Agenda item

To receive a report from the Head of Democratic Services which presents a briefing paper by the Leeds Health and Care Partnership on reviewing the local impact of national health related policy changes.

The Head of Democratic Services submitted a report which presented a briefing paper by the Leeds Health and Care Partnership on the implications of the pertinent Labour Manifesto Pledges, including the three policy shifts in relation to the NHS and Health & Care System, as well as acknowledging the focus on immediate financial and performance pressures.  Consideration was also given to the findings of the independent investigation of the NHS in England that was undertaken by Lord Darzi.  A summary of the findings set out in a letter from Lord Darzi to the Secretary of State for Health and Social Care was also appended for Members information.

The following were in attendance:

·  Councillor Fiona Venner, Executive Member for Equality, Health and Wellbeing

·  Councillor Salma Arif, Executive Member for Adult Social Care, Active Lifestyles and Culture

·  Caroline Baria, Director of Adults and Health

·  Victoria Eaton, Director of Public Health

·  Shona McFarlane, Deputy Director Social Work and Social Care Service

·  Tim Ryley, ICB Accountable Officer (Leeds Place)

·  Phil Wood, Chief Executive of Leeds Teaching Hospitals NHS Trust (LTHT)

·  Sam Prince, Executive Director of Operations, Leeds Community Healthcare NHS Trust (LCH)

·  Alison Kenyon, Deputy Director of Service Development Leeds and York Partnership NHS Foundation Trust (LYPFT)

The Executive Member for Equality, Health and Wellbeing gave a brief introduction and then handed over to the ICB Accountable Officer (Leeds Place) to highlight key aspects of the report. In summary, the following points were made:

Ø  There are a number of national pledges that focus on neighbourhoods and communities with prevention as the focus of a new model of health.  This aligns with local ambitions set out in the Leeds Health & Wellbeing Strategy, with the neighbourhood and local care partnership work to date being a strong base from which to build a neighbourhood health model.

Ø  Further work on timeframes and policy detail are still to emerge in relation to the anticipated shifts “from treatment to prevention” and “from acute care to primary care”.

Ø  The Darzi review highlighted the under investment in public health, primary care, and prevention over a number of years and so it is unclear to date how and in what timeframe the ambition for a shift in resources will take place, especially against a background of long elective waiting lists and a very tight financial climate.

Ø  in Leeds there is a already strong focus on Public Health across all areas of the council and NHS work, with the recent Director of Public Health Annual Report and the Marmot City work shaping priorities and supporting ambitious change.

Ø  The commitment towards children’s health is a very welcome ambition and does align with the Leeds City Ambition.

Ø  Key pressures on the NHS continue to include Elective Waiting Times (still people waiting more than 18months not 18 weeks) and GP Access (despite record numbers of appointments).

Ø  The major themes identified as part of the independent investigation by Lord Darzi will also inform the government’s forthcoming 10-year health plan, which is expected next spring.

During the Board’s discussions, the following issues were also raised:

Ø  Capital budgets – In acknowledging the findings of Lord Darzi around the impacts of insufficient capital investment in the NHS nationally, the Board discussed the local challenges surrounding capital investments for primary care and mental health estates.

Ø  New hospital provision in Leeds – Linked to the government’s New Hospitals Programme established in 2019, particular reference was made to the investment plans at Leeds Teaching Hospitals NHS Trust in terms of building a new hospital on the site of Leeds General Infirmary (LGI) which will include a fit for purpose new home for Leeds Children’s Hospital, a new adults’ hospital and one of the largest centralised maternity centres in the UK. The Chief Executive of the Trust explained that the government recently commissioned a review of the Programme in order put it on a sustainable footing and that the Leeds project is included in the remit of that review. The Trust and its strategic partners therefore continue to await national approvals to proceed, with a decision expected to be made on 30^th October 2024. Members were advised that the cost to rectify backlog maintenance and maintain services at the LGI site (location for the new hospitals) is estimated to be more than £630m and costs will continue to rise linked to ongoing delays.  In sharing the concerns of the Scrutiny Board, the Executive Member for Equality, Health and Wellbeing highlighted that this matter was also being considered by the Executive Board as part of its meeting on 16^th October 2024, with the intention of seeking support for a ‘Team Leeds’ approach in making a submission to the Treasury before the Budget on 30  October 2024, clearly stating the importance of modernised hospital provision in Leeds and requesting that the Leeds scheme be permitted to go ahead without delay.  The Scrutiny Board welcomed and agreed to support this approach.

Ø  Investing in prevention - To fully realise the move from sickness to prevention, the Board acknowledged the importance of investment and cross governmental work to address social determinants of health.  Members also discussed opportunities locally to help influence national policy and secure much needed investment in preventative models.

Ø  Maximising resources effectively – Recognition was also given to the importance of maximising resources more effectively through greater collaborative working, with HomeFirst and the Community Mental Health Transformation Programme being cited as positive examples of this.

Ø  Patient satisfaction – It was noted that the independent investigation of the NHS in England undertaken by Lord Darzi had found that patient satisfaction with services has declined and the number of complaints has increased.  Members were advised that the highest percentage of compensation claims nationally are linked to maternity services.  In Leeds, the vast majority of NHS services, including GP Practices and Maternity Care, are rated good or outstanding, with maternity related claims being lower than the national average. Overall, importance was placed on all partners collectively keeping close attention to the quality of local services through mutual quality assurance arrangements.

Ø  Digital Inclusion – Members discussed the third policy shift for the NHS which is “from analogue to digital”.  It was acknowledged that the focus on improving on the use of digital is something Leeds has recognised as an important feature of efficient and safe health care delivery and has pioneered the use of data with the joint NHS/Leeds City Council Office of Data Analytics (ODA) and through the Leeds Care Record.  The work in HomeFirst in joining data systems had also been a critical aspect of its success.  It was noted that considerable further work is still needed and therefore this remains on the agenda of the Leeds Health and Care Partnership.

The Chair thanked everyone for their contribution to the Board’s discussion.

RESOLVED –

(a)  That the contents of the report, along with Members comments, be noted.

(b)  That the Adults, Health and Active Lifestyles Scrutiny Board is supportive of a ‘Team Leeds’ approach in making a submission to the Treasury before the Budget on 30 October 2024, clearly stating the importance of modernised hospital provision in Leeds and requesting that the Leeds scheme be permitted to go ahead without delay.