Venue: Hunslet Room, Voluntary Action Leeds, Stringer House, 34 Lupton Street, Leeds LS10 2QW
Contact: Helen Gray 0113 3788657
Note: A pre-meeting for Board Members only will be held at 1.30 pm (just prior to the formal meeting)
Representatives of Clinical Commissioning Groups
Nigel Gray NHS Leeds North CCG
Directors of Leeds City Council
Dr Ian Cameron – Director of Public Health
Steve Hume – LCC Adults and Health
Sue Rumbold – LCC Children and Families
Representative of NHS (England)
Louise Auger - NHS England
Third Sector Representative
Kerry Jackson – St Gemma’s Hospice
Representative of Local Health Watch Organisation
Lesley Sterling-Baxter – Healthwatch Leeds
Tanya Matilainen – Healthwatch Leeds
Representatives of NHS providers
Sara Munro - Leeds and York Partnership NHS Foundation Trust
Dean Royles - Leeds Teaching Hospitals NHS Trust
Thea Stein - Leeds Community Healthcare NHS Trust
Welcome and introductions
The Chair welcomed all present and brief introductions were made.
Additionally, Councillor Charlwood noted that Dr Alistair Walling had been appointed to represent NHS Leeds South and East Clinical Commissioning Group by Annual Council on 25th May 2017.
Appeals against refusal of inspection of documents
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.
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:-
The agenda contained 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)
No late of business were added to the agenda.
Declarations 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.
No declarations of disclosable pecuniary interests were made.
Apologies for Absence
To receive any apologies for absence
Apologies for absence were received from Councillor G Latty, Gordon Sinclair, Phil Corrigan, Julian Hartley, Cath Roff, Steve Walker, Moira Dumma and Julian Hartley. The Board welcomed Councillor Flynn, Dean Royles, Steve Hume, Sue Rumbold and Louise Auger as substitutes to the meeting.
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 by members of the public under the Open Forum.
To approve the minutes of the previous Health and Wellbeing Board meeting held 20th April 2017 as a correct record.
RESOLVED – The minutes of the previous meeting held 20th April 2017 were agreed as a correct record.
To consider the report of the Executive Lead, Leeds Health and Care Plan which provides an overview of the emerging Leeds Health and Care Plan; and the next phase on the continued conversation with citizens.
The Board considered an overview of the emerging Leeds Health and Care Plan – Leeds’ description of what it envisaged health and care will look like in the future and how it will contribute to the delivery of the vision and objectives of the Leeds Health and Wellbeing Strategy 2016-21.
Paul Bollom, Interim Executive Lead for the Leeds Health and Care Plan, presented the report seeking support from the Board for the draft narrative of the Plan to be published in order to develop a citywide conversation with citizens. Stuart Barnes, NHS Leeds North CCG was also in attendance.
The draft narrative set the Leeds Plan in context with the West Yorkshire Sustainability and Transformation Plan. To achieve the maximum chance of engaging the public and delivering change; the Plan was user friendly and accessible reflecting the core value of working with the population. Discussion would be held alongside the wider future discussion on provision of public services – ‘changing Leeds’ discussions.
A copy of the draft ‘Leeds Health and Care Plan’ narrative document was attached as Appendix A along with a copy of the ‘Changing Leeds’ document at Appendix B
During discussions the following matters were raised:
· Acknowledged and welcomed the opportunity for the Community Committees to have had early discussions on the Leeds Plan during the Spring 2017. A request for an update to the community committees was noted
· The need to realise the value of the collective Leeds Pound and emphasise this within the health economy and beyond; acknowledging that service users may be buyers as well as consumers who could form co-operatives or social enterprises. This was also an opportunity to engage businesses in the ambitions of the Leeds Health and Care Plan; to interact with inclusive growth alongside Leeds Growth Strategy and with the Leeds Academic Health Partnership
· A request for the draft Plan to include a foreword emphasising the role of feedback in shaping a live document that will evolve. Associated to this, a review of the language and phrasing to ensure a plain English approach and to avoid inadvertently suggesting that areas of change have already been decided. The narrative to also clarify who will make decisions in the future
· The Plan to include case studies
· Acknowledged the need to broaden the scope of the Plan in order to “if we do this, then this how good our health and care services could be” and to provide more detail on what provision may look like in the future
· Noted the request for the Plan to provide more focus on some of the options from the Joint Health and Wellbeing Strategy
· References to taking self-responsibility for health should also include urgent care/out of hospital health
· References to the role of the Leeds Health and Wellbeing Board and the Joint Health and Wellbeing Strategy to be strengthened and appear earlier in the Plan
· Assurance was sought that the Plan would be co-produced as part of the ongoing conversation
· A focus on Leeds figures rather than ... view the full minutes text for item 9.
To consider the report of the Leeds Health and Care Partnership Executive Group (PEG) which provides an overview of the financial positions of the health and care organisations in Leeds, brought together as one single citywide quarterly financial report
The Board considered the report of the Leeds Health and Care Partnership Executive Group (PEG) which provided an overview of the financial positions of the health and care organisations in Leeds, brought together as one single citywide quarterly financial report.
The report provided a financial ‘health check’ to clarify where the current and expected financial pressures were in the local health and care system. This gave the Board an opportunity to direct action to support an appropriate and effective response as part of the Boards role in having strategic oversight of both the financial sustainability of the Leeds health and care system; and of the executive function carried out by the Leeds Health and Care Partnership Executive Group.
Bryan Machin, Chair of the Citywide Directors of Finance Group, presented the report. He highlighted key headlines from the report including:
- The Leeds health & care system ended 2016/17 in a more favourable position than that predicted at quarter 3.
- The plans for health and care services within Leeds City Council and for the Leeds CCGs demonstrated the delivery of a breakeven position across the future 4-year planning period. However, this was reliant on the assumed delivery of significant levels of recurrent savings and the CCGs being able to access some of their previously accumulated surpluses.
- The aggregate 4-year plans of the three NHS Trusts would not achieve breakeven across the whole period without receipt of additional national funding, better management of demand, and delivery of significant levels of savings.
- The significant financial risk associated with the plans of all partners and that further citywide action is required to mitigate the risks in single organisation plans.
A question was raised over whether budget sharing to further the ‘one approach’ to health and care would be supported by the Directors of Finance. It was noted that although this approach may be viewed favourably, consideration would have to be given to the evidence required to support this approach. Members recognised that statutory and regulatory responsibilities may impact on collaboration but felt that this approach should be explored.
Further discussions noted the continuing austerity measures and the challenge of finding money upfront to invest in collaborative working. Concern was expressed that CCGs may not be able to draw down any previously accumulated surplus funds, as suggested in the report, due to Treasury restrictions and national funding pressures. An approach to PEG was suggested in the first instance to consider the opportunities for collaboration and budget sharing.
a) Having reviewed the Leeds health & care quarterly financial report, the Board noted its contents and the comments made during discussions;
b) To note the extent of the financial challenge over the next year and until 2021 and the need to further develop a shared system-wide response and assurance that this challenge will be met;
c) As part of the Boards’ role to provide clear guidance to the Leeds Health and Care Partnership Executive Group on the possible actions required to achieve financial sustainability, ... view the full minutes text for item 10.
To consider a report summarising the city’s challenges relating to workforce. The report presents information on three potential and developing solutions, seeking the Boards consideration of it’s’ role in progressing, steering and directing future work to address the challenges.
Tony Cooke, Chief Officer Health Partnerships Team, presented a report summarising the city’s challenges relating to workforce and three potential and developing solutions. The Board was asked to consider it’s’ role in progressing, steering and directing future work to address the challenges, in the short term these were identified as:
- The impact of nursing bursaries (25% drop in applications)
- The impact of Brexit (96%fall in people coming to the UK to work)
- The number of health and care practitioners due to retire within the next 5 years (600,000)
The challenges ahead had highlighted the need to systematically “Grow your own workforce” with a focus on the establishment of a Health and Care Academy for Leeds, promotion of the living wage and supporting disabled people into employment.
Health & Care Academy – The Health and Social Care Academy would support a better targeting of employment opportunities in the city’s more deprived areas. In answer to a query the Board received assurance that the Health Academy would focus on business as well as clinical skills, recognising the role of small and medium businesses in the health and care sector.
Work Related Long Term Illness - 32,000 people in Leeds received Employment & Support Allowance (ESA) - financial support for those who were unable to work through disability or illness. Of these, it was suggested that a large number had work related anxiety or musculoskeletal issues; and with the right support available to employers, that skilled and/or experienced workforce could be retained.
Dave Roberts, LCC Financial Inclusion Manager, provided the Board with information on the ‘Living Wage’, in particular:
- The influence the public sector had on the private sector
- 60% of children living in poverty are from working households
- The proven link between poverty and ill-health
Discussion followed on the proposal for public services to collaborate and develop a strategy to encourage momentum within the private sector for the Living Wage, noting a seminar had been proposed by the Integrated Commissioning Executive (ICE) as an initial focus for the strategy. Comments included:
- Quality Care work – Paying appropriate wages will encourage staff retention, boost health and care outcomes and alleviate child poverty
- One approach to training - 57,000 people in Leeds work in the health and care sector and were largely trained within the organisation they work for. ‘One approach’ to training would encourage rotation throughout the health and care sector settings and break down barriers between the health and care settings in the public/private sector.
- The opportunities for joined up learning and training, recognising that there were issues across the public and private sectors which required the same training – such as moving/handling technique
- Awareness that many working in the health and care sector do so whilst they gain non-health and care related qualifications and/or language skills. Once complete, they often move out of the health and care sector
- The impact of the Apprenticeship Levy and whether this could be invested in ... view the full minutes text for item 11.
To receive and note the Better Care Fund 2016-17 reports for Quarters 2, 3 and 4
Steve Hume, Chief Officer, Resources & Strategy (LCC Adults & Health) presented a report for information on the completed Better Care Fund (BCF) reporting templates for quarters 2, 3 and 4 for 2016-17. The report noted that a requirement of the BCF is that completed reporting templates are submitted quarterly to NHS England to provide assurance that the conditions of the BCF are being met.
RESOLVED – That the completed BCF reporting templates for quarters 2, 3 and 4 for 2016-17 be noted for information.
Date and Time of Next Meeting
To note that the next formal Board meeting will be held on Thursday 28th September 2017
RESOLVED – To note the date and time of the next formal Board meeting as Thursday 28th September 2017 at 10.00am (with a pre-meeting for Board members at 9.30am).