Agenda and draft minutes

Leeds Committee of the West Yorkshire Integrated Care Board

Tim Ryley - Place Based Lead, Leeds Health & Care Partnership

Directors of Leeds City Council

Victoria Eaton – Director of Public Health

Caroline Baria – Director of Adults and Health

Farrah Kahn – Deputy Director Social Care, Children and Families

Representative of Local Health Watch Organisation

Jane Mischenko – Co-Chair, Healthwatch Leeds

Representatives of NHS providers

Sara Munro - Leeds and York Partnership NHS Foundation Trust

Phil Wood - Leeds Teaching Hospitals NHS Trust

Ruth Burnett - Leeds Community Healthcare NHS Trust

Representative of Leeds GP Confederation

Jim Barwick – Chief Executive of Leeds GP Confederation

Leeds Committee of the West Yorkshire Integrated Care Board

Rebecca Charlwood - Independent Chair

Clinicians Joint Representative

Jason Broch, Chief Clinical Information Officer

Representative of Communities of Interest

Pip Goff - Director, Volition

The Chair welcomed Members and attendees and provided updates on the following events:

·  Ed Whiting OBE had been appointed as the new Leeds City Council Chief Executive, expected to commence his role in January 2025. Ed has had a diverse career in senior Whitehall and civil service roles alongside work with local government. The Chair noted it was particularly pleasing following from Tom Riordan CBE, speaking from being in care as a child, that Ed had been a foster carer and looked forward to championing the role foster caring plays in Leeds.

·  A message of thanks was also extended to Tom and the Interim Chief Executive, Mariana Pexton, for their dedicated work. 

·  A funding boost of £2.94million had been secured for radiotherapy in Leeds, to make treatments more personalised and smarter to support cancer patients.

·  Mental health emergency calls were taken by Leeds and York Partnership NHS Foundation Trust (LYPFT), as part of a pilot service, which sought to reduce pressure from 999 calls and direct people to crisis services more efficiently.

·  On the 21^st of November, in support of International Men’s Day, ReThink: Men’s event was scheduled at Leeds Kirkgate Market to champion the health and wellbeing of men in Leeds.

·  Dame Linda Pollard was to step down from her role as the Chair of Leeds Teaching Hospitals Trust (LTHT) in summer 2025. The Chair celebrated her many achievements over her 30 years of service in the NHS and as a role model for women.

·  Jim Barwick, Chief Executive of Leeds GP Confederation Leeds, shared that The Leeds Community Dermatology Collaborative had been honoured with the Proud2bOps National Award for Operational and Clinical Partnership of the Year. The award, announced in the previous week, celebrated outstanding collaboration in healthcare and was presented to the team at The Light in Leeds.

To consider any appeals in accordance with Procedure Rule 15.2 of the Access to Information Rules (in the event of an Appeal the press and public will be excluded)

(*In accordance with Procedure Rule 15.2, written notice of an appeal must be received by the Head of Governance Services 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:-

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 formal late items.

To disclose or draw attention to any interests in accordance with Leeds City Council’s ‘Councillor Code of Conduct’. 

No declarations of interest were made.

To receive any apologies for absence

Apologies for absence had been received from Councillor S Golton, Paul Money, Superintendent Dan Wood, James Rogers, Anthony Kealy, Helen Hart, Corrina Lawrence, Sarah Forbes, Selina Douglas with Dr Ruth Burnett deputising, Julie Longworth with Farah Kahn deputising and Jonathan Phillips with Jane Mischenko deputising.

At the discretion of the Chair, a period of up to 10 minutes may be allocated at each ordinary meeting for members of the public to make representations or to ask questions on matters within the terms of reference of the Health and Wellbeing Board.  No member of the public shall speak for more than three minutes in the Open Forum, except by permission of the Chair.

At the discretion of the Chair, a period of up to 10 minutes may be allocated at each ordinary meeting for members of the public to make representations or to ask questions on matters within the terms of reference of the Health and Wellbeing Board. No member of the public shall speak for more than three minutes in the Open Forum, except by permission of the Chair.

No matters were raised under the Open Forum via public submission, but the Chair provided an update in relation to a previous query presented to the Board by Dr John Puntis on the issue of the impact health charges were having on migrants, refugees and asylum seekers.

It was outlined that LTHT had advanced their response to this issue, within the context of changes to national policy, with the Illegal Migration Act 2023 being passed in July 2024, which had led to a high volume of people needing help and advocacy with understanding their rights. The Leeds Migrant Health Board (MHB) Annual report was to be considered by the Board later on the meeting agenda (Minute 24 refers), which had identified key priorities of the MHB. It was recognised that whilst migrant health charges affected migrants, refugees and asylum seekers, the MHB has focused its priorities on areas where there were specific challenges for these communities and where there was a need to address inequalities and improve outcomes. Councillor Venner further highlighted that she had raised the migrant health charges issue at a recent Leeds Strategic Migration Partnership Board where it was noted that charges were a particular issue which had an impact on overall access.  In part fear of incurring charges could also be a factor. Evidence to support a better approach to the issue was mostly anecdotal and the scope was difficult to quantify, however, the potential of case studies of experiences would allow improved systematic understanding and it was hoped an increased focus to address barriers to access, could be an area to further explore and consider. As a method for campaigning for a better approach it was further suggested that lobbying Government was an option available to Members.

A written response had been provided to Dr John Puntis relating to the implementation of the national policy framework and that the Board had raised wider impacts to migrant communities with the Home Office following last year’s iteration of the Migrant Health Annual Report.

It was agreed that the MHB would reflect on the area of migrant health charges being considered as part of a wider workshop session in December where the future priorities of the MHB will be considered. The outcome of these discussions will be reported back to the Leeds HWB. 

To approve the minutes of the previous Health and Wellbeing Board meeting held on the 23^rd of July 2024 as a correct record.

RESOLVED– That the minutes of the meeting held on the 23^rd of July 2024 be agreed as a correct record.

The report of the Leeds Health and Wellbeing Board summarised that Leeds has an ambition to be the best place to train and work in at any age. We have a health and care workforce that is highly motivated, creative and caring, working together to deliver high-quality care and improve health outcomes in Leeds. A key part of achieving this ambition is creating ‘an inclusive, valued and well-trained workforce’. This is highlighted as one of the 12 priorities in the Leeds Health and Wellbeing Strategy 2023-2030.

The report of the Leeds Health and Wellbeing Board summarised that Leeds had an ambition to be the best place to train and work in at any age. Leeds had a health and care workforce that was highly motivated, creative and caring, working together to deliver high quality care and improve health outcomes in Leeds. A key part of achieving this ambition was creating ‘an inclusive, valued and well - trained workforce’. This was highlighted as one of the 12 priorities in the Leeds Health and Wellbeing Strategy 2023 -2030.

In attendance for this item were:

• Nadeem Siddique - Head of Community Relations and Cohesion, Leeds City Council
• Geoff Turnbull - Equality, Diversity & Inclusion Manager, Leeds City Council
• Mahreen Hussain - West Yorkshire Police (WYP)
• David Ball – WYP

The Chair introduced the item, noting it had been brought to the Board in response to the disorder and civil unrest that had occurred across the country over summer 2024. It was a priority for Health and Care system leaders to ensure staff felt valued, well trained, and supported in light of increased abuse directed towards care providers and in line with the NHS Freedom to Speak Up policy and Guardian roles. Whilst patients had a right to access health and care services, there was a need to ensure there was a balance of care provision and staff welfare.

The following information was highlighted to Board Members by the Head of Community Relations and Cohesion and the Equality, Diversity & Inclusion Manager:

·  The incidents in Southport had led to a significant scale of disorder across the UK, with rising racism and anti-Muslim hatred.

·  The Government had promoted social cohesion and resilience to extremism to enable support of front line workers and their capacity to safely address social unrest.

·  Data for increases in hate crime were significant, however, many incidents were unreported.  Work was to focus on preventing these incidents and improving public confidence in services.

·  A Social Cohesion Strategy was in development, with a key priority being to allow safe spaces for dialogue, to support staff by listening to lived experience and also for alternative views to be discussed.

·  As part of the Council’s equality agenda, preventative methods against the discrimination of protected characteristics were linked to the Anti-Social Behaviour Team and Safer, Stronger Communities.

·  A Hate Crime Strategy had been developed with relevant partners, such as WYP, and was governed by a robust process, including the Leeds Hate Crime Strategic Board, chaired by Councillor M Harland (Executive Member for Communities, Customer Service and Community Safety) which supported the Hate Crime Operational Group.

·  A Hate Crime Officer had been appointed in the Council, that would liaise with WYP and support improved reporting capacity, such as third party reporting through Community Hubs and identifying high risk areas.

·  There were improved methods for reporting hate crimes or incidents online and also engagement with schools had been conducted by Stop Hate UK, a charity raising awareness to all forms of discrimination.

·  Prevention was integral  ...  view the full minutes text for item 21.

The report of Synergi-Leeds Partnership outlines that the partership is an innovative and ambitious citywide approach focused on addressing ethnic inequalities in mental health. The partnership is jointly led by Leeds and York Partnership Foundation Trust (LYPFT) and Public Health in Leeds City Council (LCC), and the core programmes are delivered and supported by colleagues in LYPFT, LCC, Volition and Leeds Involving People. The expanding network or ‘community of practice’ of statutory and voluntary sector organisations plays a vital role in advancing the priorities outlined in the Leeds All-Age Mental Health Strategy and specifically in ‘reducing the over representation of people from Black, Asian and Minority Ethnic communities admitted in crisis’.

The report of Synergi -Leeds Partnership outlined that the partnership was an innovative and ambitious citywide approach focused on addressing ethnic inequalities in mental health. The partnership was jointly led by Leeds and York Partnership Foundation Trust (LYPFT) and Public Health in Leeds City Council (LCC), and the core programmes were delivered and supported by colleagues in LYPFT, LCC, Volition and Leeds Involving People. The expanding network or ‘community of practice’ of statutory and voluntary sector organisations played a vital role in advancing the priorities outlined in the Leeds All -Age Mental Health Strategy and specifically in ‘reducing the over representation of people from Black, Asian and Minority Ethnic communities admitted in crisis’.

The following attended the meeting to present the item:

• Caron Walker - Chief Officer - Consultant/Public Health
• Sharon Prince -Deputy Director for Psychological Professions at LYPFT
• Laura Hodgson - Head of Public Health, Adults and Health
• Karen Cruise CEO of Flourished Minds CIC
• Sinead Cregan Director of Innovation and Development, Inspire North

Jim Barwick, the Chief Executive of Leeds GP Federation, introduced the item as he represented sponsorship of the partnership leadership team. The partnership programme was award winning, and reflecting on previous work, the approach was of high importance, lessons had been learnt and organisations were committed to further the work. Future operations were to focus on mapping areas most in need, improved communication principles and to hold open conversations on difficult topics.

The Board was provided with the following information:

·  A strong partnership foundation had evolved, with delivery involving Public Health, Forum Central, LYPFT, Leeds Involving People and Volition. The work focused on whole system change, identifying inequalities for each organisation through a social justice lens.

·  The approach was to identify racial inequality and to then challenge processes to be more inclusive, which required intensive data gathering, holistic understanding and collaborative partnerships to inform appropriate prevention and intervention measures.

·  Commitment to open dialogue to understand people of ethnically diverse background’s experience of service access and health outcomes were essential.

·  The work was validated against the seven principles of anti-racist framework. Organisations needed to commit to acting upon service feedback and anecdotal data so that people’s lived experience were a focus for change. Having safe spaces for discussions and leadership that represented EDI were essential.

·  Work and funding streams stemmed from the All Age Grants Programme and the Commission for Racial Equality.

·  Flourished Minds was a social enterprise part funded by the Synergi programme, gathering data to better understand and support mental health issues in ethnically diverse communities. Outreach work had been conducted at Carr Manor Community School, consisting of open dialogue with young people to develop connection and trust and to tailor suitable approaches in support of self worth and wellbeing.

·  The outreach work allowed young people to better recognise that good mental health was at the forefront of a positive life and teachers and care providers outlined that the work had improved education outcomes and students were more settled and patient.

·  Following partnering with  ...  view the full minutes text for item 22.

The report of Chief Officer, Consultant/Public Health outlines that the Health and Social Care Act 2012 transferred responsibility for the development and updating of Pharmaceutical Needs Assessment (PNAs) to Health and Wellbeing Boards (HWBs), becoming effective from 1st April 2013.

The report of Chief Officer, Consultant/Public Health outlined that the Health and Social Care Act 2012 transferred responsibility for the development and updating of Pharmaceutical Needs Assessment (PNAs) to Health and Wellbeing Boards (HWBs), which became effective from 1^st April 2013.

The following attended the meeting to present the item:

·  Caron Walker - Chief Officer, Consultant/Public Health

The Board was provided with the following information:

·  Some Community Pharmacies had outlined their intention to hold strikes to protest budget cuts and increased workload pressure.

·  The Board were responsible, on behalf of Public Health, for the development of and updates to PNAs, with the process approximately half way completed. It had been agreed by the Board for an update on pharmacy provision to be provided at the 6 month mark.

·  As of April 2024, 5 out of the 130 Pharmacies in Leeds had submitted notices of closure. There were pressures across West Yorkshire regionally, and the UK nationally, leading to the closure or reduction in opening hours for Pharmacies. 

·  Features of PNAs were to identify gaps in provision, review data and to outline timeframes and accessibility pressure following changes to processes, including closures and reductions in opening hours.

During discussions, the following matters were considered:

·  Healthwatch had reviewed the impact of the pharmacy first model had on accessibility and on wider system impacts, with increased pressure on GPs and A&E rooms. The impact on accessibility was more significant in rural areas.

·  It was confirmed that the consultation on changes to Pharmacy provision was currently open and was held online, with some non-digital submission methods available on request, but this was limited due to resource constraints. The next consultation was planned once the draft PNA had been published.

·  Members noted support to promote the consultation and information relating to changes in provision in order to better understand the impacts on prescriptions and options for delivering medication.

·  Identifying needs through market shaping work, including learning from demand on primary care, was required to devise a strategic approach, alongside required legislation changes. It was noted that further input from providers was sought.

·  A message of thanks was extended to the Chief Officer, Consultant/Public Health, for leading on the technical process in support of the Board’s responsibilities.

RESOLVED –

a)  That the responsibilities of the HWB in relation to pharmaceutical service provision in Leeds, be noted.

b)  That the information within the notification log, which will be shared with the HWB six monthly as described above, ahead of each public meeting, be considered.

The report of Leeds Migrant Health Board outlines that this is the second Annual Report of the Leeds Migrant Health Board (LMHB). The report describes work by the Board and its members to address the health needs of migrants in 2023-24 and presents recommendations for future work by partners and the wider health and care system.

The report of Leeds Migrant Health Board outlined that this was the second Annual Report of the Leeds Migrant Health Board (LMHB). The report described work by the Board and its members to address the health needs of migrants in 2023 -24 and presented recommendations for future work by partners and the wider health and care system.

The following attended the meeting to present the item:

• Pippa Bird - Chief Officer/Consultant in Public Health, Adults and Health
• Catherine Ward - Health Improvement Principal, Adults & Health
• Helen Binns - Families First Project Manager, Children & Families

The Board was provided with the following information:

·  Leeds was culturally diverse, with data displaying that 27% of the population was of an ethnic minority background in 2024, which had rose from 19% in 2019. English was not the first language for approximately 70,000 people.

·  Leeds was considered a city of sanctuary where refugees, asylum seekers and vulnerable people were welcome.

·  Work conducted by LMHB had informed and altered the strategic direction of the health and care system to improve understanding and outcomes for migrants across statutory, voluntary and community care providers.

·  The political context, and national media coverage, created challenges for services and staff. From experience, migrants often lived in deprivation and had complex needs; fast paced Government policy changes and local unrest had impacted service provision and building trust with migrant communities was essential to improving service access.

·  Examples of improved processes were noted as, translation service procurement in primary care, the establishment of action workshops and to empower the voices of migrants by informing their views and needs at a commissioner level.

·  The annual report had focused on the health of the Roma communities in Leeds, with assessment results informing pathways to improve health outcomes and service accessibility.

·  Data displayed Roma people had a life expectancy 10 years below the UK average, tended to reside in the less affluent areas and there were issues of distrust with health professionals. Five grants had been awarded through Forum Central, amounting to £12,000, following emerging health needs assessment data, with the final results yet to be confirmed.

·  Through ICB funding, a small team within Children’s and Families, had conducted family support and social work, including drop in sessions at the St Vincent's Centre, to understand the Roma lived experience and the service access barriers.

·  Roma families were often comprised of large family groups, with an average of 6-8 children living in inadequate housing space. For GP appointments, digital communication was less preferred and language barriers often impacted access. There was also some misunderstanding when to use different services and there was also a hesitancy to request care provision.

·  There had been issues with scabies for Roma families, which was often difficult to treat when living in poverty, as well as measles, where patients were unable to attend GP appointments.

·  Public Health had provided accessible communication messages to Roma communities to offer the loan of steamers, as well as partnership offers for laundry to address the rise  ...  view the full minutes text for item 24.

To note the date and time of the next meeting as Thursday the 20^th of March 2025 at 1:00pm.

RESOLVED - To note the date and time of the next meeting as Thursday the 20^th of March 2025 at 1:00pm.