To consider the report of the Chief Executive Officer, Leeds Healthwatch, and the Chief Officer Health Partnerships which introduces the final report of the 2021 Big Leeds Chat (BLC) and to agree and support the proposed recommendations for future governance alignment of the Ten Statements for action.
The joint report of the Chief Executive Officer, Leeds Healthwatch, and the Chief Officer, Health Partnerships introduced the final report of the 2021 Big Leeds Chat (BLC) which identified ten themes from the conversations held with members of the public in community settings and now proposed as ten Big Leeds Chat Statements for action. The report also sought consideration of how future governance arrangements align with the BLC Statements for Action, noting that the proposed accountability and reporting approach had been agreed in principle at the previous Health and Wellbeing Board meeting.
Hannah Davies, Healthwatch Chief Executive, provided the Board with the background to and development of the BLC which had launched in 2018 supported by the Peoples Voice Partnership. As the Coronavirus pandemic waned, the Partnership Executive Group had identified the need to revisit the BLC to gather information on people’s experiences. The 2021 BLC gathered health and social care decision makers together to visit a diversity of venues and groups across 40 events including Leeds’ Local Care Partnership areas and events with groups representing “communities of interest”.
Chris Bridle, NHS Leeds Engagement Team Manager, highlighted the importance of the connections made between the senior decision makers and residents during the events. The Board was provided with the high-level themes identified during discussions which were of key importance to participants and which decision makers highlighted for direct action by health and care services.
Abiola Ajijola, Project Officer, Local Care Partnerships (LCP) Development Team, provided the Board with an overview of some of the work undertaken building on existing services in response to the recurring theme of ‘access to healthcare’. In the Middleton LCP area, work with Leeds “100% Digital” team had provided digital access to healthcare support, prescriptions and advice and this approach would be rolled out across Leeds. In the West Leeds LCP area the Third Sector and Primary Care Network worked together to promote healthy living and eating choices to improve long term health. Access to greenspaces had been a recurring theme across all BLCs, and in Morley the LCP Development Team was working with the Morley Town Deal Board to invest in greenspaces to tackle health and air quality.
Paul Bollom, Head of Health and Care Development, gave the Board a presentation highlighting the governance arrangements to support each of the ten Big Leeds Chat Statements for Action:
1. Make Leeds a city where children and young people’s lives are filled with positive things to do.
2. Make Leeds a city where there are plentiful activities in every local area to support everyone’s wellbeing.
3. Make Leeds a city where people can connect with services face-to-face when they need to.
4. Make Leeds a city where people feel confident they will get help from their GP without barriers getting in the way.
5. Make Leeds a city where each individual community has the local facilities, services and amenities they need.
6. Make Leeds a city where fears about crime and antisocial behaviour are no barrier to enjoying everything the community has to offer.
7. Make Leeds a city where services acknowledge the impact of the pandemic on people’s mental health and where a varied range of service- and community-based mental health support is available.
8. Make Leeds a city where there are affordable activities that enable everyone to stay healthy.
9. Make Leeds a city where green spaces are kept tidy and welcoming, because services understand the vital role they play in keeping people well.
10.Make Leeds a city where everyone can get around easily on public transport, no matter their location or mobility needs.
Paul detailed the ten themes underneath the headline and the proposed forum to lead on delivery and reporting back to the HWB. Each lead forum will report back to the Board on:
· Whether there is a plan to ensure the city as a whole is working towards the aim;
· Is there an implementation plan to ensure progress is tracked and measured?
· Does the forum understand the variance and gaps in terms of ensuring the themes are addressed in all Leeds’ communities?
· Updates on progress in all of Leeds’ communities against each theme.
Jim Barwick reported that Gaynor Connor, Director of Primary Care & Same Day Response, will lead the “GP Access” theme. He also acknowledged that access to GP services had been an issue during the pandemic and that the swift changes brought in to support GPs had presented a challenge to some service users – such as digital access or new and additional roles which were not always understood. Work was being undertaken to explain care navigation and to listen to people at a local level. The variation within GP services was acknowledged, some of this could be attributed to the location of the GP practice (i.e in an area of high health inequalities); or the increase in demand across all practices. As work continued to ensure all services resumed, the Primary Care Programme Board had been established to work with contract leads and consider:
· How to use data to improve quality and reduce health inequalities
· How to make the best responsive use of the workforce
· How to join together same day response with all aspects of primary care
During discussions, Board Members who had attended BLC events highlighted the following matters:
· The impact of isolation and missing out on social interaction during the pandemic on men’s mental health and general wellbeing;
· The willingness of attendees to engage and speak of their health and care experiences and the value of listening and taking action;
· How people value their local greenspaces and centres;
· The nuanced view of health and care – when people spoke of the NHS they thought of hospitals, but when people spoke of their own health and care they thought of General Practice
The Board additionally discussed the following matters:
The role of community Pharmacists in supporting General Practice - The Government had announced proposals to further enhance the role of appropriately trained Pharmacists to provide more services which formerly would have been undertaken by a GP. Some Pharmacists attached to GP practice may already undertake annual medication reviews and work in care homes, but further work would be required to better connect them to community Pharmacists and to communicate the changes.
General Practice services – Patient access to a GP had been a focus for some time but responding to the pandemic required General Practice to review its processes and efficiencies. It was important to clarify that General Practice and General Practitioners were not now the same. The development of Primary Care Networks allowed General Practices to make use of a wider skill mix and provide a variety of essential services on site – such as mental health support, physiotherapy and specialist nurse services and a traditional appointment with a GP or Nurse appointment may not be the most appropriate for the patient.
Mental Health – In Leeds the impact of the pandemic was felt in the two most recent student cohorts who had moved to the city and had no physical social interaction or study. There was much focus on ‘digital exclusion’ but there were groups of people whose only social life had been on-line which was detrimental to their mental health and their ability to socially interact. This was also true of older people who prior to the pandemic had enjoyed community groups or Neighbourhood Networks, and the Board noted the request for these groups to be considered by those tasked with addressing Statement 7) “Make Leeds a city where services acknowledge the impact of the pandemic on people’s mental health and where a varied range of service- and community-based mental health support is available”
Social Prescribing – The value of social prescribing and early intervention measures to improve mental health and general health.
Shared Prosperity Funding – Whether there was the opportunity to link the themes arising from the BLC into work to reduce health inequalities supported by the Shared Prosperity Fund.
a) The Health and Wellbeing Board welcomed the Big Leeds Chat Report, including the feedback from decision makers, and supported wide dissemination of the final report.
b) The Health and Wellbeing Board noted the findings of the BLC ‘21 and the actions against the ten BLC Statements identified by citizens.
c) The Health and Wellbeing Board agreed to support the proposed governance for each BLC Statement.