►
From YouTube: Leeds City Council - Adults, Health and Active Lifestyles Scrutiny Board - 16th November 2021
Description
No description was provided for this meeting.
If this is YOUR meeting, an easy way to fix this is to add a description to your video, wherever mtngs.io found it (probably YouTube).
A
Okay
good
afternoon,
everyone
and
welcome
today's
to
the
to
today's
meeting
for
adult
health
and
active
lifestyle
scrutiny
board.
My
name
is
counselor
abigail
marshall
cutting-
and
I
am
the
chair
of
the
board-
lovely,
to
see
you
all
again
and
you
will
be
nice
if
we
can
have
a
quick
introduction
just
to
also
let
you
know
that
today's
meeting
has
been
webcast
on
the
council's
website,
so
that
any
interested
members
of
the
public
that
are
unable
to
observe
in
person
will
be
able
to
observe
remotely.
C
C
A
Thank
you
all
very
much
and
thanks
for
coming
harry,
if
you
just
stay
there
and
just
go
through
items
one
to
five
for
us.
Thank
you.
Thanks
check.
B
Under
agenda
item
number
one,
there
are
no
appeals
against
the
refusal
inspection
of
documents
under
gender
item
number
two.
There
are
no
items
for
exclusion
of
the
press
and
public.
Today
under
agenda
item
number
three:
there
are
no
late
items
of
business
under
agenda
item
number
four:
can
I
please
invite
board
members
to
declare
any
interests?
B
A
Thank
you
very
much.
Okay.
Now
to
the
minutes,
I
must
say
I'm
sorry.
I
was
unable
to
be
here
on
the
5th
of
october,
but
to
say
big,
thank
you
to
counselor
scopes,
who
did
a
very
good
job.
I
did
watch
it.
So
thank
you
right
can
I
ask
to
approve,
as
a
correct
record
of
the
minutes
of
the
last
meeting
held
on
the
5th
of
october
2021.
A
A
Okay,
excellent.
Thank
you
right
straight
to
agenda
item
number
seven
so
having
previously
discussed
the
implica
implications
of
the
new
health
and
care
bill
in
context
with
our
board,
we
did
agree
to
maintain
a
watching
brief
regarding
the
development
of
the
local
integrated
care
system.
We're
pleased
to
have
tim
with
us
this
afternoon
and
I
believe
you've
got
a
presentation
for
us
as
well
so
over
to
you
tim.
F
Okay,
thank
you
councillor
and
thank
you
for
the
opportunity
to
come
and
update
you
on
the
work
that's
happening
both
across
west
yorkshire,
but
also
within
leeds.
F
I
think
it's
important
to
say
we're
now
in
a
period
of
stakeholder
involvement
that
runs
through
november
december
and
into
early
january.
Unfortunately,
just
the
timing
issues
that
that
commenced
on
the
8th
of
january
on
the
8th
of
november,
which
was
just
after
the
papers,
would
have
come
out
for
this
board.
F
So
we've
scheduled
the
sort
of
full
and
more
detailed
consultation
on
the
constitution
of
the
integrated
care
board
for
the
january
meeting,
so
the
full
papers-
and
so
on,
will
come
for
that,
but
I
thought
it'd
be
good
to
give
you
a
bit
of
an
update
and
a
sense
of
where
we
are
for
now,
so
just
got
a
few
slides
to
go
through
if
that's
all
right,
angelo
and
okay.
Thank
you.
F
So
we
go
to
the
the
second
slide.
If
that's
okay,
thank
you
so,
and
we
will
obviously
make
sure
that
people
are
aware
of
these.
What
what
this
these
slides
show!
This
slide
is,
if
you
like,
a
bit
of
a
description
of
all
the
nomenclature
and
names
and
things
within
the
ics,
but
also
some
of
the
important
flows
so
they're
at
the
top
right
hand,
corner
you'll
see
that
there
are
health
and
well-being
boards.
F
That's
the
health
and
well-being
boards
of
the
five
places
in
west
yorkshire,
including,
of
course,
the
leeds
health
and
well-being
board
and,
very
importantly,
I
think
the
the
arrows
go
in
two
directions
from
those
boards.
Those
boards
shape
and
inform
the
integrated
care
partnership
at
west
yorkshire,
and
they
inform
the
the
leads
based
equivalent
committee.
F
If
I
talk
a
little
bit
about
the
first
one
which
sort
of
runs
across
at
the
top,
so
the
health
and
well-being
boards
will
play
an
important
part
in
informing
and
shaping
the
strategy
of
the
whole
of
west
yorkshire
and
that
will
be
held
and
owned
by
the
integrated
care
partnership
board,
which
is
the
top
left
on
your
screen,
and
that
board
is
already
exists.
We've
been
meeting
for
a
number
of
years
across
the
ics
in
a
partnership
forum
and
meets
on
a
regular
basis.
F
It
involves
a
multitude
of
partners
both
from
the
nhs
local
authorities,
third
sector,
and
that
will
continue
to
me
and
continue
to
be
chaired
by
council
swift.
Currently
I
have
from
calderdale
and
that
board
sets
the
overall
strategy
and
direction
for
the
partnership.
F
I
suppose,
just
from
a
leads
point
of
view,
let's
not
lose
sight
of
that
important
arrow
from
the
health
and
well-being
board
in
to
that,
because
to
me,
that's
where
the
understanding
and
the
knowledge
that
will
create
the
right
strategy
needs
to
come
from,
and
then,
if
we
keep
going
around
down
to
the
left,
what
you'll
you'll
then
see
is
the
integrated
care
board
and
this
board
will
will
be
if
you
like,
the
sort
of
statutory
body,
the
new
statutory
body
that's
coming
through
in
legislation,
it's
where
the
money
will
go
for
the
west
yorkshire
system
at
least
initially
there's
a
whole
set
of
requirements.
F
Although
I
have
to
say
much
more
permissive
than
many
of
the
previous
changes
in
nhs
legislation
and
that
board's
membership
will
be
made
up
of
representatives
not
just
of
commissioning
but
provision
as
well
and
not
just
of
nhs
people,
but
there'll,
be
a
place
for
local
authority
place
third
sector
on
that
board.
F
That
board
then
will
operate.
We'll
have
a
number
of
statutory,
typical
subcommittees
that
you'd
expect
around
remuneration
and
audit
and
so
on,
which
you
can
see
on
the
bottom
left
there,
but
really
importantly
from
a
leads
perspective,
and
indeed
for
the
other
places
in
west
yorkshire.
F
At
the
same
time,
it
will
be
accountable
for
delivering
the
requirements
that
the
nhs
has
that
we've
set
out
through
our
partnership
strategy
at
west
yorkshire
and
also
importantly,
it
will
take
the
steer
from
the
health
and
well-being
board
on
our
strategy,
as
we
do
now
in
the
nhs
and
and
across
the
whole
city,
at
the
health
and
well-being
board
and
its
strategy.
F
I
think,
in
terms
of
the
consultation,
what
we,
what
all
the
stakeholder
involvement
process
that
we're
going
through
in
the
engagement
that
will
happen
over
through
november
december
and
january.
What
we're
really
looking
at
is
the
constitution
of
that
icb
board
at
west
yorkshire
that
will
be
set
so
again,
a
statutory
requirement
has
a
constitution
and
that
constitution
will
be
made
available
and
also
importantly,
the
scheme
of
delegation.
F
So
those
are
the
bits
that
we
are
effectively
engaging
on
and
we'll
talk
about
in
more
detail
in
january.
At
the
scrutiny
board
that
we,
when
I
come
back
for
that,
so
if
we
go
on
to
the
next
slide
and
then
I'll
that
will
just
take
us
through
a
bit
more
into
leads.
F
So
you
can
see
on
the
right
hand,
side
here
in
the
blue
and
I'm
gonna
deliberately
not
worry
too
much
about
detailed
writing.
But
on
the
blue,
you
can
see
again
that
the
committee
of
in
leeds
the
leads
icb
committee
and,
at
the
bottom
right
hand,
corner
you'll,
see
the
icb
board
and
the
delegation
and
accountability
between
the
two
that
committee
in
many
ways
replaces
the
ccg
governing
body.
F
However,
it
replaces
it
with
a
remark:
a
marker,
markedly
different
membership,
in
that
it
involves
wider
partners,
local
authority,
third
sector
and
also
the
nhs
providers
in
the
city,
whereas
before
the
ccg
governing
body
with
acceptance,
I
think
of
victoria
director
of
public
health,
and
it
was
mainly
made
up
of
independent
members
and,
gps
importantly,
is
the
line
from
the
health
and
wellbeing
aboard
again
fire
its
strategy,
which
should
steer
that.
So
I
think
that's
a
really
important
piece.
F
So,
in
terms
of
where
we've
got
to
with
that
we've,
we've
broadly
agreed
that
architecture
that's
described
there
and
we
are
some
way
on
to
developing
the
membership
of
that.
That
committee,
in
terms
of
where
scrutiny
fits
really
importantly,
scrutiny,
continues
to
look
into
leads
and
do
the
job
you
do
now,
both
with
the
nhs
and
the
local
authority,
and
I
don't
see
in
many
ways
that
that
will
change
people
like
with
me
and
colleagues
sat
here
will
continue
to
attend
on
the
issues
that
affect
leads.
F
Where
I
know
those
conversations
going
on
is
how
the
best
to
manage
those
bits
that
are
managed
at
a
west
yorkshire
level.
We
already
have
that
some
some
joint
arrangements,
but
I
think
it'll
be
important
from
a
scrutiny
board
point
of
view
in
leeds
that
you
will
want
to
hold
the
icb
accountable
just
as
much
as
and
give
that
oversight
just
as
much
as
you
do.
The
arrangements
in
leads,
so
I've
not
drawn
that
on
there,
but
it's
very
much
there,
as
sort
of
I'm
almost
want
to
put
an
arrow
encompassing
all
of
that.
F
F
F
We
very
much
want
healthwatch
to
be
part
of
that,
and-
and
john
has
kindly
agreed
to
be
on
on
that
committee,
and
then
there
will
be
the
leads
partners
which
includes
the
local
authority,
director
of
public
health
as
and
the
director
of
public
health
and
also
nhs
providers,
and
a
representative
of
the
gp
confederation
and
importantly,
the
third
sector,
and
then
there'll
be
some
officers
of
the
ics
who
will
be
leads
based.
F
So
that
will
be
sort
of
me,
probably
redesignated,
a
finance
person,
a
nurse
and
a
medical
officer,
and
there
will
be
an
independent
chair
and
because
one
of
the
important
things
about
this
committee
is
we'll
be
holding
some
of
the
contracts
with
provider.
Colleagues,
and
if,
from
from
a
conflict
of
interest
point
of
view,
it's
really
important
that
the
chair
is
seen
to
be
independent
of
those
providers
and,
of
course
it
will
also
be
able
to
co-op
members
and
make
other
arrangements,
but
I'd.
F
Rather
it
did
that,
rather
than
we
prescribe
ahead
of
time,
where
that
might
be
one
of
the
important
things
we
are
looking
around.
That
is
certainly
at
an
ice
at
west
yorkshire,
icb,
board
level.
We,
we
are
very
keen
that
we
have
someone
from
the
race
quality
network
as
an
attendee,
and
I
think
we
probably
want
to
mirror
something
similar
and
similar
in
leads,
but
those
those
are
still
ongoing
discussions.
F
So,
as
I
mentioned,
a
period
of
period
of
stakeholder
involvement
commenced
on
the
8th
of
november,
that's
around
the
icb
constitution
and
the
scheme
of
delegation
put
the
link
in
there
we'll
clearly
bring
that
back
in
detail
to
the
january
meeting
and
we'll
continue
to
develop.
Those
leads
place-based
arrangements
and
again
share
those
with
you
in
in
detail
for
january.
F
So
yeah
I'll
stop
there.
If
that's
okay,.
A
Thank
you
very
much
tim
before
we
take
questions
or
comments
from
the
board.
Do
you
have
any
contributors
that
would
like
to
say
anything
to
your
presentation,
you're
all
happy
with
what
tim
has
said:
excellent
all
right
to
the
board.
Now,
yes,
dr
bill.
J
J
F
All
right
victoria
may
know
the
answer
better
than
I
do.
Public
health
will
certainly
be
involved
in
the
integrated
care
partnership
and
my
understanding
is
and-
and
it's
set
out
that
they'll
be
on
there
will
be
a
representative
on
the
board
of
the
the
integrity
care
integrated
care
board.
F
How
you
have
a
board,
it's
very,
very
odd.
We
don't
like
the
language.
Any
of
us
have
got
to
be
honest,
calling
an
organization
which
is
what
the
icb
is
an
integrated
care
board
and
then
having
a
board
of
it
as
well
is
just
very
difficult
for
anyone
to
get
their
heads
around.
But,
yes,
public
health
should
be
absolutely
through.
I
don't
know
victoria
if
you
want
to
add
to
that.
G
Yeah,
just
very
briefly,
that's
also
my
understanding,
john,
that
there
will
be
a
a
kind
of
a
place
around
the
table
for
a
public
health
kind
of
colleague
at
west
yorkshire
level,
but
the
the
the
detail
of
how
the
the
detail
of
that
and
the
links
to
the
rest
of
the
system
I
understand
are
yet
to
be
worked
out.
I'll.
Just
I'll.
G
Just
add
that
we
did
have
some
conversations
with
west
yorkshire
ics
colleagues
last
week
to
try
to
look
at
how
on
earth
does
this
work
with
the
public
health
system?
And
how
can
we
be
quite
proactive
around
that
in
west
yorkshire,
so
they
were
really
fruitful
conversations.
G
We
we
have
a
workshop
in
january
to
to
to
work
through
more
of
that
nobody's
cracked
this
nationally.
So
I
think
we
are
my
senses
and
my
understanding
is
we're
ahead
of
the
game
and
having
those
conversations
in
west
yorkshire,
but
the
we
need
to
work
that
through,
I
think
in
general.
What
we
felt
is
that
the
we've
got
a
really
good
public
health
system
that
works
from.
G
You
know
very
local
localities
right
through
to
leads
level
and
then
right
through
to
a
regional,
yorkshire
and
humber
level,
with
the
new
public
health
arrangements
around
uk
health
security
agency
and
and
and
the
new
post-phe
arrangements.
But
the
bit
that
feels
less
developed
is
the
west
yorkshire
part
of
that,
so
because
it's
just
because
it's
so
very
new,
so
all
five
west
georgia,
public
health
directors
of
public
health
are
actively
involved.
G
In
those
conversations,
we're
we're
all
we're
all
very
keen
to
make
sure
that
we
get
that
right
in
terms
of
that
two-way
relationship
with
with
us
as
place
as
well.
So
we're
really
invested
in
in
that
next
step
of
those
conversations,
and
so
so
it
feels
very
positive,
but
the
details
not
there
yet
john,
but
appreciate
your
question.
Thank
you.
D
Thank
you,
madam
chairman,
in
the
sort
of
opening
few
words
of
your
presentation,
you
said
nothing's
going
to
change.
F
F
F
So
it's
not
that
the
there
will
be
no
change,
but
I
think
in
terms
of
on
the
ground
and
the
kinds
of
decisions
that
we
will
make
in
leeds
and
the
conversations
that
we
would
have
at
many
of
our
partnership
forum,
which
are
both
mix
of
sort
of
boards
and
other
groups
and
meetings
across
the
city.
Those
things
will
continue
to
run
continue
to
be
funded.
F
An
example
might
be.
The
ccg
is
a
sort
of
key
funder
of
the
the
academic
health
partnership
and
you
might
envisage
well
okay,
the
ccgs
disappearing
where's
that
funding
going
well.
The
funding
will
carry
on.
I
mean
these
academic
health
partnerships
will
continue
to
exist,
funded
through
the
nhs
and
the
council
and
the
universities
in
partnership.
F
So
I
think
at
that
level
we
will
not
need
to
change
anything
significantly
now.
What
we
might
choose
to
do,
as
leads,
is
continue
to
evolve
and
develop
those
things,
but
it
goes
back
to
west
yorkshire
has
been
operating
more
or
less
in
this
kind
of
way.
Now,
for
quite
a
while
is,
is
an
exemplar
model
of
how
the
ics
legislation
is
envisaged.
A
Are
you
okay,
counselor
gibson.
K
Thank
you
chair.
I
think
dr
beale
sort
of
sort
of
asked
my
question
and
then
the
answer
may
be
that
there
is
a
place
for
public
health
on
the
west
yorkshire
board.
But
I'm
going
to
ask
the
question
anyways
to
be
a
little
bit
more
explicit.
So
having
read
through
the
acts,
there's
a
it
says,
there's
a
duty
to
our
regard
to
the
need
to
reduce
inequalities
between
patients
and
as
part
of
that
I'll
quote,
to
promote
integration.
K
Now
it's
my
understanding
that
actually
there's
not
really
that
much
of
a
change
in
terms
of
how
this
spill
has
been
written
between
the
the
06
nhs
act
and
the
the
2012
health
and
social
care
act,
so
those
that
sort
of
provisions
always
has
been
there
for
with
us
for
a
long
time.
But
my
question
is:
is
there
a
new
emphasis
now
given
the
context
in
which
this
legislation
was
written
and
therefore,
given
the
spirit
of
the
act
work
more
closely
with
housing,
public
transport,
education,
etc
to
reduce
health
inequalities?
K
And
I
think
it's
worth
it's
worth
saying
as
well,
that
this
bill,
it
seems
to
seems
to
me
to
miss
an
opportunity
to
be
explicit
in
its
recognition
and
encouragement
of
the
of
the
wider
role
of
the
nhs
to
play.
It's
to
play
a
role
as
as
anchor
institutions
and
and
what
I
mean
by
that
is
the
the
nhs
agencies
due
to
their
size
and
scale
and
rootedness
in
their
communities,
could
and
ensuring
should
potentially
influence
social
and
economic
and
environmental
factors
that
shape
health
inequalities.
K
F
Thank
you,
councillor,
gibson,
really
helpful
question.
There
is
a
different
spirit.
I
I
struggle
when
I
read
the
legislation
to
tease
out
whether
the
spirit
that
is
feel
it
definitely
feels
different
in
leeds
in
west
yorkshire,
as
a
leeds
in
west
yorkshire
feel
or
whether
it's
really
there
at
the
heart
of
the
legislation.
F
F
F
I
think
I
know
we're
starting
to
do
some
of
that
work
in
quite
a
lot
of
detail
and
the
anchor
institution
programming
leads
is
good
and
you
know
well-known
nationally
and
something
I
I
would
want
us
to
really
press
on
with
so
yeah
absolutely
support
support.
Your
comments
probably
is
a
bit
of
a
missed
opportunity.
A
L
It
thanks
chair
thanks
tim
mine's,
just
a
very
brief
question.
C
I
know
you
touched
on
the
amount
of
involvement
by
external
boards
and
third
sector.
I
just
wonder
with
this
framework
how
much
the
decision
making
in
terms
of
funding
allocations
and
procurements
is
actually
changing.
So
is
it
going
to
become
more
of
a
kind
of
top-heavy.
F
F
So,
in
terms
of
where
sort
of
contracts
and
big
decisions
about
the
money
are
made
at
the
meri
at
the
moment,
in
a
sort
of
formal
legal
sense,
the
money
come,
the
nhs
money
comes
through
to
the
ccg
and
the
ccg
will
sign
off
its
budgets
and
so
on
for
the
year
ahead,
and
indeed
have
a
medium-term
investment
plan.
F
Sat
behind
that
in
the
new
world,
the
people
who
will
be
signing
off
those
budgets
is
that
broader
coalition
of
members
on
that
that
list
that
I
put
up,
which
includes
the
third
sector
in
a
way
they're
not
on
the
on
the
current
ccg
board,
it
includes
local
authority,
includes
the
nhs
providers.
I
think
that
gives
us
huge
opportunities
to
look
at
the
totality
of
the
picture.
There's
some
challenges
in
there
competitive,
but
we
we.
F
It
is
the
right
direction
and
it
is
building
on
what
we've
already
been
doing
in
leeds.
So
once
formally,
the
ccg
sets
that
budget
behind
the
scenes.
The
work
between
officers
is
to
go
around
and
talk
to
everybody
and
try
and
set
that
in
a
in
a
collegiate
way,
so
that
we
aren't,
we
aren't
sort
of
scrapping
over
the
pennies,
which
has
been
working
really
well
in
the
last
few
years.
So
this
to
me
is
the
next
step
on
that,
and
it
is
coming
to
leads
most
of
that.
F
A
Thank
you
very
much,
councillor
gibson
and
then
victoria.
Thank
you.
K
You've
sort
of
answered
it
tim
really.
I
mean
the
legislation
says
that
the
icb
only
has
to
have
regard
for
the
icp.
Doesn't
it
so
it's
all
about,
as
regard
to
sorry,
have
to
have
regard
in
terms
of
the
strategies
of
the
itp
being
formed
by
that.
So
it's
very
loose.
K
Isn't
it
the
term
and
it's
all
about
leadership,
but
you
you've
sort
of
answered
it
in
the
sense
that
there's
an
opportunity
within
the
constitution,
the
form
formation,
the
constitution
for
the
itb,
to
sort
of
have
to
to
enshrine
that
they
that
we
do
pay
more
than
just
lip
service
to
to
to
the
icp.
But
it
sounds
like
that's
what
you're
you're
looking
the
direction
that
you
go
in
with
the
constitution
anyway,.
F
Yes,
yeah,
certainly
west
yorkshire
is
really
keen
that
we
don't
pay
lip
service
to
that
partnership
forum,
which
is
the
icp
and
a
little
little.
There
are
some
sort
of
small
examples
of
that.
We,
whilst
we
can't
make
the
chair
of
that
board
a
member
of
the
icb
board
in
our
constitution,
we
set
out
there'll,
be
a
formal
attendee,
which
I
think
in
itself
says
a
lot
about
our
intention.
F
At
the
same
time,
we
are,
we
are
building
on
what
we've
been
doing
for
two
three
four
years,
where
that
strategy
that
we
set
at
a
west
yorkshire
partnership
level
with
its
ten
high,
it
changed
the
most
important
changes
and
priorities
are
going
to
are
going
to
be
enshrined
almost
enshrined
within
what
we
do
and
tracked
by
the
board.
So
the
board
will
take
those
from
the
partnership
and
track
them
routinely
and
ask
leigh's
to
track
its
version
of
the
wake
fields
and
so
on.
F
So
I
I
believe
west
yorkshire
has
got
the
approach
right.
We
can
test
that.
We
need
to
test
it,
but
we
are
in
a
probably
a
much
better
place
because
of
what
we've
done
already
than
some
other
places.
Where
that
it
may
well
be
lip
service-
and
I
you
know,
I
think
it's
true
of
the
health
and
well
being
board
in
leeds
as
well,
that
we
don't
pay
lip
service
to
it,
we're
all
very
committed
to
proving
the
health
of
the
poorest
fastest.
F
You
know
those
things
matter
to
us
all
that
isn't
the
case
in
other
places.
In
england,
I've
worked
out
in
the
past.
So
let's,
let's
keep
hold
us
to
that,
because
that's
the
important
challenge
and
it's
absolutely
essential
if
we
to
succeed
for
the
people
of
leeds
and
west
yorkshire.
More
generally.
G
Thank
you
chair.
I
just
wanted
to
add
a
comment
to
echo
what
tim's
emphasised
around
local
leadership
around
the
health
inequalities
question
counselor.
I
think
it's
absolutely
the
right
question
and
it's
it's
been
a
conversation
that
we've
had.
G
You
know
intensively
over
the
last
few
months
about
how
we
make
sure
the
health
inequalities
work
that
we
want
to
happen
across
the
city
and
across
west
yorkshire
is
enabled
by
the
new
arrangements
and
as
as
tim's
described,
that
actually
doesn't
come
through
specifically
enough
in
the
legislation
it
it
will
come
from
local
leadership
and
commitment.
G
So
I
think
that
we've
got
a
real
opportunity
to
to,
as
leaders
make
sure
that
this
happens
locally
and
we
what
we
one
of
the
things
we
really
want
to
do
is
join
up
the
the
great
work
that
nhs
colleagues
are
doing
around
their
healthcare
contribution
to
addressing
health
inequalities,
which
is
one
of
the
green
boxes
that
was
on
them.
G
So
we
we've
we've
had
a
lot
of
local
conversations
about
absolutely
being
committed
to
that,
and
also
the
relationship
with
health
and
well
being
board
with
that
central
commitment
to
in
improving
the
health
of
the
poorest,
the
fastest.
G
The
relationship
to
the
board
and
how
we
continue
to
strengthen
that
is
is
something
that
will
come
from
ourselves
as
local
leaders
and
and
just
to
assure
the
board
that
you
know
that's
at
the
center
of
all
of
our
thinking
and
planning
the.
But
it
doesn't
happen.
It
doesn't
happen
by
default.
It
happens
and-
and
I
think
the
fact
that
you've
raised
it-
and
this
board
has
raised
it-
you
know
is-
is
absolutely
right,
because
we
need
to
be
held
to
account
for
that.
G
I
think
the
final
thing
to
say
that,
as
a
west
yorkshire
system,
the
conversations
have
also
been
very
supportive
around
those
wider
determinants
of
health
and
the
role
of
the
the
west
yorkshire
organization
there.
So
there
is,
there
is
a
public
health
team
at
west
yorkshire
in
the
in
that
in
the
ics,
which
is
why
just
going
back
to
the
conversations
I
said
we
had
last
week,
we
need
to
really
work
out.
Who
does
what
and
how
that
best
works
across
us
in
the
new
arrangements?
G
A
Thank
you
very
much
victoria
for
reassuring
us
sorry.
We
will
have
to
stop
there
on
this
particular
item,
but
I
would
like
to
highlight
that
the
scrutiny
board
will
actually
be
focusing
our
january's
meeting.
We
will
be
formally
considering
and
sharing
the
views
of
the
ict
constitution,
as
well
as
the
leads
place-based
arrangements
as
part
of
the
wider
consultation
process,
so
that
will
be
in
january
of
2020
to
well
after
you've
all
had
a
very
good
christmas,
so
tim,
we
will
be
inviting
you
back
if
that's
all
right.
A
A
So
within
your
agenda,
pack
is
a
briefing
paper
that
has
been
produced
in
liaison
with
partners
across
the
local
health
and
care
system,
and
this
presents
a
further
update
on
the
current
understanding
of
the
system.
Impact
of
the
covet
19
pandemic
in
leads,
as
well
as
providing
an
insight
to
the
response
plans
and
measures
that
are
in
place
too.
So
I
believe
helen
is
here,
hi
helen.
How
are
you
good
over
to
you
now.
L
Thank
you
so
much
counselor.
Thank
you
for
inviting
me
I'd
like
to
thank
particularly
neil
mcguire
from
our
health
partnerships
team
who
has
pulled
together
the
paper
I
think
a
briefing
paper
is
probably
a
misnomer
for
a
paper
of
this
size
and
apologies,
because
it
is
quite
diverse
and
disparate.
I'm
delighted
to
welcome
some
colleagues
here,
cats
here,
fiona's
here,
sam,
prince
and
claire
smith,
so
we
will
do
our
best
to
answer
questions.
L
If
the
questions
we
can't
answer
will,
of
course,
come
back
to
the
board.
I
suppose
I
just
wanted
to
give
a
brief
introduction.
L
L
There's
some
good
news
in
that.
We
are
now
recovering
some
of
the
capacity
in
some
of
the
areas,
and
indeed
there
were
more
outpatient
appointments
in
general
practice
in
september
than
there
were
before
the
pandemic
and
that
our
capacity
and
outpatients
diagnostics
also
picked
up.
But
we
need
to
be
aware
of
the
continued
gaps
in
workforce
and
the
impact
of
social
distancing
on
the
numbers
of
patients
that
can
be
safely
seen
in
any
of
those
settings.
L
Outflow
from
hospital
remains
a
significant
concern
and
I'm
sure
that
catherine,
I
will
touch
on
that
afterwards.
Social
care
workforce
we've
touched
on
in
this
report,
but
cap
again,
is
now
leading
some
very
intensive
work
across
the
city
on
on
workforce.
We
might
want
to
pick
some
of
that
up
important
to
note,
I'm
not
sure
it
comes
out
in
the
paper
that
pressures
across
particularly
acute
mental
health
services
also
continue
to
be
significant,
particularly
among
female
patients
and
acuity,
not
just
volumes.
Sometimes
the
numbers
of
admissions
don't
show.
L
What's
behind
it,
so
a
number
isn't
a
number.
A
number
of
people
come
through
any.
Actually,
the
numbers
of
admissions
have
come
down,
but
the
sickness,
the
way
in
which
those
people
are
presenting
increases
their
length
of
stay
and
their
needs.
L
There
is
an
element.
There
is
a
section
here
around
dental
services
provided
by
nhs,
england,
colleagues,
I'm
going
to
preempt
the
questions
and
just
remind
colleagues
that
we're
not
the
commissioner
for
dental
services.
I'm
really
pleased
that
we've
been
able
to
include
something-
and
I
know
emma-
has
offered
to
come
back
to
talk
about
any
of
that
in
more
detail.
L
So
I
think
those
were
the
the
kind
of
introductory
comments
I
wanted
to
make.
I
don't
know
catholic
fiona,
whether
I'm
sure
that
fiann
will
provide
an
update.
I
think
the
other
thing
about
these
papers
is
the
minute
we
finish
them.
Something
changes
so
very
conscious
that
three
weeks
ago
this
was
the
position
so
there's
some
slightly
better
covered
news,
which
we
might
let
fiona
brief
you
on
and
then
victoria
god,
I'm
sorry
it's
a
it
was
a
compliment,
I'm
so
sorry
to
be
one
of
those
weeks.
L
I
do
know
what
I'm
doing
really
so
victoria
may
be
able
to
update
on
that
and
I'm
sure
that
cath
will
pick
up
other
issues.
So
that's
probably
enough
for
an
introduction
and
leave
it
to
you
too.
A
I
I
just
wanted
to
make
some
overall
comments
on
the
paper,
but
I'm
happy
for
victoria
to
go
for
next.
If
that
fits
better
okay.
G
Well,
I'm
more
than
happy
just
to
give
a
very
brief
narrative
on
where
we
are
today
in
terms
of
the
the
covid
position.
Obviously
it's
very
live.
I
mean
I'm
just
flicking
through
the
latest
notes,
the
so
in
overall
terms,
you'll
have
seen
I'm
sure
from
the
national
press.
The
sort
of
that
rates
have
dropped
slightly
over
the
last
week,
nationally,
but
obviously
from
a
very
high
base.
So
we've
still
got
very
high
levels
that
have
fallen
over
the
last
week
or
so,
and
the
position
in
leeds
is
relatively
positive.
G
G
We
don't
know
exactly
what
will
happen
there,
but
but
in
leeds,
where
we've
we've
gone
under
300
now
for
our
overall
city
rate,
which
is
very
positive
compared
to
where
we've
been
over
the
last
month,
we,
the
the
the
critical
rate
in
our
over
60s
population,
has
fallen
even
further
so
that
that
was
down
by
30
37
on
seven
week,
average
last
night,
which
is
great
to
see.
G
Obviously,
that's
that's
the
rate
wiki
particular
eye
on
in
terms
of
pressures
into
the
nhs
system
and
and
most
severe
health
risk
and
we're
in
a
more
positive
position
than
the
rest
of
yorkshire
and
humber
on
both
those
rates
at
the
moment,
so
our
rates
are
lower
for
both
over
60s
and
over
70s,
actually,
as
well
as
the
general
population
compared
to
the
rest
of
yorkshire
and
humber,
and
also
compared
to
the
national
england
average
at
the
moment.
G
So
as
a
city,
even
though
we
can
never
be
complacent
rates
are
still
high,
they
have
fallen
most
more
steeply
than
the
other
parts
of
the
country
and
obviously
all
of
this
plays
directly
into
pressures
on
our
nhs
colleagues.
So
we
can.
G
We
can
very
accurately
predict,
with
the
the
time
lag,
when
those
rates
in
communities
with
around
a
two
week
lag
then
then
present
to
to
increase
demand
in
in
the
hospital,
particularly
and
so
again,
I'm
sure
colleagues
will
will
go
on
to
explain
that,
even
though
the
the
the
covid
position
is
still
higher
than
we'd
like
and
still
there
in
in
in
local
nhs,
it's
it's
it's
not.
The
numbers.
Aren't
what
they
were,
because
we've
seen
this
rising
the
the
reduction
in
community
infections?
G
So
so
at
the
moment
it
looking
is
looking
more
positive,
the
the
the
projections
ahead.
We
get.
We
get
projections
ahead
for
the
next
set,
it's
a
78-day
projection,
which
obviously
is
as
far
as
the
modelers
can
can
stretch,
and
that
suggests
again
that
downward
trend
both
in
terms
of
rates
and
also
in
terms
of
the
the
hospital
numbers.
G
G
There's
a
huge
sort
of
range
of
other
pressures
that
are
coming
through
that
colleagues
and
will
describe,
but
but
every
covid
case
we
can
prevent
and
and
and
keep
out
of
the
system
is
helpful
to
support
the
overall
pressures
in
in
the
hospitals
and
the
rest
of
the
nhs
and
obviously
the
other
thing
we
keep
a
close
eye
on
is
other
respiratory
infections,
and
particularly
flu
at
the
moment,
there's
very
little
evidence
of
flu
with
us.
It's
not
hit
yet
obviously
the
later.
G
That
is
the
better
and
because
it
means
we
can
get
our
covered
cases
down.
As
far
as
we
can
before
we
see
any
flu,
and
we
hope
that
flu
will
be.
You
know
at
a
manageable
and
minimal
level,
which
is
why
obviously,
the
the
flu
immunisation
campaign
is
as
critical
in
terms
of
take
up
as
the
covid
vaccination
campaign
at
the
moment,
so
that
I'll
leave
it
there.
G
I
Yeah,
I
just
wanted
to
take
some
overall
comments
on
the
paper
and
how
various
strategies
that
we
have
across
the
council
and
across
the
city
are
responding
to
the
fact
that
we're
in
this
context
of
of
the
global
pandemic.
So
obviously
the
paper
outlines
a
huge
range
of
impacts
and
I
think
it's
really
helpful,
where
it
demonstrates
the
four
waves
showing
the
impact
across
time
and
in
another
in
a
number
of
areas.
So
the
paper
refers
to
mental
health.
I
We've
obviously
got
the
all-age
mental
health
strategy
and
future
in
mind,
which
is
the
young
people,
children,
young
people's
mental
health
and
well-being
strategy.
I
chair
the
future
of
mind
board
and
it
was
timely
that
the
strategy
was
due
to
be
refreshed
anyway,
so
it's
been
newly
refreshed
this
year
very
much
in
the
context
of
covid
and
what
that
means
for
children,
young
people's
mental
health
and
well-being
and
for
the
pressure
on
services.
I
The
the
paper
first,
the
joint
strategic
assessment,
which
is
obviously
really
key
in
terms
of
that,
will
give
us
the
evidence
we
need
to
know
where
we
need
to
direct
resource
and
energy
of
over
the
coming
years,
and
also
keeping
the
experience
of
people
in
receipt
of
services
and
in
our
communities
and
in
our
grassroots
organizations
that
are
serving
those
communities
very
centrally.
I
So
the
allyship
programme
is
referred
to
briefly,
I
think,
which
is
where
each
member
of
the
health
and
wellbeing
board-
and
this
is
very
senior
people
like
tim's
on
the
health
and
well-being
board.
Chief
executive
teaching,
hospitals,
trust,
lpft,
lch.
Every
board
member
is
paired
with
a
small
third
sector
organization.
That's
delivering
work
with
communities
that
are
facing
health
inequalities,
so
I'm
paired
with
gates
at
the
gypsian
traveler
exchange,
for
example.
I
So
that's
giving
us
all
really
direct
experience
of
organizations
that
are
serving
our
most
disadvantaged
communities
in
the
city
and
that
will
inform
our
planning
going
forward.
Obviously,
the
workforce
crisis
is
a
is
a
is
a
massive
issue
and
kathmandu
talk
about
that
in
more
detail,
but
it
is
ultimately
about
the
fact
that
we're
losing
staff
to
hospitality
and
retail
and
you
know-
can't
compete
with
their
salaries
and
we've
had
meetings
across
the
systems.
I
Look
at
how
we
address
this
because
it's
a
crisis
now
we're
not
in
winter,
yet,
okay,
those
are
those
my
introductory
comments
chair.
Thank
you.
Thank
you.
Councillor.
C
You
chair,
I
I
just
wanted
to
talk
a
little
bit,
because
the
report
does
talk
a
little
bit
about
the
vaccine
uptake
and
we
know
health
and
why
the
inequalities
have
been
exasperated
by
the
pandemic,
particularly
more
deprived
communities,
and-
and
I
guess
what
I'm
trying
to
say
is.
Whilst
we've
done
a
great
amount
of
work
with
the
vaccine
program
and
we've
made
some
really
good
inroads,
there
are
still
communities
that
we
have
got.
The
uptick
is
is
lower.
C
I
mean
I'm
just
going
to
give
an
example,
I
went
to
get
my
booster
done
at
the
local
walking
center
and
I
bumped
into
an
old
neighbor
who's
about
the
same
age.
As
my
mum
and-
and
I
said,
oh
hello,
you
know
it's
good
to
see
you
here.
Have
you
come
for
your
booster
and
she
said
no.
I've
come
for
my
first
dose.
So
what
that
tells
you
is
it's
really
important
that
we
are
still
in
those
communities,
because
there
are
people
that
are
coming
in
for
their
first
dose?
C
So
I
think
we've
got
to
still
bear
in
mind
that
we've
got
to
continue
doing
all
the
work
that
we're
still
that
we
have
been
doing
and-
and
we
can't
leave
these
communities
that
we
know
are
most
impacted
by
coverage
behind.
So
I
think,
from
my
perspective,
as
exact
member
and
and
from
what
I
hear
the
rap,
the
appetite
is
very
much
still
there
that
we've
got
to
continue
with
that
piece
of
work
and
it
has
to
carry
on
when's.
C
A
E
Yeah
I'd
be
fascinated
to
hear
more
around
where
the
groups
are
that
are
having
resistance
to
you
know,
taking
up
first
or
second
or
even
tertiary
vaccines.
You
know
is,
is
that
education?
Is
it
religious,
the
cultural
or?
Is
it
a
whole
mix
of
different
things
that
are
causing
that
you
know
if
you're,
if
you're
struggling
with
other
aspects
of
your
life,
maybe
the
vaccine
isn't
isn't
the
top
of
the
topic
of
priorities
of
it?
E
I'd
be
curious
to
understand
that,
because
I
you
know,
I
think
many
of
us
kind
of
that
do
facebook
see
you
know
there
is
a
stuff,
I
see
quite
still
quite
a
strong
wild
class
as
anti-backs,
which
is
you
know
the
whole
kind
of
well.
Let's
not
discuss
it
here,
but
you
know
the
the
the
misinformation
that
gets
peddled,
but
I
don't
necessarily
think
that
that's
necessarily
the
same
case
across
the
piste
one
follow-up
question
it
it
was
mentioned
that
leeds
is
doing
actually
better
with
rates
overall
at
the
moment.
E
Is
that
because
we
had
a
peak
earlier
on
or
our
cases
overall
across
across
a
consistent
period?
Better,
that's
all
thanks.
G
You
want
me
to
pick
up
on
that
those
I
can
start
on
both
of
them,
but
I'm
happy
for
those
to
come
in.
G
So
in
terms
of
our
position
now
in
relation
to
other
areas,
I
mean
that
this
there's
likely
to
be
it's
likely
to
be
a
combination
of
many
things
and
there's
people
disagree
on
the
analysis
of
why
I'm
sure
you'll
appreciate,
I
think
I
mean
there's
something
really
interesting
happening
at
the
moment
with,
if,
if
we
look
to
cut
very
local
area
maps
of
the
of
the
places
with
the
highest
rates,
what
what
you
generally
see
now
is
almost
an
inverse
of
what
you
saw
earlier
on
in
the
pandemic.
G
So
earlier
on,
it
was
higher
in
you
know:
dense
more
deprived
inner
city
areas.
It
was
really
high.
G
I
mean
if
people
remember
last
last
october,
when
we
hit
the
highest
place
in
the
country
with
headingley,
with
our
student
population,
with
with
the
rate
there,
so
those
groups,
so
our
19
to
24
year
old
adults
are
currently
the
very
lowest
cohort
with
for
infection,
probably
because
most
of
them
have
had
it
or
they've
either
had
the
job
or
have
the
virus
or
both,
and
similarly
with
those
communities
who
were
kind
of
exposed.
G
Very
early
on
immunity
is
higher
than
people
in
more
affluent
areas
who
have
worked
from
home
so
far
been
less
exposed.
So
we've
got
this
kind
of
strange
thing
happening
at
the
moment
where
the
communities
who
haven't
had
it
so
far
are
looking
really
high,
but
that
will
settle
down
as
the
immunity
works
through.
G
So
I
think
at
the
moment,
because
leeds
is
a
pretty
young
city
and
the
rate
in
that
young
adult
the
group
is,
is
the
lowest
it
kind
of
it
plays
out
in
our
demographics
that
we
are,
you
know,
other
other
core
cities,
with
a
lot
of
university
students,
sort
of
mirror
the
same
pattern.
G
Having
said
that,
I
I
think
that
another
factor
for
us
in
leeds
is
partly
about
our
response
and
the
fact
that
we
still
have
an
incredibly
robust
response
on
the
ground.
G
We've
we've,
never
in
the
city
had
a
large
outbreak
of
the
scale
that
many
other
neighbours
have
had
in
a
big
factory
or
work
workplace
that
forever,
because
we
have
a
brilliant
infection
control
team
that
that
is,
you
know,
is
preventing
and
managing
outbreaks
on
very
early
cases
and
in
our
schools,
currently
we're
in
a
much
better
position
than
other
places
with
higher
numbers
of
school
cases
and
outbreaks,
because
we
have
teams
out
there
risk,
assessing
and
advising
all
of
our
lead
schools
and
not
everywhere,
has
the
capacity
to
do
that.
G
So
I
think
it
partly
reflects
our
demography,
but
also
reflects,
as
counselor
area
has
described,
that
that
approach
that,
from
the
beginning,
we've
we've
been
really
focused.
On
prevention,
we've
been
very
targeted
on
the
the
groups
that
need
it
most,
so
I
think,
and
that
still
goes
on
today,
teams
are
out
there
doing
that
today
to
keep
the
rate
low.
G
So
it's
probably
a
combination
of
all
of
those
things
and
I'm
sure
councillor
for
sam
will
come
in
on
the
which
groups,
but
I
mean
in
very
broad
terms-
and
we
can
certainly
share
some
more
detail
on
this,
with
the
scrutiny
board.
If
you're
interested,
we
have
a
group
that
meets
fortnightly
every
other
thursday
called
the
nobody
left.
G
No
one
left
behind
group
which
looks
at
vaccine
inequalities
across
the
city,
and
we
we
get
very
granular
local
data
on
exactly
which
age
groups
which
people
from
different
ethnic
backgrounds,
which
parts
of
the
city
etc
have
to
have
taken
up
the
vaccine.
So
we
we
can.
We
can
really
track
that
very
closely
and
it's
quite
detailed
information
that
we
we
can.
G
We
can
certainly
share
that
with
the
board,
broadly
speaking,
that
that
there's
a
there's
a
declining
uptake
in
terms
of
age,
so
someone's
got
a
brilliant
slide
that
the
further
you
go
down
the
age
groups,
the
the
lower
the
percentage
of
take
up.
We
know
that
in
our
deprived
communities,
there's
a
lower
take-up
than
in
our
more
affluent
communities
and
also
and
where
we
have
more
and
ethnically
device
diverse
communities,
there's
a
lower
take-up
than
with
predominantly
white
british
populations.
G
A
Much
yeah
that
would
be
very
helpful.
I'd
really
love
to
see
those
that
data.
Thank
you
counselor
latte
and
then
dr
bill
and
then
counselor
anderson.
D
We
are
so,
I
believe,
heading
towards
the
pandemic,
changing
into
endemic,
and
the
only
comparison
that
most
of
us
have
is
with
influenza.
D
D
I
know
that
this
pandemic
is
new,
so
to
speak,
but
should
there
not
be
more
effort
to
make
us
regarded
as
something
that
we
are
all
of
us
working
towards
making
endemic
so
that
we
can
all
every
year
shot
along
again
then
get
two
jabs
and
carry
on
with
our
lives,
which
would
reduce
what
has
been
quite
a
quite
a
serious,
psychologically
psychological
effect
on
an
awful
lot
of
people.
D
The
fact
of
this
this
thing
sitting
on
our
shoulder
waiting
to
pounce
when
in
actual
fact-
or
this
is
how
I
see
it
from
what
I
read
influenza-
isn't
that
far
behind
it
in
terms
of
danger
to
particularly
to
old
people.
So
could
you
give
me
something
sort
of
reassuring
on
that
or
the
fact
that
you
know
we
are
thinking
of
moving
this
way
that
we
do
want
to
get
people
thinking
this
way,
or
am
I
just
living
in
cloud
cuckoo
land.
G
Would
you
like
me
to
start
on
that
one
I'm
happy
for
colleagues
to
come
in.
I
don't
know
if
someone
might
want
to
say
something.
So,
yes,
you're
right,
council,
latte
that
you
know
there
is
a
lot
of
flu
deaths
every
year
and
they
don't
get
reported
in
the
same
way
that
the
kova
deaths
do
and
on
the
evening
news
every
night.
So
it's
much
less
visible
to
people
and
one
of
the
things
that
certainly
we
would
always
say,
and
certainly
on
a
national
level.
G
The
chief
medical
officer
would
always
say
is
that
the
the
true
figure
of
of
the
impact
of
the
pandemic
is
looking
at
the
the
excess
deaths
from
all
causes.
G
You
know
it's
that,
28
days
after
a
covered
positive
covered
tests,
it
doesn't
necessarily
mean
primarily,
the
coverage
was
primary
cause
of
death,
etc
and,
from
a
registrar
point
of
view,
the
definition
is
wherever
covert
is
mentioned,
on
the
death
certificate,
it's
counted
as
cover
death,
so
there's
all
sorts
of
nuances
around
numbers
and
how
we,
how
we
define
them,
but
so
I
think,
there's
something
about
us,
keeping
as
a
system
a
really
close
eye
on
the
overall
excess
deaths
which,
thankfully
from
because
we
get
this
every
day
and
thankfully,
is-
is
now
dipped
below
the
five-year
average.
G
It
was
way
above
as
a
measure
of
how
how
it's
hitting
our
whole
population.
So
I
think
that's
that's
something
and
I
think
your
point
around
I
mean
obviously
moving
from
pandemic
to
endemic.
G
As
we
know,
there
is
a
lot
of
talk
about
how
we
we
learn
to
live
with
the
virus,
and
you
know
the
fact
that
we're
here
today
is
a
as
an
example
of
that
about.
You
know
how
we
all
kind
of
maybe
don't
go
back
to
the
normal
that
was
before,
but
but
think
about
ways
that
you
know
life
goes
on.
Education
goes
on
with
with
measures.
Work
goes
on
with
different
measures,
and
so
I
think
that
it
feels
like
the
territory
we
are
in,
I
mean.
G
Obviously,
the
unknowns
for
the
future
are
potentially
around
new
variants
that
may
come
in,
that
may
have
vaccine
escape
and
then
actually
the
vaccines
that
we
have
won't
do
the
job
for
next
year
and
but
but
that's
you
know,
I
think,
in
terms
of
the
planning
for
the
different
scenarios.
You
know.
G
That's
all,
that's
that
feels
like
that.
There's
a
there's,
a
sense
of
the
fact
that
kovid's
still
with
us
it's
moving
to
more
endemic
levels.
We
we
can't
predict
it,
but
we
need
to
get
ready
for
how
that
virus
may
change
over
time,
but
actually
that
needs
to
run
in
alongside
a
lot
of
other
business
as
usual
for
all
sorts
of
other
health
issues
that
are
that
are
hitting
us
as
a
city
and
as
a
as
a
as
a
country.
So
I
I
do.
G
I
think
that
is
my
sense
of
where
we
are
that
this
has
completely
overtaken
all
of
our
lives
for
the
last
20
months,
and
now
it's
still
with
us,
but
but
there's
a
balance
of
how
we
manage
it.
Alongside
everything
else,
we
have
to
manage
and,
and
I'm
sure
health
colleagues
would
you
know,
support
the
whole
thing
about
kobe,
just
being
one
one
element
of
the
pressures
so
I'll
leave
it
there.
Thank
you.
B
So
I
pick
up
so
we're
already
planning
now
for
next
year
and
business
of
business
as
usual
will
be
two
vaccinations
for
covered
and
for
flu.
That's
exactly
where
we
wanted
to
be
this
year,
but
there
was
a
bit
of
misalignment
in
terms
of
vaccine
supply,
both
flu
and
co
and
coverage,
and
also
misalignment
as
to
which
groups
would
will
be
targeted
for
vaccination.
B
So
the
planning
has
started
now
so
that
next
year
we
go
into
the
autumn
winter
period.
With
everybody
hearing
the
message
about
it,
it's
just
as
important
to
get
flu
as
it
is
and
covered
and
vaccination,
and
we
will
do
our
utmost
to
make
sure
they
could
be
administered
on
the
same
day.
So
it's
convenient
for
people
as
well.
M
Quo,
hello,
I'm
claire
smith,
I'm
the
chief
operating
officer,
at
least
teaching
hospitals
trust.
I
think
that's
a
very
difficult
question
to
answer.
We've
we're
clearly
learning
a
lot
about
this
disease
and
we've
been
learning
a
lot
about
it
for
the
last
20
months
at
pace
and-
and
I
think,
if
we
think
about
how
long
flu
has
been
around
and
our
ability
to
prepare
for
that
and
every
winter,
as
you
know,
council
is
the
winter,
is
a
huge
challenge,
not
just
the
nhs,
but
also
for
our
social
care.
M
Colleagues
as
well,
and
when
we
consider
at
the
moment,
ltht
has
currently
got
well
we're
now
down
to
three
wards
that
are
fully
covered,
positive
plus
patients
in
critical
care
that
that
is
in
addition
to
the
work
that
we
would
normally
be
doing
and
the
preparation
that
we
would
normally
be
making
for
for
flu.
M
So
I
think,
because
of
the
it's
the,
I
think,
it's
the
intensity
of
the
time
frame
of
learning
the
intensity
of
our
ability
to
respond,
and
I
think
we
are
certainly
until
we
get
over
the
hump
of
this
winter,
which
I
have
to
say
is
is
a
is
of
concern
because
of
the
level
of
unknown
about
flu,
because
of
course,
flu
last
year
was
so
very
low.
Because
of
so
we
were
all
isolating
and
not
interacting
with
each
other.
M
So
we
really
don't
know
what
the
progression
of
either
of
those
two
were
going
to
be
over
the
course
of
this
next,
this
next
six
months.
So
I
think
that
question
will
be
easier
to
answer.
Perhaps
it's
probably
a
bit
of
a
cop-out
but
probably
easier
to
answer
in
about
four
or
five
months
time.
G
Council
latte
just
to
briefly
come
back
on
that
last
question.
I
think
that,
as
we've
gone
to
this
point
in
the
pandemic,
it
feels
now
there's
much
more
of
a
conversation
about
balancing
different
risks
to
health.
So
obviously,
in
the
height
of
the
pandemic,
you
know
the
overarching
focus
was
uncovered.
G
So
we
need
to
continue
to
do
that,
but
but,
but
what's
been,
really
interesting
is
that
for
for
for
the
first
time
in
a
long
time,
lots
of
people
have
been
interested
in
public
health
in
in
vaccination
and
in
inequalities
as
well
about
being
quite
shocked
around
the
inequalities
that
kovid's
brought
up,
and
I
think
that
if,
if
we
look
at
all
of
our
vaccination
programs,
we
have
identical
issues
about
poor
uptake
in
the
same
communities.
G
G
How
do
we
keep
that
intense
focus,
going
beyond
covert
for
lots
of
other
things
that
have
a
huge
impact
on
health
and
and
use
the
learning
and
share
the
balance
of
risk,
and
I
think
the
part
of
the
other
dimension
of
that
is
about
other
risks
to
health,
which
aren't
other
infectious
diseases,
but
are
around
say
the
the
whole
debate
about
getting
kids
back
into
school.
Even
though
rates
have
been
high
because
actually
it's
more
damaging
to
long-term
health
for
for
children
to
miss
education
and
their
impact
on
their
mental
health.
G
As
councillor
venna
raised
before,
we
know
we're
seeing
other
other
implications
of
being
one-dimensional
about
coverage,
we've
got
to
see
it
within
that
that
wider
risk
of
of
other
issues
around
the
public's
health.
So
I
think
it
will
be,
which
is
partly
the
conversations
we're
going
to
bring
back
around
some
of
the
work
we
want
to
do
around
health
inequalities
and
how
we
move
on
from
covid
towards
the
challenges
that
we
now
face,
looking
much
more
broadly
at
public
health.
A
Thank
you
very
much
victoria
dr
bill.
J
Thanks
very
much
chair
I
mean,
I
think
the
the
first
place
first
thing
to
say
is
to
thank
all
the
nh
staff
and
all
those
who
work
in
social
care
for
what
they've
been
doing
over
the
last
18
months,
and
indeed
those
people
who
are
unpaid
carers
as
well,
because
my
my
buddy
in
the
health
and
well-being
board
is
actually
from
carers
leads.
J
So
I
think
that
we
need
to
understand
that
a
lot
of
support
has
come
from
people
who
actually
care
for
others,
including
school
children
as
well,
very
important
to
say
so
that
that's
the
starting
point
mention
has
been
made
of
of
the
media
and
indeed
on
the
today
program
this
morning
on
radio
4.
So
I'd
like
to
ask
a
few
detailed
questions
about
how
we're
doing
in
leeds
compared
with
what
we
hear
on
the
media
elsewhere.
The
first
is
a
e.
J
We
we
learn
from
the
papers
and
also
thanks
to
whoever
prepared
this.
This
document,
which
was
very
helpful
and
a
large
increase
in
a
number
of
people,
turning
up
an
a
e
and
we
hear
of
people
having
coronaries
having
strokes
sitting
in
ambulances
for
hours
on
end
before
they
can
even
get
in
as
far
as
a
and
e,
let
alone
sort
of
definitive
treatment.
J
So
the
question
on
that
is
what
proportion
of
patients
to
a
e
say
in
the
last
month
in
leeds
have
had
to
wait
more
than
four
hours,
which
is
the
sort
of
target.
I
know.
Targets
are
not
terribly
popular,
but
it
does
give
us
an
indication
of
what
people
could
expect
from
the
nhs
all
things
being
equal.
So,
first
of
all,
what
proportion
of
patients
have
to
work
on
four
hours.
J
Secondly,
we
were
really
getting
on
top,
I
think,
of
the
situation
before
koved
in
terms
of
reducing
the
number
of
delayed
discharges.
What
were
previously
known
as
bed
blockers,
people
who
didn't
need
hospital
care
anymore,
but
couldn't
go
back
anywhere
else
because
they
couldn't
go
home
because
they
didn't
have
the
right
support
or
they
couldn't
go
into
residential
care,
because
there
were
no
vacancies
which
could
support
their
needs.
So
how
are
we
doing
in
terms
of
delayed
discharges
in
this
city?
J
And
thirdly-
and
I
am
sad
that
to
gain
nhs-
england
are
not
here,
but
I'm
not
going
to
let
dentistry
escape
totally,
because
it's
not
only
primary
dental
care,
there's
also
secondary
dental
care,
and
so
it
does
involve
the
hospital.
A
J
J
M
Okay,
shall
I
shall
I
start
so
just
from
from
the
perspective
of
ambulance,
so
we
do
we're
doing
very
well
within
within
leaves
in
terms
of
our
ambulance,
handover
and
I'm
pleased
to
say,
there's
been
no
patience.
I've
waited
longer
than
two
hours
for
handover
within
the
city
of
leeds
and
the
majority
of
patients.
We
are
able
to
do
a
transfer
in
less
than
an
hour
and
our
target
is
15
minutes.
M
That
is
what
we
aim
for
to
have
a
handover
within
that
time
and
we're
one
of
the
best
in
the
country,
certainly
in
the
upper
quartile,
for
for
that,
it's
a
real
priority
for
us,
because,
obviously
with
the
size
of
leads
in
both
lgi
and
st
james's.
If
we're
not
able
to
be
able
to
retain
that,
then
that
holds
up
ambulances
for
the
rest
of
west
yorkshire.
M
So
we
really
do
really
really
focus
on
that
in
terms
of
our
a
e
position
and
delivery
of
the
standard
within
four
hours,
we're
in
I'm
afraid
to
say
in
the
mid
60
for
that
at
this
point
in
time,
but
that
still
places
us.
So
for
the
last
week,
for
example,
we
were
61
out
of
123
trusts
who
report
in
the
country
for
our
standards,
and
that
shows,
I
think,
the
level
of
pressure
that's
been
experienced
in
the
nhs
across
the
whole
of
the
from
across
the
whole
of
the
of
the
country.
M
We
have
a
huge
amount
of
work,
as
you
would
expect
in
train
to
in
order
to
be
able
to
reduce
that
from
an
emission
avoidance
from
an
attendance
avoidance,
all
sorts
of
different
things
which
I'm
more
than
happy
to
share
at
a
future
point
and
we're
making
some
really
great
strides
in
terms
of
our
same
day,
emergency
care
offering
on
both
sides
of
the
city
as
well,
which
I'm
really
pleased
with,
which
is
being
supported
by
all
partners
that
are
around
this
table.
To
today
from
a
delayed
discharge
perspective.
M
And
we
have
seen
an
increase
in
terms
of
the
number
of
patients,
although
that
is
at
the
moment
in
terms
of
patients
with
no
reason
to
reside
around
220
patients
within
the
hospital.
Today.
That
does
have
an
impact
on
the
hospital,
but
also
because
of
the
acuity
that
we're
seeing
across
the
whole
of
of
health
as
well,
which
means
that
our
bed
occupancy
level
is
running
extremely
high,
so
that
that
level
of
pressure
is
felt,
and
I'm
sure
catherine
and
colleagues
are
happy
to
expand
on
that
further.
M
But
we
are
internally
doing
a
lot
of
work
to
try
and
ensure
that
we
are
making
our
preparing
our
patients
our
citizens
as
early
as
possible
for
discharging
that
they
are
informed
and
engaged
in
the
discharge
process
as
well
from
a
p
dentistry
perspective.
So
it
the
it's
difficult
to
answer
that
question.
So,
unfortunately,
we
do
have
some
patients
that
have
waited
nearly
two
years
to
have
some
treatment
in
pediatric
dentistry,
but
they
will
be
classed
as
routine,
so
they've
all
been
clinically
triaged.
M
M
We
were
significantly
impacted
in
dental
services,
as
you
know,
because
it
was
an
aerosol
generating
procedure
and
we've
invested
hundreds
of
thousands
of
pounds
in
additional
drills
now,
but
actually
it's
very
fancy
and
kind
of
sucks
it
all
out
so
that
it's
not
the
toothy
the
air
to
to
try
and
increase
the
number
of
patients
that
we
can
treat.
M
There
has
been
an
impact
in
terms
of
community
service
and
the
there's
a
number
of
services
that
have
not
been
able
to
continue
to
provide,
which
has
meant
that
there's
been
a
greater
level
of
referral
into
the
acute
trust
and
we'll
continue
to
work
with
colleagues
in
nhs
england
on
that,
in
order
to
be
able
to
put
alternative
provision
in
place
across
the
city
across
the
city
of
leeds.
M
So
it
is
a
challenging
position
across
all
of
the
all
of
the
domains.
However,
we
have
seen
some
exemplary
work
coming
from
our
clinical
teams
from
our
partners
across
adult
social
care
and
also
our
community
partners
as
well.
So
I
think
we
I'm
just
going
back
to
the
previous
point
from
councillor
latte.
I
think
a
lot
depends
on
how
this
winter
is
going
to
go
in
terms
of
how
those
numbers
bear
through,
but
certainly
from
from
an
ambulance
perspective,
which
was
the
start
of
your
question.
A
Thank
you
very
much.
I
would
like
angela
to
just
give
an
update,
quick
on
the
dental
plan
that
we
have
for
january,
so
that
dr
bill
would
be
rest
assured
that
we're
definitely
not
letting
me
go.
B
Thank
you,
chair,
yeah,
just
to
to
make
sure
members.
We
have
had
that
direct
liaison
with
nhs
england.
B
They
did
with
their
apologies
in
terms
of
being
able
to
attend
this
meeting,
albeit
that
they
did
make
sure
that
they
informed
the
briefing
paper,
but
on
that
they
are
also
keen
to
come
to
a
future
meeting,
perhaps
early
in
the
new
year,
so
that
we
can
actually
look
at
this
in
in
greater
detail,
because
I
know
dentistry
has
come
up
quite
a
few
times
in
in
discussions,
so
whereas
they
did
help
inform
that
broader
covered
impact
paper.
B
For
today,
we
are
looking
at
arranging
a
date
where
we
can
look
for
just
focus
on
dentistry.
A
C
Thank
you
chair,
I'm
more
than
concerned
about
children
with
bad
teeth.
Really
we
should
be
looking
at.
Why
not
what
you
know,
what
building
up
cases
for
the
service?
We
should
be
trying
to
avoid
them
having
to
be
on
a
waiting
list
and
what
what
on
earth
is
happening
with
children's
teeth
anyway?
That
wasn't
my
question:
do
we
know
how
effective
this
year's
flu
jab
concoction
is
going
to
be,
I
mean,
has
it
actually
been
tested
in
reality?
C
Are
we
just
not
in
the
flu
season
yet
or
is
it
a
complete
coincidence
that
we
haven't
got
any
flu
or
is
it
due
to
people
more
people
getting
the
flu
jab
this
time
round?
C
That's
my
first
question.
I've
got
some
other
ones.
Shall
I
I've
got
four,
oh
okay,
so
my
other
one
was
and
to
do
with
the
flu
jab
again.
What's
the
historic
take-up
of
the
flu,
jack
flute,
jab
across
deprived
and
beam
communities?
G
Shall
I
make
a
start
on
those
I'm
just
pausing,
because
I
was
just
getting
the
latest
data
so
in
terms
of
the
the
likely
coverage
of
the
this
year's
flu
vaccination
counselor
anderson,
the
what
happens
every
year
is
that
the
there's
a
judgment
made
on
the
three
strains
of
flu
that
are
likely
to
hit
us
in
the
northern
hemisphere
that
is
based
on?
What's
happened
in
the
winter?
That's
just
happened
in
the
southern
hemisphere.
G
The
problem
this
year
is
there's
been
very
little
flu
in
the
southern
hemisphere
because
of
because
there's
been
very
little
mixing.
So
those
judgments
people
aren't
quite
as
confident
because
they've
had
less
to
go
on.
So
my
latest
advice
from
our
colleagues
nationally
is
that
there's
a
reasonable
expectation
that
there's
a
fifty
percent
protection
from
this
year's
three
three
strains
likely
to
be
that
the
strain
that
people
encounter
so
that's
slightly
lower
than
than
usual,
but
that
that's
the
latest
advice
we
have
it's
around
that
50
mark.
G
So
that's
that
one
in
terms
of
the
uptake
the
we
work
with
so
in
terms
of
the
the
uptake
on
on
the
flu
vaccination.
They
we
work
with
nhs
england
data
that
they
break
down
into
different
population
groups
and
the
data
that
we
have
is
broken
down
into
this
there's
different.
There's
health
and
social
care
workers.
There's
pregnant
women,
there's
the
kind
of
school
age
kids
over
65s
in
different
age
groups.
G
At
the
moment,
the
data
that
we
get
from
nhs
england
doesn't
include
the
ethnic
background
of
people.
We
we
need
to
generate
that
that
data
locally,
which
we'll
do
but
but
the
the
the
the
we
we
do,
get
it
on
a
ward
basis.
So
we
can.
We
can
obviously
look
at
that
at
a
very
local
level
as
well,
so
there
is
overall
this
year,
sorry
I'm
just
reading
this
is
this
has
just
come
through
today.
G
So
far
this
year
we've
got
a
41
uptake
of
everyone.
Who's
been
eligible
for
flu
vaccine
so
far,
who've
actually
taken
up
the
vaccine
and
generally
that's
very
high
for
the
over
65.
So
in
the
over
65s,
that's
85
in
the
50
to
64.
it's
it's
lower,
it's
around
and
70.
G
So
so
as
you
as
you
move
down
those
ages
like
covid
and
that
you
get
a
lower
percentage,
but
we
I
can
certainly
we
we
do
get
a
regular
update
on
on
the
take-up
of
flu
and
it
is
still
quite
early
in
the
the
season.
So
people
are
still
getting
the
flu
invitations
now
and
of
course,
this
year
it's
the
biggest
flu
campaign
of
sam
can
say
more
about
it.
G
This
is
the
biggest
flu
campaign
the
world
has
ever
seen
and
we've
ever
seen,
because
it's
now
for
every
single
school
child
last
year
it
was
just
up
to
year
seven.
So
we've
never
done
this
before
in
high
schools.
But-
and
you
know,
my
understanding
is
the
high
school
rollout
is
going
really
well,
I'm
just
looking
at
these.
It's
70
school
age
at
the
moment
so
and
that's
through
a
nasal
spray,
not
a
vaccination
for
for
children,
so
we
have
on
that
ethnicity.
G
C
Yeah,
just
briefly,
it
was
timely.
The
lord
mayor's
cast
just
come
in
and
it
counselor
the
lord
me
and
I
did
a
a
went
to
chapel
town
and
got
our
flu
job
done
and
did
a
press
release
on
the
back
of
that.
I
think
that
was
important
for
us
and
coming
from
an
ethnic
background
and
encouraging
people
from
ethnic
backgrounds,
and
I
think
it's
a
really
important
question.
C
I
think
perhaps
the
awareness
is
there
actually
are
our
communities
getting
the
the
flu
jab
and
I
think
that
anecdotally,
from
what
I'm
hearing,
I
think
there
is
more
awareness
there.
I
think
we
need
to
build
on
that
and
I
think,
as
elected
members
and
leaders
across
the
community,
we've
got
a
role
to
play
on
that,
but
I
do
think
it's
a
really
good
question.
Thank
you.
A
E
Had
it
so
good,
two
two
two
linked
questions,
one
going
about
something
that
was
said
a
wee
while
earlier
on
and
going
back
to
the
flu
vaccine
efficacy.
So
you
said
that
the
flu
vaccine
efficacy
is
currently
estimated
to
be
50
effective.
Is
that,
based
on
efficacy
against
the
known
strains
that
we
now
know
are
going
to
be
dominant
or
is
it
based
on
statistics,
because,
actually
out
of
the
three
that
we've
got
the
jabs
for
we
know
there's
you
know
three
plus
x
out
there
that
may
become
dominant,
so
is
it?
E
Is
there
no
efficacy
against
the
cohort
of
you
know
flu
that
is
circulating
or
is
it
because
it's
still
quite
early
in
the
season?
Actually,
you
know
the
the
efficacy
is
kind
of
very
on
the
side
of
caution.
The
second
one
I
may
not
be
able
to
answer
this,
but
you
mentioned
that
there
was
planning
being
made
for
combined
flu
and
copied
jabber
roll
out
next
year.
Is
there
anything
further
that
can
be
said
on
that
or
anything
that
can
be
shared?
B
When
we
don't
know
yet,
this
is
quite
a
dynamic
situation.
So,
as
soon
as
we
know,
I'll
obviously
inform
people
but
don't
know
just
yet.
G
Just
on
the
first
question:
counselor
the
it's
based
on
the
match
so
where
there
is
a
match
of
the
flu
that
we
see
circulating
here
with
one
of
the
three
that's
in
that
the
efficacy
is
really
high,
but
it's
it's
whether
the
match
is
right.
If
that
makes
sense,
and-
and
and
the
judgment
I
mean
again-
it's
not
it's
not
my
view
that
it's
a
50.
Obviously
these
are
our
colleagues
in
the
new
uk
health
security
agency.
G
G
A
C
It's
just
following
up
on
the
flow
job,
obviously
go
back
to
2
15
16.
When
I
was
unhealth,
we
was
on
the
corridors
with
flow
patients.
However,
with
the
injection
this
is
the
time
is
rolling
out.
So
it's
hard
to
tell
how
many
people,
but
what
you
have
to
balance
just
forget
about
220
and
go
back
to
219
18
and
see
if
those
figures
match
him
today
and
it's
around
november
time.
You
should
have
a
better
picture.
C
C
Thank
you
chair.
This
will
be
a
really
quick
one,
paragraph
43
in
the
report
on
figure
14.
C
Should
the
statistics
in
the
little
table
at
the
bottom
should
that
not
say
2021,
because
you've
got
the
chart
going
from
march
20
to
september
21,
but
then
in
the
little
table,
underneath
you've
got
week
a
day
by
day,
but
it's
got
20
20..
I
don't
know
why
we'd
want
to
know
2020
out
of
all
of.
L
Cancer
anderson,
I
think,
you're
correct
and
I'm
delighted
that
you've
paid
close
attention
to
every
figure
and
and
we'll
make
sure
that
our
data
colleagues
know
that
you've
paid
attention
to
every
figure.
Thank
you
so
much.
I
think
you're
right,
I
think
2021
is
a
year
that
just
never
ended,
and
I
think
it
probably
reflects
to
be
honest.
The
fact
that
we
feel
we're
still
in
2021,
because
2021
has
never
got
away,
but,
yes,
he's
completely,
I'm
sure
you're
correct.
Thank
you.
C
The
other
one
was
in
paragraph
44
is:
can
you
just
update
me
on
or
update
us
on
the
current
position,
because,
obviously
this
report
was
written,
probably
a
little
while
ago
now,
so
what?
What
is
the
number
of
beds
occupied
by
covered
patients?
Is
it
still
as
bad
as
it
says
in
there.
M
There's
85
85
patients
today,
eight
of
which
are
in
our
critical
care
unit.
That's
actually
been
a
drop
from
last
week.
We
we
had
quite
a
spike
a
few
weeks
ago,
which
was
a
bit
concerning,
but
we
have
started
to
see
that
number
come
down
so
yeah
we've
got
80
between
85
at
the
moment,
and
that
will
our
predictions.
M
We
do
a
one
week
ahead,
predictions
just
so
that
we
make
sure
that
we're
ahead
of
the
head
of
the
the
disease
in
terms
of
being
able
to
be
able
to
place
patients
in
a
timely
way,
and
that
number
looks
as
though
it's
going
to
continue
to
come
down
over
the
course
of
the
next
week
to
hopefully
just
just
shy
of
of
82
75.
So,
and
I
look
forward
to
that
day,
that
that
continues
together.
A
Thank
you
happy
dr
bill.
J
Thank
you
chair.
I
want
to
look
back
and
then
look
forward.
J
We
know
that
basically,
the
nhs
was
not
prepared
adequately
for
what
has
happened
for
the
kovic
pandemic
and
michael
marmot
has
told
us
that
over
the
last
decade,
the
decade
of
austerity
that
certain
groups
certainly
inequalities
increased
some
groups
were
actually
moving
backwards
and
the
gaps
were
getting
wider
and
the
nhs
at
the
time
pre-pandemic
had
tens
of
thousands
of
vacancies
for
doctors
for
nurses,
maybe
for
other
staff
groups
as
well.
J
So
what
I
would
like
to
ask
now
going
forward
is
what's
the
current
situation
in
leeds
in
terms
of
the
number
of
vacancies
unfilled
vacancies
of
doctors,
both
within
the
hospital
and
tim's
gone,
unfortunately,
but
also
as
far
as
gps
are
concerned.
What's
the
number
of
vacancies
unfilled
vacancies
for
nurses?
What
other
staff
groups
also
do
we
face
vacancies
and
what
is
being
done
to
improve
the
situation
if
those
vacancies
still
occur.
M
If
I,
if
I
may
so,
I
will
have
to
come
back
to
you
with
the
exact
numbers,
I'm
afraid
in
terms
of
the
in
terms
of
the
vacancies
around
both
the
nursing
and
the
doctors,
because
I
think
it's
only
appropriate.
I
get
those
numbers
right.
We
are
doing
a
huge
amount
around
our
recruitment.
We
have
done
an
extensive
international
recruitment
to
support
and
bring
in
really
excellent
nurses
and
from
anthem
doctors
as
well
from
out
from
from
outside
of
of
the
uk.
M
M
There's
a
there's
a
number,
so
we've
been
so
that's
the
some
of
the
work
we've
been
doing.
I
think
the
where
we
have
to
get
this
right
is
actually
in
terms
of
the
work
national
workforce
planning.
M
So
I
think-
and
I
think
it's
certainly
from
how
we,
how
we
try
and
influence
him
leads
and
with
some
of
the
some
of
that
work
and
the
work
that
julian
hartley,
our
chief
exec,
has
done
and
linda
pollard
are
our
chair
as
well
to
try
and
influence
some
of
that
is
really
critically
important,
because
if
we
don't
start
appropriately
recruiting
the
number
of
radiographers
that
we
need,
the
number
of
you
know:
junior
doctors,
that
we
need,
etc.
M
Then
this
position
is
going
to
continue.
So
we
are
going
to
be
as
an
nhs
in
this
in
this
difficult
position
for
quite
some
period
of
time
until
some
of
those
workforce,
training
issues
are
actually
worked
through,
and
I
think
I
think
that's
the
shame
from
from
before.
J
Yeah,
recruiting
from
overseas
is
fine.
It
depends
where
you're
recruiting
them
from,
because
some
of
our
recruits
have
been
from
actually
countries
where
they
are
themselves
short
of
doctors
and
nurses
and
are
considerably
poorer
in
this
country,
and
I
do
have
some
concerns,
and
even
within
this
country,
if
we
get
more
doctors
in
our
hospitals
in
leeds,
does
that
mean
to
say
manchester
or
birmingham
or
wherever
are
getting
fewer?
So
I
I
think,
there's
a
much
bigger
global
national
and
global
problem,
which
needs
sorting,
but
certainly
workforce
planning
in
this
country
is
absolutely
essential.
M
I
would
agree:
workforce
planning
is
absolutely
critical
and
certainly
the
the
submissions
that
we
make
on
an
annual
basis
shows
the
whole
time
equivalency
gap
that
we
have
and
that
is
submitted
to
to
the
national
to
the
national
team.
We
are
very
careful
in
terms
of
the
point
that
you
made
around
international
recruitment
and
ensuring
that
we
don't
destabilize
other
vulnerable
communities
abroad.
So
I
I
just
would
like
to
provide
some
assurance
on
that.
L
Yes,
I'm
going
to
come
back
to
you
on
the
on
the
figure
on
the
gp
vacancy
rate,
because
my
text
has
failed
to
fail
to
see
you
an
answer.
Just
I
just
wanted
to
re-emphasize.
I
think
it's
through
the
paper,
but
but,
however
many
clinical
staff
we
recruit
if
the
clinical
capacity
is
is
occupied
by
people
who
need
social
care.
L
We
need
more
of
everybody,
but
I
think
the
work
that
we're
trying
to
focus
on
right
now
as
much
as
the
clinical
stuff,
which
is
certainly
not
going
to
stop
and
the
work
that
we're
trying
to
do
to
recruit
those
staff
doesn't
stop.
But
I
think
it
is
really
important
that
we're
really
focused
now,
particularly
on
home
care
staff
and
care
home
staff.
So
I
think
I
think,
and
cath
can
maybe
update
on
the
the
vacancy
rate
for
those,
but
I
think
it
in
the
round.
K
Thank
you,
chair.
Are
you
able
to?
Are
you
bridging
the
gap
at
the
moment
with
agency
staff
and,
of
course,
agency
stuff?
So
when
you
talk
about
vacancies,
there
are
actually
feet
on
the
ground.
If
you
like,
delivering
services
and-
and
if
that
is
the
case,
are
you
receiving
some
financial
support
from
from
central
government
because
obviously
to
to
to
pay
for
agency
staff
just
because
it's
more
expensive
if
they
recognize
that
and
is
that
happening.
B
So,
where
we
can,
we,
we
do
use
agency
staff.
I
think
at
this
moment
in
time
the
funding
isn't
the
issue.
The
issue
is,
is
staffing
and
and
we're
looking
at
all
different
ways
in
which
you
can
use
different
workforce
so
making
sure
that
we
don't
just
focus
on
our
registered
staff,
but
also
our
non-registered
staff
and
increasing
their
roles
talking
at
a
variety
of
roles
working
with
our
third
sector.
Colleagues,
who
play
an
absolutely
vital
role
in
supporting
the
the
statutory
sector,
so
looking
at
all
different
ways
of
doing
things.
H
Yeah,
I
think
it
was
very
important
that
we
actually
do
talk
about
social
care.
I
know
the
nhs
is
a
national
obsession,
but
we
are
as
we
my
colleagues
have
said,
part
of
the
system
and
I
have
never
known
recruitment
so
so
severe
in
terms
of
a
challenge.
H
On
one
level,
we
we
had
quite
a
good
covert
experience
to
start
within
social
care
in
terms
of
workforce.
When
the
country
shut
down,
there
was
furlough,
social
care
was
able
to
recruit
really
well
for
the
first
time
in
33
years
that
I
have
worked
in
the
sector
and
to
give
you
an
illustration
of
that
in
terms
of
regularly
supplying
home
care,
we
at
our
best
had
21
people
waiting
for
home
care.
H
H
Those
sectors
have
experienced
recruitment
challenges
themselves
and
are
putting
up
their
rates
of
play,
pay
rather
so
to
work
in
a
supermarket.
Now
it's
between
nine
pound,
20
and
10
pounds
70,
and
you
get
10
off
your
weekly
shop,
which,
if
you
are
a
low-wage
worker
which
care
workers
are
that.
That
means
a
lot
to
you
and
it's
a
heck
of
a
lot
stressful
than
working
in
social
care.
We
have
amazon
advertising
at
ten
pound,
forty
with
golden
hellos
of
anything
between
one
and
three
thousand
pounds
which
are
denuding
social
care
rapidly.
H
Social
care
workers
do
not
feel
as
valued
as
nhs
in
the
national
consciousness.
I
still
think
you
know
everybody
clapped
for
the
nhs
and,
by
the
way,
brackets
will
clap
for
social
care
as
well,
and
they've
had
a
really
torrid
time.
A
number
of
them,
particularly
in
care
homes,
are
traumatized
by
the
number
of
deaths
that
they
witnessed
with
people.
They
don't
often
care
about.
You
know
we
talk
about
care
homes
being
like
an
extended
family
and
that's
not
just
the
residents.
H
It
is
the
staff
as
well,
so
it
is
really
really
tough
and
as
much
as
we
are
struggling
to
secure
home
care,
we're
also
struggling
with
care
home
capacity.
So,
even
though
you
look
at
something
like
capacity
tracker,
which
is
the
national
monitoring
tool
on
paper,
it
looks
like
there's
lots
of
vacancies.
H
Actually,
the
care
homes
can't
recruit
staff
either
so
we're
having
real
difficulty,
placing
people,
anybody
with
some
degree
of
complexity-
and
that's
usually,
people
living
with
dementia,
the
care
homes
would
choose
not
to
so.
If
we
look
at
at
the
amount,
some
of
the
delays
in
the
acute
mental
health
sector,
it's
people
with
complex
dementia
who
are
waiting
a
very
long
time,
which
is
distressing
for
them
and
for
their
families,
because
an
acute
hospital
world
is
not
a
good
place
to
be
if
you're
somebody
living
with
dementia.
H
H
We
have
set
up
as
a
system,
a
workforce
task
group
and
we've
been
meeting
at
eight
o'clock
every
morning
since
last
week,
so
nearly
killing
me
to
go
fast
and
furious
and
what
we
need
to
do
so
we
are
looking
at
we've
got
a
staff
mobility
framework
in
place
amongst
the
statutory
organizations
to
see
whether
or
not
when
it
gets
really
sticky.
Can
we
move
staff
around
we're?
Looking
at
bank
arrangements,
so
nhs
colleagues
already
have
a
staff
bank?
H
H
We
are
looking
at
a
talent
pipeline
through
the
health
and
care
academy
and
doing
a
recruitment
campaign
we're
going
to
gear
up
to
do.
We
want
this
city
to
show
its
love
for
social
care
workers
make
them
feel
valued
and
try
and
attract
them
into
social
care
roles.
Now,
as
part
of
that
pay
is
absolutely
key,
and
it's
really
positive
that
the
government
has
put
the
national
living
wage
rate
for
next
year
up
to
9.50
and
9.50
this
year
is
what
the
foundation
living
wage
fund.
H
No,
the
real
living
wage
foundation
has
recommended
as
a
as
a
real-living
wage,
it's
9.90
next
year,
so
we
are
talking
as
a
system
about
whether
or
not
we
can
bring
forward
paying
that
9
pound
50.
Now,
because
we
really
need
to
go
out
with
an
improved
offer
for
for
permanent
wages,
not
not
just
bonuses
to
stay
loyalty
bonuses.
I
don't
think
that
will
be
enough,
not
when
I'm
competing
with
amazon
offering
thousands.
H
H
Ideally
even
more,
we've
talked
about
international
recruitment
and
we
are
trying
to
weed
social
care
trying
to
piggyback,
on
the
back
of
that,
to
look
at
recruiting
social
care
nurses
because
in
other
parts
of
the
country,
not
in
leeds,
but
it's
maybe
only
a
moment
of
time.
Nursing
homes
have
deregistered
as
nursing
and
just
dropped
down
to
a
residential
care
because
they
cannot
secure
nurses
and,
I
would
say,
nursing
caring
leads.
We
have
just
about
got
enough
and
we
would
really
rather
like
to
have
some
more.
H
There
is
no
no
give
on
this
at
all,
and
if
somebody,
if
we
don't
have
enough
nursing
homes,
then
hospitals
will
really
really
get
backed
up
quite
rapidly.
If
they're
not
already,
you
will
be
aware.
We
have
in-house
our
own,
we
care
academy,
so
that's
recruiting
entry-level
people
into
social
care.
We
do
the
training
and
then
they're
guaranteed
a
job
interview.
So
it's
a
really
important
pipeline.
H
We
are
looking
at
using
social
media
to
recruit
rather
than
and
as
well
as
road
shows,
because
talking
to
care
providers,
social
media
is
where
it's
at
now.
That's
where
you
get
your
success.
So
looking
at
facebook
feeds
and
things
like
that,
and
then
we
want
to
double
the
intake,
we're
able
to
take
through
the
we
care
academy.
So
we
can
get
that
pipeline
going
and
that's
just
some
some
examples
of
some
of
the
things
we're
doing.
H
We
could
have
really
done
with
starting
this
three
months
ago,
but
you
know
we
are
where
we
are,
but
I
think
this
is
going
to
be
a
really
really
challenging
winter.
A
Yeah,
thank
you
very
much
for
that.
Kath,
I'm
still
talking
about
workforce
crisis.
Obviously
the
government
announced
last
week
about
frontline
staff
who
have
not
been
vaccinated
will
not
be
allowed
to
come
back
into
work.
How
are
you
going
to
deal
with
that
gap
because
there
are
so
many
of
them?
A
I
mean
I
don't
know
in
terms
of
have
you
got
figures
where
do
you
think
we
are
in
leads
with
with
with
our
announcements
and
how
many
frontline
do
we
actually
have
that
will
have
to
leave
their
jobs
and
what
is
the
plan
to
replace
those
who
would
be
sent
home.
H
H
Having
rung
round
the
care
homes
we
talk
to
them
daily.
If
not
weekly,
we
think
that
the
figure
is
better
than
that.
We
we
think
there
are
fewer
unvaccinated
and
so
far
the
homes
have
said.
16
staff
have
left
so
we're
going
around
doing
a
further
validation
of
figures.
H
H
The
numbers
having
the
first
dose
is
86.32
percent
numbers
with
second
dose
82.0,
two
percent.
So
a
way
to
go
now
the
implementation
time
for
this
we've
got
a
longer
lead-in.
The
government
are
talking
about
the
sort
of
cutoff
date
being
in
april
of
next
year,
because
I
think
ourselves
and
health
colleagues
are
all
saying
we
cannot
afford
to
lose
any
staff
over
winter.
Please
give
us
a
lead
along
a
longer
leading.
H
My
view
is
that
there
are
bound
to
be
people
who
will
not
want
to
get
vaccinated
and
will
leave
care
completely.
So
we
had
people
leaving
a
care
home
but
going
to
work
in
home
care
or
supported
living.
Those
people
will
will
leave
completely,
and
I
do
not
know
what
the
government's
plan
is
to
replace
those
workers,
because
at
least
the
nhs
has
a
workforce
plan,
even
though
the
figures
might
not
be
right.
B
Yes,
so
so
to
date,
we
have
really
concentrated
on
promoting
the
taking
the
vaccine
rather
than
requiring
it.
So
I
do
believe
that
over
the
next
few
months,
we
will
see
some
people
who
have
been
a
little
bit
later
in
making
that
decision
to
have
the
vaccine.
They
will
take
it,
and
some
people
will
look
at
the
consequences
and
feel
that's
what
we
need
to
do.
B
We
will
work
with
people
in
as
compassionate
way
as
we
possibly
can
trying
to
understand
their
reasons
for
not
wanting
to
take
the
vaccine,
see
if
we
can
give
them
any
assurance
to
make
that
decision,
and
but
at
the
moment
I
I'm
expecting
that
we
will
get
some
national
guidance
as
to
how
we
deal
with
this
as
a
whole.
Nhs,
because
I
feel
for
us
to
put
different
systems
in
place
between
trust,
is
the
wrong
thing.
So
people
feel
that
they
can
pop
between.
A
Thank
you,
sam
counselor,
harrington.
C
Thank
you
chair.
It's
just
a
suggestion
for
kath.
Really
I
don't
know
if
you've
ever
heard
of
an
organization
called
tempest
nouveau
who
are
actually
based
at
leeds
prison
and
they've,
been
doing
fantastic
work
all
over
the
country
really
and
they've
won
some
awards
recently,
as
well
in
actually
recruiting
ex-prisoners
into
work
forces.
C
So
there
may
well
be
some
white
collar
crime,
people
who
would
not
be
a
major
risk
to
to
be
risk
assessed
to
work
in
social
care,
but
actually
giving
them
an
opportunity
to
start
doing
that
before
they
leave
prison
and
there
are
several
prisons
within
yorkshire
and
humber
side
that
are
actually
working
with
tempest
nubo
at
the
moment,
and
there
are
some
women,
you
know,
got
two
women's
prisons
in
wakefield
and
at
us
and
richard,
so
it
may
be
a
possibility
to
start
recruiting
in
those
places
too.
A
Thank
you
very
much.
I
have
another
question
it's
regarding
vaccinations,
so
maybe
it
counts.
The
rf
are
we
given?
So
if
someone
has
had
fisa
one
and
two
and
the
booster
does
it
has,
will
it
do
you
need
to
still
have
the
same
or
you're
okay
to
have
another?
I
think.
C
C
A
C
A
A
M
F
M
So
we
are
tech,
so
we
are
testing
at
day
at
presentation
day
if
they've
been
admitted
day
two
and
day
five,
and
so
we're
doing
that
routinely
just
to
ensure
that
we
don't
we
manage
our
risk
of
neurocommunal
infection
if
a
patient
is
then
going
on
to
a
care,
home
or
residential
care
or
somewhere
like
that,
we
are
testing
all
of
those
patients
before
they
leave,
so
that
we
have
a
clear
understanding
of
their
coveted
status.
C
Thanks
chair,
I
was
just
wondering
kathy
you
mentioned
about
some
nursing
homes
lowering
and
becoming
a
residential
home.
What
is
happening
to
the
residents
from
from
the
nursing
homes
who've
clearly
been
assessed
as
needing
nursing
care.
Thank
you.
H
Well,
just
to
stress,
that's
not
happening
leeds.
It
was
whole
that
I
know
where
it
was
deregistered.
They
have
to
be
there's
a
there's,
a
protocol
for
a
home
closure
well
or
in
this
case
it's
a
deregistration
of
the
nursing
element.
Those
the
home
would
notify
cqc.
They
notify
the
local
authority.
They
work
with
the
home
to
assess
the
individuals
and
move
them
to
other
provision.
A
Okay,
any
other
questions
that
is
very
good.
Okay.
We
will
now
move
on
to
agenda
item
nine
over
to
you,
angela.
B
B
This
report
also
references
the
scrutiny
board's
discussion
last
month
in
relation
to
the
plans
for
redesigning
the
community.
Neurological
rehabilitation
servicing
leads
a
written
statement
setting
out
the
observations.
The
conclusion
and
the
recommendations
of
this
scrutiny
board
was
subsequently
produced
in
consultation
with
board
members
and
was
submitted
to
the
leads
community.
Healthcare,
nhs
trust
and
nhs
leads
clinical
commissioning
group,
and
so
a
copy
of
this
statement
can
be
found
in
appendix
3
for
information.
A
Thank
you
very
much.
Our
next
meeting
is
a
budget
working
group
meeting.
So
really
this
is
our
last
formal
meeting
of
the
year
and
I
want
to
use
this
opportunity
to
say
a
very
big
thank
you
to
each
and
every
one
of
you,
especially
all
of
you
from
the
nhs
for
all
your
hard
work
sacrifice,
and
I
mean:
can
we
just
give
them
a
hand
over
clothes?
Please.
A
In
a
very
tough
tough
two
years
and
2021,
obviously
we
saw
some
some
light.
You
know
compared
to
where
we
were
last
year
and
we're
still
we're
still
trying
to
still
break
through
the
difficult
times
and
without
your
help
we
will
not
be
where
we
are.
So
we
just
want
to
say
thank
you
and,
on
behalf
of
the
board,
for
all
your
help,
we
still
have
lots
of
questions
and
lots
of
scrutiny,
but
we're
in
this
together,
and
we
really
really
hope
that
2022
will
be
a
much
better
year
for
us
than
21.
A
So
thank
you
from
the
bottom
of
our
hearts.
If
we
don't
see
you
before
christmas,
you
will
have
a
very
merry
christmas
and
stay
safe
with
your
family.
So
thank
you
very
much
and
if
you've
not
had
some
pies,
we've
got
some
means
pies.
Please
do
help
yourself
to
one
before
you
leave,
so
thank
you,
everyone!
Thank
you.
Everybody.
C
C
B
C
To
come,
actually
I
I
lost
a
brother
in
in
a
care
home
to
cover
it
and
I
have
to.
I
have
to
agree
with
you
the
care
that
he
got
from
those
care.
Workers
were
fantastic,
we
have
been
in
touch
and
we
have
been
going
in
and
trying
to
support
them
as
much
as
we
can.
But
I
do
understand
what
you're
saying,
because
we're
hearing
this
from
the
care
staff.
C
You
know
it,
it
is
hard
and
when
you
think
about
I'm,
not
I'm
not
just
in
the
nhs,
please
don't
think
I
am,
but
when
they
work
in
a
care
home,
they
get
to
know
the
people
and
they
feel
the
loss
as
much
as
we
the
family
do.
So
I
just
totally
totally
understand
where
you're
coming
from,
but
can
I
just
say,
fantastic
job.
Thank
you.