Agenda item

To consider a report of the Assistant Chief Executive (Customer Access and Performance) presenting a summary of the quarter two performance data for 2011-12 which provides an update on progress in delivering the relevant priorities in the Council Business Plan 2011-15 and City Priority Plan 2011-15. 

Members considered a report of the Assistant Chief Executive (Customer Access and Performance) providing a summary of the quarter 2 performance data relevant to the Scrutiny Board (Health and Well-being and Adult Social Care), with two key issues being highlighted; the budget and health inequalities.  Appended to the report were detailed City Priority Plan performance reports in respect of the following priorities:

• Help protect people from the harmful effects of tobacco
• Support people to live safely in their own homes
• Give people choice and control over their health and social care services, and
• Make sure that people who are the poorest improve their health the fastest

The latest performance report from NHS Airedale, Bradford and Leeds was also provided, which gave an overview of performance against key performance indicators for the Leeds element of the NHS Airedale, Bradford and Leeds Cluster

  Attending for this item were:

·  Councillor Lucinda Yeadon – Executive Member (Adult Health and Social Care)

·  Heather Pinches – Performance Manager Planning, Policy and Improvement LCC

·  Dr Ian Cameron – Joint Director of Public Health – NHS Leeds and LCC

·  Sandie Keene – Director Adult Social Services LCC

·  Stuart Cameron-Strickland – Head of Policy, Performance and Improvement Adult Social Services – LCC

Considering the City Priority Performance Plan reports and the Adult Social Care Directorate Scorecard, the key areas of discussion were:

• Safeguarding referrals, the increased focus on safeguarding for adults in view of recent media coverage of incidents in other parts of the country; the multi-agency approach and the importance of Elected Members taking an interested view in Adult safeguarding
• Budgetary pressures; that the overspend was decreasing and that this could be attributed to the work being done to enable people to live in their homes for longer, thereby decreasing the amount of time people needed to spend in residential or nursing home care

Members raised concern that the print used to produce the report was especially small, which may lead to the document not being used to full effect due to the difficulties reading it

Considering the report provided by Airedale, Bradford and Leeds NHS

setting out performance for Leeds, the key areas of discussion were:

• Fractured neck of femur operated within 48 hours, with concerns being raised that performance had decreased and that delays could lead to fatalities
• 30 day readmission rates, following elective discharge and that these remained too high
• Emergency home visits and that waiting times of 1 and 2 hours were lengthy
• C.difficile rates
• Diabetes treatment
• Health visitor numbers
• Stroke care, with concerns that the information provided lacked clarity
• Alcohol related harm, particularly whether there was sufficient treatment slots available for those in need

Dr Cameron responded to the points raised by Members and provided

the following information:

• That the concerns raised were noted and that much work was being carried out to address the issues highlighted by the performance indicators and as a result it was hoped that an improving picture would be seen when this data was next presented
• There had been significant progress in addressing the occurance of MRSA and that addressing C.difficile rates was a top priority for the local health economy.  It was confirmed that the situation was improving but it was likely that it would take time for improvement activities to translate into an improved performance indicator due to the significance of the issue
• That over recent years greater investment had been directed towards bariatric surgery to help counteract the health impacts associated with obesity, including diabetes and that further trend information would be provided
• That as part of the proposed NHS reforms, responsibility for services for 0-5s would remain with the NHS until at least 2015
• That a further written response would be provided on the performance indicator for stroke care and the actions taken to improve performance in relation to the operation times to treat fractured neck of femur episodes
• It was confirmed that currently there were not enough treatments slots for people with alcohol related issues, although additional financial investment was to be directed to this area next year, subject to priority setting

The Board discussed the possibility of receiving data captured over a longer period of time which would enable trends to be identified.  In responding, Dr Cameron informed Members that they way the data had been produced had already been the subject of much debate; that any changes to the format would need to be considered by colleagues in the NHS and that he would take this request back for consideration

The Board also discussed the process for setting targets and whether these should be determined locally

In responding, Dr Cameron referred to the NHS Outcomes Framework which provided a suite of indicators aimed at measuring outcomes.  It was suggested that in the future, Scrutiny Board might wish to consider how the 3 Clinical Commissioning Groups and the NHS Commissioning Board were performing against this suite of indicators

RESOLVED –

i)  To note the two key issues of the budget and health inequalities which were highlighted

ii)  To note the overall progress in relation to the delivery of the Health and Wellbeing City Priorities and that a Scrutiny Inquiry into Tobacco would commence in January 2012

iii)  To note the information provided by NHS Airedale, Bradford and Leeds and the comments made by Dr Cameron

iv)   To note that further information would be provided to the Board by Dr Cameron on the following issues:

• the layout of performance indicator reports
• bariatric surgery
• stroke care