Agenda and draft minutes

Health and Wellbeing Board
Monday, 16th September, 2019 1.50 pm

Venue: Moyes Centre, Bishops Way, Seacroft, Leeds, LS14 6NU (next to Bishop Young C of E Academy)

Contact: Harriet Speight  0113 3789954

Items
No. Item

Representatives of Clinical Commissioning Group

Dr Gordon Sinclair – Chair of NHS Leeds Clinical Commissioning Group

Tim Ryley – Chief Executive of NHS Leeds Clinical Commissioning Group

 

Directors of Leeds City Council

Victoria Eaton – Deputy Director of Public Health

Cath Roff – Director of Adults and Health

Sue Rumbold – Chief Officer, Children and Families

 

Third Sector Representative

Ruth Kettle – Community Links

 

Representative of Local Health Watch Organisation

Dr John Beal - Healthwatch Leeds

Hannah Davies – Healthwatch Leeds

 

Representatives of NHS providers

Sara Munro - Leeds and York Partnership NHS Foundation Trust

Dr Philip Wood - Leeds Teaching Hospitals NHS Trust

Thea Stein - Leeds Community Healthcare NHS Trust

 

Safer Leeds Joint Representative

Paul Money - Chief Officer, Safer Leeds

 

Representative of Leeds GP Confederation

Jim Barwick – Chief Executive of Leeds GP Confederation

 

 

12.

Welcome and introductions

Minutes:

The Chair welcomed all present and brief introductions were made.

 

The Chair encouraged Members and public present to attend the next Big Leeds Chat event due to take place at Kirkgate Market on 7th November 2019, to have their say on the development of health plans and strategies in the city.

 

The Chair also noted the publication of the latest Suicide Audit in Leeds, which echoed finding from previous years that those living in the most deprived areas of Leeds, particularly middle-aged men, are most at risk of dying through suicide.

 

 

13.

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)

Minutes:

There were no appeals.

 

 

14.

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:-

 

Minutes:

There were no exempt items.

 

 

 

15.

Late Items

To identify items which have been admitted to the agenda by the Chair for consideration

 

(The special circumstances shall be specified in the minutes)

 

Minutes:

There were no formal late items. However, the following supplementary information was distributed to Members after agenda publication:

 

-  Item 12.2 Appendix 1 (Draft Leeds Health and Care Plan 2019 – 2024)

-  Item 14 Appendix 1 (Draft Better Care Fund Plan 2019/20)

 

 

16.

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.

 

 

Minutes:

There were no declarations of disclosable pecuniary interests.

 

 

17.

Apologies for Absence

To receive any apologies for absence.

Minutes:

Apologies for absence were received from Councillor Golton, Alison Lowe, Ian Cameron, Steve Walker, Julian Hartley and Anthony Kealy.

 

Ruth Kettle, Victoria Eaton, Sue Rumbold and Dr Philip Wood were in attendance at the meeting as substitutes.

 

 

18.

Open Forum

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.

Minutes:

Tom Fellows, Head of NHS relations at Nuffield Health, informed the Board of the not-for-profit programmes run by invited Members of the Board to contact him following the meeting on matters. Specific programmes included wellbeing provision in schools and support groups for children and young people with cystic fibrosis.

 

Dr John Puntis, Leeds Keep our NHS Public, raised some concerns regarding the West Yorkshire and Harrogate Five Year Strategy for Health and Care, specifically in relation to the national context of funding arrangements including the impact of Private Finance Initiative (PFI) on NHS hospital trusts and restrictions to patient access. The Chair recognised the potential for the digital exclusion to contribute to health inequalities and highlighted the positive work occurring through a number of programmes in Leeds including the 100% Digital Leeds movement. The Chair also highlighted the importance of better understanding the local implications of PFI in Leeds and regionally.  Furthermore, the Chair informed Dr Puntis of the opportunity to engage with the West Yorkshire and Harrogate Five Year Strategy for Health and Care and to provide feedback via the West Yorkshire Partnership website.

 

 

19.

Minutes pdf icon PDF 39 KB

To approve the minutes of the previous Health and Wellbeing Board meeting held 14th June 2019 as a correct record.

Minutes:

RESOLVED – That the minutes of the meeting held 14 June 2019 be approved as an accurate record.

 

 

20.

Priority 12 - The best care, in the right place, at the right time: Palliative and End of Life Care for Adults in Leeds pdf icon PDF 415 KB

To consider the report of the Leeds Palliative Care Network that provides an overview of the work of the network, including the Dying Matters programme.

Additional documents:

Minutes:

The Leeds Palliative Care Network submitted a report that provided an overview of the work of the network, including the Dying Matters programme.

 

The following was appended to the report:

 

-  Leeds Palliative and End of Life Care Framework for Adults

-  Leeds Palliative and End of Life Care Draft Outcomes Framework

 

The following were in attendance:

 

-  Dr Mike Stockton, Chair of the Leeds Palliative Care Network

-  Lucy Jackson, Chief Officer, Public Health, Leeds City Council

-  Diane Boyne, Leed Pallative Care Network Manager at St. Gemma's Hospice

 

Members were provided with a presentation, which highlighted the following:

 

·  Access issues, in Leeds and nationally;

·  Key milestones in 2018/19;

·  Draft outcomes and priorities for the future.

 

Members discussed a number of matters, including:

 

·  Opportunity to strengthen the framework through an  all age approach, to include children and young people and challenges around transitions and engaging them on talking about palliative care and end of life as key influences in their homes and communities;

·  The need for consideration of economic impact in line with the identified projections for future need;

·  The need for better integration between hospitals and hospices to ensure early identification of need and a focus on ‘Leeds Left Shift’ in the framework;

·  Support for the think family approach around palliative and end of life care particularly in relation to carers and bereavement services;

·  The need for consideration of how Leeds can better resource community palliative care in line with the Leeds Left Shift, which is currently significantly dependent on the third sector explored through the Integrated Commissioning Executive (ICE).

·  The need for consideration of how the city provides care at home utilising frontline staff through a more holistic approach to care.

·  The importance of better understanding and addressing why lower proportions of mixed and black ethnic groups have a preferred place of death recorded and die in their preferred place of death when compared to other ethnic groups.

·  The importance of better understanding and addressing the linkages of areas experiencing higher levels of deprivation that have a lower proportion of people dying in their preferred place of death.

·  The need for the health and care system to challenge itself in reducing the inequality gaps highlighted in the Health Needs Assessment.

·  Suggestions for further consideration of the quality of life of those living in poverty and who are homeless in relation to palliative and end of life care. Representatives present sought more support with data blockages, to enable them to identify the needs are different populations.  The Chair suggested that a session be held focused on reducing inequalities in end of life care.

 

RESOLVED –

 

a)  To note the breadth of work driven by the Leeds Palliative Care Network including the work of the Dying Matters Partnership;

b)  To note the Board’s recognition of people receiving palliative care and those at end of life as a key priority population in city plans;

c)  To note the Board’s comments on the draft population level outcomes for people at end  ...  view the full minutes text for item 20.

21.

Leeds Carers Partnership Strategy pdf icon PDF 208 KB

To consider the report of the Leeds Carers Partnership that presents a new draft Leeds Carers Partnership Strategy, including how the strategy will help deliver the Leeds Health and Wellbeing Strategy and Leeds Health and Care Plan.

Additional documents:

Minutes:

The Leeds Carers Partnership submitted a report that presented a new draft Leeds Carers Partnership Strategy, including details of how the strategy will help deliver the Leeds Health and Wellbeing Strategy and Leeds Health and Care Plan.

 

The following was appended to the report:

 

-  Draft Leeds Carers Partnership Strategy Plan on a Page

-  Draft Leeds Carers Partnership Strategy

 

The following were in attendance:

 

-  Val Hewison, Chief Executive of Carers Leeds

-  James Woodhead, Head of Commissioning for Adults and Health, Leeds City Council

-  Martin Earnshaw, Head of Primary Care (Proactive Care), NHS Leeds CCG

 

The Head of Commissioning (Adults and Health) introduced proposed interactive strategy and five key priority areas, as well as proposals for consultation. The Chief Executive of Carers Leeds noted the importance of a meaningful strategy for carers, which gives them confidence that actions will be fulfilled.

 

Members discussed a number of matters, including:

 

·  The need for the strategy to be fully aligned to the Young Carers Strategy, to ensure that all carers are supported consistently throughout their lives;

·  Support for the interactive format as a more accessible form of engagement with communities;

·  Opportunity for the strategy to be linked to the Inclusive Growth, recognising the importance of supporting carers in the workplace and economic health and wellbeing;

·  The development of the additional incentive scheme for GP practices to become involved. Jim Barwick, the GP Confederation representative, noted that they would like to join the partnership, and would make contact.

·  Opportunity for the strategy to challenge the health and care system to address longstanding issues and holding each other to account for actions, pledges and performance. In particular, working with our wider workforce to create a cultural change in health and care in Leeds around carers.

·  Importance of putting carers’ voices and experiences at the heart of the strategy and in how the strategy measures progress.

 

RESOLVED –

 

a)  To note the progress made by the Leeds Carers Partnership in developing the draft strategy;

b)  To note Members comments on the development of the strategy, including the public engagement proposal.

 

 

22.

Annual Refresh - Future in Mind: Leeds Local Transformation Plan for children and young people's mental health and wellbeing pdf icon PDF 260 KB

To consider the joint report of the Director of Operational Delivery (NHS Leeds CCG) and the Director of Children and Families (Leeds City Council) an update on driving forward the strategy to transform how we support and improve the emotional and mental health of children and young people and therefore, ultimately impact on the wellbeing of all of the population through the annual refresh of the Leeds Local Transformation Plan.

Additional documents:

Minutes:

The Director of Operational Delivery (NHS Leeds CCG) and the Director of Children and Families (Leeds City Council) submitted a joint report that provided an update on driving forward the strategy to transform how we support and improve the emotional and mental health of children and young people and therefore, ultimately impact on the wellbeing of all of the population through the annual refresh of the Leeds Local Transformation Plan.

 

The following was appended to the report:

 

-  Future in Mind: Leeds Local Transformation Plan for children and young people’s mental health and wellbeing – Draft Annual Refresh October 2019

 

Jane Mischenko, Lead Commissioner for Children & Maternity Services at NHS Leeds CCG, introduced the report, highlighting the prevalence of mental health problems amongst children and young people, particularly in areas of high deprivation, and the projections for rapid growth in coming years. 

 

Members discussed a number of matters, including:

 

·  The success of the MindMate programme in schools, but equally the need to address support for schools in relation to managing exclusions and off-rolling;

·  The challenge of investment into services, and the need to continue to commit to delivering a Leeds Left Shift and effectively using additional funding outlined in the NHS Long Term Plan. Particularly actions to mitigate the risk of a projected rise in numbers of children experiencing poor mental health due to demographic challenges and the higher proportion of increasing numbers of children and young people occurring in areas experiencing the highest levels of deprivation in Leeds where they are more likely to experience Adverse Childhood Experiences (ACEs).

 

RESOLVED –

 

a)  To endorse the refreshed Leeds Local Transformation Plan for publication before 31 October;

b)  To note the Board’s recognition of the achievements over the last 4 years;

c)  To note the Board’s recognition of the strength of the child and young person’s voice, in particular the impact of the MindMate Ambassadors;

d)  To note the breadth and connection between partners and practitioners across the system and thank them for their continued commitment;

e)  To note the Board’s recognition of the strong contribution this strategy and plan delivers to the core prevention agenda of the city;

f)  To note the Board’s recognition of further work in the next year and through the subsequent plan to:

- To embed a ‘think family’ approach in the city

- To address the lack of parity of investment in children and young  people’s mental health

- To transform services for those in adolescence and approaching young adulthood (16-25)

 

 

23.

Our approach to improving health and wellbeing across Leeds and West Yorkshire and Harrogate pdf icon PDF 274 KB

12.1 Leeds Health and Care Plan: Continuing the Conversation

 

To consider the report of the Head of the Leeds Health and Care Plan (Health Partnerships) that provides an overview of the review of the Leeds Plan and the significant engagement to date which has supported its development.

 

(Appendix to follow)

 

12.2 Development of the WYH 5 Year Strategy for Health and Care

 

To consider the report of the West Yorkshire and Harrogate Health and Care Partnership that presents a draft of the narrative of the Five Year Strategy and the process for further developing and refining it.

 

 

Additional documents:

Minutes:

12.1 Leeds Health and Care Plan: Continuing the Conversation

 

The Head of the Leeds Health and Care Plan (Health Partnerships) submitted a report that provided an overview of the review of the Leeds Plan and the significant engagement to date which has supported its development.

 

The following was appended to the report

 

-  Leeds Health and Care Plan 2019 – 2024 Improving health: transforming the system, Working Draft Version 9

 

The Head of Leeds Plan introduced the report, highlighting the set of qualities and behaviours set out in the report and the city ambitions. Members were informed that an action plan was currently being developed.

 

Members discussed a number of matters, including:

 

·  The need to further engage front line staff around the culture change envisaged;

·  The need to clarify and define what is meant by a whole system ‘left shift’ in Leeds for future documents.

 

RESOLVED –

 

a)  To note the engagement and progress to date in developing a draft Leeds Plan;

b)  To note the Board’s comments in relation to the draft Leeds Plan.

 

 

12.2 Development of the WYH 5 Year Strategy for Health and Care

 

The West Yorkshire and Harrogate Health and Care Partnership submitted a report that presented a draft of the narrative of the Five Year Strategy and the process for further developing and refining it.

 

The following was appended to the report

 

-  Draft Five Year Strategic Plan

 

The following were in attendance:

 

-  Ian Holmes, Director for West Yorkshire and Harrogate Health and Care Partnership

-  Rachael Loftus, Head of Regional Health Partnerships

 

The Director introduced the report and the Five Year Strategic Plan, highlighting the opportunity to engage with the Board at the earliest opportunity along with the planning timetable leading up to implementation.

 

Members discussed a number of matters, including:

 

·  Support for the overall approach, specifically the improved references to tackling health inequalities in all programmes at West Yorkshire and Harrogate level and having a greater focus on the conditions needed for health and working with wider partners.

·  Support for the integration and recognition of oral health in primary care within the draft plan and the need for similar consideration within the Leeds Plan.

·  The Chair also queried whether any of the unspent dentistry budget from the national Specialist Commissioning budget could be potentially re-invested locally on in-school dentist provision, as opposed to being returned to central government. An update would be provided to the Chair in due course on this matter.

·  Concerns around the direction of travel being suggested nationally to rationalise the number of CCGs to one per Integrated Care System, which Members felt would not be appropriate for West Yorkshire and Harrogate given the large geography of the partnership. The Director responded that a strong message has been sent back to NHSE/I from the WYH Partnership that a single CCG would not be suitable.

 

RESOLVED –

 

a)  To note the timescale and process for the further refinement and sign-off of the strategy;

b)  To note the Board’s comments and  ...  view the full minutes text for item 23.

24.

Update on CQC Leeds System Review Action Plan pdf icon PDF 210 KB

To consider the report of the Lead for CQC System Review & Leeds CQC System Review Task and Finish Group that provides a summary of the progressions of the Board’s action plan made to date.

Additional documents:

Minutes:

The Lead for CQC System Review & Leeds CQC System Review Task and Finish Group submitted a report that provided a summary of the progressions of the Board’s action plan made to date.

 

The following was appended to the report

 

-  CQC Leeds System Review Action Plan

 

The following were in attendance:

 

-  Paul Bollom, Head of Leeds Plan

-  Emma Geary, Project Officer, Health Partnerships

 

The Head of Leeds Plan introduced the report, explaining that the self-judged action plan was developed following a Local System Review (LSR) of Leeds carried out by the Care Quality Commission (CQC).

 

Members discussed a number of matters, including:

 

·  Members welcomed the progress made, particularly in relation to ‘How Does it Feel for me?’ group;

·  The need for some of the actions to be integrated into the Leeds Plan ensuring that a positive difference has been made to the health and care system as a result of completed actions and continued focus.

·  Cath Roff provided an overview of Action 5: development of a one’ system suite of measures dashboard / scorecard as action lead, which will be brought to the Board at a future meeting.

 

RESOLVED – To note the Board’s comments and feedback.

 

 

25.

Draft Leeds Better Care Fund Plan 2019/20 pdf icon PDF 225 KB

To consider the report of the Chief Officer of Adults & Health (Leeds City Council) and the Director of Operational Delivery (NHS Leeds CCG) that seeks approval of the draft Leeds BCF Plan 2019/20.

 

(Appendix to follow)

Additional documents:

Minutes:

The Chief Officer of Adults & Health (Leeds City Council) and the Director of Operational Delivery (NHS Leeds CCG) submitted a report that sought approval of the draft Leeds BCF Plan 2019/20.

 

The following was appended to the report:

 

-  Draft Leeds Better Care Fund Plan 2019/20

 

The following were in attendance:

 

·  Steve Hume, Chief Officer for Resources and Housing, Leeds City Council

 

The Chief Officer introduced the report, noting the continued financial challenge associated with mental health residential placements. Members were advised that there was still opportunity for comments to be incorporated into the plan if Members wished to submit comments following the meeting.

 

RESOLVED – To agree the draft Leeds Better Care Fund Plan 2019/20.

 

 

26.

For information: Leeds Drugs & Alcohol Strategy & Action Plan 2019-24 pdf icon PDF 163 KB

To note, for information, the report of the Director of Public Health (Leeds City Council) that presents the updated Leeds Drug & Alcohol Strategy and Action Plan 2019-2024

Additional documents:

Minutes:

The Board received, for information, the report of the Director of Public Health (Leeds City Council) that presents the updated Leeds Drug & Alcohol Strategy and Action Plan 2019-2024.

 

RESOLVED – To note the contents of the report.

27.

For information: Connecting the wider partnership work of the Leeds Health and Wellbeing Board pdf icon PDF 328 KB

To note, for information, the report of the Chief Officer (Health Partnerships) that provides a public account of recent activity from workshops and wider system meetings, convened by the Leeds Health and Wellbeing Board (HWB). It contains an overview of key pieces of work directed by the HWB and led by partners across the Leeds Health and Care System.

Minutes:

The Board received, for information, the report of the Chief Officer (Health Partnerships) that provides a public account of recent activity from workshops and wider system meetings, convened by the Leeds Health and Wellbeing Board (HWB). It contains an overview of key pieces of work directed by the HWB and led by partners across the Leeds Health and Care System.

 

RESOLVED – To note the contents of the report.

 

 

28.

Any Other Business

Minutes:

No matters were raised on this occasion.

 

 

29.

Date and Time of Next Meeting

Wednesday 11th December 2019 at 2 pm.

Minutes:

Wednesday 11th December 2019 at 2 pm.

 

The meeting ended at 4:40 pm