedback Form (Appendix 1 refers)
• Charging Review – Consultation Events Summary (Appendix 2 refers)
• Charging Review 2012 2012 – Feedback Forms Summary (Appendix 3 refers)
• Feedback Form Summary (Appendix 4 refers)
• Charging Review Consultation Feedback – Statistically Significant Variations (Appendix 5 refers).

The following representatives were in attendance and responded to Members’ queries and comments:

-  Councillor Lucinda Yeadon (Executive Board Member for Adult Social Services) – Leeds City Council

-  Sandie Keene (Director of Adult Social Services) – Leeds City Council

-  Janet Somers (Consultation and Involvement Officer) – Leeds City Council, Adult Social Services

-  Alden Chadwick (Charging Review Project Manager) – Leeds City Council, Adult Social Services.

At the request of the Chair, the Executive Board Member for Adult Social Services presented the report highlighting the following key areas:

• that the consultation had informed the revised charging proposals contained in the Charging Review report to be presented to the Executive Board on 24 April 2013
• that each stage of the consultation process had been discussed at the all-party group
• that service users comments will be included in the Charging Review Report to the Executive Board
• that the report to be considered today details the intensive consultation process
• that it was originally planned to bring the consultation report earlier in the year but the complex processes (particularly around CareRing) took more time than expected.

In summary, specific reference was made to the following areas:

• Clarification of the aims of the CareRing and Telecare Service; Home based Sitting Service and Mental Health Services.
• To congratulate officers in achieving a feedback of 4,000 forms
• Clarification of how CareRing compared with other telecare services provided by private organisations.

(The Director of Adult Social Services responded and explained that there are few 3rd sector providers of alarm services – however she knew that Age UK provided a service. She pointed out that we would be looking at the revised charges and charging comparisons at the workshop on 12 April.)

• Clarification regarding Adult Social Care’s knowledge of service users use of attendance allowance i.e. if they used the allowance to contribute to their charges.

(The Director of Adult Social Services responded and explained that attendance allowance is not taken into account in assessing people’s contribution. However, Adult Social Care has no way of requiring people to use their attendance allowance to pay for services.)

• Concerns that it was unfair that CareRing service users wouldn’t have a financial assessment, because if they did, the majority wouldn’t have to pay anything.

(The Director of Adult Social Services responded  ...  view the full minutes text for item 98.

To receive and consider a report from the Assistant Chief Executive (Customer Access and Performance) providing a summary of performance against the strategic priorities relevant to the Health and Well-being and Adult Social Care Scrutiny Board.

The Assistant Chief Executive (Customer Access and Performance) submitted a report providing a summary of performance against the strategic priorities relevant to the Health and Well-being and Adult Social Care Scrutiny Board.

Appended to the report were copies of the following documents for the information / comment of the meeting:

·  Performance Reports for the Health and Wellbeing City Priority Plan Priorities 2012/13 Quarter 3 (Appendix 1 refers)

·  Adult Social Care Directorate Priorities and Indicators (Appendix 2 refers).

The following representatives were in attendance and responded to Members’ queries and comments:-

-  Councillor L Yeadon (Executive Board Member for Adult Social Services) – Leeds City Council

-  Sandie Keene (Director of Adult Social Services) – Leeds City Council

-  Stuart Cameron-Strickland (Head of Policy, Performance and Improvement) – Leeds City Council, Adult Social Services

-  Dr. Ian Cameron (Joint Director of Public Health) – NHS Airedale Bradford and Leeds/Leeds City Council.

In summary, specific reference was made to the following areas:

·  The need to make more headway on the smoking figures.

(The Joint Director of Public Health responded and confirmed that tobacco would be included in the Children and Young Peoples’ Plan.

Further work was being undertaken on smokeless tobacco and from 1^st April 2013 the three Clinical Commissioning Groups would be addressing smoking cessation with a view to taking ownership of the issue.  However tobacco would remain a top priority for the Board.)

·  Clarification of the role of people trained to be peer assessors.

(The Joint Director of Public Health responded and agreed to come back on the timescale issues via the Principal Scrutiny Adviser.)

·  The need to avoid implementing more and more reviews and strategies in this area and to seek practical advice from other local authorities in this area.

·  The need to target schools with a view to catching them young when discussing the dangers of tobacco smoking.

·  Clarification of the total spend on smoking cessation.

(The Joint Director of Public Health responded and agreed to come back on the costings via the Principal Scrutiny Adviser.)

·  Clarification of how much was invested by the Council in tobacco firms in relation to the West Yorkshire Pensions Fund.

·  Clarification of the data used in relation to Leeds being named ‘Best City for Health and Wellbeing’.

(The Joint Director of Public Health responded and highlighted the delays in accessing data due to the changes within the NHS.)

·  To express concerns again that the gap was not narrowing.

·  The need for the Board to acknowledge that poverty and children was a huge issue for the Board and of the fact that poverty had improved over the last 30 years.

·  The need to acknowledge the importance of starting with a partnership approach to tackle inequality of health.

·  Clarification of how the Board’s recommendations made last year on fuel poverty and free school meals were being taken forward.

·  Clarification as to why the target around helping people with poor physical or mental health to learn or relearn the skills for daily living was  ...  view the full minutes text for item 99.

To receive and consider a report from the Head of Scrutiny and Member Development outlining the strengths and areas for development in relation to the Health and Well-being Board.

The Head of Scrutiny and Member Development submitted a report outlining the strengths and areas for development in relation to the Health and Well-being Board.

Appended to the report was a copy of a document entitled ‘Review of Partnership Boards’ prepared by the Shadow Health and Wellbeing Board for the information/comment of the meeting.

The following representatives were in attendance and responded to Members’ queries and comments:

-  Councillor Lisa Mulherin (Executive Board Member for Health and Wellbeing) Chair of Leeds’ Shadow Health and Wellbeing Board

-  Rob Kenyon (Head of Partnerships and Organisational Effectiveness) – Leeds City Council, Adult Social Services

-  Dr Andy Harris, Leeds South and East Clinical Commissioning Group – Shadow Health and Wellbeing Board

-  Susie Brown, Third Sector Leeds – Shadow Health and Wellbeing Board.

At the request of the Chair, the Executive Board Member for Health and Wellbeing and Chair of Leeds’ Shadow Health and Wellbeing Board presented the report with specific reference to the memebership of the Board and the proposals in place for the end of May when the new Board goes ‘live’. 

It was noted that the Shadow Health and Wellbeing Board was at a different stage of development to other Strategic Partnerships, with the key focus being on influencing commissioning and service delivery.  It was also noted that health service providers were not represented on the shadow board.

An outline of the draft Health and Wellbeing Strategy was provided, to help demonstrate the joint working and planning that had taken place within the shadow board. 

In summary, specific reference was made to a number of areas, including the following matters:

• The balance between preventative medicine and acute services.

(It was highlighted that the transfer of public health responsibilities to the Council provided significant opportunities to influence health outcomes – through a whole-council approach.  One of the aims of the Health and Wellbeing Strategy was to raise aspirations within communities and to jointly address priority areas: a key focus being the wider determinants of health and wellbeing.)

• Data sharing across the Leeds health economy and organisational boundaries.

(The role of Health Champions/ Area Leads was highlighted as offering important links into the overall Health and Wellbeing Strategy)

• Clarification around the definition of ‘Deprived Leeds’ referred to within the report.

(It was clarified this referred to Medium Super Output Areas (MSOAs) – each with a population of around 7,000.  Those MSOA’s identified as being in the bottom 10% nationally were classed as representing ‘Deprived Leeds’.) 

• The representative and advocacy role played by Third Sector Leeds as part of the membership of the (shadow) Health and Wellbeing Board.
• A pragmatic approach to demonstrating progress in priority areas highlighted in the draft Health and Wellbeing Strategy.
• The role and benefit of the Health and Wellbeing Board in helping to target resources effectively across the City.

RESOLVED –

a)  That the contents of the report and appendices be noted.

b)  That this Board takes specific note of the:

a.  Context of the shadow board  ...  view the full minutes text for item 100.

To receive and consider a report from the Head of Scrutiny and Member Development outlining the Scrutiny Board’s work schedule for the remainder of the municipal year.

The Head of Scrutiny and Member Development submitted a report which presented the Scrutiny Board’s outline schedule for the remainder of the current year.

Appended to the report were copies of the following documents for the information/comment of the meeting:

• Scrutiny Board (Health and Wellbeing and Social Care) 2012/13 Municipal Year – Work Schedule (Appendix 1 refers)
• Review of Children’s Congenital Cardiac Services – Copy of the High Court Full Judgement (Appendix 2 refers)
• ‘’Save and Sustainable Review of Children’s Congenital Heart Services’’ – IRP Review – Letter from the Department of Health dated 15^th March 2013 (Appendix 3 refers)
• Executive Board minutes of a meeting held on 13^th March 2013 (Appendix 4 refers).

The Principal Scrutiny Adviser presented the report and responded to Members’ queries and comments.

In summary, specific reference was made to the following areas:

• The need for the Board to address the movement of services within the NHS.
• The need for the Board consider the role of the three Clinical Commissioning Groups and their respective commissioning plans.
• Discussion around Primary Care and the merits of undertaking an inquiry that considers access to primary care services (with particular reference to GP access times and access to pharmacy services.)
• Waiting times for minor injuries and Accident and Emergency.
• Further discussions about the development of Healthwatch Leeds.

The Principal Scrutiny Adviser made specific reference to the Scrutiny Board Working Group meeting on 12^th April 2013 to consider the charging proposals.

Reference was also made to proposals around unplanned dental services in West Yorkshire with a provisional date of 15^th April 2013 set aside for a Scrutiny Board Working Group to consider this issue. The Principal Scrutiny Adviser agreed to confirm these arrangements in due course, together with a requirement to convene an additional Scrutiny Board meeting in mid -May 2013.

In concluding his presentation, the Principal Scrutiny Adviser informed the meeting that there had been a delay in formulising the Dementia strategy and action plan.

RESOLVED –

a)  That the contents of the report and appendices be noted.

b)  That the Principal Scrutiny Adviser be requested to incorporate the above issues with the Board’s work schedule for April/May 2013.

(Councillor G Hussain left the meeting at 12.50pm during discussions of the above item)

Wednesday, 24^th April 2013 at 9.30am (Pre-meeting for all Board Members at 9.30am)

Wednesday 24^th April 2013 at 10.00am in the Civic Hall, Leeds

(Pre meeting for Board Members at 9.30am)

(The meeting concluded at 12.55pm)