Agenda item

To receive a report from the Head of Democratic Services which presents an update from the ICB Accountable Officer (Leeds Place) on the refreshed Healthy Leeds Plan.

The Head of Democratic Services submitted a report which presented an update from the ICB Accountable Officer (Leeds Place) on the refreshed Healthy Leeds Plan.

The following were in attendance:

• Councillor Salma Arif, Executive Member for Adults Social Care, Public Health and Active Lifestyles
• Caroline Baria, Interim Director of Adults and Health
• Victoria Eaton, Director of Public Health
• Tony Cooke, Chief Officer Health Partnerships
• Catherine Sunter, Head of Population Health Planning, Leeds ICB
• Jo Howard, Population Health Outcomes Development Lead, Leeds ICB

The Head of Population Health Planning and Population Health Outcomes Development Lead presented the report and outlined the following information:

• The plan outlined the Health and Care contribution towards delivery of the Health and Wellbeing Strategy, achieving the ambition that Leeds will be a caring city for people of all ages, where people who are the poorest improve their health the fastest.
• The plan was ambitious to improve health goals in line with the system commitments to population needs. This was different from traditional approaches that focus on primary care and point of access.
• There are 9 exclusive segments of population and life stages that will be targeted by the plan, which are children and young people, healthy adults, maternity, long term conditions, cancer, severe mental illness, learning disabilities and neurodiversity, frailty and end of life.
• The draft plan set out within the agenda pack had been considered by the Leeds Committee of the West Yorkshire ICB on 5^th July 20203 and due to be considered by the Leeds Health and Wellbeing Board during its meeting on 20^thJuly 2023.
• Comments from the Scrutiny Board, ICB and Health and Wellbeing Board were to be incorporated into the plan.
• The Healthy Leeds Plan consultation had engaged with the public and shaped shared system goals and expected outcomes.
• It was noted that there were too many goals in the original Healthy Leeds Plan and the 2023 plan will be comprised of 2 system goals ‘reduce preventable, unplanned care utilisation across health settings’ and ‘increase early identification and intervention’.
• The plan had taken inspiration from the New York Staten Island system with reduced goals, effective planning and realistic implementation.
• The goals were deemed reflective of the financial climate.
• The broader purpose and next steps of the plan were to contribute to the West Yorkshire Joint Forward Plan and influence local plans to meet regional and national goals. At a West Yorkshire ICB level the Leeds Place plan is unique in terms of its focus on populations which is in line with the Leeds system operating model.
• The small scope of goals gave greater ability for tracking and the actions being undertaken as a system to address the goals will remain under review as part of an annual refresh of the plan.
• All system partners have a role in achieving these system goals.  A small number of priority data-led initiatives will be identified.  These will in general be delivered through existing governance infrastructure – the relevant Population or Care Delivery Board and Local Care Partnership.
• The progress for goal 1 ‘reduce preventable, unplanned care utilisation across health settings’ will be robustly monitored with target reductions.
• Goal 2 to ‘increase early identification and intervention’ will be informed via goal 1 data.
• Indices of Multiple Deprivation (IMD) 1 to 10 had been used to determine levels of deprivation for areas across Leeds to identify needs of specific communities.
• Once finalised and published, there will also be an easy-to-read version made available and this will be published at the same time.

In response to questions from Members and subsequent discussion, the following was outlined:

• It was noted the plan will focus on maximising the Leeds pound through engagement with the Population and Care Delivery Boards to strive for allocative efficiency. As the Scrutiny Board continues to monitor delivery of the plan, the Chair also emphasised the importance of maintaining an oversight of how well local NHS and local authority funding is being fully maximised, including cost sharing provisions.
• It was outlined that IMD1 populations had more unplanned care and IMD10 was predominately planned care. This model will not ignore the pockets of deprivation in the more affluent wards, as lessons can be learnt from IMD1 and feed out to other areas with the overall aim for improved services for everyone.
• Differences were noted between the healthcare systems of England and Staten Island, however, the process of the health led approach and focus on wider determinants and division of areas was appropriate and effective.
• The projections, detailed from page 71 of the report, were expectations of unplanned system utilisation alongside population growth and aimed to be realistic and then add targets for less unplanned care with further data to be shared back to the Board if improved from the projections.
• The recruitment aims, detailed on page 114 of the report, were explained as being developed against NHS England national priority indicators and the GP recovery plan, and would consist of 515 full time equivalent staff for Leeds which can be appointed specifically to meet needs, such as social prescribers or ambulance staff.
• Data comparing current Leeds GP full time equivalent employment figures with that from 5 years was agreed to be compiled and the Chair advised that this can form part of the report that is expected for the Board’s September meeting around improving access to General Practice.
• More GPs will be needed to be proportional to future population increases. It was noted various schemes such as the GP recovery plan identified how staff are best utilised, primary care was best for complex, long term needs, and preventative public health measures should limit unplanned care forecasts.
• Collective challenge was impacted by the rise in demand and needs of the population, services had to prioritise backlogs so proactive, preventative methods in the community needed to be targeted to relieve pressure from the care system.
• A streamlined approach was needed to pull services up together for any future technological developments, including Artificial Intelligence (AI). Various digital initiatives were outlined to be working towards this including the Academic Health Partnership; however, it was noted to be at an early stage of development with challenges including GDPR and access.
• Technological developments should have people and community as a priority to ensure trust and access and AI should not be implemented too fast as services are mostly utilised by older people. It was noted a watching brief should be kept over emerging technology in the system by the Board.
• It was highlighted that a number of the targets set out in the plan were reflected of those set out in the overarching Joint Forward Plan developed by the West Yorkshire ICB.
• Each Population and Care Delivery Board has an outcomes framework along with outcomes measures that they are accountable for delivering.  It was agreed these would be shared with the Board.  Population and Care Delivery Boards are responsible for advising the Health and Care system in how to improve outcomes, experience and make a better use of resources for their population.

In conclusion, the Chair thanked everyone for their contributions and requested that the Board’s comments and requests for information be noted.

RESOLVED - That the report, along with Members comments and information requests, be noted.