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A
A
This
meeting
has
been
webcast
on
the
council
website
so
that
interested
members
of
the
of
the
public
or
other
stakeholders
who
would
have
loved
to
be
here
but
aren't
able
to
be
here,
can
actually
observe
the
meeting
remotely.
So
this
meeting
recording
will
also
be
available
on
the
council's
website
shortly
after
today's
meeting,
I
would
like
to
now
ask
what
board
members
to
introduce
themselves
and
I
will
start
with
Dr
Bill.
A
C
A
C
C
E
A
A
It
may
be
helpful
to
note
that
the
matters
arising
from
the
June
meeting
page
15
of
the
agenda,
so,
if
there's
anything
any
one
of
you
from
the
board
would
like
to
raise
please.
This
is
your
time
to
do
so.
A
We
also
have
a
briefing
note
on
the
neonatal
Care
on
which
was
only
received
on
Friday
and
that's
also
on
page
18
minute
five,
so
we
will
not
be
going
into
any
details
with
that
until
we
have
got
further
information,
because
what
has
come
through
at
the
moment
is
insufficient
for
us.
So
we
will
not
be
dealing
with
that
in
today's
agenda.
A
Do
I
take
it
that
we
can
approve
what
you
have
received
as
correct
record.
Is
that
a
nod
from
all
of
us
excellent?
Thank
you
very
much.
That's
for
the
21st
of
June!
How
about
for
the
19th
of
July?
Is
that
a
yes,
okay,
excellent?
So
thank
you
very
much
board
members
straight
now
to
agenda
item
number:
seven
on
lead,
stroke,
services,
update
and
I'll
hand
back
to
Stephen
Courtney,
our
principal
scrutiny
advisor.
Thank
you.
H
Thank
you
chair.
This
report
attached
to
the
main
report
is
a
general
progress
on
stroke,
services
and
Leeds.
Since
the
board
last
considered
its
meeting
in
October
2021,
we
have
a
number
of
representatives
from
the
indicator
care
board
in
Leeds
and
Leeds
Community,
Mental,
police,
Community,
Healthcare
trust
and
also
representatives
from
these
teaching
hospitals
Trust
share
through
wheelchair.
Perhaps
if
you
could
have
invite
those
colleagues
to
introduce
themselves,
take
us
through
the
report
and
then
to
to
members
for
questions
chair.
I
Hi
I'm
Lindsay
McFarland,
head
of
pathway,
integration
for
long-term
conditions
at
the
ICB
in
Leeds.
A
E
A
L
I'm
Marissa
men's
I'm,
a
stroke
and
so
on
and
clinical
leader
for
stroke
services
at
lth.
M
I
Okay,
so
that's
a
scrutiny
board
meeting
last
October
that
we
attended
NHS
lead
ccg.
Now
the
Leeds
ICB
leads
teaching
hospitals
and
Leeds
Community
Health
Care
all
committed
to
developing
a
strategy
for
stroke
services
for
the
city
and
we'd
previously
used
the
term
strategy.
However,
based
on
feedback
from
stakeholders,
we've
reflected
that
strategies
are
quite
often
seen
as
five-year
fixed
documents
with
minimal
detail
on
how
elements
will
be
delivered.
I
Development
of
the
vision
and
priorities
document
was
due
to
commence
in
October
of
last
year
via
the
formation
of
a
stroke,
Vision
task
group,
and
this
was
formed
last
year
and
meets
monthly
and
includes
good
stakeholder
representation,
including
all
Health
Partners
across
the
city,
lead
city,
council
and
the
ambulance.
Trust,
therefore
increasing
the
opportunity
for
collaboration
and
the
identification
of
opportunities
to
resolve
challenges
faced
in
the
delivery
of
stroke
care
as
a
lead
system.
I
While
several
immediate
stroke
priorities
have
been
progressed,
the
work
on
finalizing
the
stroke,
vision
and
priorities
document
for
publication
and
progressing
some
future
priorities
has
been
delayed
due
to
the
impacts
of
covert.
For
example,
the
omicon
covid-19
variant
has
placed
capacity
constraints
on
our
stroke
teams,
with
clinical
delivery
needing
to
be
prioritized
and
unessential
meetings
stood
down
earlier
this
year,
which
has
meant
some
of
our
co-production
and
design
workshops
have
not
been
able
to
take
place
as
we
wanted,
as
identified
in
the
paper
that,
hopefully,
you've
all
had
the
chance
to
read.
I
This
focused
work
and
commitment
as
a
system
to
strike
vision
and
priorities,
is
allowing
us
the
time
to
place
a
spotlight
on
emerging
data
and
health
inequalities,
enabling
us
to
understand,
need
and
where
to
focus.
Our
efforts,
therefore
adopting
a
true
population-based
focused
and
approach
to
the
work
that
we're
taking
forward
the
next
steps
and
timelines
of
developing
and
Publishing.
Our
vision
and
priorities
are
outlined
within
your
paper
and
essentially
continuation
of
our
current
work
over
the
coming
months
via
The
Strokes
task
group.
I
A
draft
of
our
vision
and
priorities,
document
and
work
plan
to
be
shared
via
our
long-term
conditions:
population
boards
for
agreement
in
November
of
this
year,
following
review
and
agreement
by
all
our
partners,
and
then
we
hope
to
publish
the
vision
and
priorities
in
January
of
next
year
scrutiny
members
are
asked
to
acknowledge
the
positive
work
and
priorities
progress
to
date,
despite
the
challenging
climate
and
also
note
the
revised
time
scales
as
documented
and,
of
course,
if
you
have
any
questions
with
regards
to
the
current
Services,
then
a
number
of
colleagues
are
here
today
to
help
answer
those.
A
Thank
you
very
much,
okay
and
obviously
for
those
of
you
who
were
on
the
board
last
year.
We
did
have
them
in
in
October
last
year
and
it's
amazing
how
a
year
has
gone
by
so
quickly,
yeah,
so
yeah
good
to
see
the
progress
you've
made
so
far
now
just
like
to
hear
from
board
members.
If
there
are
any
comments
or
questions
for
them.
B
B
It's
important
in
terms
of
anticoagulation,
it's
important
in
terms
of
hypertension,
but
when
we
come
to
one
of
the
other
aspects
which
is
mentioned
in
the
paper,
that
is
high
cholesterol,
it
mentions
statins
but
doesn't
mention
anything
about
the
other
contributory
things
which
are
of
relevance
and
which
are
actually
spelled
out
here
and
if
I
might
share
I'll
tell
a
story
that
happened
to
me
not
that
long
ago,
when
I
had
a
routine
health
check
and
when
the
results
had
come
through,
I
had
a
phone
call
from
the
practice
saying
the
doctor
would
like
to
see
you
so
I
made
an
appointment.
B
It
was
in
the
days
when
we
could
actually
see
doctors,
I
turned
up
and
went
into
the
surgery
sat
down
and
was
told.
Oh
it's
about
your
cholesterol
level.
The
computer
says
that
you
should
ought
to
be
on
statins.
Sorry,
why
did
the
computer
say
I
ought
to
be
on
settings?
Well,
the
reading
well,
I
I
said
what
was
the
reading.
I
was
told
it
was
4.5
now
5
is
the
sort
of
guideline
I.
Do
accept
that
as
you
get
older,
perhaps
bit
lower
might
be
helpful.
B
B
No
doubt
it
could
be
improved
and
I
just
wonder
to
what
extent
this
work
that
has
been
done
in
producing
this
has
actually
talked
to
GPS.
To
say
how
many
of
you
actually
do
diet
in
with
your
patients?
Do
you
have
a
lead
nurse
or
a
dietitian?
Who
will
talk
to
patients
because
I'm
not
suggesting
the
doctors
need
to
spend
a
lot
of
time
talking
about
the
diet,
but
I
would
like
to
see
diet
and,
and
indeed
these
other
things,
smoking
and
alcohol,
and
so
on,
but
I'm
picking
up
specifically
diet
being
part.
I
We
are
working
to
align
our
you
know
our
focused
work
on
this
stroke
priorities
document
with
our
wider
long-term
conditions,
work
program
and
also
with
our
healthy
populations
board
within
the
city.
So
you're
quite
right.
You
know
physical
activity.
Weight
management
are
all
elements
that
we
are
focusing
on:
we're
full
work
programs
in
place
and
it's
our
role.
You
know
to
ensure
they
align
and
we're
joining
up
working
with
our
local
GPS
around
that
and
exploring
all
those
Avenues
for
patients,
and
you
know,
using
opportunities
like
six
month.
I
J
Yeah
I
would
agree
and
I
think
when
we
continue
our
development
of
the
the
priorities
and
and
vision
that
there's
got
to
be
clear
reference
and
to
to
Lifestyle.
There's
the
there
are
a
number
of
concurrent
work
streams
that
are
going
on,
that
that
link
really
well
to
the
the
stroke
strategy
and-
and
we
need
to
make
reference
to
that,
so
we
are
increasing,
particularly
within
Primary
Care,
the
number
of
social
prescribers
dietitians
that
can
offer
that
extra
support
to
to
patients.
J
So
we're
also
looking
at
within
a
work
program
that
we're
under
undertaking
around
cholesterol
and
looking
at
the
where
we've
got
gaps
in
the
city,
where
there's
there's
higher
cholesterol
than
they
should
be
and
doing
a
bit
of
a
deep
dive.
Looking
at
what
what's
been
the
causes,
what
advice
has
been
given
already
and
what's
missing?
J
What's
what's
the
Gap,
what
what
are
people
not
getting,
and
if
that
and
then
we've
got
proposals
in
there
to
bolster
that
that
with
social
prescribing
and
dietitians,
and
because
we
suspect
that
there
might
be
a
case
for
for
increasing
the
lifestyle
aspects.
D
Thank
you,
I
totally
agree
with
John
what
he
says,
but
on
page
31
you
have
the
tech
with
the
doctors.
You
know
you
work
with
doctors
to
identify,
but
my
concern
is
with
the
third
sectors
as
well.
What
are
you
doing
in
third
sectors
that
have
looked
after
the
elderly
that
travel
with
high
blood
pressure?
Cholesterol,
you
name
it
they
have
it.
So
we
have
certain
third
sectors
that
cater
for
these
individuals.
We
know
that
I'm
going
back
to
the
Bain
Community,
our
culture,
our
diet
is
Rich.
D
The
elderly
tends
not
to
listen
when
we
said
that
the
younger
generation
with
the
food
you're
eating
you
need
to
change,
and
so
on
and
so
on.
So
it
would
be
really
good
for
you
to
interact
with
the
third
sector
and
also
social
prescribing,
because
it's
not
just
the
medication
or
the
overweight
cut
the
diet.
We
know
that
we
do
need
activities,
we
used
to
do
social
prescribing
you
identify
them
to
sports
centers
or
whatever.
What
are
you
doing
about
that?
D
K
Thank
you
chair,
just
a
couple
of
points
to
add
to
what
colleagues
have
said.
I
think
just
to
I
mean
thank
you
John
for
for
raising
this
important
point
and
for
those
comments
as
well.
Councilor
Taylor.
It
does
feel
pretty
critical
in
them
work
as
a
city
that
we
we
do
join
this
work
up
and
I.
K
Think
the
first
important
point
is
we
that
the
work
led
by
our
NHS
colleagues,
we
absolutely
have
to
join
up
with
the
broader
work,
that's
happening
across
the
council
and
the
city,
including
third
sex
colleagues,
because
the
NHS
can't
do
this
on
their
own.
K
So
there
is
something
about
making
sure
we
continue
to
join
this
up,
but
just
to
assure
colleagues,
Public
Health
teams
are
working
very
closely
with
NHS
colleagues,
but
we
know
this
will
be
a
major
priority
coming
out
of
covid
from
previous
discussions
with
this
board.
K
We
do
know
that
one
of
the
major
impacts
of
the
pandemic
is
that
much
prevention
work
has
been
paused
in
Primary
Care
at
National
directive,
so
we
we
have
a
backlog
that
and
we're
working
through
in
terms
of
not
just
at
nhf
health
check,
but
other
prevention
and
early
management
of
risk.
So
we
know
that
this
has
slipped.
K
We
know
it's
not
where
it
should
be
and
as
a
city,
we've
got
a
plan
to
get
that
on
track,
but
it
is
an
urgent
priority
and
we
are
starting
to
see
some
of
the
effects
of
that
coming
through
in
terms
of
numbers
of
people.
K
You
know
affected
by
conditions
that
could
have
been
prevented
earlier
on,
so
just
to
assure
the
board.
It
is
a
major
priority.
We
need
to
absolutely
join
it
up
with
the
wider
work
across
the
city
and
link
with
the
causes
and
the
risk
factors
further
Upstream,
so
not
just
smoking
healthy
weight,
physical
activity,
alcohol
related
risks,
but
also
some
of
the
the
causes
of
those
causes
about
inequalities
in
communities.
So
we
will
be.
K
We
will
be
prioritizing
that
work
as
we
as
we
move
forward
and
happy
to
update
on
on
on
that
as
we
go.
Thank
you.
A
Thank
you
very
much,
Victoria,
that's
comforting
to
know
that
it's
urgent
priority
for
us,
so
that's
really
good.
Thank
you.
Councilor
Burke
thank.
F
You
chair,
I
I,
have
two
questions
really,
but
Victoria's
partly
just
answered
one
of
them,
and
that
was
about
the
link
to
This
research,
and
you
do
mention
Health
inequalities
and,
and
sometimes
it's
always
mentioned,
isn't
it
without
the
level
of
detail
under
it
to
make
it
meaningful?
F
I
can
only
have
them
done
at
the
hospital,
so
I
would
love
to
be
able
to
do
that.
Myself
and
I
know
it
wouldn't
be
fit
for
everybody,
but
I
know
that's.
This
is
around
cholesterol,
but
perhaps
testing
of
a
wider
nature
in
communities
is
the
way
to
serve
resources
and
make
people
more
aware
of
their
things
and
perhaps
a
deeper
look
at
the
genetic
factors
that
contribute,
because
we
talk
a
great
deal.
Don't
we
about
the
other
contributory
factors,
but
genetics
plays
a
huge
part
in
lots
of
the
the
so
I
think.
F
That's
and
my
final
part
is
the
poor
stroke
care
again
my
experience
of
it.
It's
a
bit
hit
and
miss
and
I
think
that's
fair,
depending
where
you
are
and
depending
how
good
the
care
team
you're
allocated
to
so
perhaps
there's
a
piece
of
work
there,
because
prevention
is
important
that
we
all
know
Strokes
will
unfortunately
still
happen
so
the
post
so
that
we
could
have
a
uniform
level
of
care
across
the
city.
Thank
you.
I
Thank
you
for
those
comments
in
terms
of
health
inequalities
and
we're
working
with
our
our
Public
Health
colleagues
and
business
intelligence
analysts
to
really
drill
down
into
our
straight
data
available.
That's
all
published
nationally
and
really
drill
down
into
our
cohorts
of
populations
and
where
they
live
to
understand
the
needs,
and
perhaps
some
of
those
more
earlier
preventative
kind
of
interventions
that
we
could
have
put
in
place
to
learn
from
those.
So
that
work
is
well
underway.
I
And
we've
tried
to
give
you
a
feel
within
the
paper
as
well
around
a
graph
they're
demonstrating
the
variants
within
the
city
in
terms
of
the
the
prevalence
of
stroke
as
well,
and
so
just
to
say
the
results
reports
of
this
work
and
Analysis
underway
and,
as
you
say,
we're
piloting
as
well
projects
and
a
lot
of
that
work
is
in
conjunction
with
David's
pharmacists
team
within
our
organization
and,
as
you
say,
an
awful
lot
to
learn
from
that
and
Via.
I
This
work
we'll
keep
that
live
and
sharing
back
what
we're
learning
and-
and
you
know
how
we're
able
to
develop
that
further,
going
forwards
and
again
the
learnings
as
well
also
to
say
as
well
I
guess
in
terms
of
our
city-wide
Health
inequalities
agenda
from
a
Leeds
ICB,
the
organization
and
the
cities,
taking
forward
lots
of
health
inequalities
projects
and
we're
working
through
all
those
help
currently
again
working
with
a
lot
of
local
care
Partnerships
where
they
will
have
the
local
third
sector
kind
of
working
with
them.
I
So
we're
looking
at
ways
to
you,
know,
pilot
new
initiatives
and
ways
of
working,
and
you
know,
hopefully,
learn
and
inform
new
new
ways
for
the
future.
That
is
all
underway,
and
we
can
share
further
details
of
that.
D
Come
M
Victoria
speak
about
Corby
the
aftermarket,
but
can
we
also
remember
today
we
are
in
custom
living
and
it's
the
para
is
going
to
be
suffered
and
a
lot
of
them
diets
will
gone
off
real
now,
so
I'll
urge
you
to
look
at
Health
inequality,
but
look
at
those
that
really
needs
it,
because
people
won't
be
eating
properly.
D
D
Are
we
looking
at
the
top
and
I
just
think
we
should
work
in
the
deprived
area
more
and
look
for
those
individuals
that
will
struggle
more
that
don't
have
anyone
to
talk
to,
especially
we
talk
about
migrants
coming
in
who
don't
understand,
English
and
don't
know
where
to
go
and
what
to
do
those
people.
They
are
human
and
they
are
also
a
society
and
we
need
to
focus
on
those
individuals.
But
I
do
ask
you
to
look
in
the
deprived
area
of
because
the
living
coming
on.
E
Just
want
to
carry
on
on
the
prevention
theme.
E
It
says
here
that
many
people
do
not
always
take
their
medication
as
prescribed.
Why
is
it
too
complicated?
Does
it
just
can't
be
bothered?
Don't
they
understand
the
instructions
I
mean
and
we
need
to
make
it
easier
for
people?
Why
are
we
making
it
so
complicated?
If
we
know
they
don't
do
it?
What
is
it
that
they're?
Not?
Why
are
they
not
doing
that,
and
has
anybody
done
any
research
behind
that
to
find
out
what
makes
it
so
difficult
for
people
and
then
the
other
thing?
E
It
says:
oh
well,
we'll
hand
out
some
blood
pressure
monitors
to
everyone.
If
people
can't
take
medication,
they're
not
going
to
monitor
their
blood
pressure,
if
you
give
them
a
machine,
it
doesn't
mean
they're
going
to
actually
do
it.
I
mean
I.
Have
a
blood
pressure
monitor
in
the
cupboard,
but
I
couldn't
tell
you
how
long
it
is
since
I
actually
used
it.
E
J
Yeah,
it's
an
interesting
point,
because
I
think
it
is
multifactorial
why
people
don't
take
their
medication
and
a
lot
of
that
can
be
down
to
their
perceptions
of
their
medication,
whether
they
feel
the
medications
doing
them
more
harm
than
good
and
that
all
starts
with
education,
around
people's
conditions
and
and
how
medication
works
and
and
how
it
helps
so.
J
We're
hoping
through
having
more
pharmacists,
now
working
within
general
practice
undertaking
something
called
structured
medication
review
where
we
can
pick
up
some
of
the
concerns
that
people
have
around
taking
medications
and
and
address
those
so
through
the
sort
of
pilot
work
schemes
that
we're
doing
we're
trying
to
get
under
the
skin
to
find
out
from
particular,
particularly
for
the
anti-cholesterol,
reducing
medication
and
anticoagulation.
J
That's
that's
not
taken
I'm
just
like
to
if
I
could
just
pick
up
on
the
the
bit
around
inequalities
as
well,
because
that's
that's
really
important
to
me
as
clinical
lead
and
it's
something
you
know
we
chose
to
put
this
data
in
to
highlight
around
inequality,
so
I
think.
Traditionally
we
know
that
within
the
NHS
we
can
be
fairly
reactionary,
sometimes
particularly
over
the
past
two
years.
J
We've
we've
covered
where
it's
it's
been
all
hands
on
deck,
so
I
think
looking
at
inequalities
is,
is
a
key
lean
line
of
inquiry
for
us
moving
forward
and
I.
Think,
particularly
if
you
look
at
stroke
what's
interesting.
If
you
look
at
pure
numbers
of
stroke,
most
strokes
happen
in
our
older
communities.
Tend
to
be
more
affluent
because
straight
risk
just
increases
with
age.
So
what
we're
showing
here
is
that,
if
you
take
age
out,
the
equation
more
Strokes
are
happening,
are
younger,
more
deprived
communities.
A
Thank
you
very
much
Council
Farley
and
then
Victoria.
G
Okay,
thank
you,
I
suppose.
My
questions
are
really
kind
of
around
the
current
state
of
stroke
response
and
I
appreciate
officers,
nobody
from
known
from
Yaz
here.
G
G
I
know
and
well,
there
have
been
reports.
Obviously,
a
national
level
that
Strokes
have
been
de-prioritized
as
ambulance
waiting
lists
have
gone
up.
So
has
there
been
any
any
thought
about
that
in
terms
of
the
strategy?
I
suppose
again,
this
is
more
more
of
a
more
of
a
Yaz
question,
but
perhaps
you
guys
can
touch
on
it.
G
Yeah
is.
Is
there
obviously
across
the
NHS
world,
was
looking
for
new
and
different
ways
of
working
with
the
workforce
acting
to
the
top
of
its
register
and
it's
banding
is
there?
Is
there
potential
for,
in
particular,
stroke
cases,
I
know,
ltht?
The
brain
attack
team
did
a
lot
of
work
around
thrombolysis
to
to
empower
and
train
paramedic
teams
to
deliver
thrombolysis.
M
So
we'll
we'll
try
and
take
those
questions
together,
so
I
wouldn't
want
to
I,
wouldn't
want
to
speak
on
behalf
of
Yaz,
obviously,
and
don't
want
to
prejudge
or
preempt
it.
One
thing
to
note:
I
guess
for
is
at
least
teaching
hospitals
is
our
ambulance.
Handover
times
are
very
low
compared
to
others,
so
so
that
means
that
there
are
less
patients
waiting
in
ambulances
outside
our
emergency
departments
than
then
the
vast
majority
of
other
trusts.
M
So
that's
one
performance
indicator
that
we
can
be
we're
we're
doing
well
at
and
that
obviously
helps
to
to
support
a
quicker
response
time,
but
regarding
he
has
his
strategy
for
response
times
and
what
that
is,
I
wouldn't
be
able
to
comment
on
that
now.
L
I
think
our
focus
is
on
getting
people
to
the
hospital
as
soon
as
possible,
because
we
have
a
number
of
hyper
acute
treatments
and
all
hypercute
treatments
rely
on
you
having
a
brain
scan
first,
so
unfortunately
that
would
be
a
major
barrier
to
delivery
in
the
community.
You
need
to
have
a
scan
of
someone's
brain
before
you
can
give
them
thrombolysis,
so
I
think
it's
about
getting
them
to
to
hospital
as
soon
as
we
can.
But
we
are
our
response
times
with
ambulance
Handover.
L
We
wait
for
the
patients
as
they
arrive
the
pre-alerta
to
us,
so
our
brain
attack
team
are
usually
at
the
door
waiting
and
our
time
to
scan
is
really
good
compared
to
national
figures.
A
Okay,
thank
you
very
much.
I
believe
we
can
also
write
to
the
Yorkshire
ambulance
service
directly
and
get
some
answers
for
you,
councilor
Farley.
Thank
you.
Victoria
thank.
K
You
chair,
it
was
just
to
come
back
on
the
inequalities
Point
and
it
feels
important
to
make
the
distinction
between
how
we
work
with
NHS
colleagues
to
to
make
sure
that
there
are
inequalities
addressed
through
health
care.
So
the
fact
that
all
communities
have
good
access
to
health
care
and
good
quality
health
care
that
is
culturally
appropriate
Etc.
K
So
there's
a
huge
agenda
around
addressing
inequalities
in
in
healthcare
provision
that
obviously
we
work
closely
with
with
colleagues
around
which
which
works
alongside
the
broader
work
as
a
city
that
we
do,
knowing
which
people
are
most
at
risk
and
how
we
work
with
communities
with
a
really
broad
range
of
Partners,
as
Council
Taylor.
K
All
of
the
learning
from
covid
around
not
just
delivering
one-size-fits
all,
because
that
doesn't
that
doesn't
reach
all
communities
but
really
working
in
those
very
broad,
supportive
ways
to
keep
people
well
in
communities
which
is
all
of
our
all
all
of
our
jobs
in
it
and
and
the
public
health
role
of
the
councils
included
in
that.
So
I
think.
K
When
we
talk
about
inequalities,
it's
making
that
distinction
between
that
access
to
health
care
from
different
communities
and
the
broader
work
around
Health
inequalities
and
and
keeping
people
well
so
again,
I
think
there's
there's
continued
work
to
do
in
making
sure
all
of
that
is
joined
up
to
you
know
to
to
to
to
fully
complement
all
of
all
of
the
work
that's
described
in
this
paper,
but
just
just
wanted
to
bring
that
out
really
on
the
inequalities
question.
Thank
you.
A
F
A
F
You
chair
I,
probably
need
to
stop
following
you
Victoria
it
was.
It
was
just
linked
to
the
inequalities
and
and
how
strokes
and
other
diseases
will
affect
particular
groups.
You
know
afro-caribbean,
for
instance,
baby.
It's
linked
to
stroke
and
I
just
wondered
if
there
was
any
plans
to
work
with
those
particular
groups,
partly
because
of
the
reasons
councilor
Turner
highlighted
that
it's
genetic
isn't
it
because
of
other
things,
if
you
had
any
plans
to
work
with
those
particular
groups.
J
Yeah,
so
we
know
some
of
the
risk
factors
for
stroke
have
different
prevalences
in
different
ethnic
communities,
and
so
people
from
Africa
being
backgrounds
are
more
likely
to
have
hypertension,
which
then
puts
them
increased
physical,
Strokes
I
think
through
some
of
the
work
we're
doing
around
hypertension.
We're
specifically
focusing
we've
got
a
specific
Focus
around
particular
communities
where
we
know
are
at
higher
risk,
so
I
think
it's
about
and
similar
with
diabetes,
you
more
than
three
times
likely
to
get
diabetes
if
you're
from
a
South
Asian
origin.
J
So
so
we've
got
that
as
part
of
the
diabetes
strategy,
so
I
think
in
terms
of
that
prevention
work.
Yes,
definitely
an
increased
Focus
around
different
ethnic
communities.
A
Thank
you
very
much
and
thank
you
for
all
the
updates,
and
obviously
we've
been
on
this
with
yourselves
for
a
year
and
we
still
look
forward
to
more
updates
and
progress
on
this
particular
agenda
item.
So
thank
you
very
much
for
all
that.
You've
done
so
far
right.
Moving
swiftly
agenda
item
number
eight
leads
community
near
a
lot
neurological
Rehabilitation
I,
tell
you
the
medical
industry
and
their
words.
You've
got
to
go
back
to
school,
to
learn
okay,
I'll
hand
back
over
to
Steve
to
introduce
the
item
for
us.
H
Thank
you
chair
yet
again
fairly
brief
from
me
chair.
Is
this
a
report
introduced
as
a
further
update
from
NHS
colleagues
in
relation
to
community
neurological
rehabilitation
services
which
the
board
Leicester
considered
also
in
October
of
last
year,
so
the
more
detailed
update
is
provided
in
the
appendix
and
also
just
to
confirm
at
appendix
one
is
the
is
the
feedback.
H
This
is
the
board
chip
prepared
in
response
to
that
that
initial
consideration
back
in
October
21
for
information
and
the
the
update
is
provided
in
appendix
too
and
in
terms
of
presentation.
We
have
the
same
presenters
last
time
shared
with
the
exception
of
at
least
teaching
Hospital
Trust
share
yeah.
I
I
So
we
attended
the
scrutiny
award
meeting
last
October
to
summarize
the
emerging
themes
for
an
extensive
engagement,
including
staff,
patients,
carers
and
wider
stakeholders
undertaken
last
year
on
how
we
redesign
our
specialist
Community,
neurological
rehabilitation
services
in
Leeds
for
people
living
with
long-term
neurological
conditions
like
Ms,
Parkinson's,
stroke
or
traumatic
injury
to
the
brain.
I
I
These
include
the
provision
of
an
assessment
or
referral
function
and
a
rapid
48-hour
response,
Pathway
to
manage
and
facilitate
self-referrals
and
a
more
responsive
service
in
order
to
provide
rehabilitation
in
the
right
place
at
the
right
right
time
for
the
patient.
A
call
home
first
service
offer
enabling
care
closer
to
home.
I
Therefore,
increasing
accessibility
and
extended
rehabilitation
service
offer
and
bespoke
Specialty
Pathways
for
those
who
need
a
more
tailored
approach
to
ensuring
an
offer
of
personalized
care
and
continued
access
to
some
inpatient
Rehabilitation
with
the
provision
of
one
inpatient
bed
when
needed,
following
the
recognition
that
fewer
impatient
beds
are
needed
based
on
demand
and
need
analysis
undertaken
on
this
basis.
The
decision
has
therefore
been
made
to
withdraw
the
five
inpatient
beds
from
the
Estates
at
St
Mary's
permanently.
I
I
As
with
our
straight
work,
there
have
been
delays
to
this
work
and
mostly
due
to
the
omicon
variant
of
covid
and
capacity
constraints
on
our
teams,
and
these
delays
have
been
shared,
communicated
and
agreed
with
our
long-term
conditions.
Population
board
and
a
number
of
workstream
updates
are
included
within
the
paper
I'd
like
to
highlight
that
clear
communication
and
engagement
has
continued
in
relation
to
this
work.
I
Following
approval
of
the
model
in
January,
Communications
and
engagement
began
with
staff
within
the
service
to
inform
the
case
for
change,
essentially,
the
HR
process
that
has
had
to
be
worked
through,
whilst
also
forming
a
staff,
health
and
wellbeing
work
stream
to
monitor
this
and
offer
the
right
support
as
and
when
staff
require
this
during
the
change.
I
In
addition,
you
said
we
heard
a
resource
was
prepared
for
patients,
as
recommended
by
this
board,
and
current
patients
of
the
service
have
been
kept
up
to
date
with
service
changes
throughout
with
the
services
website,
reflecting
the
current
service
offer
and
current
patients
and
any
patient
entering
the
service
has
also
received
a
letter
regarding
the
current
service
offer
and
what
to
expect
phased
implementation
of
the
new
model
is
expected
during
quarter
four
of
this
financial
year
following
some
further
planned
discussions
on
the
model
with
our
long-term
conditions,
population
board,
with
consideration
of
Staff
feedback
and
data
to
inform
the
best
uses
of
our
result.
I
Sorry
to
inform
the
best
use
of
our
resources
and
the
leads
pound,
and
you
said
we
did.
We
report
will
be
published
at
this
point
outlined
as
a
new
service
model
and
ongoing
satisfaction
from
the
service
which
we
continue
to
collect
again.
You're
asked
to
acknowledge
the
positive
work
completed
today
and
also
the
priorities
that
we've
been
able
to
progress
despite
the
challenging
climate.
Thank
you.
A
Thank
you
very
much
and
I'm
pleased
to
let
you
know
that.
Yes,
we
have
acknowledged
your
positive
work.
Thank
you
very
much
for
that
members.
Have
you
got
any
comments
or
questions.
C
Thank
you
chair.
Just
a
couple
questions
maybe
go
through
them
individually
or
I'll.
Ask
two
first
and
then
you
can
answer
them
and
I'll.
Ask
my
third:
if
that's
okay,
yeah,
so
what
what
tertiary,
specialist
rehabilitation
services
are
there
in
West
Yorkshire
and
second,
what
integration
is
there
with
adult
social
care?
So
is
there
a
social
worker
attached
to
it
or
as
part
of
the
MDT,
for
example,
and
I'll
come
back
to
the
third
question?
Thank
you.
I
In
terms
of
turf
tertiary,
specialist
Services
we've,
the
Chapel
Ellerton
specialist
kind
of
neurological
Services
delivered
by
Leeds
teaching
hospitals,
so
I
guess
the
community
element
of
this
works
alongside
that
provision,
and
obviously
our
core
special
specialist
neurology
Services
Within
These
teaching
hospitals.
I
So
our
neurology
teams
work
closely
together
there
in
terms
of
wider
I
guess
Community
Rehabilitation.
My
understanding
is,
that
is,
is
that's
very
varied
across
West
Yorkshire
we've
got
this
good
service
offering
in
in
Leeds
that
we're
looking
to
improve
and
enhance,
but
I
I
couldn't
fully
describe.
You
know
the
offering
across
the
west
of
West
Yorkshire
in
detail
to.
You
can
certainly
share
some
of
that
detail
post
meeting.
If
that
would
be
helpful,
Mandy
I
don't
know.
I
In
terms
of
adult
social
care,
are
you
are
you
able
to
answer
that?
One
no
again,
I
think
that's
one
we'd
need
Helen
to
give
more
a
response
on
because
she
leads
the
multidisciplinary
teams
within
Leeds
Community
Healthcare.
C
Yeah
I
think
that's
really
important.
I
mean
the
first
question
about
tertiary,
tertiary
Services
links
to
the
question
I'm
just
about
to
ask
now
actually
but
I.
Think
it's
really
important
I
mean
if
we're
going
to
have
joined
up
services,
especially
with
adult
social
care.
Given
the
rehabilitation
service
I
mean
it
should
be,
should
be
very
joined
up
shouldn't
it.
You
know,
there's
such
a
certain
overlap
between
adult
social
care
and
and
any
rehabilitation
service,
I
think
yeah,
oh
yeah,
I'm,
sorry,
yeah.
E
We
do
have
a
number
of
specialist
social
workers
and
I'm
just
racking
my
brain
to
remember
whether
or
not
we've
got
a
specialist
one
for
stroke,
but
even
if
we
don't,
we
have
a
what
we
call
a
complex
needs
team
that
will
be
in
reaching
into
all
of
these
sort
of
specialisms.
So
if
we
haven't
got
it,
I'll
have
to
go
back
and
double
check
whether
or
not
we've
got
a
dedicated
stroke
worker.
C
So
so
the
question
was
about
the
it
looks
to
be
a
cat
now
I'm,
not
entirely
sure
whether
it
is
a
cat
or
on
the
amount
of
sessions
that
that
somebody
can
have
so
it
mentions
within
the
the
agenda
pack
that
people
can
have
up
to
six
sessions
now,
but
it
also
mentions
as
well
under
2.3
in
the
agenda
pack
and
the
item
as
one
of
the
targets
that
this
should
be
clear,
outline
and
criteria
of
what
the
community
neurological
rehabilitation
services
offers
offer
offers
available
to
all
stakeholders.
C
So
I'm
wondering
whether
or
not
you've
decided
to
cap
it
at
six
six
sessions
or
whether
or
not
you've
just
decided
to
make
clear
what
the
offer
is,
because
it
and
I'm
not
sure
what
what
it
is
because
of
the
it's
not
clear
in
the
in
the
pack
and
and
following
up
from
that.
So
I
did
a
bit
of
research
about
you
know.
C
So
you
know
what
what's
happening
in
in
this
field:
sort
of
across
England
and
it
talks
about
a
postcode,
Lottery
and
and
and
people
not
patients,
not
feeling
that
they
have
enough
sessions
to
meet
their
Rehabilitation
needs.
And
there
was
a
report
in
2020
from
the
it
was
a
joint
Point
actually
from
the
Society
of
Physiotherapy
and
the
Royal
College
of
Occupational
therapists,
who
surveyed
just
over
a
thousand
patients
and
with
health
at
long
health,
health,
long-term
health
conditions.
C
Sorry
I'm
tongue-tied
today,
and
it
said
that
just
29
of
the
patients
that
they
surveyed
and
said
that
they
received
enough
Rehabilitation.
So
what
have
you
decided
to
cap
it
or
have
you
always
had
it
at
six
sessions?
And
do
you
think
that
those
successions
is
actually
enough
to
meet
the
needs
of
people
given
that,
in
his
lead,
special
I
suppose,
as
leads
offering?
Is
it
a
better
service
offer
than
what
the
rest
of
the
country
has
I
mean?
I
I'll
attempt
to
answer
that
one,
if
that's
okay,
so
we're
currently
delivering
six
sessions
over
three
months.
That's
the
current
interim
offer
under
the
new
offer
going
forwards,
we'll
be
looking
to
move
to
eight
sessions
over
four
months
and
that's
through
I
guess
the
evidence
well
that
that's
been
determined
through
the
engagement
with
the
clinical
teams
around
what's
best
and
also
a
review
of
national
best
practice
that
Leeds
Community
Healthcare
have
have
led
on
to
make
that
assessment.
I
Previously,
the
offer
was
quite
open-ended
and
we
had
people
who
might
have
one
or
two
sessions-
and
you
know
some
some
members,
who'd
I,
guess
be
on
on
the
in
the
rehabilitation
program
for
a
number
of
months
even
years,
and
so
we
are
I,
guess
looking
to
I
guess,
set
expectations
as
someone
joins
in
terms
of
a
length
of
program
and
a
really
defined
program.
I
However,
then,
as
part
of
the
model,
we
do
have
a
re-referral
and
re-access
Route,
whereby
people
can
access
additional
kind
of
therapies
as
and
when
required.
So
there
is
that
ability
to
react
to
Service
going
forward.
So
that's
what
we've
tried
to
design
there
to
ensure
a
good
quality
service
for
more
people
that
is
accessible,
and
you
know
individuals
have
already
seen
more
timely
because
we're
able
to
increase
the
throughput
of
patients
into
the
service.
I
You
know
within
a
financial
resource
that
we've
got
Mandy
I,
don't
know
whether
you'd
like
to
add
anything.
There.
E
I
think
thank
you.
Lindsay
I
think
you've
articulated
really
well
what
they
new
plan
is,
but
I
think
it's
also.
We
need
to
identify
that,
although
we've
got
a
plan,
this
will
be
continuously
reviewed
with
patients
providing
input
to
look
at
how
it
may
need
to
be
modified
and
moved
as
we
go
along.
I
think
the
reason
for
putting
a
system
in
place
like
this
is,
we
did
have
long
waiters
and
we
had
patients
who
weren't
being
seen
at
all
in
a
timely
way.
E
Hopefully
this
will
address
that,
and
so
they
will
be
seen
in
a
better
timing.
C
You
have
my
sincere
sympathies
with
you
know,
with
with
the
budget
constraints
that
you
have,
but
it
seems
to
me
that
you
you've
traded
off,
haven't
you
between
seeing
as
many
patients
as
possible
as
quick
as
possible
and
or
and
having
or
perhaps
seeing
fewer
patients
and
longer
waiting
lists,
but
more
sessions
and
I'm
and
I
understand
why
that
you've
done
you
you've
done
that,
and
you
know,
and
perhaps
that
is
the
right
thing
to
do-
I'll
be
very
interested
to
see
what
the
patient
feedback
is
on
that,
especially
given
the
report
as
as
I
mentioned
it
was,
it
was
published
in
2020
and
that
the
main
concern
being
that
they
do
actually
receive
enough.
C
A
B
Thank
you,
chair
yeah.
Thank
you
very
much.
It's
great
to
see
the
home
first
approach,
it's
great
to
see
the
work
collaborative
work
you've
been
doing
with
patients
and
with
the
third
sector
they're
all
very
great
and
I
would
certainly
support
reducing
the
number
of
beds
from
five
to
one,
but
just
two
or
three
questions
around
that
in
detail.
B
Firstly,
these
things
never
come
singly,
so
to
have
one
bed.
Sometimes
there
will
be
no
one
who
actually
needs
it
and
the
next
day
there'll
be
two
people
who
urgently
need
it.
Presumably
there
is
some
flexibility
built
into
that,
so
those
who
need
a
bed
can
actually
have
access
to
a
bed
that.
B
Secondly,
you
talk
about
out
of
area
referrals,
a
small
number
per
annum,
presumably
you're
working
closely
with
any
localities
where
they
tend
to
refer
in
into
our
area
from
their
area,
so
that
they
can
look
about
how
they
develop
or
change
their
practice,
which
fits
into
the
the
treatment
which
they
ask
have
asked
us
to
provide
in
the
past.
And
thirdly,
you
can
bet
your
bottom
dollar.
There
will
be
some
people
who
describe
reducing
from
five
beds
to
one
bed
as
cuts.
I
Thank
you
in
terms
of
the
I
guess.
The
sourcing
of
the
bed
we're
currently
working
through
that
currently
leads.
Community,
Health
Care
are
and
we're
exploring
options
for
that
and,
as
you
say,
one
of
the
challenges
there
around
I
guess
the
planning
and
and
frequency
of
the
bed
needs.
So
we
are
exploring
options
for
for
that
bed
provision
and
we're
confident
there
will
be
a
solution
for
that.
I
I,
don't
know
Mandy
if
you
want
to
add
anything
there,
but
that
that
is
all
being
worked
for
you
in
terms
of
procurement,
kind
of
details
and
next
steps
around
that
in
terms
of
out
of
area
referrals.
Again,
we
work
closely
with
our
West
Yorkshire
colleagues
and
have
kept
them
informed
of
the
position
of
this
service
and
the
position
on
out
of
every
referrals.
I
My
understanding
from
from
hell
in
our
clinical
lead
is
we've
been
very
clear
on
Communications
and
any
kind
of
referrals
that
have
been
sent
through
inappropriately
despite
the
comms
they've
managed
fire.
You
know
onward
discussions
with
with
the
other
relevant
clinical
teams,
and
that
has
been
well
managed
and
actually
the
number
referrals
have
been
very,
very
small,
I.
I
Think
just
a
handful,
and
and
finally
your
first
coin,
with
regards
to
I
guess
this
being
seen,
could
be
seen
as
a
cut
around
a
reduction
in
beds
again
we're
working
to
ensure
we
get
the
communications
right
around
this,
especially
with
patients
around
you
know.
We've
got
a
financial
envelope
and
we've
specified
that
within
within
the
paper,
we're
not
taking
away
from
that
we're
not
removing
that,
but
actually
we're
able
to
you
know
in
terms
of
value.
I
You
deliver
a
greater
home
first
offer
through
that
disinvestment
in
the
bed
base
and
reinvestment
of
that
resource
into
more
therapy
staff.
Members
deliver
care
places
to
home
for
people
and
then
those
who
truly
need
the
inpatient
Rehabilitation
offer
you
know
an
offer
will
remain
for
them
and
yeah
we'll
communicate
that
clearly
and
then
you
know,
via
our
long-term
conditions
board
as
well.
I
We've
made
the
commitment
around
continuously
reviewing
the
offer
the
feedback
we're
receiving
I
guess
in
relation
to
the
earlier
Point
made,
but
also
you
know
we're
using
this
opportunity
to
really
understand
our
referral
numbers
into
the
service.
The
time
people
spend
in
the
service
the
outcomes
being
achieved
and
also
demand
and
need
to
really
build
that
case
of
the
future
and
our
long-term
conditions
board,
and
also
our
you
know,
integrated
care
board
going
forwards
and
well
away.
I
There
may
be
an
ask,
and
you
know
highly
likely
there
will
be
an
ask
around
Financial
investment
around
how
we
further
develop
these
Services,
but
we
are
doing
all
our
you
know
our
best
to
really
I
guess
achieve
the
best
to
our
ability.
Within
the
you
know,
Financial
resource
we've
got
available
to
really
evidence
value
before
we
ask
for
more
resource
and
I
think
this
is
a
real.
You
know
positive
example
of
how
we
are
truly
maximizing
the
resources
that
we
have
got
available
currently.
A
Thank
you
very
much
any
other
question
from
Members
or
comments.
Okay,
thank
you
very
much
Lindsay
and
the
team,
and
we
do
not
the
chain
the
time
skills
in
terms
of
what
you
have
sent
to
us
in
the
information
that
you've
given
to
ourselves.
So
that
is
definitely
noted
and
we
know
that
they
are
revised
as
well
from
what
we
had
last
year.
So
thank
you
very
much
for
that.
Okay.
A
Agenda
item
number,
nine
elective
care,
Hub
proposals
and
the
draft
response
back
to
you.
Stephen.
H
Thank
you
chair,
as
outlined
in
the
paper
chair
this.
This
item
is
on
the
agenda
to
give
members
the
opportunity
to
feed
into
and
give
comments
in
relation
to
these
teaching
hospitals
trusts
proposals
to
establish
an
elective
care
Corp
of
hand,
planned
surgery,
Hub
at
wharfdale
hospital
and
the
related
changes
to
endoscopy
services
at
that
same
location.
H
As
the
paper
sets
out,
members
have
received
details
outside
over
the
summer
outside
of
the
meeting
and
through
a
briefing
paper
from
Leeds
teaching.
Hospital
trust
and
members
also
received
a
first
update
around
the
development
of
elective
care,
Hub
at
wharfdale
back
in
February
2022..
H
So
the
proposal
is
to
set
to
give
members
the
opportunity
to
provide
a
response
by
the
deadline
that's
set
out
in
the
paper,
which
is
the
22nd
of
September,
so
this
coming
Thursday
outside
of
the
agenda
pack
and
supplied
to
members
electronically.
There's
a
draft
response
that
members
have
received
and
meet
members
each
have
a
hard
copy
of
that
of
that
paper
available.
Now,
as
I
say,
that
is
draft
discuss
with
you,
chair
in
advance.
H
So
if,
if
members
have
any
specific
comments
or
additions
or
amendments
that
that
would
be
very
helpful
to
receive
that
now
and
subject
to
any
changes
that
members
may
wish
to
raise
and
agree,
The
Proposal
is
to
agree
that
that
draft
response
has
the
board's
response
in
order
to
submit
that
to
the
trust
chair
having
to
take
any
questions.
Thank.
A
You
very
much
any
questions,
that's
the
document
and
I'm
I
believe
you
all
have
got
that.
So,
if
there's
anything,
you
would
like
to
say
add
take
out
amend
just
let
us
know:
we've
got
until
the
22nd
Thursday,
but
would
prefer
if
we
can
agree
today,
please,
if
you
do
not
mind
and
don't
you
start
reading
it
now
because
you've
had
it
all
right.
F
A
F
A
D
I
have
lower
comment
is
fine
but
live
across
the
road
with
parking.
So
apart
from
that,
it's
brilliant.
A
H
Yeah,
thank
you
chair,
so
item
10
local
Authority,
Health
Group
need
additional
guidance.
H
H
The
in
June
2022
also
gave
the
commitment
at
that
meeting
to
provide
members
with
additional
guidance
as
and
when
that
became
available
and
back
in
towards
the
end
of
July
and
the
Department
of
Health
and
Social
care
published
a
range
of
guidance,
including
some
guidance
on
health
screening
principles,
the
details
of
which
are
outlined
in
the
paper
chair
and
don't
propose
to
go
through
all
of
the
details.
H
That's
presented,
maybe
just
to
pick
out
a
couple
of
specific
things
to
highlight
so
just
in
in
terms
of
who
the
guidance
is
aimed
at
and
just
in
paragraph
seven
on
page
69.
H
It's
specifically
highlights
that
the
guys
is
the
leaders
from
across
Health
and
Social
care,
I
identify.
They
should
use
the
principles
to
understand
the
importance
of
over
certain
scrutiny,
creating
better
outcomes
for
patients
and
service
users
and
ensure
they're
accountable
to
local
communities.
H
Largely
the
guidance
doesn't
really
affect
the
the
underlying
powers
of
health,
health
and
overuse
Community
committees,
the
one
difference
being
that
the
referral
power
is
is
being
replaced
by
a
power
to
intervene
by
the
Secretary
of
State.
The
details
of
that
I
still
get
to
come
forward
so
that
we
still
are
in
that
intervening
period
where,
where
both
processors
are
allowable,
the
guidance
also
makes
it
very
clear
and
perhaps
the
clearest
it's
been
stated
for
some
time
around.
H
The
changes
to
the
new
models
of
care
are
likely
to
inevitably
I
think
the
guidance
says
chair
lead
to
changes
in
how
and
where
services
are
provided,
except
that
this,
this
guidance
is
has
been
drafted
and
is,
is
prepared
as
National
guidance.
So
there
may
be
some
local
local
flexibilities
and
local
impacts
that
that
need
to
be
reflected
in
that.
But
it's
it's
perhaps
useful
just
to
members
to
be
aware
of
that
specifically,
and
also
the
specific
mention
about
joint
health
scrutiny.
H
So
members
of
this
board
will
be
aware
that
the
a
discretionary
committee
West
Yorkshire
committee
that
was
established
back
in
November
2014
and
that
has
been
in
situ
during
this
intervening
period
until
the
Health
and
Care
Act
was
agreed,
and
so
then
the
guidance
kind
of
emphasizes
that
joint
scrutiny
is
like
to
be
likely
to
be
something
of
of
Greater
significance
over
time.
So
I,
don't
I,
won't
I.
Add
anything
else.
A
A
H
Thank
you
again,
chair
again,
I
won't
go
into
the
report
in
great
detail.
Members
of
I've
had
received
receiver
in
their
information
pack.
The
updated
work
schedule
is
attached
as
appended,
as
is
the
analysis
of
the
potential
work
items
that
was
presented
to
the
consultative
committee
back
in
July.
A
couple
of
things
specifically
to
to
note
the
report
identifies
the
progress.
That's
main
made
around
dentistry
and
bringing
forward
an
item
for
the
ball,
to
consider.
H
There's
no
further
update
to
be
provided,
I'm
still
waiting
for
details
to
come
back
from
any
single
and
done
the
West
Yorkshire
ICB
in
relation
to
that
and
we'll
discuss
that
with
the
chair
and
members
in
due
course,
and
also
the
addition
of
the
concerns
that
help
watch
have
raised
around
access
to
athletentic
services
for
children,
which
again
members
made
reference
to
in
the
pre-meeting.
H
Secondly,
specifically
around
preparations
for
November's
board
meeting
and
which
is
been
identified
to
focus
on
the
workforce
strategy
and
waiting
lists
and
times,
and
some
draft
areas
of
scope
are
presented
for
board
members
to
consider
in
preparation
for
that
meeting.
So
again,
any
specific
additions
or
Amendments
of
that
that
scoping
work
would
be
helpful
and,
last
but
not
least,
chair
just
around
the
mental
health
inquiry
that
was
proposed
by
the
board.
H
The
report
sets
out
a
number
of
developments
that
and
and
strategies
are
in
place
around
mental
health
and
identify
some
of
the
work
that
the
board
has
previously
considered.
So
in
relation
to
that,
rather
than
presenting
some
draft
terms
of
reference
to
the
board,
it's
proposed
to
hold
a
scoping
workshop
with
members
of
the
board
to
discuss
that
in
more
detail
and
specifically
identify
those
areas
where
the
board
may
add
greatest
value.
So
with
that
chair,
I'd,
take
any
comments
or
questions
from
members.
A
I
And
neurodiversity
in
particular,
and
the
barriers
they
face.
Thank
you.
D
G
Sorry,
if
I'm
missing
something
do
we
have
any
attention
of
bringing
in
NHS
partners
and
colleagues
from
across
the
council
and
public
health
discuss
winter
plans
we're
facing
a
very
difficult
win
to
write
across
across
the
country,
so
it
would
be
I
think
it
would
be
wise
for
this
board
to
look
at
what
the
plans
are
across
leads.
H
And
through
the
chair,
thank
you
councilor.
It's
not
specifically
identified
on
on
the
workshead
you're.
Clearly
the
work
schedule
is
the
boards
to
determine
I
guess
the
the
issue.
The
issue
May
well
be
looking
at
the
work
schedule
is,
is
what
the
board
isn't
going
to
do
to
to
to
release
the
capacity
in
order
to
do
that?
Maybe
that's
a
that's
a
discussion
and
decision
for
the
board
chair,
but
but
clearly,
there's
no
there's.
H
G
Obviously,
I
appreciate
the
the
discussion
we
had
around
around
around
the
work
of
the
board
earlier
in
the
year.
However,
I'm
I'm,
just
very
conscious
that
we
are
coming
into
a
very
I,
mean
we've
had
a
very
difficult
few
years
within
across
the
NHS.
More
generally,
I
think
the
very
least
we
could
do
is
perhaps
request
winter
plans
from
from
the
ICB
and
the
main
providers
within
the
city
and
how
they're
tying
in
with
with
the
council.
A
A
So
I
mean
there
are
certain
things
we
can
actually
ask
the
question
and
see
if
that
could
be
added
on
into
the
presentation,
and
we
can
talk
about
you
on
the
day
by
all
means,
because
it's
definitely
very
very
important.
So
thank
you
for
highlighting
that
any
other
questions
or
comments.
Yes,
councilor
Hutchins.
E
Yeah,
it's
just
to
say
that
possibly
the
November
meeting
you're,
looking
at
the
whole
system
impacts
report
on
waiting
lists
and
waiting
times
and
Workforce
strategy.
So
it
might
be
that
there
could
be
a
section
on
the
winter
plans
in
that
meeting
because
it
would
all
tie
in
together.
A
F
Obviously,
that's
something
we
are
welcome,
but
it's
quite
huge,
isn't
it
so
perhaps
that
overlaps
some
of
the
other
work
streams
so,
rather
than
it
being
a
standalone
we're
going
to
become
a
mammoth
City.
It
can
be
linked
up
to
the
other
bits
that
we're
going
to
look
at
throughout
the.
A
Year,
yeah,
definitely
we've
got
councilor
Vena
here
whenever
I
hear
Mammoth,
City
I
just
see
her
face,
so
definitely
I'm
sure
we'll
be
able
to
get
some
input
when
we
come
to
November's
meeting
anyone
else.
A
Oh
wow,
amazing,
okay,
thank
you
very
much
for
all
your
contributions
and
support
today
and
to
all
our
speakers
and
partners
who
have
attended
we're,
truly
grateful,
and
we
have
come
to
the
end
of
our
meeting
today.
You've
got
lots
of
time,
so
no
playing
go
back
to
business
and
we
look
forward
to
seeing
you
all
18th
of
October
is
our
next
meeting.
So
thank
you
all
very
much
truly
appreciate.