Venue: Henry Moore Room, Leeds Art Gallery, The Headrow, Leeds LS1 3AA
Contact: Helen Gray 0113 3788657
Note: There will be a pre-meeting for Board Members at 9.30 am
Representatives of Clinical Commissioning Groups
Alistair Walling NHS Leeds South and East CCG
Dr Gordon Sinclair NHS Leeds West CCG
Nigel Gray NHS Leeds North CCG
Phil Corrigan NHS Leeds West CCG
Directors of Leeds City Council
Dr Ian Cameron – Director of Public Health
Cath Roff – Director of Adults and Health
Sue Rumbold – Chief Officer, Children and Families
Representative of NHS (England)
Moira Dumma - NHS England
Third Sector Representative
Heather Nelson – Black Health Initiative
Hannah Howe – Forum Central
Representative of Local Health Watch Organisation
Tanya Matilainen – Healthwatch Leeds
Representatives of NHS providers
Sara Munro - Leeds and York Partnership NHS Foundation Trust
Julian Hartley - Leeds Teaching Hospitals NHS Trust
Thea Stein - Leeds Community Healthcare NHS Trust
Safer Leeds Representative
Michelle de Souza – Communities & Environment
Welcome and introductions
Councillor Charlwood welcomed all present and brief introductions were made. The Chair reported that Lesley Sterling-Baxter had resigned from her role as Co-Chair of Leeds Healthwatch and from the Health and Wellbeing Board. Councillor Charlwood agreed to write to Lesley to express the Board’s thanks for her work on the Board as the voice of the public and health system users.
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 formal late items of business were added to the agenda, however Members had received a supplementary pack to agenda Item 12 (iBCF (Spring Budget) and BCF 2017/18 Quarter 2 Returns) containing Appendix 2 of the report which was not available at the time the agenda for the meeting was despatched. The document had also been published to the LCC website (Minute 42 refers).
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.
There were no declarations of disclosable pecuniary interests.
Apologies for Absence
To receive any apologies for absence
Apologies for absence were received from Councillor Coupar, Councillor Golton, Councillor G Latty, Jason Broch, Steve Walker and Sam Millar. Sue Rumbold and Michelle de Souza attended the meeting as substitutes.
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.
Community engagement – In response to a representation from a member of the public about the take-up; promotion, and value of public engagement in shaping the Leeds Health & Care Plan, the Chair responded that the main focus of the consultation with Leeds Community Committees was to encourage discussion in local areas, with local representatives as this was important for shaping the future health and care system.
The Executive Lead, Leeds Health & Care Plan, acknowledged that each Community Committee operated differently in response to its locality. Further additional public consultation was planned for 2018, including public events; specific website and events targeted towards harder to reach groups and communities.
To approve the minutes of the previous Health and Wellbeing Board meeting held 28th September 2017 as a correct record.
RESOLVED – To agree the minutes of the meeting held 28th September 2017 as a correct record.
To consider the report of the Chief Officer, Leeds Health Partnerships, which provides an update on the work to review and replace the Leeds Inclusive Strategy for 2017-2023
The Board considered a report on the recent work to review and replace the Leeds Inclusive Growth Strategy for 2017-2023. A copy of the draft Leeds Inclusive Growth Strategy (IGS) was attached to the report as an appendix.
The Chief Officer, Health Partnerships, reported on a recent meeting with West Yorkshire Combined Authority. He emphasised the need for the IGS to include health and care skills based on the emerging evidence of the close links between skills and education supporting good health; and in the knowledge that the health, care and medical sectors will be one of the fastest growing.
Simon Brereton, LCC Economic Development Programme Leader, presented the Strategy which anticipated Leeds continued economic growth and included proposals to meet that challenge. He posed the question ‘how do we ensure it reaches all parts of the city?’ and highlighted the following issues:
· Leeds’s jobs growth does not reach right across the jobs spectrum. There is growth in degree level qualification jobs but middle sector job numbers are declining; and there is a gap in the market which is traditionally filled with low level skill, administrative, process jobs.
· Two thirds of the working population have not attained a level 4 qualification or above.
· Leeds has a young population that is getting younger; and we need to ensure that they have the qualifications and skills to sustain employment. The ageing population means that we need to cater for those who have been in the job market for a long time.
· The IGS includes ’12 Big Ideas’ to tackle the issues and targets 7 job priority sectors, including the health and medical sector and the aging population.
· The IGS proposed measures to tackle poverty across the city – 150,000 residents live within the 10% most deprived localities in England. Although growth was predicted, a key issue would be how to ensure that growth did not contribute to a widening disparity between rich and poor in the city.
· The IGS anticipated 80,000 new jobs by 2020, with a further 600,000 posts released through the churn of retirement or movement.
· The concentration of low paid jobs in Universities, the health and care and education sectors was noted - despite the work done to achieve the living or minimum wage; and the reliance on these sectors to equip the city for economic growth.
· Future changes to the city infrastructure through the HS2 rail link and anticipated doubling in size of the city centre will impact on the economy; jobs and how we travel to and from the workplace. Poverty and low pay required consideration at the Leeds City Region level. It was noted that people on low pay only travel an average of 1 mile for work – therefore jobs must be created throughout the city, closer to where people on low pay live.
In conclusion, a focus for the meeting was to consider the Board’s influence to challenge to bring about changes to wages and investment in order to promote economic growth and reduce ... view the full minutes text for item 39.
To consider a joint report from the Consultant in Public Health, Executive Programme Manager, LCC Projects, Programmes and Procurement Unit, and Head of Safeguarding and Community Safety Partnership Development, LCC Safer Leeds, which provides an overview of approaches taken to address challenges relating to three determinants of health and wellbeing:
a) supporting the inactive to become active,
b) air quality, and
c) domestic violence and abuse.
The report acknowledges the clear links with the priorities of the Leeds Health and Wellbeing Strategy 2016-21, and provides the Board with the opportunity to understand and discuss persistent challenges relating to these wider determinants, provide a view on what else can be done, explore and ensure links with our city’s other strategic plans (such as the Leeds Health and Care Plan, Inclusive Growth Strategy) and agree individual and collective action that can contribute to improved outcomes for people in Leeds.
The Board considered a joint report providing an overview of the approaches taken to address challenges relating to three Breakthrough Projects with very clear links to the priorities of the Leeds Health and Wellbeing Strategy and the wider determinants of health and wellbeing: supporting the inactive to become active, air quality, and domestic violence and abuse.
The report provided the Board with an opportunity to discuss and explore the challenges related to the issues; to provide a view on what else could be done to ensure links with Leeds’s other strategic plans and to consider individual or collective action that can contribute to improved outcomes for people in Leeds.
1. Supporting the Inactive to become Active – In presenting the report, Anna Frearson (Consultant in Public Health) and Mark Allman (Head of Sport & Active Lifestyles) encouraged discussion on:
- How to reduce sedentary behaviour in staff as well as residents. As representatives of large employers/organisations how to encourage physical activity and/or exercise which was acknowledged as being beneficial to work and home wellbeing.
- Meeting the challenge of what else can be done to embed support for physical activity in terms of the workplace, built environment and infrastructure
The Board acknowledged the relationship between activity, mobility, health, mental health and work and made the following comments:
· Leeds Teaching Hospitals NHS Trust staff had responded well to health and wellbeing training, challenges, etc. and the use of sustainable travel transport schemes. Extension of the Leeds Cycleway to link St James’s and the Leeds General Infirmary was identified as an additional measure to further encourage activity.
· A campaign of information and signposting on the location of cycle paths, walkways and bridleways was identified as a measure to increase their use; alongside information on cycle safety.
· Recognition of the need to link to Mindful Employer measures.
· Acknowledged that Leeds West NHS CCG was committed to factoring in physical activity in its approach to commissioning pathways of care, particularly for musculoskeletal disorders; and the commitment to build this into health coaching and Making Every Contact Count policies.
· Recognition of concerns for the health of some health & care sector staff, particularly community health staff, who were physically inactive due to the nature of their work which required them to drive between appointments and impacted on their diet as well as their ability to be active.
· The need to consider any cultural or behavioural issues which may prevent people from taking up physical activity and to consider how individual communities provide their own activities. It was noted that the Third Sector had a key role to play in being able to provide information on what is provided throughout Leeds own communities.
· The role of education – through schools, health visitors and parents to encourage physical activity.
· Whether ‘physical activity’ could be promoted through; and encourage wider involvement in; the Leeds Health & Care Plan, noting that any campaign would need to be sustainable with a long term commitment
The Board noted the intention for further discussions between ... view the full minutes text for item 40.
To note, for information, the report from Leeds Health and Care Partnership Executive Group (PEG) which provides an overview of the financial positions of the health & care organisations in Leeds, brought together to provide a single citywide quarterly financial report
For information, the Board received the report from Leeds Health and Care Partnership Executive Group (PEG) which provided an overview of the financial positions of the health & care organisations in Leeds, brought together to provide a single citywide quarterly financial report.
RESOLVED - To note the Leeds health & care quarterly financial report end of year forecast.
To note, for information, receipt of the iBCF Spring Budget and the Better Care Fund 2017/18 Quarter 2 returns
(Please note: Appendix 2 of the report will follow)
The Board received for information, a copy of the iBCF Spring Budget and the Better Care Fund 2017/18 Quarter 2 returns.
a) To note the contents of the Leeds iBCF Quarter 2 return to the DCLG
b) To note the content of the Leeds HWB BCF Performance Monitoring return to NHSE for quarter 2 of 2017/18
To note for information, receipt of the report providing a brief overview of Delayed Transfers of Care (DTOC) and non-elective admissions.
The Board received a joint report for information from the Chief Officer Resources & Strategy, LCC Adults & Health and the Director of Commissioning, Strategy & Performance, NHS Leeds CCGs which provided a brief overview of Delayed Transfers of Care (DTOC) and non-elective admissions
Sara Munro, Leeds and York Partnership NHS Foundation Trust, reported that as part of the ongoing work to ensure that the data sets provided are achievable and give an accurate baseline; a correction had been identified. The Board supported the suggestion that a letter be submitted from the Health & Wellbeing Board to NHS England to challenge the current baseline and include support for a revised baseline for Leeds. It was agreed that a letter would be drafted and circulated for comments from members prior to its submission.
a) To note the definition of Delayed Transfers of Care (DTOCs).
b) To note the impact on the system of high levels of DTOCs.
c) To note the level of improvement required to deliver the 3.5% iBCF target.
d) To note the challenges and risks faced by the Health and Care System partners in Leeds associated with delivery of the agreed iBCF trajectory.
e) To note issues associated with DTOC baselines and trajectories with assessment of position and proposed approach to changes to be reported back to HWB.
f) To note the intention for a letter to be submitted to NHS England from the Health & Wellbeing Board challenging the current data baseline and including support for a revised baseline for Leeds. A draft letter will be submitted to Board Members for comment prior to submission to NHS England.
To note the report of the Director of Public Health which provides an update on three issues:
a) The current status of the 2018-21 Pharmacy Needs Assessment
b) An early indication of the findings of community pharmaceutical services across Leeds and highlight any gaps that have become evident at this stage of the work.
c) Notes that the Pharmacy Needs Assessment will be placed on the Leeds Observatory website for a period of 60 days from 4th December 2017 to 2nd February 2018.
For information, the Director of Public Health submitted a report providing the Board with an update on three issues:
· The current status of the 2018-21 Pharmacy Needs Assessment
· An early indication of the findings of community pharmaceutical services across Leeds and highlight any gaps that have become evident at this stage of the work.
· Notes that the Pharmacy Needs Assessment will be placed on the Leeds Observatory website for a period of 60 days from 4th December 2017 to 2nd February 2018.
a) To note that the Pharmacy Needs Assessment is on track and progressing to consultation stage.
b) To note that the Pharmacy Needs Assessment will be placed on the Leeds Observatory website http://observatory.leeds.gov.uk/ for a period of 60 days for public consultation from 4th December 2017 to 2nd February 2018.
c) To note that the updated Pharmacy Needs Assessment will be brought to the Health and Wellbeing Board on 19th February 2018 for final approval and sign off, ready for publication by 1st April 2018.
d) To note the measures to be taken to address the gaps identified so far.
Date and Time of Next Meeting
To note the date and time of the next formal Board meeting as Monday 19th February 2018 at 10.00 am (with a pre-meeting for Board Members at 9.30am)
RESOLVED – To note the date and time of the next meeting as Monday 19th February 2018 at 10.00 am (with a pre-meeting for Board members at 9.30 am)