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From YouTube: Leeds City Council - Scrutiny Board (Adults, Health & Active Lifestyles) - 15 September 2020
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B
Thank
you
very
much
welcome
to
the
board
and
our
colleagues
and
partners
and
to
the
adults,
health
and
active
lifestyle.
Styles
scrutiny
board
meeting
and
like
to
welcome
you
all
here
this
afternoon
and
before
we
start
going
through
the
agenda,
could
I
welcome
and
ask
everybody
members
of
the
board
to
introduce
themselves
I'll
start
in
alphabetical
order.
So
I'll
start
with
councillor.
C
B
Right,
yes,
he
is
so
maybe
he's
just
not
able
not
able
to
come
in
at
the
moment,
so
we'll
see
if
everything's,
all
right
with
council
rick
bell.
Okay,
so
thank
you
very
much
and
for
introducing
yourselves
can
I
invite
harriet
spate
as
governor's
governance
officer,
to
run
through
the
first
five
items
of
the
agenda.
Please.
K
K
D
K
K
B
B
B
B
A
However,
following
a
request
that
was
made
by
the
board,
this
agenda
item
is
focusing
specifically
on
the
impact
that
covering
19
has
had
with
regard
to
accessing
local
nhs
dental
services
and
also
exploring
what
support
is
being
provided
to
resume
nhs
dental
services
safely
and
effectively
and
in
accordance
with
the
advice
that's
set
out
by
the
the
chief
dental
officer
and
so
I'll
pass
back
to
you
now
to
introduce
those
are
attending
for
this
item.
Thank
you.
B
E
B
Dental
network
chair
have
we
got
jane
in
the
callers,
yet
I
think
she's
struggling
to
join
her
all
right
if
an
officer
could
maybe
help
out
without
that'd
be
great
and
sam
prince,
who
is
executive
director
of
operations
lease
community
healthcare,
nhs
trust,
so
I
don't
know
who
wants
to
go
first.
Emma.
Do
you
want
to
speak
to
this
item?
Yes,
but
actually
before
that
council
charwood?
I
would
you
like
to
introduce
yourself
and
say
hello.
B
L
Don't
worry
yeah
good
afternoon,
I'm
as
we've
explained,
I'm
emma
wilson,
I'm
head
of
car
commissioning
for
yorkshire
and
the
humber,
and
I
have
commissioning
of
dental
services.
As
part
of
my
role.
I
am
going
to
assume
that
the
paper
that
was
circulated
has
been
read
by
colleagues
and
that
probably
will
generate
some
questions,
but
I
thought
it'd
be
helpful.
L
L
Now
that
was
very
much
predicated
on
the
fact
that
they
had
the
relevant
ppe
were
able
to
use
it,
able
to
use
it
effectively
and
could
deliver
urgent
care
to
those
patients
who
had
been
triaged
and
who
required
it
that
now
in
leis
you
can
see
from
the
picture.
There
is
a
pretty
strong
position,
so
we
now
have
86
practices
and
all,
but
one
are
providing
urgent
services
and
can
provide
urgent
services
using
the
relevant
ppe.
L
The
large
number
of
them
have
also
gone
on
to
be
able
to
complete
courses
of
treatment
for
patients,
so
this
is
patients
who
call
the
practice,
irrespective
of
whether
or
not
you
are
a
regular
attender
at
that
practice.
Those
practices
will
triage
you
and
will
then
offer
you
where
clinically
necessary
and
urgent
appointments.
L
There's
a
certain
expectation
of
time.
I
think
it's
about
an
hour
known
as
fallow
time
that
and
the
dentists
have
to
wait
before
they
can
then
start
the
cleaning
and
bring
other
patients
in
and,
of
course,
there's
also
the
issue
of
old
staff
being
appropriately
supported
with
the
relevant
ppe.
So
by
definition,
it
means
that
the
capacity
that
our
practices
are
able
to
offer
is
is
pretty
limited
and
we've
been
given
a
clear
steer
over
the
last
week
that
that
guidance
is
unlikely
to
change
in
the
short
term.
L
I
I'm
sure
I'd
have
to
tell
you
that
we're
still
facing
some
of
the
challenges
of
the
curvy
pandemic
and
in
dentistry,
that's
no
different.
So
it's
felt
that
at
the
in
the
present
time,
we
need
to
return
that
guidance
work
with
our
practices
to
help
them
prioritize
patients
as
effectively
as
possible,
but
make
sure
that
they
are
resilient.
L
L
L
There
are
some
challenges
in
terms
of
being
able
to
implement
and
deliver
a
service
with
that
level
of
ppe
and
the
guidance
that
is
required
and
we
are
working
with
them
to
help
them
manage
the
backlog
of
patients
and
there
is
a
backlog
of
patients.
There
are
a
number
of
patients
that
sit
on
and
practice
books
or
waiting
lists
that
do
wish
to
be
seen
for
their
more
regular
care
and
they're,
starting
now
to
work
through
some
of
those.
L
I
think
what
probably
where
jacob
is,
because
she's
the
local
dental
network
chair
james,
would
be
able
to
explain
the
challenges
of
ppe
and
the
ability
of
practices
to
prioritize
their
patients
more
effective
than
I
can.
But
I'm
very
happy
to
take
questions
if
colleagues
have
them
and
we
can
try
and
feel
them
as
best
we
can.
B
Perfect
and
we
have
some
prince
as
well,
so
in
terms
of
questions,
I
am
going
to
start
with
councillor
reagan,
then
councillor
truswell
councillor
lay
councillor
knight
and
dr
beale,
okay,
and
I
will
I
will
obviously
come
to
as
more
as
more
people
and
put
their
hands
up.
So
can
I
start
with
council
reagan,
please
thank
you.
Chair.
I
I've
got
a
fear
for
constituents
that
don't
have
that
treatment
that
that's
going
to
be
long-term.
Dental
decay,
which
is
going
to
have
more
effects
later
on
in
the
so
can.
Can
you
explain
how
what
type
of
ppe
is
used
to
prove
to
to
make
sure
that
that
practice
can
happen?
And
if,
if
we
haven't
got
that,
why
haven't
we
got
it
and.
C
B
J
Yes,
thank
you
chair.
I
have
similar
concerns
to
denise,
but
that
they've
been
covered.
I
just
wanted
to
put
this
in
the
broader
context
of
access
to
dentistry
in
general,
because
the
emphasis
is
we
are
talking
about
nhs
dentistry
and
we
know
that
over
the
last
couple
of
decades
have
been
a
massive
exodus
of
dentists
from
the
nhs
some
left.
The
nhs
completely
some
do
some
nhs
work.
Some
will
provide
nhs
care
to
children,
providing
the
parents
have
got
a
contract
with
a
private
insurer.
J
So
when
we
talk
about
the
86
pr
practices,
are
we
talking
about
all
the
practices
in
leeds?
If
not,
how
many
practices
are
there
and
how
many
practices
are
not
necessarily
following
this
nhs
approach,
or
are
they
expected
to
I'm
just
trying
to
get
a
feel
for
the
impact
basically
of
the
overall
privatization
of
dentistry
over
the
last
20
years
has
created,
and
so
we
know
exactly
what
we're
talking
about.
J
L
It
is
yes,
so
the
86
practices
are
nhs
practices.
I
don't
have
any
guidance
or
authority
with
private
practice.
We
have
the
86
and
with
the
exception
of
one-
and
I
think
I've
articulated
it's
due
to
sickness
and
there
is
a
buddying
arrangement.
All
our
practices
are
offering
triage
and
then,
where
it
is
clinically
appropriate,
will
offer
treatment
in
the
way
that
I
described
it
at
the
beginning.
I
think
you're.
Quite
right,
though,
this
is
definitely
in
a
context
of
a
challenged
position.
L
We've
all
been
always
been
challenged
with
our
access
to
dentistry,
so
it
we
didn't
start
in
a
great
place.
If
I'm
really
honest-
and
I
think
we've
been
quite
upfront
about
that
in
terms
of
our
previous
conversations
and
one
of
the
frustrations
for
us
is
as
commissioners
in
nhs
england
is
that
we
had
a
plan
to
try
and
invest
a
little
more
and
and
put
it
into
areas
of
greatest
need
and
greatest
concern.
L
That
plan
is
still
something
we
have
got
in
the
back
of
our
minds
and
we've
still
got
that
there,
but
I
think
there's
two
challenges
for
us.
The
first
is
getting
through
this
curvy
pandemic
and
making
sure
that
we
can
offer
a
resilient
urgent
service
with
a
view
to
moving
into
a
resumption,
and
the
second
is
that
we
have
to
be
really
really
clear
that
actually
financially,
things
may
be
slightly
different
for
us
in
the
second
half
of
the
year.
L
But
the
commitment
that
we
want
to
do
to
try
and
improve
access
generally
is
still
there
and
I'm
sure
that'll
be
something
that
we
can
have
a
conversation
about,
as
we
are
a
little
clearer
about
the
funding.
But
unfortunately
I
can't
speak
about
private
dentists,
although
they
have
been
involved
in
the
urgent
response
so
when
their
patients
have
needed
an
urgent
response.
They've
been
working
with
us
over
the
last
six
months,
but
I
don't
have
any
commissioning
responsibility
for
them.
J
Okay,
yeah,
just
very
briefly
thanks
very
much
for
that
answer
emma.
I
think
it
will
be
useful,
obviously
not
now,
but
to
try
and
find
out
what
the
provision
of
dentistry
is
across
the
city.
I'm
sure
we've
had
figures
in
the
past,
within
the
nhs
and
outside
of
the
nhs
and
and
to
support
our
colleagues
in
the
nhs
to
try
and
extend
that
accessibility
and
provision,
especially
in
wards
like
mine,
where
I
think
dental
disease
is
is,
is
at
one
of
the
highest
rates,
but
that's
for
another
day,
but
thank
you
very.
L
H
Are
there
any
problems
with
accessing
enhanced
ppe
for
dentistry?
Secondly,
I
just
wondered
why
if
an
agp
is
undertaken-
and
I
assume
every
procedure
by
definition
in
a
dentist
going
into
having
a
look
in
one's
mouth-
is
an
aerosol
generator
procedure.
So
if
every
procedure
is
an
aerosol
generated
procedure,
you
say
there's
an
hours
gap.
I
assume
that's
to
allow
the
droplets
to
fall
out
of
the
air.
H
I
just
wondered
why
that's
twice
the
length
of
what
we're
using
as
our
30
minute
barometer
in
intensive,
cares
in
a
e's
etc.
So
I
just
wondered
why
it's
an
hour
and
not
30
minutes
for
when
we
do
agps
and
finally-
and
perhaps
this
one
is
for
sam
page
11
of
the
report-
0.2
0.1.
The
last
bullet
point
talks
about
subject
to
the
availability
of
enhanced
ppe.
H
That's
fine,
urgent,
dental
care,
centers
are
being
established
in
a
minimum
of
10
locations
across
the
city
or
across
leeds
being
established,
are
established
whereabouts.
Are
they
going
to
be
there's
no
detail
in
the
briefing
as
to
what
do
we
do
if
we
have
an
urgent
need
for
dental
care
outside
of
the
traditional
dental
hours,
it
alludes
to
it
there,
but
if
we
could
just
have
a
little
bit
more
detail,
thank
you.
L
Shall
I
take
them
in
reverse
order,
just
because
my
memory,
they
might
need
to
prompt
him,
but
if
I
start
with
the
reverse
order,
so
I
I
think
we
might
be
looking
at
two
slightly
different
things.
We
did
establish
10,
urgent
treatment
centers
across
leeds
and
the
pandemic.
So
when
we
started
at
the
end
of
april,
when
the
chief
dental
officer
asked
us
to
establish
urgent,
we
had
10
senses
in
leeds
those
10
have
now
grown
into
the
86.
L
L
L
Well,
that
is
a
good
point.
Actually,
yes,
you're
right
previous
prior
to
culverd,
we
had
urgent
treatment
and
then
we
had
regular
nhs
access.
Didn't
we,
what
happened
was
we've
had
to
we
had
to
deem
it
all
as
urgent,
but
the
process
is
exactly
the
same,
the
triage
and
then,
where
clinically
appropriate,
you
would
be
seen,
but
the
provider
has
to
have
level
three
ppe
now
jane,
maybe
will
be
able
to
help
us
understand
why
we
don't
have
an
hour's
fallow
time.
L
We
also
struggled
in
the
training
because
in
order,
as
I'm
sure
you'll
be
aware,
in
order
to
be
able
to
use
level
3
ppe,
there
does
need
to
be
a
tester
and
somebody
who
can
make
sure
that
their
colleagues
are
safe
as
well.
We
have
now
made
sure
that,
in
all
of
our
practices,
we
have
that
system
in
place.
L
C
Absolutely
yes,
there
can
be
a
reduction
in
the
fallout
time
to
20
minutes
so
long
as
the
surgery
has
an
air
exchange
of
10
to
12
per
hour
and
unfortunately,
although
quite
a
lot
of
our
surgeries
are
trying
to
have
this
equipment
installed,
to
reduce
the
fallow
time.
Not
all
can
at
the
moment,
but
in
the
hospital
situation.
That'll
be
why
that
they
can
reduce
the
fallow
time
so
that
counts.
C
L
As
well
as
sorry,
yes,
yes,
sorry,
I've
confused
things.
I
think
it's
the
use
of
the
urgent
treatment
center.
Isn't
it
that's
confusing
there?
We
still
have
the
the
way
that
james
just
described.
We
still
have
treatment,
centers
that
are
for
out
of
hours
in
the
way
that
you
describe,
but
they
we
also
had
10
urgent
treatment
centers
in
primary
care
for
in
hours,
but
they
have
now
grown
to
be
the
86
yeah.
Does
that
look.
H
F
Although
another
question
linked
to
that
is,
do
they
get
that
free
if
they're
on
universal
credit,
but
even
if
that
is
the
case,
what
can
we
do
locally
to
increase
the
numbers
of
appointments
and
availability
for
people
who
are
in
need
of
treatment,
but
cannot
afford
private
appointments
or
cannot
afford
even
nhs
costs?
Is
that
something
that's
being
looked
up?
Thank
you.
L
I
think
the
challenge
we've
got
at
the
moment
is
to
build
back
up
that
access
to
make
sure
that
actually
it
is
access
that
does
best
can
recognize
the
challenges
of
those
who
would
struggle
to
access
a
dentist.
The
first
thing
we've
done
is
made
sure
that
every
dentist
would
at
least
be
able
to
triage
somebody,
because
you'll
know
before
patient
practices,
who
have
not
seen
a
patient
regularly.
Although
there's
no
list
patients
struggle
to
access
a
dentist,
because
if
they
hadn't
been
seen
recently
or
regularly,
then
a
practice
would
not
see
them.
L
One
of
the
arguably
positive
things
that's
come
out
of
this
is
that
now
our
expectation
is
that
practices
would
always
triage
and
acknowledge
a
patient
when
they
call
and
would
respond
to
their
urgent
need,
and
now
that
doesn't
I
appreciate
that
doesn't
cover
your
point
about
prevention,
work
and
longer
term
support
for
patients
who
need
it.
So
that's
the
bit
that
we
were
talking
about
earlier
that
we've
got
to
focus
on
once.
Practices
have
been
able
to
consider
different
ways
of
delivering
in
this
environment
and
it's
a
bit
of
a
mixed
bag.
L
We
have
got
some
practices
that
are
starting
to
do
that
that
are
starting
to
see
more
appointments
become
available
so
that
they
can
extend
their
access
patients
who
were
eligible
for
relief
on
payments.
Before
still
are
so
your
point
about
whether
or
not
they
pay
that
doesn't
make
it
that
hasn't
made
a
difference
at
all.
That
still
applies,
and
one
of
the
challenges
that
we've
got
is
because
less
patients
have
been
seen.
L
The
investment
money
that
we'd
got.
We
could
start
to
think
about
care
homes,
nursing
homes
or
the
provision
that
we
would
need
no
fixed,
a
bird.
We
want
to
do
some
work
with
those
communities
and
it's
still
our
hope
and
intention
that
we
can
do
that.
But
the
challenge
at
the
moment
of
the
capacity
and
dentistry
and
that
reduction
in
funding
will
make
it
a
challenge.
But
it's
still
something
very
much
that
we
want
to
focus
on.
L
F
Yeah,
to
some
extent,
thank
you
yeah.
I
think
it's
just
making
sure
that
we've
always
got
that
there,
as
in
the
forefront,
really
we're
making
plans
going
forward
and
a
recognition
that
there's
obviously
going
to
be
an
increasing
demand
for
that
and-
and
I'm
just
concerned
that
there
is
equality,
if
you
like
across
the
board
in
density
and
which
there
hasn't
been
anywhere
since
the
introduction
of
modern
private
appointments.
F
But
you
know
we
don't
want
that
worsened
because
of
covid,
and
it's
again
going
to
be
the
people
who
are
most
affected
by
covered
financially,
who
are
going
to
suffer
in
terms
of
dentistry
as
well,
and
it's
about
minimizing
that
gap
between
the
rich
and
the
poor.
I
suppose
they're
having
the
habits
as
much
as
we
possibly
can
going
forward.
I
completely.
L
Agree
and
if
it's
of
any
comfort
at
all
the
group
that
I'm
joining
at
four
o'clock
is
made
from
dental,
you
know,
is
the
component
from
dentistry
and
they
are
desperate
to
start
being
able
to
see.
You
know,
increase
their
capacity.
They
know
who
those
patients
are.
So
they
have
a
group
of
patients
and
they
are
aware
that
there's
an
unmet
need
out
there
as
well
so
they're,
pushing
us
to
think
about
the
guidance
and
whether
or
not
the
guidance
is
relevant.
How
we
can
do
you
know
immediately
start
to
do
something.
F
And
I
think
that's
a
very
positive
move
forward
that
you
thought
that
you
mentioned
that
they're
no
longer
no
longer
saying
well,
if
you
haven't
seen
us
for
a
while,
you
can't
have
an
appointment,
because
that
has
definitely
been
the
case.
Whereas
you
know
even
people
who
have
not
been
to
the
dentist
for
some
time
can
still
see
that
dentist.
If,
if
there
is
an
appointment
so
that.
L
B
F
D
Thank
you
chair
thanks
very
much
emma
for
that
introduction,
three
questions,
but
I
think
think
fairly
quick
thanks
for
reaffirming
that
dentist.
Dental
practices
are
now
able
to
get
adequate,
enhanced,
ppe.
I
know
that
was
a
problem
when
they
first
started
opening
up
and
it's
good
to
know
that
they
are
now
able
to
get
it.
D
There
have
been
a
number
of
anecdotal
comments
that
dentists
are
charging
for
ppe
now,
if
their
private
practices,
that
is
fine,
private
practices
can
charge
whatever
they
like
for
whatever
they
do,
but
of
course,
they're
not
allowed
to
within
the
nhs.
Can
you
confirm
that?
As
far
as
you
are
aware,
there
has
been
no
attempt
by
nhs
practices
to
make
a
charge
for
ppe.
D
The
second
is
about
plans
for
the
future,
and
actually
your
way
of
describing
the
86
practices
being
an
expanded
number
from
the
10
urgent
treatment.
Centers,
which
were
set
up,
is
actually,
I
think,
quite
a
helpful
way
of
looking
at
it.
So
can
we
assume
that
if
there
is
another
spike-
and
I
think
most
people
who
are
experts
in
the
field
say
that
there
will
be
likes
that
actually
those?
Let's
call
them
the
86
urgent
treatment.
D
D
L
Thanks,
john
again
I'll
take
them.
My
memory
allows
me
to
do
it
turning
backwards.
So
if
that's
okay,
it's
a
really
good
point
about
the
accessibility
standard
and
it's
something
that
we've
actually
got
on
our
agenda
for
our
next
contract
meeting
and
because
what
I'm
looking
for
is
what
levers
we
have
to
make
sure
that
our
practices
are
actually
conforming
to
that,
and
some
may
well
be
better
briefed
on
it
from
her
services
perspective.
L
But
I
think
whatever
levers
we
have
will
be
part
of
the
national
contract,
and
actually
the
other
thing
for
us
is
how
we
use
the
national
contract
to
do
something
we
see
as
a
quality
indicator
as
well.
It's
not
just
about
the
standard
contract,
it's
very
easy
to
say
it's
in
the
contract,
but
actually
what
difference
is
it
making
and
adding
to
the
value
of
the
information
that
we've
got
and
how
we
use
it?
L
Our
local
dental
committee
chairs
are
very
very
clear
that
where
they
know
that's
happening,
they
will
call
it
out
and
we
haven't
had
any
experience
of
that,
and
but
I
am
aware
that
any
that
private
practices
have
been
making
charges.
What
we
have
done
is
ask
them
where
we
can
to
make
sure
those
charges
are
clear
to
the
patient
before
they
start
their
treatment.
But,
as
we've
explained,
we
don't
have
any
commissioning
responsibility.
L
They
are
working
now
and
will
respond
if
we
went
into
a
local
lockdown.
That's
that's
the
one
thing,
though,
that
we
haven't
mentioned
is
we
have
still
kept
the
center
in
leads
for
patients
who
are
showing
symptoms
of
covered.
We
actually
didn't
have
any
patients
access
that,
but
we
have
kept
that
so
with
that.
That
service
is
there
for
patients
who
have
tooth
challenges
when
they
have
curved
as
well,
which
would
make
it
very
difficult
for
them,
but
in
terms
of
those
practices
that
are
offering
services
at
level
three,
then
that
would
continue.
B
E
Right,
can
you
hear
me,
can
you
hear
me
right?
Thank
you,
I'm
going
back
to
denise's
comment
about
deep
cleansing
and
what
I
know
we're
dealing
with
covet
at
the
moment.
However,
it
strikes
me
that
our
children
and
it's
got
to
start
with
our
children-
need
to
be
cleaning
their
teeth
properly
and
thoroughly
morning
and
night
to
make
sure
that
their
teeth
can
be
kept
as
free
from
problems
as
possible.
L
E
E
C
E
B
B
B
Yeah
yeah,
it
was
literally
at
the
last
time
I
think
it
was
yeah
yeah
and-
and
there
were
great
plans
which
obviously
like
most
of
our
lives
now
have
been
put
on
hold.
But
there
is,
I
know
that
there
is
there
were
plans
and
they
will
hopefully
come
back
for
hygienists
and
dentists
to
go
into
schools
and
actually
deliver
that
preventative
work
themselves.
L
B
L
I
think
foreign,
I
think
the
other
thing
just
to
mention
is
whilst
I've
talked
about
money
and
that
money
will
be
required.
We
have
got
a
commitment
from
our
dentist
to
work
differently
as
well,
and
some
of
the
challenges
are
very
much
about
pp
at
the
moment,
but
once
that
has
dissipated
a
little
bit
and
guidance
is
reviewed
and
or
hopefully
we
find
a
vaccine
solution
over
the
next
months.
Then
our
dentists
are
committed
to
looking
at
their
workforce
differently.
They
are
committed
to
working
differently
with
other
parts
of
the
sector.
L
So
even
if
the
worst
case
scenario
is
that
we
don't
have
some
of
that
additional
funding
that
we
know
will
spur
them
at
that
time.
We
absolutely
we
will
be
doing
something,
and
I
think
the
last
six
months
has
probably
prompted
our
dentist,
because
they've
worked
together
far
better
than
they
had
done
prior
to
covered.
We've
got
practices
that
haven't
worked
together.
That
buddied
up.
We.
B
Thank
you.
Thank
you
very
much.
A
really
important
point
can
I
say
a
few
thank
you
from
the
board
and
myself
to
emma
and
jane
and
sam
for
joining
us
on
this
item,
and
it's
really
as
you.
As
you
know,
it's
really
important.
Your
dental
health
is
really
important
and,
as
council
earlier
said,
when
you've
got
toothache,
it's
just
and
we've
discussed
this
before
just
the
worst.
B
It
dominates
your
entire
life
if,
if
you're
dental
health,
so
many
thanks
for
joining
us
and
we'll
look
forward
to
welcoming
back
in
the
future
to
about
any
more
updates
and
and
hopefully,
if
we
get
this
pandemic
under
control,
like
you
say,
but
moving
forward
in
that
partnership
working
that
dentists
have
done
now,
as
in
the
pandemic,
there
has
to
be
some
positives
that
that
come
out
of
that
and
it'd
be
exciting
to
hear
that
about
that
in
the
future.
Thank
you
very
much.
B
A
Thank
you
chair.
This
scrutiny
board
had
previously
maintained
an
interest
in
the
leads
health
and
care
wins
planning
process,
and
this
year,
in
particular
with
the
additional
pressure
within
the
system
due
to
cover
19.
The
board
was
keen
to
consider
what
early
progress
has
been
made
towards
ensuring
that
the
leads
health
and
care
system
is
extremely
equipped
and
prepared
to
respond
quickly
and
appropriately
to
any
change
in
demand
or
circumstances
that
winter
and
the
pandemic
may
bring.
A
So
as
part
of
this
agenda
item
as
well,
information
is
also
being
provided
on
the
range
of
business
continuity
plans,
that's
held
within
the
adults
and
health
directorate
and
how
these
were
also
used
in
the
corvids
19
crisis,
particularly
as
such
plans
across
the
council
are
also
recognizing,
as
an
essential
part
of
the
resilience
and
stability
of
a
service,
and
so
again,
charles
passed
back
to
you
to
introduce
those
that
are
joining
for
this
item.
Thank
you.
B
Thank
you
very
much
angela.
So
we
have
rebecca
and
councillor
rebecca
charlwood
executive
member
for
health,
wellbeing
and
adults,
victoria
eaton,
who
is
director
of
public
health,
shona,
mcfarland,
deputy
director
of
social
work
and
social
care
in
adults
and
health,
and
also
I'd
like
to
welcome
kath,
roth
director
of
adults
and
and
health,
and
thank
you
very
much
for
being
able
to
join
us
today
at
the
meeting
sam
prince,
who
we've
just
heard
from
in
the
previous
items.
Thank
you
very
much.
B
Executive
director
of
operations
at
leeds
community,
healthcare,
nhs
trust,
helen
lewis,
interim
director
of
commissioning
acute
mental
health
and
learning
disability
services
for
nhs
leads
ccg,
who
has
led
on
producing
the
report.
So
thank
you.
Thank
you,
helen
for
being
here
such
asap,
who
is
deputy
chief
operating
officer
for
leeds
teaching,
hospitals,
nhs
trusts,
look
forward
to
hearing
from
him
later,
gainer
connor
from
the
gp
confederation
joanna
foster,
adams.
I
don't
think
we'll
be
able
to
join
us
and
we
haven't
yet
got
alison
kenyon.
B
I
don't
think
on
the
call
on
the
meeting,
so
hopefully
she
might
be
able
to
join
us
later
from
the
leads
and
your
partnership
foundation
trust.
So
can
I
ask
councillor
charwoods
to
introduce
the
item.
I
thank
you
very
much
and
then-
and
maybe,
if
you
could
direct,
who
would
is
going
to
speak
on
it,
I'm
assuming
that
helen
lewis
will
want
to
speak
on
it
and
then
we
can
take
different
questions.
Thank
you.
C
You
know
flues
and
you
know
greater
demand
on
services
in
winter,
and
a
huge
amount
of
work
goes
into
avoiding
hospitalization,
especially
in
our
older
population,
and
we
do
a
huge
amount
of
work
around
force,
prevention
and
everything
else.
So,
there's
just
a
massive
massive
amount
of
work
that
goes
into
allowing
system
to
to
cope
through
winter,
but
this
year
is
absolutely
different.
C
Obviously,
we've
got
and
we've
had
a
whole
year
of
unprecedented
demand
on
the
system
with
the
pandemic
and
then
we'll
have
that
plus
we'll
have
our
normal
everyday
every
year,
annual
issues
that
we
have
to
to
face.
So
a
huge
amount
of
work
has
gone
into
it
and
thank
you
to
all
the
officers
and
across
the
health
and
wellbeing
sector
in
the
city.
C
M
You
thank
you.
Thank
you
councillor.
Thank
you.
Councillor
hayden.
I
think
it's
probably
fair
to
describe
this
as
ongoing
resilience
planning
than
it
is
to
describe
it
as
winter
planning.
I
think
that
the
system
hasn't
stopped
at
all
since
march,
and
I
think
one
of
the
things
that
we've
reflected
on
throughout
our
planning
is
this
is
a
continuous
cycle
of
planning,
and
the
reason
this
year
is
different.
I
think
we've
been
rehearsed
in
some
of
the
papers
is
just
probably
worth
just
sharing
with
councillors
why
this
year
is
different.
M
So
I
think
the
thing
that's
really
different
this
year
is
we
come
into
it
with
a
backlog
of
people
that
we
haven't
been
able
to
treat.
So
I
think
in
previous
years
we've
been
able
to
step
back
some
of
our
elective
activity
relatively
safely
for
four
or
six
weeks
and
use
that
space
to
treat
our
acute
patients.
M
Our
commitment
as
a
system,
as
far
as
we
can
is
to
not
do
that,
because
we've
built
up
such
a
backlog,
so
our
ambition,
whether
we
can
achieve
it
or
not,
I
don't
know-
is
to
maintain
our
elective
capacity.
As
far
as
we
can
so
that's
may
added
a
barrier.
The
second
barrier
is
that
there
are
social
distancing
requirements
in
all
our
settings,
so
we've
had
to
take
beds
out
of
our
wards.
We've
had
to
take
space
out
of
our
waiting
rooms.
We're
just
talking
this
morning
about
discharge
lounges
to
keep
people
socially
distance.
M
M
Clearly,
our
staff
will
be
affected
by
whatever
else
happens,
so
resilience
planning
around
staffing.
Our
ability
to
use
from
home
is
much
greater
than
it
was
because,
at
least
in
the
meantime,
hi
allison
ester.
Thank
you
so
much
for
joining
us.
So
we've
got
people
better
set
up
to
work
from
home,
so
I
think
we're
better
able
to
use
the
skills
of
our
of
our
remote
working
staff.
But
again
if
people
go
into
shielding
or
people
have
to
self-isolate
we're
going
to
see
increasing
pressures
on
our
staff
again,
I
guess
testing.
M
I'm
sure
that
victoria
will
answer
questions.
I'm
certainly
not
going
to
speak
to
it,
but
I
think
there
will
be
an
ongoing
set
of
issues
around
testing
and
even
if
testing
flows
well,
it
adds
a
delay
into
bits
of
our
system.
Just
inevitably,
until
we
get
a
15
minute
test,
then
everything
just
takes
a
bit
longer
and
what
that
does
is
that
then
creates
the
need
to
stream
our
patients
and
every
time
we
stream
our
patients
into
different
settings.
We
create
a
delay
and
we
create
less
flexibility.
M
So
if
you
have
to
have
your
waiting
results,
patients
separate
from
your
coverage
patients
separate
from
your
non-covered
patients,
then
it's
not
the
same
as
how
we've
had
it
in
the
past,
so
there's
a
whole
set
of
constraints.
I
think
the
other
important
area,
though,
is
around
flu
and
our
flu
planning
and
our
ability
to
really
plan
proactively
with
our
patients.
I
think
we're
probably
further
ahead
around
really
considering
the
needs
of
patients
at
risk.
M
Then
perhaps
we
would
have
been
in
a
previous
winter,
because
we're
asking
and
I'm
sure
again
we'll
be
happy
to
answer
questions
about
it,
planning
in
primary
care
all
the
time
now
about
what
we
can
do
to
proactively
reach
out
to
those
patients
to
optimize
them.
To
do
some
of
that
prevention
that
we've
talked
about
in
the
past,
but
possibly
had
less
focus
on
than
perhaps
we
will
have
this
year.
So
that's
a
little
bit
of
the
context.
M
I
think
the
other
thing
that's
different
this
year
is
that
we're
working
much
better
on
neighborhood
footprints,
so
we've
got
some
really
good,
integrative
working,
for
example,
between
general
practice
and
the
neighbourhood
teams,
around
really
understanding
the
resources
available
in
a
locality
to
see
if
people
can
help
one
another,
whereas
historically,
I
think
those
those
relationships
have
not
been
as
strong
as
they
are
now
strengthening
all
the
time
and
again,
I'm
sure
sam
are
going
to
be
happy
to
answer
questions
on
that.
I
think
we've
got
more
of
a
population
focus.
M
I
think
you
know
we're
thinking
so
this
week,
we're
looking
at
some
alternative
clinics
for
children
just
to
kind
of
think
about
the
needs
of
individual
patients
and
then
how
skills
across
the
city
can
work
together
to
deliver
some
of
that
care.
I
think
the
other
things
that
are
embedded
better
than
ever
before.
Probably
our
communication,
so
we've
had
a
conversation
this
morning
and
we've
already
got
conversations
and
comes
back
out
this
afternoon
as
we're
seeing
people
presenting
in
places
where
we
think
possibly
not
the
best
place
for
them.
M
Our
comms
teams
are
much
better
embedded.
Both
the
comms
teams
from
the
council,
but
coms
teams
in
the
ccg
are
part
of
our
planning
group
and
part
of
our
daily
planning.
So
I
think
our
engagement
with
the
public
and
our
consideration
about
how
we
talk
to
the
public
is
much
more
embedded
in
the
world.
M
Our
engagement
with
third
sector
groups,
our
third
sector
partners,
are
part
of
our
weekly
resilience
conversations
and
working
very
closely
with
us
and
seeing
that
full
offer
of
third
sector
partners
as
partners
in
health
and
care,
which
I
know
that
we've
talked
a
lot
about.
But
it
feels
I
think,
even
more
real
and
colleagues
will
be
happy
to
comment
on
that.
M
The
stress
testing
is
difficult
because
I
would
say
today
we're
already
stress
testing,
as
we
seek
over
numbers
rising
in
the
city,
as
we
see
demand
rising
as
we
try
and
keep
patients
as
many
patients
possible
as
treated.
This
is
a
live
stress
test,
and
we
will
do
all
that
we
can
as
flexibly
as
we
can
with
partners
to
maintain
that
we're
a
bit
out
of
magic
ones.
So
this
is
just
hard
work,
grit,
flexibility,
commitment,
use
of
independent
sector
partners,
independent
sector
partners,
probably
is
worth
saying
and
assad
might
want
to
add.
M
Both
nothing
and
spy
are
working
absolutely
tightly
in
partnership
with
us
we're
using
their
capacity.
They
are
working
as
system
partners
to
maximize
the
care
of
of
our
most
needy
patients.
We
are
independent
sector
providers
in
the
community
the
same.
We
are
treating
people
in
order
and
they
are
really
all
working
in
partnership.
So
I
think
the
partnership's
as
strong
as
I've
seen
in
20
years
in
the
city,
the
demands
are
probably
significantly
higher
than
than
I
think
any
of
us
have
seen
in
our
times
in
health
and
care.
M
B
G
Thank
you
very
much.
Yes,
the
the
question
here:
planning
planning
for
winter
or
planning
for
the
future.
I
suppose
the
winter
is
the
is
the
hard
bit
that's
coming
up
there
is.
There
is
abroad,
a
very,
very
strong
feeling
that
the
seeing
of
a
doctor
is
something
that
rests
in
the
past
that
now
you
talk
to
him
over
the
phone.
G
If
you're
lucky,
you
don't
talk
to
the
same
doctor
all
the
time
you
talk
to
a
practice,
so
the
question
of
a
doctor
having
continuity
with
a
patient
and
what
we're
talking
about
here,
we're
planning
for
winter,
we're
trying
to
stop
the
things
happening
that
get
worse
in
winter,
that
we
know
about
now,
as
well
as
the
falls
and
all
the
other
things
that
go
with
it.
The
this.
G
So
when
are
we
going
to
get
around
to
waving
the
big
stick
to
doctors
and
saying
you
really
are
going
to
have
to
talk
to
people
because
diagnosis
starts
with
when
they
walk
through
your
surgery
door,
not
when
they
pick
up
the
phone,
because
you
can't
see
them,
you
don't
know,
what's
happening,
you
can't
see
their
faces,
there's
a
lot
more
to
it
than
perhaps
a
zoom
call
or
a
skype
call
or
a
telephone
call.
I
I
could
it
to
death,
but
you
know
you,
I
think
you've
got
the
point.
Have
you.
M
So
I'm
just
going
to
give
a
brief
response
and
ask
again
if
she
wants
to
add
so
I
think
you
you
started
by
talking
about
telephone
calls
and
then
you
moved
to
video
calls.
I
think
one
of
the
things
that
all
partners
are
doing
is
evaluating
both
nationally
and
locally.
What
sorts
of
patients
can
be
well
managed
through
video
consultations
and
which
patients
can't?
I
think
the
other
thing
I
think
the
other
thing
that
we
are
doing
is
continuing
and
stepping
up
our
annual
review
process
for
patients.
I'm
sure
that
gainer
will
add
to
that.
M
Conditions,
in
particular
sorry,
I
have
a
lockdown
dog
who
doesn't
pay,
and
so
I
think
the
proactive
care
piece
is
still
an
absolutely
critical
part
and
we
clearly
won't
be
giving
flu
jabs
over
the
telephone,
so
there
will
be
face-to-face
opportunities
scanner.
Do
you
want
to
add
to
that?
I'm
sure
this
is
a
an
ongoing
conversation
that
you
would
have
had
already
with
council
latin.
K
K
So
because
we're
in
a
a
command
and
control
situation
in
relation
to
the
pandemic
and
gp
practices
have
been
been
asked
to
adhere
to
a
standard
operating
procedure
as
part
of
the
delivery
of
their
contract.
That
standard
operating
procedure
requires
100
telephone
triage
so
before
patients
are
seen,
it's
a
requirement
that
there
is
that
level
of
of
telephone
triage
and
then
from
there.
K
The
kind
of
next
bit
would
be
consultation
via
video
and
then,
if
it's
not
been
possible
to
resolve
the
issue
by
a
phone
or
video
and
if
clinically
appropriate,
the
patient
would
be
seen
face
to
face.
A
hundred
percent
of
our
94
practices
are
offering
telephone
triage.
100
of
our
practices
are
offering
video
consultations
and
100
of
our
practices
are
offering
face-to-face
consultations
in
the
way
that
I've
just
described,
and
if
I
could
maybe
give
some
figures
just
to
give
some
context
now.
K
K
I
think,
as
as
as
helen
said,
our
focus
now
in
terms
of
as
we
as
we
move
from
the
the
height
of
the
first
wave
of
the
pandemic
into
more
of
a
stabilization
reset.
Not
only
were
practices
asked
to
continue
to
to
be
working
in
in
the
way
that
I've
just
described,
but
practices
were
also
directed
nationally
to
to
start
looking
them
proactively
at
those
patients
who
are
who
are
vulnerable
and
there's
work
going
on
both
nationally
and
locally
in
terms
of
risk
stratification.
K
K
Hopefully,
sort
of
colleagues
and
members
will
appreciate
that
for
many
of
our
94
practices,
who
are
all
independent
businesses,
their
workforce
can
be
quite
small.
So
if,
if
any
of
that
workforce,
you
know
it
needs
to
isolate
because
of
you
know,
potential
contacts
with
with
people
again
it
can
be.
It
can
be
quite
significant.
K
The
experience
for
some
patients
may
be
that
they're
facing
a
door,
that's
locked
with
an
entry
system
and
again
this
is
just
to
kind
of
protect
the
workforce
and
some
of
those
practices
where
being
able
to
open
the
door
freely
to
anybody
walking
in
has
been
assessed
has
been.
That
has
been
of
risk
and
I'll
pause
that,
because
I'm
sure
colleagues
have
got
other
questions.
I'm
happy
to
answer
those.
G
The
people
who
are
not
receptive
to
telephone
and
video
appointments
that
they're
also
the
sort
of
people
who
all
their
lives
have
been
used
to
having
a
doctor-
and
I
make
this
point
again-
that
we
no
longer
have
doctors,
we
have
practices,
we
don't
know
who
we're
dealing
with.
I
do.
I
do
think,
I'm
I'm
probably
banging
against
a
door.
That's
not
not
that
wide
open.
So
I'll
say
thank
you
very
much,
and-
and
we
did
that.
K
Thank
you,
council.
Sorry,
thanks,
council
latte,
I
think
I
think
you're
right.
I
think,
for
you
know,
for
lots
of
people
that
experience
of
the
model
of
general
practice
as
was,
is
never
going
to
be
the
same
again,
and
we
need
to
understand
how,
when
we,
when
we
reset
how
we
take
account
of
all
of
that,
like
they
don't
do
cause,
don't
cause
inequalities
or
things
that
are
adversely
affecting
patients.
But
I
think,
as
well
as
the
pandemic,
we're
also
sadly
facing
challenges
in
terms
of
our
workforce
in
primary
care.
K
B
J
Probably
on
part
of
this,
we
obviously
have
rehearsed
before
about
whether
lockdown
was
too
late
and
the
suspension
of
local
testing
and
how
many
lives
may
have
been
lost
in
leeds
in
the
rest
of
the
country.
But
when
we
emerged
from
lockdown,
the
the
principal
foundation
on
which
that
was
based
was
the
promise
of
a
world
testing,
a
world-beating
testing
system
and
clearly
that
idea
has
been
knocked
into
a
cult
hat
and
at
the
moment
we've
obviously
got
a
massive
increase
in
the
infection
rating
leads.
J
It's
gone
up
from
just
under
five
to
over
17
a
matter
of
relatively
few
weeks.
We've
got
today
the
nhs
providers
saying
that
the
testing
system
is
going
to
seriously
hobble
the
nhs
capacity
to
treat
patients
because
tests
are
not
available
and
they're
not
being
turned
around
quickly
enough.
We've
got
a
situation
where
some
of
my
constituents
are
contacting
us
as
local
counselors
and
saying
I
can't
get
a
test
for
my
family
or
my
child
anywhere
at
all.
J
We've
got
some
who
have
been
signposted
outside
of
leeds.
We
know
that
the
so-called
world
leading
system
is
really
not
contacting
any
more
than
about
three
quarters
of
the
people
in
leeds
who
test
positive.
As
I
understand
it,
and
of
those
only
about
56
of
their
close
contacts
are
being
contacted.
So
I'm
just
wondering
if,
if
victoria
can
give
us
an
update
on
the
testing
system
and
what
assistance
we
are
receiving
as
a
city
from
the
government,
now
we've
gone
on
to
the
sort
of
second
level
of
their
particular
interest.
J
Just
a
few
of
the
then
quick
questions.
Helen
has
reassured
us
on
ppe,
so
hopefully
that
is
going
to
be
a
robust
situation,
unlike
what
we
faced
previously,
it
would
be
useful
to
know
what
the
latest
position
is
regarding
hospitalization.
Are
the
infection
rates
beginning
to
show
up
in
terms
of
hospitalization
and
finally
chair?
Thank
you.
J
B
N
The
government
has
announced
that
it
will
supply
ppe
free,
two
care
providers.
You
have
to
register
via
a
portal,
and
then
you
can
get
that
sent.
They
will
provide
that
quantum
of
ppe
above
what
you
would
normally
have,
and
we
still
have
the
safety
net
mechanism
of
the
local
authority
supplying
any
care
provider
if,
for
whatever
reason,
they
might
run
out
urgently.
N
So
ppe
feels
pretty
robust.
We
have
given
resources
out
to
care
homes
through
the
infection
control
fund.
Not
all
of
the
money
was
claimed,
so
that
allows
us
to
then
redistribute
it
with
a
slightly
wider
criteria,
which
I
think
what
the
sun
was.
It
was
worth
about
130
pounds
per
bed
to
give
further
assistance,
so
we've
done
that.
N
I'm
waiting
to
see
whether
or
not
there
will
be
a
second
round
of
infection
control
fund
going
into
the
winter
because
having
the
money
to
pay
for
staff
and
wages,
while
they're
self-isolating,
has
been
a
really
important
feature
of
the
control
fund.
But
I
thought
of
while
promises
were
sort
of
noises
were
made
nationally.
Nothing
firms
come
out.
N
Testing
is
proving
to
be
very
challenging,
it's
quite
a
complicated
system
depending
on
the
scenario.
So,
if
you
suspect
you
have
an
outbreak,
you
go
via
what's
called
pillar
one,
if
it's
your
routine
testing,
which
is
happening
on
a
rolling
program
of
weekly
for
care
staff
and
then
28
days
for
residents.
That
goes
by
a
pillar
too.
N
What
I
have
seen
is
concern
expressed
by
our
regional
public
health,
england,
colleagues,
saying
they
are
issuing
a
significant
quantum
of
tax,
but
only
getting
roughly
half
back.
So
where
have
the
other
half
gone,
and
is
it
confusion
about
what
is
it
pillar
one?
Is
it
pillar
two
depending
on?
Is
it
routine?
Is
it
an
outbreak?
N
Sometimes
we
use
our
very
local
facilities
with
ltht
where
they
offer
us
some
tasks.
If
we
need
something
done
urgently
or
is
it
so
we're
not
quite
sure
where
they're
being
sent
but
they're
not
coming
back
and
some
care
homes
are
reporting,
it's
taking
seven
days
plus
to
get
the
the
result
of
the
test,
which
makes
managing
staff
really
difficult,
but
potentially
people
are
having
to
self-isolate
when
they
don't
need
to
that
affects
all
the
ability
to
roster.
N
N
It
was
you
only
need
to
wear
a
face,
mask
and
face
shield.
If
somebody
is
symptomatic
now
we
just
wear
it
all
the
time,
and
so
I'm
hoping
that
the
the
risk
of
transferring
infection
to
residents
is
reduced
because
of
all
the
measures
we've
taken
between
now
and
then,
but
we'll
just
have
to
see
how
it
goes.
We
have,
I
think,
it's
19
today,
out
of
151
homes,
where
we
have
either
staff
or
a
resident
testing
positive,
but
we
don't
have
anything
where
it's.
N
I
think
it's
above
three
people
affected
victoria's
probably
got
the
act.
She
lives
and
breathes
this.
It
should
try
to
get
it
all
at
her
fingertips
and
can
recite
it
in
her
sleep,
but
I
think
the
last
time
I
looked
at
it,
there
was
nothing.
There
was
nothing
like
you
know,
it's
eight
people
and
it's
a
whole
wing
of
a
care
home,
we're
not
seeing
that
yet
and
hopefully
won't
so
I'll
leave
it.
There.
O
O
We
could
have
a
longer
conversation
about
this,
but
I
guess
the
current
position
we're
in
and
all
the
most
of
the
things
that
are
hitting
the
media
today
are
around
the
what's
called
the
pillar
ii
testing,
the
national
testing
program,
that's
run
by
department
of
health
and
social
care,
which
is
that
there
clearly
is
a
lack
of
capacity
all
of
our
testing
sites.
We
had
a
report
this
morning.
O
You
know
the
I'm
sure
many
people
on
this
call
have
got
inboxes
full
of
full
of
people
struggling
to
get
a
test,
and
I
think
what
what
what
we're
doing
locally
is
trying
to
help
support
local
people
to
navigate
the
system
and
and
get
it
get
a
test
in
any
which
way
they
can.
What
we
don't
do
is
clearly
run
that
national
system,
so
we
can't
you
know
we
can
only
try
and
help
people
to
nav
to
navigate
it.
O
The
the
the
the
the
issues
that
cath's
just
described
run
alongside
that
so
in
terms
of
the
pillar,
one
testing,
which
is
run
nationally
too,
but
it's
run
by
public
health
england.
There
is
still
there
are
still
issues
of
tests
not
coming
back
test
taking
too
long.
So
again,
what
we've
done
and
working
really
closely
with
our
hospital
colleagues
is.
We
have
been
able
to
free
up
more
lab
capacity
in
ltht
to
help
speed
up
that
process.
O
In
the
meantime,
we've
clearly
had
this
national
issue
completely
kind
of
hit
the
country,
so
our
all
of
our
energy
to
increase
local
testing
for
local
people
is
now
having
to
deal
with
ensuring
that
even
key
workers
can
get
a
test,
so
everybody's
working
flat
out
to
try
and
resolve
that,
but
we
are
raising
with
the
national
team,
and
we've
done
it
again
today
that
we've
we've
got
to
have
more
local
influence
over
both
testing
and
tracing,
because
this
is
this
is
an
example
of
when
that
doesn't
happen.
What
what?
O
What
what
the
situation
ends
up,
as
so
that
that
that's
where
we
are
at
the
moment,
we've
got
our
local
we've
got
our
local
pop-up
testing
van,
which,
as
a
council
we've,
we've
set
up
to
run
alongside
the
national
testing
service.
So
we're
we're
using
that
resources
as
flexibly
as
we
can
to
try
to
get
people
tested
if
they
really
can't
get
an
a
test
in
the
national
system,
but
we're
having
to
prioritize
key
workers
and
their
families
at
the
moment,
and
we
want
to
increase
that
resource.
O
So
we
get
at
least
more
local
safety
nets
when
people
can't
access
the
local
system,
the
national
system-
I
will
just
finish
and
say
the
having
said
all
of
that.
Our
testing
rate
is
still
relatively
high
in
leeds
because
we
get
the
testing
rate
for
the
city
every
day.
At
the
same
time,
we
get
our
infection
rate
and
the
the
positive,
the
positivity
rate,
and
so
before
this
issue
with
the
national
system,
we
were
testing.
Our
testing
rate
was
the
highest
in
the
whole
of
yorkshire
and
humber.
O
O
Can
I
just
add
one
more
point
that
and
hospital
colleagues
may
want
to
comment
on
the
the
numbers
in
ltht,
but
in
in
relation
to
your
point,
cancel
trust
well
around
the
infection
rate
and
how
it's
spreading
we're,
keeping
a
really
close
eye
on
the
age.
The
trends
across
different
age
groups
and
people
will
be
aware
that
this
latest
wave
was
predominantly
caused
by
a
surge
in
cases
in
young
adults.
O
So
in
leeds
the
the
age
group
with
the
highest
numbers
of
number
infections
is
still
young
adults,
but
in
leeds
it's
very
close
closely
followed
by
adults
in
the
35
to
64
age
group.
So
it's
not
as
stark
as
some
other
areas
where
it's
it's
absolutely
about
young
adults
and
not
about
other
ages.
We
are
over
the
last
week
starting
to
see
more
spread
into
other
age
groups,
and
we
we
now
are
seeing
increases
across
all
all
age
groups
in
the
city.
O
P
P
Because
clearly,
what
we're
trying
to
do
is
to
try
and
get
those
staff
members
back
into
work
as
quickly
as
we
possibly
can.
So
that's
in
terms
of
the
the
testing
in
terms
of
the
hospital
infection
rates.
As
I
say,
we've
been
testing
all
of
our
patients,
as
they've
been
being
admitted
into
hospital
at
its
peak,
we
had
in
the
region
of
240
patients
who
were
in
our
bed
base
with
confirmed
covate
and
more
recently,
we've
had
that
drop
right
down
to
single
digit
figures,
fours
and
fives.
B
D
Thank
you
chair
a
couple
of
areas
I'd
like
to
explore.
The
first
is
picking
up
the
third
part
of
the
title
of
this
board,
the
active
lifestyles
which
we
don't
spend
a
lot
of
time
on
actually,
but
I
think
it's
a
very
important
part
of
our
remit
and
particularly
bearing
in
mind
the
left
shift,
the
upstream
approach
that
we
need
to
be
adopting
to
keep
people
from
as
far
as
possible
needing
to
go
to
their
gp
or
needing
to
go
to
the
hospital.
D
B
B
Lovely,
thank
you
so
who's
going
to
answer
the
the
dr
bill's
first
question
about
keeping
active.
I
I
know
we
don't
actually
spend
because,
especially
during
this
year
with
the
pandemic
on
and
everything
in
terms
of
active
lifestyles,
but
I
have
been
having
fortnightly
one-to-ones
with
council
rafiq
and
mark
almond
about
the
leisure
centers
and
active
lifestyles
and
active
leads,
and
so
I
can
maybe
arrange
for
them
to
produce
it
for
mark
to
produce
a
report
for
the
next
scrutiny
board
on
what
has
been
happening.
B
O
We're
really
pleased
that
from
the
21st
of
september.
So
I
think,
that's
next
week
we're
setting
up
a
new
referral
pathway
from
all
leads
general
practices
to
be
able
to
directly
refer
to
active
leads
for
people
to
have
opportunities
for
for
a
whole
range
of
activities,
including
walking,
cycling
etc,
which
hopefully,
if
they're
all
if
they
all
proved
to
be
kovid
safe,
and
we
can
keep
that
going
as
much
outdoor
activity
as
possible.
B
D
Clearly
that
is
against
all
the
rules,
but
it's
very
important
that
the
families
and
the
carers,
the
the
family
carers
of
people
in
residential
care,
do
see
their
loved
ones,
not
only
for
the
the
health
and
well-being
board
of
the
person
in
residential
care,
but
also
the
rest
of
the
family
as
well,
and
I
I
saw
a
couple
of
photographs
earlier
today
of
a
lady
who,
before
lockdown
was
looking
quite
a
generally
healthy.
She
may
well
have
been
poorly,
but
she
looked
well.
D
You
know,
playing
with
her
granddaughter
during
lockdown
went
into
a
care
home
a
second
photograph
taken
very
recently
when
one
can
only
describe
it
as
a
very
elderly
and
poor
looking
old
woman.
So
you
know,
having
not
been
able
to
see
her
family
over,
that
period
of
time
has
had
a
disastrous
effect.
D
I
know
singing
in
churches
is
not
allowed
at
the
moment,
but
I
guess
older,
ladies
and
gentlemen,
don't
actually
produce
as
much
aerosol
as
cathedral
requires,
so
maybe
they
could
do
a
bit
of
singing
in
the
care
home.
I'm
sure
they
can
do
a
number
of
other
things.
So
are
we
trying
to
make
sure
that
people
in
care
homes
do
have
whatever
activities
they
can
to
keep
them
occupied?
N
N
Certainly
what
what
I
would
like
to
see
is
that
family
members
get
added
to
the
routine
testing
that
is
available
to
staff,
so
they
can
be
seen
as
an
essential
part
of
somebody's
life
as
much
as
the
paid
staff.
I
think
we
are
some
way
off
that
being
in
any
way
remotely
happening
until
we
could.
We
can't
even
get
sort
of
key
workers
tested
routinely
in
a
safe
way.
N
It's
a
little
way
off
getting
family
members
routinely
tested,
but
that's
what
we
would
like
to
see,
obviously
because
of
the
status
of
our
infection
rates.
Victoria
has
to
issue
advice
out
to
the
care
homes
which
we
do
through
our
weekly
bulletin,
and
they
do
take
individual
decisions
based
on
their
own
perception
of
risk.
Obviously,
we've
got
about
16
homes.
I
think
that
are
closed
because
of
current
infections
and
that's
understandable.
N
So
it's
just
trying
to
sort
of
balance
the
risk
with
the
the
absolutely
essential
human
contact
that
care
home
residents
need
from
their
loved
ones,
and
I
don't
think,
there's
any
easy
or
right
answer
around
this.
We
are
hearing
some
homes
having
some
real
challenges
around
their
insurance
cover
as
well.
N
But
we
are
trying
to
encourage
and
support
care
homes
to
be
as
creative
as
possible,
because
you
know,
if
they're
not
going
to
get
the
mental
stimulation
from
seeing
their
family
members,
they
need
to
do
it
from
the
community
of
residents
and
stuff.
That's
within
the
care
home.
But
you
know
I
think
practice
is
variable,
it's
safe
to
say
we
we're
keeping
an
eye
on
it,
we're
trying
to
encourage
and
support
as
best
we
can.
N
B
F
We've
always
been
aware
of,
but
are
also
because
often
presenting
as
gastrointestinal
symptoms,
and
what
approach
will
be
taken
by
gps,
for
example,
towards
children
who
present
with
gastrointestinal
symptoms,
possibly
have
covariate.
Obviously
they
could.
That
could
be
other
things,
but
will
they
be
investigating
whether
those
symptoms
are
covered
related,
and
I
appreciate
that
that's
going
to
add
to
an
already
struggling
system
of
testing
for
copied.
But
to
what
extent
are
we
taking
those
reports
seriously?
B
M
Of
work
is
the
piece
of
work
that
we're
doing
jointly
between
general
practice
and
the
hospital
to
see
whether
we
can
provide
some
enhanced
clinics
for
children
after
school.
When
we
know
people
come
home
after
school,
don't
feel
very
well
and
to
provide
some
additional
capacity
system
through
the
one-on-one
service,
so
that
people
can,
if
they
can't
get
a
primary
care
appointment,
so
that
and
travel
with
whatever
it
is
that
that
they
have
to
provide
some
additional
capacity
so
again
has
been
involved
in
that
piece
of
work.
M
I
believe
that
we're
just
about
to
be
able
to
start
that.
I
can't
count.
I
can't
respond
to
detail
around
the
clinical
pathways
counselor
knight,
but
what
I
can
do
is
ask
our
lead,
commissioner,
for
children's
services
just
to
provide
some
confirmation.
I
suppose
my
general
response
would
be
that
I
expect
general
practice
to
be
up
to
date
in
national
guidance,
around
diagnostics
and
I'm
sure
that
they
are,
but
I
will
seek
some
assurance
around
specifically
whether
we've
updated
any
of
our
pathways
work
around
children's
presenting
symptoms.
M
K
Yeah,
thank
you
thanks
helen
yeah.
I
think
you're
right
in
terms
of
just
making
sure
that
we've
got
everything
you
know
documented
down
in
terms
of
the
right
pathways.
It's
very
difficult
for
children,
isn't
it
given
that
they
can
their
symptoms
and
their
kind
of
condition
can
change
very
quickly.
So
gps
are
always
very
heightened
to
you
know
to
how
chill
unwell
children
are
presenting,
and,
as
helen
said,
you
know
the
work
that
we're
doing
with
ltht
to
look
at
if
there
are
children
that
present
at
the
emergency
department.
F
Yes,
thank
you
very
much.
It's
a
really
quick
question.
Hopefully
for
kath
it's
it's
with
regard
to
the
pillar
ii
testing.
Captain
there's
there's
one
particular
home
in
in
the
weatherby
ward
that
I'm
aware
of
where
they've
been
they've
been
told.
The
workers
have
been
told
that
the
they're
not
going
to
bother
doing
any
testing
because
they
can't
get
the
results
back.
F
So
when
you
said
that
there
seemed
to
be
an
awful
lot
of
tests,
somebody
said
there
were
a
lot
of
tests
going
out,
but
they
weren't
all
necessarily
coming
back
that
it
may
be
that
some
care
homes
are
actually
doing
the
same
thing
and
so
that
what
they've
been
saying
to
staff
is
well
when
we
can
get
some
indication
when
we're
likely
to
get
some
test
results
back
then
we'll
start
testing
staff
again,
but
they
haven't
been
tested
for
at
least
a
month.
So
I'm
quite
concerned
about
that.
F
N
I
certainly
have
heard
of
holmes
getting
to
the
point
where
they're
saying
well,
what's
the
point:
if
it's
taking
seven
days
plus
it's
not
operationally
useful
to
them,
it
would
be
helpful
to
know
which
home
you
are
referring
to,
although
I
could
probably
work
it
out
by
a
process
of
deduction.
But
if
you
could
drop
me
a
line
that
would
be
helpful
because
we'll
have
a
conversation
with
them.
N
We
certainly
know
some
of
the
big
homes
just
physically
cannot
swap
all
their
stuff
in
one
day
either
it's
just
not
possible,
so
they
have
to
do
a
rolling
program
anyway,
but
we
would
still
encourage
them
to
to
take
up
routine
testing.
I
think
the
fact
that
a
number
of
people
have
been
picked
up,
who
have
been
asymptomatic
and
tested
positive,
is,
is
reason
for
why
you
would
have
testing.
N
Although
you
know
we
would
always
say
just
observe
the
best
infection
protection
control
measures
in
your
practice
and
just
having
knowledge
around
testing
outcomes
is,
is
sort
of
secondary,
almost
a
safe
infection
control
practice.
But
if
you,
let
me
know
which
home
it
is
we'll
have
a
chat
with
him
about
it.
Yeah,
I
will
do.
E
Thank
you
chair.
I'm
really
wanting
to
say
that
the
testing
will
be
difficult.
We
shall
find
that
people
can't
get
the
the
test
they
wanting
done.
If
they
a
large
amount
of
our
citizens,
don't
stop
meeting
in
in
great
big
groups
as
they've
been
asked
not
to
do.
I
think
we
need
to
keep
that
message
pounding
out
that
they
have
to
be
careful
and
they're
really
not
taking
any
notice,
and
until
these
people
start
being
responsible
and
behaving
as
they
should
behave,
we
shall
be
in
a
very
poor
position.
E
O
O
So
this
is
why
there
is
a
focus
on
trying
to
limit
the
spread
within
social
gatherings.
It's
much
less
likely
to
be
in
workplaces,
another
more
controlled
environment,
so
yeah.
I
just
would
support
your
comments
to
say
we
need
to
look
at
reducing
our
contacts
in
in
the
best
way
that
we
can.
Whilst
we
keep
people
with
us
and
we
keep
society
as
going
and
the
economy
going
as
much
as
we
can,
and
it's
that
difficult
balance
we
need
to
continue
to
strike.
O
I
So
I'd
want
to
look
at
how
or
how
we
can
promote
that
more
with
with
within
this
context
of
where
we
are
because
it's
a
rare,
it's
a
real
issue
for
for
our
neighborhood
networks,
because
they
they
they're
having
to
get
extended
funding
from
other
from
other
charitable
organizations,
and
they
can't
get
that
funding
because
they
can't
do
the
activities.
So
you
know
it's
a
it's
there's
a
real
dilemma.
There.
C
N
N
You
know
they
ran
a
charity
shop
as
part
of
their
their
sort
of
business
profile
or
whether
or
not
there's
external
funders
who've
required
them
to.
You
know
definitely
produce
activities.
Statistics
around
people
attending-
I
don't
know
lunch
clubs
or
something,
but
we
have
tried
to
support
our
neighborhood
networks
to
negotiate
with
those
other
external
funders,
but
certainly
the
ones
where
it
had
a
traded
activity.
B
I
Yes,
they
have,
but
you
know-
and
it's
great
isn't
it
that
we're
supporting
them
with
with
the
with
the
main
car
grant,
but
that
only
provides
basic
funding
to
keep
the
to
keep
the
organization
afloat,
a
lot
of
the
activities
that
they
do,
the
luncheon
clubs
and
all
the
rest
of
it.
They
can't
take
place
because
of
the
covered
restrictions
of
less
than
six
people
meeting
in
community
spaces,
so
that
adds
to
their
isolation
and
it
will
add,
it
will
add,
to
more
elderly
people
going
into
hospital
care
over
the
winter
over
the
winter
period.
B
So
if
I
can
ask
helen
to
just
give
us
some
helen
lewis,
sorry
to
give
us
some
basically
many
thanks
for
answering
this
question
so
comprehensively.
But
if
you
could
ask
and
talk
to
us
about
the
next
steps
in
our
resilience
planning,
I
won't
use
the
word
winter,
just
to
say:
what's
gonna
happen
going
forward.
Please
thank.
M
M
M
I
think
I
would
just
go
back
to
what
I
said
before,
which
is
we're
now
testing
this
live,
and
you
know,
as
of
today,
we're
already
seeing
significant
pressures
in
the
system,
and
I
just
talked
to
you
about
you
know,
as
of
today,
we've
needed
to
create
an
additional
covid
ward
and
therefore
moving
patients
around
the
system
and
our
occupancy
levels
are
already
increasing.
So
I
think
it's
safe
to
say
we
are
testing
our
principles
and
our
flexibilities
already.
M
The
creek,
the
key
milestones
probably
worth
also
mentioning
just
while
councillors
are
on
the
call
that
we're
also
responding
to
new
hospital
guidance,
so
hospital
discharge
guidance,
which
is
slightly
more
thought
through
than
what
we
were
doing
in
march
around
making
sure
that
only
people
who
absolutely
clinically
essentially
need
to
be
in
hospital
stay
in
hospital
and
that
creating
capacity,
ideally
in
people's
own
homes
or,
if
not
in
community
bed,
settings
for
people
to
have
their
further
assessments.
We've
had
a
really
detailed
planning
meeting
around
that
this
morning,
as
well.
M
So
as
a
health
system,
we're
really
focusing
on
how
we
create
capacity
for
people
to
have
their
ongoing
needs
assessed
outside
of
the
hospital
setting
to
free
up
the
hospital
for
those
people
who
absolutely
need
hospital
care.
So
that's
not
without
its
challenges.
We
want
to
reflect
on
mental
health
capacity
as
well
so
holly
from
mental
health
trust
on
the
call,
but
we're
working
as
a
health
economy
to
see
if
we
can
create
some
additional
capacity
and
mental
health
services.
M
Recognizing
that,
with
these
two
kinds
of
covered
surge,
there's
people
with
covet
and
there's
people
affected
by
covet
and
we're
seeing
increased
need
for
people,
mental
health
conditions,
there's
another
piece
of
planning,
particularly
around
the
ics
footprint,
integrated
care
system
footprint,
but
also
around
work
with
third
sector.
To
maximize
this,
support
that
we
can
give
to
people
with
mental
health
needs
to
address
that
surge
in
mental
health
and
demand
that
I
know
victory
familiar
with
as
well.
M
So
I
think
we
have
constant
system
calls
and
each
part
of
the
system
is
much
better
connected
through
a
zoom
throughout
teams
call
now
weekly
or
fortnightly
around
those
things
that
we
can
do
as
a
system.
So
I
think
we're
ongoing
testing,
but
I
think
what
what
we're
really
doing
is
moving
to
a
live,
ongoing
response
situation
and
just
continuing
to
flex
as
best
we
can
through
partners.
M
The
step
up
is
almost
to
reverse
all
the
things
we
stepped
down.
So
I
guess
our
step-up
plan
I
want
to
comment-
is
taking
down
those
things
are
which
are
more
discretionary,
which
are
the
things
we
stopped
previously.
I
think
what
I
started
with
and
I'll
finish
with,
I
guess
is
our
aspiration-
is
to
only
step
those
things
down.
M
If
we
absolutely
don't
have
enough
staff
to
keep
those
things
going
safely,
whereas
before
what
we
did
was
stopped
everything
because
we
didn't
know
what
was
going
to
happen,
we
still
don't
know
what's
going
to
happen,
but
we're
clearer
of
the
impacts
of
stepping
some
of
those
things
down.
So
we
are
having
system
conversations
daily,
weekly,
whatever
we
need
to
do
to
balance
those
risks
on
behalf
of
the
population
and
the
population's
health
needs,
whereas
I
think
the
first
time
things
like
wasatch
could
talk
to
us.
M
You
know
we
had
we
closed
all
our
theaters,
because
we
thought
we'd
need
them
for
intensive
care.
We've
got
a
more
robust
system.
We
won't
need
to
do
that
again,
so
there
are
some
things
which
will
be
better
and
there
will
be
things
that
will
be
equally
challenging.
So
I
think
it's
a
live
testing
system.
M
The
formal
steps
are
going
back
to
health
and
gag
hold
on
the
5th
of
october,
but
the
plan
is
the
plan
that
we've
described
to
you,
which
is
how
do
we
work
really
flexibly
and
use
the
capacity
we
have
to
best
affect
bearing
among
all
the
uncertainties?
I
think
it's
probably
the
best
way
to
describe
our
plan.
Less
colleagues
would
like
to
add
to
that.
C
Only
that
I
think
everybody
works
in
good
faith,
the
the
first
time
around,
and
we
did
things
that
we
felt
were
absolutely
necessary.
But
it
was
a
learning
opportunity
as
well,
and
there
were
some
services,
definitely
that
we
done
in
community
that
we
wouldn't
do
again.
In
the
same
way,
we
may
need
to
look
at
how
we
reduce
some
of
those
services,
but
we
wouldn't
stop
them,
and
but
I
think
we're
very
well
aware
of
those
now.
H
Yes,
I
am
here
that
was
really
interesting.
Five
minutes
there
really
so
we've
re-introduced
a
covert,
positive
ward.
Obviously,
back
in
march,
we
didn't
know
as
much
as
we
did
and,
like
you
say,
we
shut
down
lots
of
services
and
we
did
redeployed
staff.
We
had
surgeons
who
thought
that
they
might
be
intubating
patients.
There
was
all
manner
of
absolute
chaos
and
everybody
stepped
up
and
helped
crossed
special
specialties.
H
H
Where
are
all
those
additional
staff
going
to
come
from
because,
as
obviously
as
a
frontline
worker,
I'm
conscious
of
the
fact
that
for
the
first
time
in
30
years,
I
don't
just
have
to
worry
about
the
patient's
safety?
I
now
have
to
worry
about
my
colleagues
safety
as
well,
and
we
have
to
remember
that
more
healthcare,
health
and
social
care
workers
are
purported
to
have
died
from
covert
than
our
soldiers
during
the
iraq
war,
and
there
is
still
a
genuine
risk
to
our
our
work.
M
So
yeah,
so,
thank
you.
Sorry.
I
probably
have
caveated
that
more
clearly,
I'm
going
to
ask
saj
to
comment
because
he's
got
the
detail
of
the
step-up
plans
within
the
hospital
around
what
how
that
resilience
will
work.
What
I
should
have
said
was
we
will
keep
services
going
until
the
point
where
staffing
does
not
allow.
M
We
have
to
make
those
choices,
so
I
didn't
say
that
clearly
enough,
so
the
conversation
that
sam
and
I
have
just
had
is,
we
will
read,
we
will
clearly
have
to
redeploy
stuff
so
that
the
staff
on
the
front
line
are
well
enough,
supported
that
we
can
maintain
the
safety
of
those
staff.
I
think
I
think
that's
different
is
ppe.
M
I
think
the
other
thing
that
is
different
is
testing
but
as
gainer
referred
to
before,
we
are
absolutely
mindful
that
the
health
of
our
staff-
and
I
think
it's
true
in
the
mental
health
trust
too-
that
the
health
of
our
staff,
particularly
of
our
bme
staff,
has
been
absolutely
foremost.
And
one
of
the
conversations
about
you
know
face-to-face
care
is,
there
are
choices
between
the
preferences
of
our
patients
and
the
safety
of
our
staff,
and
I
think
that
is
a
theme
all
the
way
through
the
work.
P
P
As
you
quite
rightly
saw
says
highlighted,
the
majority
of
our
clinical
workforce
was
geared
up
to
deal
with
corporate
presentations,
so
surgeons,
helping
anaesthetists,
etc,
and
what
we've
now
got
is
a
position
whereby
we
are
clinically
reviewing
all
of
our
patients
and
prioritizing
those
patients
that
were
the
elective
patients
who
have
been
waiting
for
their
procedures.
So
our
clinicians
are
undergoing
clinical
validation
of
the
way
to
list
and
prioritizing
those
that
we
classify
as
priority
one
and
priority
two,
and
so
that's
our
rhythm
of
managing
patients
based
on
clinical
need.
P
Once
we've
managed
through
the
p1
and
the
p2.
So
the
priority
one
the
priority:
two
patients.
We
will
start
to
work
through
the
chronological
order.
So
the
long
waiters
and,
of
course
we
can
do
that
at
the
moment
with
the
number
of
covered,
positive
patients
that
we
have
in
our
bed
base
and
the
precautions
that
we
have
in
place.
So
as
I
was
highlighting
because
we
continually
test
our
patients
so
at
day,
seven
being
an
inpatient,
we're
testing
patients,
patients
coming
through
elective
routes,
patients
coming
through
non-elective
routes
with
testing.
P
So
we
know
we
can
keep
patients
and
our
staff
safe.
Based
on
those
testing
regimes
that
we've
got
in
play.
Clearly,
there
will
come
a
tipping
point.
If
we
get
back
to
the
levels
that
we
were
in
in
kobe
phase,
one
or
the
original
spike,
then
we
will
need
to
designate
additional
awards
to
the
care
for,
for
those
covered,
positive
patients.
But
what
we've
got
is
we've
got
a
ward
by
ward
plan
of
which
ward
we
move
to
next
and
how
we
staff
that
ward.
P
Given
we
didn't
know
how
many
patients
we
would
get
coming
through
the
doors
with
core
weed.
So
I
think
that
that
that's
in
in,
as
has
I
can
put
it
simply
in
terms
of
how
we
intend
on
going
back
up
clearly
if
we
get
back
up
to
the
volumes
of
240
250,
we
will
start
impacting
on
our
ability
to
maintain
the
elective
work
program
and,
as
helen
says,
these
patients
are
the
very
patients
that
would
be
waiting
a
long
period
of
time
or
have
been
cancelled
previously.
H
Thank
you
very
much.
Can
I
just
come
back
helen
yeah
sure,
yeah
yeah,
I
guess
the
worry
is,
isn't
that
normally
we
sit
here
and
we
talk
about
our
winter
pressures
and
we
talk
about
bulge
wards
or
you
know
introducing
additional
wint
awards
that
we
will
staff.
However,
we
staff
them
usually
yeah,
but
we're
already
talking
about
losing
the
the
resilience
report
talks
about
100
and
130
beds
already
having
been
lost
because
of
social
distancing.
H
I
assume
that's
things
like
turning
six-bedded
bays
into
four
bedded
bays,
but
that's
still
quite
a
lot
of
beds
that
we're
going
to
go
into
a
winter,
which
winter
is
always
difficult,
not
because
necessarily
of
demand,
but
of
acuity
and
longer
longer
his
hospitalization
and
we've
got
this
other
two
elements
hanging
over
us
one.
Is
we
don't
quite
know
what
covert
will
do
in
the
winter,
because
if
back
in
march
we
were
saying
protect
the
nhs
let's
get
through
to
the
summer.
H
Well,
we
can't
say
that
now,
let's
protect
the
nhs
let's
get
through
to
winter.
You
know
that
doesn't
work
the
same
way,
but
at
the
same
time,
we've
got
all
these
consequences
of
the
the
impact
of
covid
so
on
our
cancer
patients
on
our
heart
patients
on
our
diabetic
patients,
etc,
which
will
also
increase
excess
deaths.
H
B
B
Our
thanks
from
from
everybody
on
on
the
subject
of
business,
continuity
is
going
to
be
a
huge
and
resilience
is
going
to
be
a
huge
issue
for
us
and
we'll
keep
an
eye
on
shona.
Would
you
like
to
comment
on
on
the
report,
and
but
we
are
coming
back
to
it
in
the
next
couple
of
weeks
as
well,
but
if
you'd
like
to
comment
on
on
it
and
then
we
can,
you
know
it'd
be
nice
to
hear
from
you.
Thank
you.
Okay,
thanks.
M
O
C
C
C
It
there's
a
directorate
resilience
group
which
meets
twice
a
year
and
it
receives
updates
on
the
business
continuity
plans
and
also
performance
manages
them.
So
it
makes
sure
that
they're
kept
up
to
date
and
at
the
beginning
of
this
year,
the
march
meeting,
which
happened
just
as
we
were,
we
were
hitting
crisis
with
with
kobe
19.
It
was
noted
that
we
were
green
on
all
of
the
business
continuity
plans
that
we
had
that.
Those
of
us
slipped
slightly
appendix
one
shows
that
there's
some
two
that
are
due
and
that
were
due
in
june.
C
C
I
think
one
of
the
interesting
thing
about
business
continuity
plans
is
they're
very
good
when
it
comes
to
an
emergency.
So
when
we
had
the
floods
in
2015
and
we
had
assisted
living
leads
was
was
physically
engulfed
with
the
floods,
then
business
continuity
plan
was
brilliant
in
in
supporting
the
the
managers
and
the
staff
in
that
service
to
understand
exactly
what
they
needed
to
do.
C
In
response
to
that
immediate
crisis
that
lasted
for
five
or
six
days
until
they
were
able
to
get
back
into
the
building
and
start
to
start
to
restore
and
recover
with
covert
it
was.
It
was
slightly
different.
We
we
didn't
really
have
a
five-day
crisis
and
then
it
was
over
and
we
were.
We
were
able
to
get
back
it
just
built
and
built.
C
C
C
Whenever
we
are
revising
the
business
continuity
plans,
we
will
have
learned
from
this
whole
whole
incident
really,
but
it's
more
than
an
incident,
isn't
it
it's
it's
the
way
we
live
our
life
now,
so
so
as
to
say
it
was
useful
at
the
beginning,
we
will
learn
from
what
we
did
immediately
after
the
immediate
crisis
of
kobet
19
and
build
those
into
future
business
continuity
plans
and
we've
moved
beyond
the
original
business
continuity
response
into
a
business
as
usual
situation,
so
I'll
leave
it
there.
If
there's
any
questions
or
any
comments
from
anyone.
B
Thank
you.
Are
there
any
questions
for
shona
on
the
continuity?
I
think
it
showed
that
did
work.
You
know
we
we've
often
looked
at
the
continuity
plans,
haven't
we
and
over
the
years
and
it
was
really
needed
and
it
really
worked.
So
yes,
so
I
don't
think
I've
got
any
comments.
So
that's
that's
that's
great
and
obviously
we
will
keep
coming
back
to
looking
at
this
as
as
we
go
forward,
but
thank
you
for
for
being
here
this
year.
This
afternoon
it's
been
really
it's
been
a
lot
to
take
in.
B
I
think
I'll.
I
think
I
think
cold
colleagues
will
agree,
but
the
the
level
of
expertise
and
knowledge
is
just
second
to
none.
I'm
just
incredibly
impressed
and
you
know
I'm
I
don't
know
how
you're
all
doing
it.
To
be
quite
honest,
it's
really
impressive
huge
huge
thank
you
not
just
for
this
afternoon,
but
for
all
you
all
everything
you've
done
over
the
last
six
months
and
everything
that
you're
going
to
have
to
do
going
forward
and
we'll
see
you
again
soon.
B
A
Thank
you
chair,
so
yeah.
This
is
the
last
agenda
item,
so
this
report
asked
the
board
to
consider
its
work
schedule
for
the
remainder
of
this
municipal
year,
so
the
latest
version
of
the
schedule
you'll
find
in
appendix
one
of
the
report
with
regard
to
the
next
meeting.
In
particular,
the
board
is
going
to
be
focusing
its
attention
on
how
carbon
19
has
impacted
specifically
on
local
mental
health
services.
A
Also
scheduled
for
october
is
an
item
on
budget
saving
proposals.
So
initial
proposals
relating
to
the
budget
are
expected
to
be
considered
by
executive
order
at
its
meeting
next
week
with
the
view
to
consultation
on
those
taking
place
during
the
autumn.
As
part
of
that
consultation
process,
it
was
agreed
with
all
scrutiny
chairs
that
the
proposals
being
taken
would
be
formally
considered
by
scrutiny
boards
as
related
to
their
respective
remits
during
their
october
meeting
cycle,
but
prior
to
the
scrutiny
boards
meeting
on
the
20th
of
october
there's
also
a
remote
working
group
meeting.
A
That's
been
planned
for
the
5th
of
october
at
10
o'clock
and
this
is
to
provide
the
opportunity
for
board
members
to
discuss
the
optional
option
appraisal
process
that
is
linked
to
the
development
of
the
budget
saving
proportions.
So
invitations
have
already
been
extended
to
all
board
members
with
regards
to
that
meeting
and
just
to
provide
a
further
update
surrounding
available
leisure
centre.
A
So,
during
the
board's
last
meeting
it
was
agreed
that
the
the
chair
and
I
would
consider
how
best
to
still
accommodate
this
outstanding
piece
of
scrutiny,
went
from
last
year
in
relation
to
the
issues
that
was
surrounding
the
renovation
of
air
relations
center.
So
linked
to
this,
the
chair
would
like
to
hold
a
remote
working
group
meeting
during
late
october
for
all
board
members
to
discuss
the
details
of
the
renovation
project.
A
The
issues
encountered,
but,
more
importantly,
any
lessons
arising
from
that
so
and
following
this,
the
working
group's
findings
and
conclusions
will
be
reported
back
to
the
full
discretely
borders,
part
of
its
november
meeting.
So
once
an
hour,
a
date
has
been
identified
for
this
work
meeting.
Then
I'll
circulate
invitations
to
our
board
members.
So
to
conclude,
chair
members
are
asked
to
consider
an
agree
or
make
any
further
suggested
amendments
to
its
work
schedule
at
this
stage.
Thank
you.
Thank.
B
No
thank
you
it.
You
know
it's
going
to
be
a
lot
going
forward
and
we've
got
a
lot
to
tackle
so,
but
I
thank
you
all
for
your
work
on
work
since
we
started
in
back
in
may,
with
working
groups
online
and
for
your
excellent
questions
today
and
input
and
the
level
of
expertise
on
this
on
this
board
and
knowledge
of
your
communities
is
just
second
to
none,
and
I
really
really
appreciate
it.
B
B
B
B
B
I'm
I'm
thinking
ahead
to
november
when,
because
we're
doing
the
budget
things
in
october
and
yeah,
sorry,
I'm
getting
ahead
of
myself
yeah!
That's
right!
Thank
you
very
much,
sorry
zandi.
Thank
you
for
clearing
that
up.
Okay,
thank
you
very
much
and
have
a
lovely
evening
enjoy
the
sun
bye.
Thank
you.
Bye.