►
From YouTube: Leeds City Council - Adults, Health & Active Lifestyles Scrutiny Board - 11th July 2023
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
thanks
for
joining
today.
My
name
is
Andrew
skates
I'm,
a
council
of
Beeson
holbeck
and
I.
Am
the
chair
of
the
adults,
health
and
active
lifestyle.
Security
Board
today,
we're
going
to
have
I
think
a
really
interesting
meeting,
we're
going
to
talk
about
the
mental
health
strategy
and
the
leads
be
healthy
plan,
I'm
going
to
start
with
some
introductions,
so
we'll
go
around
the
table
if
that's
okay,
just
before
we
do
that,
just
want
to
inform
everyone.
This
meeting
has
been
it's
a
public
meeting.
A
It's
been
broadcast
on
YouTube
and
it's
available
for
watching
later
on,
as
well.
If
you're
interested
so
I've
already
introduce
myself
our
manuscripts
Council
police,
chair
of
this
board,
we'll
go
to
my
left.
Thank
you.
K
Councilor
comrade
heartbrook
councilor
for
Rothwell.
L
A
Can
you
just
use
your
microphone
please
thank.
E
You
sorry
rookie
mistake:
I'm
Alison,
Kenyan
I'm,
the
deputy
director
of
service
development
with
leads
in
Europe
partnership,
Trust.
P
A
B
Thank
you,
chair
under
agenda
item
number
one.
There
are
no
appeals
against
the
refusal
of
inspection
of
documents
under
agenda
item
number.
Two
there
are
no
items
which
would
require
would
require
the
exclusion
of
the
press
or
the
public
under
item
number.
Three.
A
late
item
of
business,
which
is
item
number
11,
has
been
added
to
the
meeting
agenda
with
agreement
from
the
chair.
This
item
relates
to
Leeds
tier
three
specialist
Weight
Management
Service
under
agenda
item
number.
Four
can
I
ask
members
to
declare
any
interest
they
might
have.
B
Thank
you
under
agenda
item
number.
Five
apologies
have
been
received
from
Council
first
with
the
councilor
Alderson,
acting
as
a
substitute
and
we've
also
received
apologies
from
Council
Kijiji,
and
then
we've
also
received
apologies
from
councilor
Fiona
venner,
who
is
the
executive
member
for
children's
social
care
and
health
Partnerships.
Thank
you,
chair.
A
Thank
you
very
much.
Okay,
I'm.
Moving
on
to
the
minutes,
I'll
start
with
any
matters
of
accuracy.
Anyone
want
to
raise
any
amount
of
accuracy.
Okay,
good!
Are
we
happy
to
move
them?
I
can
see
nods
around
the
rim.
Super.
Thank
you.
Okay,
on
to
maximizing
I
start
with
comments
from
you,
Angela.
Please.
N
Thank
you
chair,
so
primarily
in
relation
to
minute
number
10,
which
refers
to
the
sources
of
work
for
the
scrutiny
bar
discussion
and,
firstly,
just
to
confirm
the
director
of
Public
Health
is
progressing.
N
The
board's
request
to
raise
the
issue
of
cannabis
use,
particularly
amongst
young
people
with
the
drug
and
alcohol
board
in
order
to
provide
a
briefing
paperback
to
Barb
members,
and
that
will
help
determine
whether
this
warrants
any
further
work
from
the
scrutiny
board
and
I
can
also
confirm
that
the
children
and
family
scrutiny
board
had
used
its
meeting
on
the
5th
of
July
to
discuss
a
briefing
paper
from
Public
Health
on
the
issue
of
fair
ping,
again
primarily
amongst
children
and
young
people,
and
also
to
note
that,
as
chair
of
this
board,
Council
Scopes
was
also
present
at
that
meeting
and
in
conclusion,
the
children
family
scrutin
abroad
have
agreed
to
explore
this
further
via
a
working
group
approach
that
will
be
arranged
after
the
summer
and
that's
to
include
representation
from
this
barge
as
well.
N
A
Actually,
I
just
want
to
come
also
on
that
board.
Meeting
I
felt
like
it's
really
helpful
to
debate
about.
Vaping
Council
lay
spoke
really
well
about
the
challenges,
but
also
the
the
ability
that
vaping
does
have
to
help
people
quit
smoking,
and
so
we've
got
to
recognize
that
in
any
strategy,
what
councilor
Cohen
agreed
to
do
in
terms
of
how
we
look
at
this
was
a
quite
quite
nicely.
Was
there
the
three
areas
that
I'd
suggested
so
what
we
can
do
as
a
council?
A
What
we
can
get
our
help
convince
our
partners
to
do
so,
whether
that's
the
police
or
trading
standards
or
other
partners
in
the
city
and
then
also
to
look
at
what
we
need
in
terms
of
national
legislative
changes
and
then
we'll
lobby
as
a
cross-party
scrutiny
committed
to
do
that
or
his
board
will
do
that.
So
hopefully,
that'll
be
really
positive.
Are
the
any
other
amounts
of
rising
that
people
want
to
raise
at
this
meeting,
can't
see
anyone
indicating
so
we'll
move
on
okay.
A
So
our
first
substantive
item
today
is
item
number
seven,
which
is
the
Leeds
mental
health
strategy
and
I'm
going
to
ask
Council
Arif
to
introduce
it
in
the
first
instance,
you
can
assume
everyone
who's
speaking
assume.
We've
read
the
papers
already,
but
if
there's
anything
specific
you
want
to
try
out,
please
do.
Thank
you.
D
Thank
you
chair.
So,
whilst
mental
health
Falls
within
my
Public
Health
remit
I'm
introducing
this
item
on
behalf
of
councilor
venner
in
casabella's
role
on
on
Health
Partnership,
as
she
has
unfortunately
another
meeting
today
and
we
are
part
way
through
our
mental
health
strategy,
20
20
25,
which
is
a
key
part
of
the
wider
health
and
well-being
strategy
and
our
Improvement
plan
for
mental
health.
The
vision
is
for
leads
to
be
a
mentally
healthy
City
for
everyone
and
is
owned
by
all
partners
and
across
sectors
and
has
three
passions.
D
These
are
to
reduce
mental
health
inequalities,
improve
mental
health
of
children
and
young
people,
improve
flexibility,
integration
and
compassionate
response
of
Services
mental
health
needs
to
have
been
increasing
over
recent
years,
and
particularly
since
the
pandemic
for
children
and
young
people
with
long
waits
for
some
Services
work
by
public
health
shows
anxiety
and
depression
in
school
age
and
18
to
25
year.
Rules
is
increasing
is
an
increasing
challenge
as
our
issues
around
neurodiversity,
such
as
autism
and
ADHD,
and
gender
identity
in
relation
to
Services.
The
mental
health
strategy
acts
as
a
roadmap
for
improvement.
D
R
Thanks
chair
and
thanks,
Council
Arif
and
one
thing
it's
worth
pointing
outside
I'm
not
going
to
talk.
Particular
I've
got
a
lot
a
length
of
time
that
we
had
the
session
in
March,
where
we
had
a
good
run
through
the
the
strategy
and
and
some
of
the
key
things
that
were
brought
out
with
the
importance
of
the
Community
Mental
Health
transformation
program.
R
So
we've
got
Liz
present
with
us
who
can
talk
with
some
Authority
about
all
the
great
things
that
are
happening
under
that
program
and
then
likewise
the
importance
of
moving
really
strongly
on
on
public
mental
health,
mental
health
promotion
and
prevention.
So
Karen's
here
to
to
talk
about
that
and
then
more
generally
on
on
some
of
the
outcomes
that
the
services
are
delivering.
R
Some
of
the
challenges
and
and
Alison
can
probably
speak
with
authority
about
sort
of
the
I
guess
the
sort
of
the
way
we've
managed
the
system
over
a
number
of
years
and
some
of
the
Partnerships
we've
put
in
place.
So
Council
Harris
mentioned
some
of
the
challenges
I'm
just
going
to
highlight.
There's
a
lot
of
things,
obviously
in
the
paper,
but
I'm
just
going
to
highlight
a
couple
of
the
things
that
that
we
know
are
proving
relatively
difficult
at
the
moment
and
that
we're
trying
to
action.
R
So
in
terms
of
Crisis
Services,
we
know
a
third
of
people
that
are
accessing
crisis.
Services
haven't
been
previously
known
to
those
services,
and
so
obviously
that
indicates
that
the
reach
of
our
RL
intervention
and
Prevention
Services
isn't
as
ideal
as
we'd
want,
and
that
is
particularly
a
challenge
for
black
and
minority
communities.
So
one
of
the
things
that
that
we've
put
in
place
is
a
piece
of
work
called
the
Synergy
program
which
seeks
to
improve
outcomes
in
in
that
area.
R
Likewise,
physical
health,
some
recent
data
showing
that
lots
of
people
with
mental
health
problems
have
high
levels
of
smoking
and
those
premature
mortality,
I.E
early
death
for
a
lot
of
people
with
particularly
the
most
serious
mental
health
challenges.
Unquestionably,
that's
something
we
need
to
improve
over
the
years
and
then,
finally,
as
you
might
expect,
some
of
the
the
challenges
of
Modern
Life
that
that
we
see
not
just
in
people
with
mental
health
problems
but
across
the
board
at
the
moment,
housing
challenges,
employment
challenges
are
undoubtedly
influencing
things
like
anxiety
and
depression.
R
So
one
of
the
things
that
we
know
we
need
to
to
further
develop
is
employment
support
for
people
at
all
levels
with
mental
health
issues,
so
I'm
just
going
to
hand
over
briefly
to
to
Liz
who's
going
to
give
us
a
quick
run
through
the
the
Community
Mental
Health
transformation
work.
Thank.
P
You,
as
the
chair,
said,
I'll
assume
the
papers
read,
but
I
thought
it
might
be
helpful
just
to
pick
out
a
few
theme.
Some
of
the
key
discussion
points.
If
that's
okay,
thank
you
very
much
for
inviting
us
to
come
and
talk
more
about
the
work
as
well.
We're
really
happy
to
share
the
work
and
take
any
questions,
but
the
paper
sets
out
a
bit
of
the.
P
Why
we're
doing
this
and
lots
of
that
will
be
well
familiar
to
what
to
you
all
and
your
and
your
communities
as
well,
and
it
also
sets
out
the
key
areas
of
work.
The
work
we've
done
today
and
some
of
the
progress
and
our
next
steps
and
some
of
the
key
challenges
which
will
be
challenges
that
are
coming
across
the
mental
health
strategy
and
wanted
to
be
clear
on
the
scope
of
the
work.
P
So
the
scope
is
for
adults
and
older
people
with
what
we're
calling
complex
and
ongoing
mental
health
needs
in
policy
terms.
That's
often
referred
to
as
severe
mental
illness
or
serious
mental
illness.
So
it's
more
about
the
moderate
to
severe
level
of
need
and
people
with
ongoing
and
complex
needs,
but
really
paying
attention
to
all
the
things
in
people's
lives
that
can
affect
their
mental
well-being
and
onward
recovery.
So
access
to
good
housing,
employment
support,
social
connections
and
things
like
that
and
children
are
not
in
scope
of
this
work.
P
But,
really
importantly,
we
need
to
pay
attention
to
Transitions,
which
we
know
is
an
ongoing
area
of
concern
and
also
all
the
data
around
the
growing
need
in
children
and
young
people.
We
need
to
be
thinking
ahead
to
what
does
that
mean
in
terms
of
the
demand
that
will
be
coming
down
the
line
into
Adult
Services?
P
In
terms
of
why
we're
doing
this
work,
we've
got
lots
of
good
provisioning
leads,
particularly
in
the
third
sector.
We've
got
a
really
rich
and
diverse
third
sector,
but
we
know
that
lots
of
the
services
we
have
aren't
very
well
joined
up
in
Leeds.
We
have
lots
of
different
services
with
different
criteria
and
what
that
can
mean
for
people
is
getting
referred
between
services
and
that
feeling
of
being
bounced
around
the
system.
P
For
one
of
a
better
phrase,
which
is,
is
a
bad
experience
for
people
and
also
frustrating
for
the
people
that
work
in
the
system.
And
we
also
know
we've
got
long
ways
to
particular
services
and
psychological
therapies
and
sometimes
limited
support
for
people
once
they're
discharged
from
a
community
health
Team.
P
And
so
what
we're
trying
to
do
is
is
make
better
use
of
all
the
good
stuff.
We've
got
and
join
it
up
together,
so
that
it's
an
integrated
offer
paying
attention
to
people's
psychological
needs.
Physical
health
needs
and
social
needs
as
well,
and
how
we've
been
doing
that
is
developing
the
concept
of
what
we're
calling
an
integrated,
Community,
Mental,
Health
Hub,
and
what
that
will
be
is
a
multi-agency,
multi-disciplinary
team
working
with
and
around
a
local
care
partnership
and
to
best
meet
the
needs
of
people
with
complex
and
ongoing
mental
health
needs.
P
And
the
paper
talks
a
bit
more
about
what
they
will
look
like.
We
want
to
start
fairly
small
with
those
and
test
them
in
three
local
care
Partnerships,
so
we
can
get
some
learning
before
we
look
to
scale
that
up
further
in
2024,
and
a
lot
of
this
will
be
about
culture
change
as
well.
So
there
are
some
improvements
we
can
make
in
terms
of
how
people
work
together,
but
the
culture
change
will
be
really
important,
and
so
we've
tried
to
pay
a
lot
of
attention
to
that
in
how
we've
done
the
work.
P
So
it's
been
a
lot
of
partnership
working
across
all
sectors,
lots
of
engaging
with
communities
and
working
with
people
with
lived
experience
throughout
all
the
work
we've
been
working
closely
with
healthwatch
and
leads
involving
people
to
lead
on
that
involvement
and
engagement,
work
and
in
terms
of
next
steps,
we're
very
busy
at
the
moment
in
terms
of
mobilizing
to
Pilot
those
first
three
hubs
from
the
Autumn
and
then
we'll
be
looking
to
scale
up
further
next
year
and
the
other
point
to
make
is
this
program
comes
with
significant
investment,
so
we've
been
using
a
lot
of
that
investment
to
get
ready
for
this
new
way
of
working.
P
So
we've
recruited
a
lot
of
additional
roles
across
the
NHS
and
the
third
sector
and
some
additional
specialist
Mental
Health
social
worker
roles
and
we've
also
invested
money
for
Community
grant
funding
and
that's
about
getting
money
to
real
Grassroots
organizations
to
try
out
some
different
types
of
community
support,
and
so
that
was
really
the
kind
of
summary
I
wanted
to
to
give
and
happy
to
take
any
questions.
Thank
you.
R
Yeah
I
mean
it
depends
how
you
want
to
to
do
this.
Obviously
Karen
can
maybe
give
that
a
couple
of
minutes
also
on
some
of
the
public
mental
health
and
Early
Intervention,
which
is
obviously
you
know
really
closely
connected
to
how
we
manage
other
parts
of
the
system.
Q
Yeah
I'm
I'm
here
this
afternoon,
partly
because
the
my
team,
the
public
around
the
Bell
team
and
providers,
strategic
leadership
for
a
priority
One,
but
also
I,
also
chair,
the
Mental
Health
Partnership
board,
co-chair
it
with
Hannah
Davies
from
healthwatch.
So
if
there's
any
questions
around
the
partnership
board,
I
can
I
can
certainly
answer
them,
because
Hannah
wasn't
able
to
make
it
this
afternoon,
you'll
see
from
the
papers
that
we're
very
much
focused
on
Priority
One,
which
is
about
Target
and
mental
health
promotion
and
prevention.
Q
So
it's
very
much
Upstream
work
that
we
do
across
our
team.
So
it's
it's.
You
know,
thinking
about
increasing
protective
factors
for
good
mental
health
and
trying
to
reduce
those
many
risk
factors
that
we're
aware
of
and
for
poor
mental
health.
Q
So
we
have
a
number
of
approaches
to
do
that
and
we
use
things
like
five
ways
to
well-being
and
we
do
fund
training
across
the
city
for
mental
health
and
suicide
prevention
work
and
because
we
also
lead
on
work
stream,
one
which
is
about
focusing
on
on
Sport
and
populations
impacted
by
the
pandemic
and
to
see
mentally
healthy.
Q
We
we're
funding
some
work
around
I,
suppose
the
best
way
to
describe
it
is
helping
to
get
resilience
in
those
people
who
are
helping
others
so
volunteers,
whether
that
be
in
food
banks
or
cafes
or
other
areas
where
people
actually
trust
trust
those
people
that
work
with
them
on
a
long-term
basis
and
so
training
up
those
people
to
be
able
to
better
look
after
their
own
mental
health,
but
then
to
be
able
to
help
others
as
a
consequence
of
that,
so
that
a
lot
of
our
work
is
around
that
you've
probably
had
a
mindful
employer.
Q
That's
some
of
the
work
that
we
do,
but
we
also
work
across
the
board
around
reducing
stigma
and
and
discrimination
in
terms
of
improvemental,
health
and
and
everything
that
goes
with
that.
So
we're
quite
involved
with
their
priority
too,
as
well
around
reducing
the
over-representation
of
people
from
some
ethnic
minority
communities.
Q
But
the
other
area
of
our
work
is
which
some
of
you
will
be
aware
of
is
reducing
suicide
and
self-harm.
So
we
have
a
whole
program
around
that.
But
our
work
is
very
much
focused
on
trying
to
keep
people
healthy
before
they
get
into
I
have
to
end
up
into
the
system.
So
it's
about
targeting
those
approaches.
Q
We
were
very
pleased
to
launch
last
Friday
our
new
program
around
keeping
people
mentally
well
across
the
city
and
that's
called
being
you
leads,
and
some
people
in
the
room
have
I've
got
the
badges
to
promote
that
and
we're
doing
this
slightly
well
quite
differently
to
how
we
did
it.
Previously,
we've
got
a
provider
collaborative
so
the
seven
voluntary
sector
organizations
that
came
together
to
bid
for
this
contract
I
can
give
you
details
if
you
want
to
know
which
organizations
are
involved.
Q
You'll
have
heard
of
most
of
them,
but
it's
all
third
sector
organizations
working
across
the
city
to
promote
training,
to
promote
group
work
and
activities,
and
also
to
tackle
stigma
and
discrimination
around
mental
health.
So
I
can
give
you
further
details
at
any
point.
You
want
around
that,
but
that's.
We
are
very
much
focused
on
the
Upstream
work
around
keeping
people
mentally
well
and
mentally
healthy
and
being
able
to
talk
about
their
mental
health
across
the
city.
So
I'll
leave
it
there.
Q
D
Yeah,
just
thank
you
for
that
chat
and
just
to
add
really
in
relation
to
be
on
your
leads.
When
we
were
having
the
conversations,
it
was
really
important
that
we
felt
that
we
needed
to
go
into
the
community
and
work
with
providers
that
were
from
the
community
that
understand
the
needs
of
the
community
and
recognizing
that
every
Community
is
different
and
so
I
just
really
wanted
to
Echo
what
Karen
has
said
and
the
need
for
us
to
ensure
that
that
support
is
available
at
Grassroots
level
chair.
Thank
you.
A
Super
thank
you
very
much
I'd,
just
also
like
to
just
say
thanks
to
Tony,
because
I
I
am
you've
added,
quite
a
lot
of
extra
data
since
chairs
brief
and
I
appreciate
that
that's
helpful.
A
If
you
want
to
ask
a
question,
please
indicate
in
the
usual
way
I'm
going
to
just
start
by
asking
a
question
to
start
us
off
with
Just
Around
neurodes
verse
assessments
for
children,
so
my
understanding
is.
We
are
not
where
we
should
be
and
really
Keen
to
know
how
we're
going
to
catch
up.
Thank
you.
E
Thank
you
chair.
The
world
of
neurodiversity
is
really
quite
challenging
at
the
moment,
and
in
the
last
few
years
we
have
seen
a
significant
increase
in
both
children
and
adults,
referrals
to
neurodiverse
services
for
assessment
and
the
increase
and
I'm
going
to
say
it's
about
doubled
in
the
last
few
years,
and
the
increase
has
meant
that
the
capacity
of
the
services
that
we
provide
across
leads
and
Beyond.
E
It
does
not
have
the
capacity
to
cope
with
the
increase
in
referrals
and
there's
been
some
significant
challenges
around
Workforce
across
Mental,
Health,
Service
Providers,
and
which
is
included
the
neurodiversity
teams
as
well.
So
we
have
had
gaps
in
in
Workforce
provision
there
as
well.
E
Another
part
of
my
day,
job
is
I,
am
the
senior
responsible
officer
for
the
Western
Yorkshire
program
on
neurodiversity
and
we've
been
doing
a
piece
of
work
that
looks
at
the
amount
of
money
that
the
system
the
NHS
system,
is
spending
on
assessments,
because
people
have
the
right
to
choose
to
go
to
a
private
provider
if
they
have
to
wait
longer
than
the
the
recommended
waiting
time,
and
if
we
took
all
of
the
resources
that
spent
on
new
diverse
assessments
across
West
Yorkshire,
we
still
wouldn't
have
enough
money
to
bolster
the
system
to
meet
the
demand.
E
Therefore,
what
we're
looking
at
is
what
what
are
we
going
to
do
differently?
At
the
moment?
There
is
a
number
of
kind
of
pilot
programs
and
innovations
that
are
going
on
to
look
at
providing
services
in
a
different
way
and
whether
we
can
meet
people's
needs
without
the
need
for
an
assessment
and
diagnosis.
So
can
we
access
resources
and
support
for
children
in
schools
that
doesn't
need
that
label
attaching
to
them?
Can
we
just
make
this
a
needs?
E
Less
needs
LED
approach
and
there's
a
number
of
Pilots
going
on
and
across
West
Yorkshire
and
indeed
there's
a
a
meet
a
focus
meeting
an
event
tomorrow,
no
a
week
tomorrow
in
Leeds
to
look
at
this
very
this
very
issue,
so
I
I
can't
sit
here
and
say
that
we
have
the
solution
right
now.
E
There
are
some
challenges
from
a
funding
group
for
this,
in
that
it
is
not
part
of
the
mental
health
investment
standard.
So
there
is
not
ring
fenced
resource
for
this.
E
There
has
been
additional
resource
supplied
from
leads
in
the
last
two
years
to
address
particularly
children's
neurodiversity
assessment
waiting
times,
but
again
that's
against
a
picture
of
growing
demand.
So
it's
not
met
it's
not.
It's
not
kept
up
with
the
demand.
So
I
don't
sit
here
with
a
solution
for
you
today.
E
What
I
can
say
is
there's
a
significant
amount
of
work
to
address
this
going
on
across
the
city
and
and
to
also
raise
the
profile
at
a
national
level
to
see
if
we
can
get
some
additional
resources
attracted
into
in
into
this
area.
A
Okay,
thank
you
very
much.
I
think
I
think
it
sounds
like
you
recognize
the
real
challenge
for
young
people
in
terms
of
if
it
affects
their
schooling.
If
the
assessment
comes
three
years
later,
it's
for
a
child,
that's
an
eternity
I.
Think
I.
Think
you
understand
that
point.
So
that's
that's
appreciated.
If
you
could
it'd
be
helpful,
if
you
could
just
write
a
short
note
for
the
board
about
the
work
going
on
and
send
it
to
Angela
to
share
it's
okay,
that's.
G
Thank
you
for
supporting
my
earlier
hand,
looks
I,
appreciate
that,
given
what
you've
just
said-
and
you
know,
you've
been
really
Frank
and
honest
about
the
the
situation
that
you
find
yourselves
in
so
I'm
I
suspect
he'll
be
equally
as
Frank
about
the
questions
that
I'm
going
to
ask
now.
So
a
notice
from
the
report
there
isn't
there
isn't
a
lot
of
mention
around
learning
disabilities
and
neurodiversity
I
presume
that
that
does
fall
under
your
remit
as
Swift.
Doesn't
it.
G
E
The
it's
the
difference,
we're
a
different
hospital
trust,
we're
a
different
NHS
provider.
E
However,
at
the
West
Yorkshire
level
we're
working
the
same
integrated
care
system,
so
we
do
an
awful
lot
of
joint
work,
so
we
are
working
very
closely
with
them
around
the
neurodiversity
agenda,
we're
in
provider
collaboratives
with
them
around
Eating
Disorders
forensic
services
and
Children's
Services.
G
So,
what's
your
experience
of
specialist
services
for
people
with
neurodiversity
and
learning
disability?
What's
your
not
personal
experience,
I
mean
what
what's
being
fed
back
to
you
about
those
Services,
specifically
hospitals
and
other
specialist
services
like
locked
rehab,
just
an
honest
assessment
of
what
what's
going
on.
E
There's
been
a
quite
a
lot
of
work
over
the
last
few
years
to
redesign
the
way
services
for
people
with
complex
learning
disabilities
that
are
sometimes
associated
with
neurodiversity
and
I.
Think
this
is
some
of
the
challenge
that
we
have
at
the
moment
is
people
with
neurodiverse
conditions.
It
does
not
necessarily
mean
you
have
a
learning
disability.
If
you
have
a
learning
disability,
it
doesn't
necessarily
mean
you,
you
have
a
new
you
that
you're,
a
neurodivergent
so
they're
often
seen
as
they're,
often
labeled
collectively,
but
actually
there
are
very
different
needs.
E
That
doesn't
mean
to
say
people
with
a
learning
disability
don't
sometimes
have
neurodiverse
conditions.
So
we
have
reconfigured
assessment
and
treatment
services
for
people
with
complex
learning
disabilities,
and
there
are
now
two
units
that
operate
across
West
Yorkshire.
We
moved
the
unit
from
Leeds
and
that
went
into
Bradford
and
Wakefield,
which
is
provided
by
Southwest
Yorkshire
partnership
and
Bradford
District
care
trust,
and
we
continue
to
work
in
partnership
with
them
in
terms
of
people
with
a
complex
rehab
need.
E
So
these
are
people
with
very
complex
Rehabilitation
needs
and
that
often
use
multiple
resources
from
different
agencies
and
can
be
quite
challenging
to
get
on
the
right
Pathway
to
recovery.
Again
there
is
a
West
Yorkshire
service
that
is
hosted
by
the
leads
in
your
partnership:
Foundation
trust
that
is
now
working
towards
developing
and
implementing
a
new
model
of
care
so
that
we
are
able
to
support
people
with
complex
Rehabilitation
needs
in
the
community
in
their
own
homes,
rather
than
them
needing
to
be
in
restrictive
Hospital
environments.
E
So
there's
some
been
some
significant
resources
allocated
to
that
through
the
transformation
one
is
through
the
new
money.
That's
come
into
Mental
Health
Services
over
the
last
three
years
and
I,
and
on
that
point
of
resources,
I
will
just
say
that
we
have
seen
significant
investment
in
services
in
Leeds
and
across
West
Yorkshire
in
in
mental
health
services,
for
people
with
complex
and
severe
mental
illness,
and
it
to
be
fair.
E
It's
the
first
time
we've
seen
this
level
of
investment,
the
redesign
around
the
community
mental
health
program
and
the
transformation
program
for
about
30
years,
and
so
it's
allowing
us
to
look
at
new
models.
New
ways
of
working
to
support
individuals
needs.
G
Thank
you
for
that
and
look.
Let
me
just
cover
everything
that
you've.
You
know
I
understand
the
the
difficult
situation
that
you're
you're
all
in
there's
never
been
parity
between
mental
health
and
and
physical
health,
and
indeed
physical,
health
and
Social
Services
as
well,
and
it
tends
to
be
sort
of
mental
health
provision
and
social
services
that
are
having
to
deal
with
the
most
complex
people
with
learning
disabilities,
neurodiversity
and
mental
health
issues
that
are
possibly
in
crisis
and
at
risk
to
themselves
and
others.
G
Now
it
sounds
great
about
what
you're
doing
in
terms
of
the
community
provision
and
of
course
we
certainly
did
need
more
Community
provision
nobody's
denying
that
at
all.
But
what
do
you
think
about?
How
much
provision
there
is
out
there
for
people
that
that
Community
provision
isn't
adequate
so
for
people
that
do
need
to
be
in
hospice
or
people
that
do
need
to
be
in
locked
rehab,
because
my
experience
is
actually
that
that
there
isn't
enough
of
that
provision
and
whilst
a
sort
of
left
shift
to
preventative
certain
Services
is
great
in
theory.
G
Sometimes
it's
not
adequate
enough
to
make
sure
that
those
people
are
safe.
You,
the
families,
are
safe
and
communities
are
safe
and
as
well
and
sort
of
saying,
like
Okay.
Well,
we've
got
community
support.
If
it's
not
adequate
and
the
beds
aren't
there
he's
putting
everybody
at
risk
and
what
you
tend
to
see.
Is
people
really
deteriorate
because
they're
just
not
getting
the
support,
they
need
what
they
really
need
is
being
hospital
or
locked
rehab
and
they
just
aren't
the
beds
there.
G
So
they
end
up
going
to
you,
know
whales
or
down
south
or
wherever
it
is
miles
away
from
the
family
and
you
see
them
deteriorated
and
the
situation
gets
worse
and
worse
so
I'm
I'm
saying
you
know
it's
great,
that
we've
got
that
left
shift,
but
I'm
I
would
expect
you
to
say
as
well
that
we
need.
We
do
need
more
beds.
E
So
there
there
are,
there
are
gaps
in
provision
in
some
areas,
so
looking
at
people
with
complex
needs
well
complex,
autism,
we're
doing
some
work
around
at
the
moment
about
what
might
some
provision
look
like
what
we're
trying
to
do
is
look
at.
Can
we
provide
support
to
people
in
the
least
restrictive
environment?
So
it's
not
necessarily
about
hospital
beds
and
lot
rehab
and
there
is
a
move
to
probably
not
grow
that
capacity.
So
in
Leeds
we
have
a
lot
rehab
a
lot
Rehabilitation
Ward
for
males.
We
don't
have
one
for
females.
E
E
What
we
do
need
to
do
is
provide
more
complex
packages
of
care
around
those
individuals
in
the
community
and
so
the
the
modeling
work
that
we've
done
suggests.
We
actually
have
the
right
number
of
beds,
but
we
don't
necessarily
have
the
wraparound
packages
of
care
for
individuals
balanced
in
the
right
way.
At
the
moment,
when
we
don't
have
that,
what
we
see
is
those
individuals
come
back
into
the
acute
care
system
and
putting
pressure
into
that
system,
and
that's
where
we're
seeing
most
people
placed
out
of
area
at
the
moment
we
are.
E
We
have
some
significant
challenges
in
Leeds
and
again,
we've
done
a
lot
of
work
around
modeling.
How
many
beds
do
we
need?
If
we
get
the
levels
of
community
support
right,
then
we
anticipate
well.
We've
we've
calculated
that
we
have
the
right
number
of
beds.
So
it's
what
our
focus
is
on
where
our
focus
is
at
the
moment.
E
Sorry,
that's
my
Lancashire
action
coming
out
and
where
the
focus
is
at
the
moment
is
about
focusing
our
attention
on
increasing
that
capacity
around
Community
Care
to
prevent
those
people
deteriorating
to
keep
them
well
and
keep
them
at
home,
because
we
know
a
significant
amount
of
crisis
is
preventable.
So
that's
that's
where
the
focus
of
our
attention
is
that's.
When
the
community
transformation
program,
we've
got
a
similar
amount
of
work
on
a
work
stream
that
I'm
chairing
within
the
mental
health
strategy
and
that
we've
just
renamed
since
the
paper
was
written.
E
The
crisis
transformation
program
because
we're
doing
the
same
thing
about
increasing
capacity
working
with
third
sector
colleagues
to
prevent
those
deteriorations
and
then
we've
got
the
more
specialist
redesigned
programs.
So
have
we
got
the
right
number
of
beds?
Probably
is
the
answer?
I'm
you're
never
going
to
get
me
to
say
we're
absolutely
100
certain,
because
a
lot
of
this
is
Art,
not
necessarily
science.
E
So
we'll
we've
probably
got
the
right
number
of
beds
and
we're
focusing
our
attention
on
the
right
areas,
but
we
know
the
challenge
is
we
know
that
we've
not
got
enough
Workforce
we've
got
significant
challenges
in
the
mental
health.
Workforce
Market,
that's
not
a
leads
issue.
That's
a
national
issue!
E
The
you
know.
We
really
welcomed
the
prime
minister's
Workforce
announcements
last
week
for
the
NHS
about
the
additional
numbers
and
training,
but
that
doesn't
solve
our
issue
right
now.
E
So
we're
focusing
on
that-
and
we
know
you
know
we-
we
need
to
move
quicker
and
faster
because
of
the
challenges
that
we
know
face
our
population
that
they
die
sooner.
They
have
more
physical
health
issues
than
the
general
population.
I
hope
that
kind
of
answers.
Your
question.
G
Doesn't
it
you
know
people
should
stay
in
the
homes
and
we
should
support
them
to
stay
in
the
homes
rather
than
go
to
some
luxury
Hab
or
Hospital,
but
when
people
are
are
at
crisis,
where
they
really
are
at
risk
themselves
and
others
and
the
family
just
can't
cope,
and
actually
the
sort
of
support
that
traditionally
put
in
tends
to
be
care
agencies,
specialist
care
agencies
for
for
people
with
you
know
that
specialize
in
people
learn
disabilities,
autism,
mental
health
or
whatever,
but
you
know
they
struggle,
you
know,
and
they
can't
be
there
24
7
or
even
if
they
can
be
there.
G
24
7,
but
you
know
it:
they're
still
themselves
are
at
risk
and
therefore
that
placement
is
always
at
risk
of
breaking
down
and
the
family
can't
cope
and
they're
just
screaming
out
for
actually
some
support.
That's
going
to
be
able
to
some
some
real
treatment
and
support
that
just
can't
be
delivered
in
the
community.
That's
my
experience
of
working
on
on
the
front
line
of
social
work.
G
So
often
the
amount
of
cases
that
that
is
the
situation
and
they
just
cannot
get
them
the
support
that
they
need
so
okay,
you've
said
that
we've
got
enough
beds
perhaps,
and
we
don't
need
that
lock
there
as
much
to
increase
our
capacity
in
large
rehab.
So
what
is
the
community
offer?
What
is
it
going
to
be?
That's
different
to
the
to
what
we
currently
have
at
the
moment
is
leaving
too
many
people
vulnerable
and
again
I'm
going
to
say
that
I
understand
that
you've
got
a
very
tough
job
and
you've
got
my
sympathies.
G
E
Okay,
so
support
packages
around
individuals
with
complex
needs,
I'll
ask
Liz
shortly
to
talk
about
the
work
that
we're
doing
in
the
community
mental
health
program,
but
in
the
complex
rehabilitation
service
we
are
partnered
with
third
sector
providers
who
employ
key
workers
and
support
workers,
and
we
have
mental
health
nurses,
Community
Mental,
Health
nurses,
who
will
also
work
alongside
those
teams
with
occupational
therapists
and
psychologists.
So
they
will
put
a
program
of
support
around
an
individual
and
that
can
be
really
intensive.
They
can
be
with
them.
E
You
know
they
can
visit
numerous
times
in
a
day
they
can
spend
prolonged
periods
of
times
with
the
individuals
to
help
them
rehabilitate
and
and
learn
how
to
you
know,
undertake
the
normal
activities
of
daily
living
that
many
of
us
around
this
table,
don't
think
twice
about
and
can
be
quite
difficult
for
them
to,
for
some
of
our
individuals
to
cope
with
and
and
to
and
to
do
so,
they'll
support
them
in
that
way
and
they'll.
E
There
is
a
number
of
kind
of
programs
that
are
psychology
psychologically
based
interventions
that
can
be
provided
for
people,
and
so
the
packages
are
tailored
very
individually.
Around
these
needs
and
they're
evaluated
to
make
sure
that
the
progress
is
being
made
in
the
right
direction.
So
that's
that's
the
nature
of
the
complex
rehabilitation
service
once
somebody's
kind
of.
If
you
will
graduated
through
that
program,
they
would
fall
under
the
remit.
The
Community
Mental
Health
teams
and
the
aim
there
is
to
support
them
and
to
help
them
maintain
their
well-being.
E
We
work
in
the
in
the
hubs
and
Liz
will
talk
about
this
in
a
minute.
The
Partnerships
are
really
important,
with
not
just
other
Healthcare
Providers,
but
housing
with
social
care
with
you
know,
Employment
Services,
because
it's
all
of
those
other
aspects
of
somebody's
life
that
will
keep
them
well.
E
So
this
is
where
the
hubs
offer
this
new
opportunity
of
working
differently.
So
we
just.
P
P
Some
referrals
and
people
of
the
same
individuals
have
been
referred
to
lots
of
different
Services,
because
people
don't
know
where
to
go
for
help,
and
that
means
that
that
same
person
might
be
looked
at
by
several
different
clinicians
have
different
assessments,
so
some
of
that
time
kind
of
goes
back
into
support
people.
There
are
some
key
principles
of
the
model.
So
if
somebody
has
a
mental
health
need,
they
can
be
referred
into
an
integrated
Hub,
they
can
self-refer.
P
P
We
hope
that
that
might
help
prevent
some
people
going
into
crisis,
because
sometimes
they
just
need
to
feel
supported
by
somebody
and
that
somebody's
there
to
work
with
them
and
for
some
people
it
might
be
what
we
call
a
brief
intervention
where
they
work
together
on
understanding
what's
going
on
for
that
person
and
what's
brought
them
to
that
point,
what
are
some
of
the
things
they
need
help
with,
and
it
might
be
a
really
simple
intervention
around
some
support
from
a
third
sector
organization
or
a
community
well-being,
connector
or
a
social
prescriber.
P
It
might
be
that
they've
got
lots
of
complex
needs
and
it
might
be
lots
of
different
things
relating
to
needing
some
psychological
therapeutic
support.
Housing
needs,
employment,
support
and
so
the
big
I
suppose
the
gift
of
this
idea
of
this
Hub
is
that
you've
got
all
those
people
and
agencies
working
together
with
that
individual
to
work
out
in
partnership
with
that
person
and
their
family
and
careers.
P
What
do
they
need
to
help
them
stay
well,
and
that
might
be
things
like
some
psychological
therapeutic
interventions
we've
put
in
and
a
lot
of
funding
into
recruiting,
more
psychological
therapists
and
different
types
of
roles.
So
we
can
offer
group
work
as
well,
because
sometimes
that
means
people
can
get
access
to
psychological
therapy
a
bit
quicker.
P
There
are
other
key
things
that
we
have
to
do
so
everybody
will
have
access
to
a
named
key
worker,
so
they'll
have
a
continuity
and
a
point
of
contact
to
work
with
them.
Everybody
has
to
have
a
personalized
care
plan,
that's
theirs
and
they
own.
So
what
we
hope
that'll
give
is,
is
a
greater
sense
of
clarity
about
you
know:
personalized,
lead
care,
planning,
somebody
being
clear:
what
are
the
interventions
that
are
going
to
be
offered
to
me
to
help
me
stay
well,
we'll
need
to
work
really
closely
with
crisis
services.
P
So
if
somebody's
needs
change,
how
do
we
get
them
into
the
right
service
or,
if
somebody's
in
crisis?
How
do
we
get
them
into
that
Hub
offer
sooner,
and
we've
also
done
lots
of
work
with
different
city-wide
specialist
services,
so
if
I
take
perinatal,
for
example,
or
or
connect,
which
is
a
specialist
eating
disorder
service?
P
So
if,
if
how
do
those
specialist
Services
support
the
teams
in
the
Hub
in
terms
of
upskilling
people,
but
if
somebody's
needs
change,
how
do
we
get
them
into
that
specialist
service
really
quickly
without
somebody
having
to
tell
a
story
all
over
again
without
it
having
to
be
a
new
referral?
So
so
lots
of
the
changes
might
be
about
how
teams
work
better
together,
which
might
not
feel
from
an
outside
view,
offer
a
service
user
what's
different
for
me,
but
actually
it.
P
A
Super
thank
you
very
much.
Okay,
I'm
going
to
move
on
to
Dr
John
Biel
next,
please
thank
you.
C
Thank
you,
chair,
Can
can
I
just
start
by
going
back
to
councilor
Gibson's
question
and
your
answer
about
neurodiversity.
C
Clearly,
we
understand
the
difficult
situation
in
which
you
you
are
placed
with
more
referrals
than
you
can
actually
cope
with,
but
as
I
understood
it,
what
you
were
saying
is
we're
looking
at
a
way
in
which
we
don't
have
to
do
the
full
assessment
and
diagnosis
and
can
perhaps
find
other
ways
of
of
taking
that
forward
as
I
understand
it.
At
least
a
number
of
those
children
who
are
referred
for
autism
eurodiversity
are
referred
because
an
assessment
and
diagnosis
unlocks
additional
support
within
the
education
system.
C
Shall
I
move
on
to
what
I
was
going
to
talk
about
the
findings
of
the
survey
I
appreciate
that
it
wasn't
a
random
sample
and
that
the
sample
size
is
fairly
small?
And
indeed
looking
at
those
who
might
be
University
students,
the
the
number
of
16
to
25
year
olds
was
only
21,
so
it's
a
very
small
sample,
but
on
page
37
it
says
most
students
felt
that
people
who
are
facing
challenges
aren't
treated
fairly
at
their
place
of
study.
C
So
my
question
is
what
work
has
been
done
and
or
is
being
planned
with
the
universe
cities
in
this
city
to
try
and
ensure
that
it
doesn't
end
up
with
you
know,
crisis
which
could
lead
to
suicide,
and
the
other
question
I'd
like
to
ask
is
going
going
back
to
crisis
services
adult
stroke,
older,
adult
crisis.
C
I
was
slightly
surprised,
it's
only
graded
as
Amber,
because
when
you
look
at
the
three
measurements,
one
of
them
percentage
of
people
receiving
a
mental
health
crisis
assessment
in
naught
to
four
hours,
52.5
against
the
target
of
85
percent
I,
think
that
is
a
very
clear
red
rating
so
and,
to
some
extent,
you've
probably
answered
the
question
I
was
going
to
ask,
but
I
would
just
say
that
for
some
time
in
this
city,
crisis,
Services
have
been
recognized
as
not
being
as
good
as
they
ought
to
be.
C
A
E
If
I
may
I'll
answer
your
crisis
question
first
and
then
I'm
going
to
hand
over
to
Liz
for
the
student
the
response
to
the
student
support.
Yes,
we
are
not
meeting
the
target
at
the
present.
If
you
were
to
see
the
trend
data,
it
would
show
that
we
were
meeting
it.
The
issue
is
absolutely
down
to
Workforce
at
the
moment,
and
we
have
been
working
hard
to
recruit
into
vacant
pulse.
E
To
look
at
you
know
different
methods
and
approaches
to
make
the
roles
more
attractive
to
people
to
to
encourage
them
again.
There's
been
some
reconfiguration
within
our
crisis.
Services.
I!
Don't
need
to
give
you
the
detail,
but
it
should
be
that
we
start
to
see
an
improving
position
in
the
response
times
so
yeah
and
you're
absolutely
right.
The
community.
The
crisis
transformation
program
is
focusing
on
those
areas
that
have
been
repetitive
in
the
feedback
that
we've
had
from
service
users
about
where
the
failings
are
in
crisis
services.
P
I'll
come
in
response
to
the
question
about
the
university,
so
lead
student,
Medical
Practice
in
the
light.
Local
care
partnership
is
one
of
our
early
implementer
sites
and
I,
and
it
that
decision
was
made
before
I
came
into
past.
But
I
think
that
part
of
the
reason
for
that
was
recognizing
the
need
around
that
population
and
also
it's
quite
a
specific
population.
In
terms
of
its
you
know
the
demographics
and
the
need,
so
we've
been
working
really
closely
with
them
in
different
ways.
P
So
when
we
started
the
work,
we
did
a
lot
of
mapping
work
to
understand
what
other
different
Services
provided
by
the
University
versus
the
NHS
and
other
care
agencies,
and
where
that,
where
there
might
be
gaps,
lead
student,
Medical
Practice
in
the
light,
as
a
Primary
Care
Network,
as
as
being
very
proactive
in
using
access
to
funding
to
put
in
new
roles
within
a
primary
care
level.
P
So
they
have
some
additional
mental
health
practitioners
they've
got
a
mental
health
practitioner
specifically
to
focus
on
eating
disorders
and
disordered
eating,
because
they
know
that's
an
area
of
Greater
need
in
their
population,
and
we've
been
working
really
closely
with
the
universities
around
their
health
and
well-being
offers
and
we've
put
in
place.
Some
new
roles
called
Community
well-being
connectors
who
are
there
to
work
with
people
they
take
referrals
from
the
University,
as
well
as
other
agencies
and
they're
there
to
support
people
who
might
struggle
to
access
services
that
are
out
there.
P
So
they
can
go
along
to
groups
with
them.
They
can
get
them
ready
for
certain
appointments.
As
Alison
said,
what
we
need
to
do
is
make
sure
the
links
with
the
crisis.
Work
are
really
carefully
sort
through,
so
that
we
aren't
creating
any
gaps
that
people
might
fall
through
and
we've
also
done
a
lot
of
work
around.
P
How
do
we
strengthen
the
relationship
between
specialist
Pharmacy
and
psychiatrists
to
GPS
to
help
them
better,
manage
people
in
primary
care?
So,
there's
quite
a
lot
of
international
students
who
might
come
having
been
prescribed
certain
types
of
medication
that
GPS
might
be
less
familiar
with,
are
able
to
manage
so
we've
improved
the
Psychiatry
import
into
Primary
Care
to
help
them
work
with
people
around
the
medication
needs,
and
things
like
that.
A
Thank
you.
Okay,
thanks
for
that,
councilor
Richie.
I
Thanks
Jack
I
just
want
to
dig
into
the
Community
Mental
Health
transformation
consultation,
so
I
had
a
little
bit
of
involvement
and
experience
of
that
first
through
the
lcps,
where
I
think
initially
they
set
up
these
well
the
90
days,
brainstorming
sessions
and
or
something
and
my
view
of
those
I
mean
I,
don't
want.
I
You
know,
you'll
give
me
overview,
but
was
there
were
a
bit
rushed
and
didn't
seem
as
organized
and
well
coordinated,
and
then
I
also
had
some
quite
extensive
involvement
in
the
leads
involving
people
consultations
and
they
had
it
small
working
group
with
lived
experience
and
we
had
a
workshop
there.
You
might
may
have
been
at
that
I'm,
not
sure
itself
Liz,
but
to
me
that
went
really
well.
So
my
question
is:
what
did
you
get
out
of
that?
P
Thank
you,
and
so
the
90
day
it
was
called
90
day
learning
cycle,
which
is
an
improvement
methodology
that
lead
to
New
York
partnership.
Foundation
trust
have
been
using
and
it's
meant
to
be
a
focused
sort
of
scan
of
the
evidence
around
different
models
and
things
like
that.
I
think
the
learning
was
that
was
too
ambitious
and
we
clearly
never
got
a
crack
something
that
complex
in
90
days.
It
wasn't
90
days
either
because
we
had
to
pause
for
two
months
because
it
was
when
I'm
a
problem
hit.
P
P
So
we
got
from
that
some
principles
and
then
we
went
kind
of
wide
again
and
had
lots
of
design
workshops
over
last
summer
in
Early
Autumn,
where
we
got
old
partners
and
people
lived
experience
in
a
room
and
looked
at
different
bits
of
provision
in
the
pathway,
went
back
out
to
the
local
care
Partnerships
and
said
this
is
what
we're
thinking.
What
do
you
think
give
us
your
feedback
and
kind
of
built
that
into
the
model
I
think
the
biggest
learning
is
this
stuff
really
takes
time
to
to
do
it?
P
Well
with
all
the
partners
around
the
table
to
do
genuine
lived
experience,
involvement
and
Care
involvement
takes
time.
It's
not
easy,
but
but
I
think
what
we're
trying
to
achieve
is
a
culture
change,
so
so
invested
in
the
relationships
now
feels
important
and
actually
a
lot
of
the
feedback
we've
had
around.
That's
been
really
positive
and
lots
of
good
work
around
trauma
and
farmed
care
as
well
so
yeah.
I
So
will
it
be
ongoing
discussions
and
feed
getting
feedback
from
those
group
like
the
leads
involving
people
group,
because
some
of
the
the
meat,
the
regular
meetings
suddenly
stop?
For
some
reason,
I
didn't
really
understand
why,
but
as
it
as
it
gets
implemented
because
I
know,
one
thing
that
was
brought
up
on
it
is
referred
to
in
here
is
the
trauma
service.
At
the
moment
I
mean
I've
had
casework
based
on
it,
and
people
are
passed
on
Pillar,
To
Post
from
primary,
secondary
and
back
again,
and
that's
certainly
been
picked
up.
P
You
and
there's
a
few
bits
to
that,
so
we're
aiming
to
start
piloting
those
first
three
hubs
from
Autumn,
so
we're
working
with
the
local
care
partnership
team
at
the
minute
to
say
we
need
to
come
back
out
and
and
give
people
an
update
and
work
with
people,
and
then
we
need
a
kind
of
regular
feedback
mechanism
in
terms
of
lived
experience,
involvement
because
because
it's
so
important,
we
get
this
right.
P
We
have
put
some
investment
into
resourcing
that
properly
so
there's
a
there's,
a
lead
in
involvement,
lead
who's
employed
by
leads
involving
people,
and
they
formed
an
involvement
Network
so
that
there's
a
there's
a
group
there
who
can
meet
and
and
be
a
sort
of
reference
group,
be
involved
in
different
working
groups.
They
need
to
grow
that
and
it's
it's
not
as
diverse
as
it
could
be
in
terms
of
its
membership.
P
They're.
Not.
There
are
now
four
additional
involvement
workers,
each
of
who
sit
in
a
in
a
third
sector
organization
with
the
relevant
sort
of
specialism.
So
there's
a
worker
looking
at
carers
needs
a
worker
focusing
on
racialized
communities,
a
worker
focusing
on
working
age
and
younger
adults
and
a
worker
focusing
on
older
people.
So
we
want
to
make
sure
that
we
keep
having
that
conversation
go
to
the
groups
where
we
need
to
understand
any
particular
barriers
to
access
or
different
types
of
support
that
we
might
need
to
provide
in
a
different
way.
P
So
that's
an
ongoing
dialogue,
really
healthwatch
have
been
providing
some
additional
support
recently
as
well
around
strategic
inputs.
So
there
will
be
an
updated
involvement.
Engagement
plan
coming
through
our
program
board
in
the
next
couple
of
months,
so
but
any
any
feedback
separately
or
any
questions
more
than
happy
to
take
them
and
I
can
put
you
in
touch
with
the
relevant
involvement,
lead.
I
I
We
were
asked
to
as
world
councilors
through
our
LCP
to
do
a
bit
of
a
a
week
survey,
not
just
us
but
other
partners,
every
contact
that
they
had
to
ask
them
if,
if
they
were
having
an
impact
on
the
mental
health
and
during
the
course
of
that
week,
I
had
22,
separate
inquiries
that
had
you
know,
I'd
asked
them
all
the
feeling
about
it
and
that
so
it's
making
me
depressed
or
I'm
feeling
down
about
it.
So
I
recorded
all
those
and
22
people
referenced
mental
health
and
mood.
I
I
I
Now,
that's
as
I
said
beyond
your
control,
so
this
additional
resource,
for
example,
with
the
connect
I,
think
you
call
them,
can
City
connect
workers
or
whatever
that
have
been
put
out
there.
They'll
come
up
to
the
same
problems
that
we
do
as
a
housing
problem.
Often
they
refer
back
to
your
local
counselor
to
try
and
resolve,
but
it's
out
of
our
control
because
there
isn't
enough
Council
houses,
the
so-called
affordable
housing
and
the
government's
help
to
buy
scheme
which
subsidizes
billion
pound
property
developers
aren't
affordable,
affordable
for
people.
I
So
we're
really
tackling
this
with
one
hand
behind
our
back
as
far
as
I'm
concerned
it's
out
of
our
control,
but
that's
the
crucial
thing:
it's
like
the
foundations.
Isn't
it
to
get
a
good
point,
a
lot
of
the
mental
health
issues?
We
need
to
sort
out
those
car
services,
and
that
means
funding
local
authorities
adequately
and
just
to
say
on
on
those
contacts
that
I
had
it's
interesting,
that
it
reflected
I.
I
Think
out
of
75
women
contacting
me
out
of
those
22
which
ties
in
well
with
your
cohort
characteristics
and
that's
the
other
thing
that
I'm
sure
will
be
addressed,
but
the
lack
of
males
male
mental
health
and
the
lack
of
Engagement,
be
it
presenting
at
services
and
responding
to
consultations.
I
I
suppose
that
was
more
of
a
comment
chair
but
I
think
it
needed
saying.
A
Yeah,
thank
you
I.
Take
that
as
a
comment
thanks,
Kevin
councilor,
Richard,
I,
think
you're
absolutely
right
on
the
housing
and
I,
don't
think
the
service
look
like
they're
disagreeing:
okay,
I'm
going
to
bring
in
councilor
hartbook
next.
K
Thanks
chair,
councilor
Gibson
spoke
very
eloquently
and
very
passionately
about
clients
that
were,
at
the
very
extreme
end
of
need,
almost
kind
of
at
the
point
where
I
was
just
too
late,
but
actually,
when
they're
already
in
crisis,
picking
up
to
some
extent
of
what
councilor
Richie
was
saying
around
a
lot
of
mental
health,
you
know
I
think
as
a
society.
One
good
thing
I
would
say,
is
we
talk
about
it
more
to
some
extent,
the
taboos
around
talking
around
mental
health
have
come
down
a
lot.
K
You
know
that
I
don't
around
the
number
of
males
who
were
reporting
mental
health
issues
such
as
females
I,
don't
know
for
one
moment
think
that's
gender
I
think
it's
more
to
do
with
propensity
to
step
forward
and
to
seek
to
seek
help,
but,
irrespective
in
irrespective
of
funding,
it's
clear
there
is
more
need
out
there,
because
with
identification
and
with
removing
taboos,
people
are
stepping
up
and
saying
actually
yeah
I'm,
not
all
right
and
whether
that's
because
of
housing
or
whether
it's
because
of
jobs,
whether
it's
because
they're
worried
about
climate
change
or
or
whatever
else
is
Weighing
on
them,
and
you
know
sort
of
giving
them
that
going
from
you
know,
sort
of
swimming
to
floundering
help
help
is
needed
and
I
think
for
many
of
those
I
mean
a
lot
of
all.
K
The
work
that
you
do
is
when
people
are
already
I
guess
a
good
way
through
that
Journey.
But
there's
a
lot
I
think
can
be
done
with
diverting
people
who
it's
more
situational
mental
health.
You
know
it's
mental
health
because
of
what's
happening
to
them
and
how
they're
and
their
their
robustness
in
coping
with
that
rather
than
I,
suppose
anything
kind
of
more
clinical
I
I
would
say
now.
I
know
organizations
I've
worked
with
a
business.
K
K
Are
you
doing
everything
possible
to
leverage
the
resources
and
capabilities
of
others
to
make
sure
that
a
so
you
know,
different
organizations
are
sharing
best
practice,
but
also
to
require
Frank
to
make
sure
that
the
ones
that
come
to
you
are
the
ones
that
have
to
come
to
you,
rather
than
the
ones
that
could
be
dealt
with
either
by
whether
it
be
counselors
or
by
somebody
with
some
trade
I'm
thinking
about
kind
of
mental
first
aid,
rather
than
kind
of
you
know,
that's
how
it
gets
to
you
your
kind
of
mental
heart
surgeons,
I.
K
Don't
try
to
think
how
you
get,
how
you
kind
of
the
ones
that
could
get
a
lot
more
serious
if
it's
not
dealt
with
get
dealt
with
more
at
a
community
level
or
a
business
level,
or
an
organizational
level
that
isn't
taking
resources
using
up
yours.
What
are
quite
clearly
especially
spiritual
resources
thanks.
A
Thanks
just
before
you
come
in
also
there's
there's
definitely
some
of
the
partnership
work
from
page
56
onwards
on
the
pack,
but
I'll.
Let
her
madison
comment
as
well.
Thank
you.
E
E
There
is
a
whole
spectrum
of
work
that
goes
on
to
support
people
with
mild
to
moderate
mental
illness,
and
that
starts
really
with
the
work
stream,
one
that
I'm
sure
Karen
will
talk
about,
but
there's
the
the
work
that
is
going
on
or
the
services
that
are
provided
by
Leeds
Community
Healthcare,
which
is
the
talking
therapies,
which
is
the
new
name
for
what
we
affectionately
refer
to
as
I
apt.
E
They
likewise
have
seen
a
similar
growth
in
referrals
and
struggling
in
some
of
the
capacity
issues
and
but
actually
looking
at
their
data.
They
are
doing
reasonably
well
at
some
of
that
access
stuff
and
that
recovery,
the
recovery
rates
that
are
required,
but
I,
think
this
is
where
the
role
of
social
prescribing
of
employees
being
good
employers
and
and
that
kind
of
thing
it
needs
to
be
paid
attention
to.
Are
we
doing
everything
we
can
within
secondary
care
services?
I
like
to
think
we
are
there's
possibly
more?
E
We
could
do,
but
there's
a.
We
are
there
to
support
that
whole
volume
of
activity
that
goes
on
at
that
end
of
the
spectrum,
that
is
about
preventing
people's
mental
health,
deteriorating
to
the
point
where
it
becomes
necessary
for
them
to
seek
help
from
secondary
Care
Mental
Health
Services.
Q
Thanks
very
much
just
to
come
back
on
a
couple
of
them.
The
points
people
have
raised
previously
I
think
I'll,
try
and
work
backwards,
because
I
can
remember
it
easier
that
way:
cancel
the
heartbrew
first
about
training
and
stopping
people
kind
of
getting
further
along
the
pathway
around
towards
crisis.
Q
What
we're
really
Keen
to
do
is
keep
people
well
in
the
first
place,
so
it's
not
just
about
people
with
mild
mental
health,
actually
I'm
further
up
the
stream
than
that
as
well,
for
people
to
be
able
to
not
only
talk
about
their
mental
health
and
well-being,
but
actually
think
about
the
things
that
might
improve
that
we
know
what
the
risk
factors
are.
Q
Our
own
mental
health
inequalities
is
an
obvious
one
that
that
people
haven't
really
talked
about
this
afternoon,
but
there's
a
huge
disparity
around
mental
health
and
inequality
that
we
need
to
think
about
so
focus
in
some
of
our
work
in
those
more
areas
that
really
need
that
we
talk
about
the
mental
health
of
of
men
and
we
do
have
a
good
support
network
in
leads
around
men's
mental
health.
Q
A
lot
and
there's
quite
a
number
of
organizations,
and
certainly
from
a
public
health
perspective,
we've
funded
quite
a
lot
of
men's
organizations
or
through
small
grants
to
work
with
men
to
think
about
how
they
start
talking
about
mental
health
by
actually
talking
about
their
feelings
and
much
more
broadly,
so,
there's
quite
a
lot
of
work
that
we're
doing
across
the
city
very
much
from
very
much
Upstream
around
that
preventative
approach
around
getting
people
to
to
think
about
their
mental
health
and
not
everybody
uses
those
terms.
Being
you
leads
our
new
new
approach.
Q
Is
we
don't
use
the
word?
Mental
Health
Service,
a
it's,
not
a
service
in
B.
We
wanted
to
not
give
it
the
kind
of
recognition
that
this
is
a
mental
ill
service,
because
we
know
that
that
will
immediately
put
people
on
it's
about
people
being
able
to
be
more
thinking
about
and
promote
in
their
own
health,
in
its
broadest
sense
and
and
coming
back
to
to
councilor
Richie's
point
about
those
wider
factors,
the
impact
on
on
someone's
mental
health.
Q
We
know
about
all
those
and
yes,
we
have
to
still
try
to
mitigate
them
where
we
can,
but
certainly
the
work
that
we're
beginning
to
do
around
the
work
that
Michael
Marmot
promoted
around
actually
giving
people
not
only
the
best
start
in
life,
but
actually
tackling
those
wider
things
that
we
know
impact
on
on
someone's
physical
and
mental
well-being.
So
we
need
to
do
both.
I
would
say
we
need
to
do
where
we
can
to
support
people
who
may
may
be
struggling
for
whatever
reason,
but
also
thinking
about
that
brother.
Q
How
do
we
change
things
for
the
future
so
that
people
don't
have
to
end
up
in
in
some
sort
of
Mental
Health
Service,
which,
for
all
the
reasons
and
you've
been
outlining
this
afternoon,
make
it
really
difficult
for
someone
whether
they
actually
even
seek
that
help
in
the
first
place
or
until
it's
too
late?
So,
for
example,
you
know
my
work
around
Suicide
Prevention.
We
still
know
that
the
vast
majority
of
people
who
take
their
whole
life
are
men.
Q
You
still
see
that
so
a
lot
of
our
work
is
a
focused
on
on
focusing
on
on
supporting
men
around
that
agenda
and
also
students.
We
know
we
know
students
are
more
likely
to
take
their
own
life,
so
making
sure
we
have
preventative
approaches
to
to
look
alike
as
well.
Looking
at
both
risk
factors,
the
individual
responses
and
those
groups
are
at
highest
risk,
so
I'll
leave
it
there
chair.
A
O
Thank
you
chair
just
briefly
just
to
Echo
Karen's
comment,
Sarah
and
thank
the
councilor
first
question.
I
think
it's
it's
such
a
fundamental
point
that
we
know
that
around
eight
to
ninety
percent
of
mental
health
is
created
in
communities
we
can
see.
The
demand
for
services
is,
is
growing
beyond
measure
and
we
will
never
solve
the
problem
by
Services
alone.
Our
service
colleagues
are
not
in
there.
You
know.
Obviously,
Services
have
got
a
critical
role
to
play
for
the
people
who
absolutely
need
them.
O
So
there's
something
about
getting
that
balance
right.
So
I
really
welcome
that
the
comment
I
think
the
the
other
point
to
go
further
on
that
some
some
of
you
may
have
be
familiar
with
some
of
the
published
evidence
recently.
That
also
says.
Not
only
is
it
not
going
to
solve
the
problem,
but
it's
fundamentally
damaging
to
individuals
who
are
living
in
conditions
that
are
harming
their
physical
and
mental
health
and
then
to
actually
locate
the
problem
with
them.
As
you
know,
so
they
are
then
the
problem.
O
There
is
something
that
matter
with
you
and
I
think
that
we,
we
really
run
the
risk
of
actually
compounding
inequalities
and
people's
ability
to
recover
and
again
going
back
to
the
Marmot
City
approach.
If
we
send
people
back
into
the
conditions
that
make
the
mill
in
the
first
place,
then
you
know
we
never
solve
that
problem,
so
I
think
in
Leeds.
O
What
we're
really
proud
of
is
the
fact
that
you
know
Karen's
leading
a
work
within
the
strategy
that,
as
a
city,
you
know
we
can
always
do
more,
and
it's
always
hard
to
make
the
case
for
prevention,
particularly
in
mental
health,
because
we
we
often
default
to
Services,
more
so
than
in
physical
health,
but
the
fact
that
we've
managed
to
carve
out
and
hold
on
to
at
least
some
resource
to
do
the
work
that
Karen's
described
is
an
important
bit
of
the
strategy
and
I
welcome
the
opportunity.
A
Thank
you
very
much.
Victoria
I
think
very
well
made
points
okay,
I'm
going
to
bring
in
counselor
Farley
next.
J
Thank
you
chair,
so
I'm
I've
got
two
sets
of
questions,
we'll
start
with
we'll
start
with
Workforce
first,
so
we
had
reference
earlier
to
the
new
NHS
long-term
Workforce
plan.
J
J
Obviously,
within
that
you
know,
there's
you
know
we
don't
have
enough
staff
as
it
is
so
are
we
looking
at?
Can
I
go
the
the
shape
of
the
workforce?
Has
there
been
a
shift
in
roles,
development
of
new
roles,
ensuring
that
kind
of
staff
are
working
to
the
top
of
their
register,
looking
at
effective,
effective
deployments
within
across
across
all
the
different
partners?
J
Obviously,
as
we've
now
got
ics's
and
much
more
Integrated
Systems,
which
is
obviously
welcome,
welcome
following
the
toll
fragmentation
of
of
the
of
the
system
10
years
ago
or
just
over
10
years
ago,
so
yeah
can
you
tell
us
a
little
bit
more
about
about
the
workforce
and
where
we're
heading.
E
Thank
you
yeah
welcome
the
opportunity
actually
to
talk
about
this.
It's
something
that's
paid
great
attention
to,
certainly
within
secondary
Care
Mental
Health,
Services
I'll
start
with
the
the
day-to-day
shortages
that
we
experience,
because
we
have
gaps
in
in
posts
and
that
is
across
all
the
different
professional
groups.
E
We've
done,
the
immediate
actions
are
around
you.
Utilizing
banking
agency
and
we've
done
an
awful
lot
of
work
to
reduce
our
agency,
spend
and
increase
the
number
of
Bank
stuff
or
temporary
staffing
that
we
can
call
upon
when
we
need
them
to,
and
that's
been
quite
successful.
E
So
we
are
able
to
safely
run
the
services
as
we
need
and
we've
had
some
particular
challenges
in
our
community
mental
health
services,
and
we
have
redeployed
staff
from
within
our
ypft
who
have
a
clinical
background
that
are
in
non-clinical
roles
now
and
we've
redeployed
a
number
of
those
into
our
community
services
to
ensure
that
we're
able
to
provide
the
access
and
the
assessments
as
needed
to
the
teams.
E
E
It
is
multifaceted,
some
of
the
schemes
that
we've
had
great
success
with
are
around
the
apprenticeship
scheme,
so
we
have
maximized
our
apprenticeship,
Levy
and
the
number
of
apprentices
that
we
have
in
in
the
services,
and
that
includes
interclinical
roles
into
Healthcare,
support,
workers
and
and
and
other
roles
like
that,
we
continue
to
run
a
number
of
kind
of
recruitment
campaigns
where
we
have
worked
with
colleagues
in
the
council
and
colleagues
from
across
West
Yorkshire
to
advertise
about.
E
You
know,
Leeds
and
Yorkshire
being
a
great
place
to
work
and
live
and
to
make
the
packages
around
those
posts
more
attractive
incentives.
You
know
golden
hillels
that
kind
of
things
refer
a
friend
scheme
Etc
and
we've
had
some
success
with
those,
but
the
part
of
the
challenge
of
that
is
we're
fishing
in
a
small
pond
at
the
moment.
So
we
recycle
a
lot
of
Workforce
around
the
different
mental
health
providers.
E
Another
area
that
we've
looked
at
is
developing
those
new
roles.
So,
for
example,
one
of
our
challenging
areas
of
recruitment
is
in
consultant
psychiatrists,
so
we
have
developed
a
number
of
specialist
roles
and
and
developed
nurses
and
therapists
into
specialist
roles
where
they
can
take
on
some
of
the
responsibilities
of
you
know
that
were
previously
undertaken
by
medical
staff
and
the
other
area
that
we've
had
great
success
with
is
partnering
with
our
third
sector
colleagues
across
Leeds.
E
E
We
we're
looking
at
care
coordination
being
passed
to
them
and,
and
that
kind
of
thing
and
we've
had
some
real
good
success
with
that
the
workforce
challenges
are
knocking
on
into
the
third
sector.
So,
whereas
previously
they
had
no
issue
recruiting
staff
they're
now
beginning
to
find
it
more
challenging
to
do
so,
and
so
those
are
just
some
of
the
schemes
that
you
know
that
we're
that
we're
undertaking
the
the
the
the
challenge
with
all
of
those
schemes
is
they
are
great.
E
But
sorry,
I
should
mention
that
we
are
part
of
the
leads
one
Workforce
as
well
and
in
fact,
I
think.
That's
that
is
still
chaired
by
Sarah
Munroe
who's,
our
chief
executive,
so
we're
working
with
with
colleagues
across
Leeds
on
on
that
development
program
as
well,
and
the
challenge
is
that
the
rate
of
delivery
of
the
new
Workforce
isn't
at
the
rate
of
attrition
that
we've
seen
in
in
recent
months
and
years
from
from
Mental
Health
Services.
We've
also
got
things
like
retire
and
return
schemes
and
Etc.
P
Okay,
it
was
just
to
add
to
that
in
the
context
of
Community
Mental
Health
transformation,
we're
doing
all
of
the
stuff
that
Allison's
talked
about,
but
it's
also
about
how
we
retain
stuff,
not
just
how
we
recruit
them.
So
we've
been
doing
lots
of
work
thinking
about
what
are
what
do
career
Pathways
look
like
so
people
feel
like
they've
got
somewhere
to
go
and
we've
put
a
lot
of
thought
into
investing
in
what
we
call
recruit
to
train
roles
or
that
we
we
train
people,
but
then
we
keep
them
in
the
lead
system.
Essentially,
thanks.
J
I
think
you've
just
you've
sort
of
answered
answered,
one
of
my
follow-ups,
which
was
around
like
progression,
because,
obviously
you
talked
about
the
apprenticeships,
but
once
you've
got
the
apprenticeship
where'd
you
go
from
there,
I
suppose
again,
the
you
know.
The
the
key
issue
at
the
moment
for
a
lot
of
the
NHS
Workforce
is
around
well
with
retent
in
terms
of
retention
is
pay.
J
The
government
is
completely
refusing
to
acknowledge
that
quite
a
lot
of
our
NHS
Workforce
has
had
a
pay
cut
of
the
past
13
years
last
years,
and
the
refusal
to
remunerate
people
properly
for
the
work
that
they're
doing
in
the
context
of
in
the
context
of
kind
of
increasing
workload,
increasing
work
pressures
is,
is
clearly
driving
people
away.
J
You
know,
for
you,
know,
band
five
nurses
on
around
well,
just
under
30
000.
At
the
moment
yeah
you
could
go
and
work
in
PR,
and
you
know
it's
for
similar,
similar
sorts
of
money
without
the
additional
stress
and
pressure
of
the
shift
system.
So
do
you
think
that
that's
impacting
on
on
your
ability
to
attract
to
the
to
the
workforce
and
I'd
also
just
asked
what
does
what
does
the
international
Workforce
look?
Like?
J
Obviously,
we've
been
a
number
of
reports
looking
at
how
how
nursing
has
been
increased
over
the
past
past
several
years
and
quite
a
big
chunk
of
that
is
coming
from
overseas.
So
what
does
that
look
like
within
the
context
of
the
lead
system.
E
I'm
not
sure
I
want
to
comment
on
the
pay
thing,
if
I'm
really
honest
I
suppose-
and
this
is
a
personal
view-
and
I
must
caveat
that-
that
the
challenges
with
any
pay
rise
that
comes
there,
isn't
an
increase
in
the
funding
part
to
do
it.
We
get
an
inflationary
uplift,
usually
into
public
sector
Services
each
year.
If
there's
a
pay
increase,
it
has
to
come
from
within.
E
So
then
there's
a
consequence
of
that
balancing
services
in
terms
of
the
international
recruitment
program
we've
done
that
jointly
across
West
Yorkshire
and
for
mental
health.
It's
not
been
that
successful.
I'll
be
honest.
There
has
been
some
small
numbers
of
people
come
from
abroad,
but
there
isn't
a
particular
plethora
of
people
abroad.
E
You
know
there's
obviously
a
challenge
in
mental
health
Workforce
internationally,
as
well
as
nationally,
so
we've
not
had
a
great
deal
of
success
and
there
has
been
some
issues
with
integration
of
some
of
those
International
workers
into
the
services
that
as
they've
arrived.
So
while
we
will
try
to
keep
on
trying
with
that
approach,
we're
not
relying
on
that
as
being
a
a
an
income
of
you
know
an
incoming
Workforce
incoming
Workforce
numbers
of
any
significance
really
and
really.
J
Thank
you.
Thank
you.
I
I
I
suspect,
as
you
might
not
be
able
to
opt
for
not
to
comment
on
that,
which
is
why
I
I,
like
the
politics
on
heavy
there,
I
I,
suppose
the.
But
my
next
question
is
more
around
kind
of
the
relationship
between
between
the
system
and
patience,
because
it
was
the
reference
made
to
to
kind
of
neurodiverse
services
and
assessment
having
a
lot
of
issues
in
terms
of
kind
of
people.
J
Obviously,
an
increase
in
demand
has
led
to
an
increase
in
people
waiting.
How?
How
are
these
challenges
being
communicated
to
patients
and
what
I'm
thinking
is
kind
of
if
waiting
times
are
increasing,
are
people
being
informed
of
like
how
long
they
can
can
expect
to
wait?
How
how
has
this
been
passed
on?
Is
there
proactive
communication
around
these
issues.
E
I
would
like
to
say
there
is,
but
we
have
been
looking
at
the
moment.
We
are
developing
communication
to
go
out
to
GPS
to
inform
them
of
the
waiting
times
because
they
make
the
referrals
into
the
services.
E
So
when
the
the
in,
when
the
person
who
sat
before
them-
and
they
said
I'll,
make
the
referral
and
we're
going
to
be
providing
GPS
with
more
up-to-date
and
accurate
information
about
what
the
current
waiting
times
are,
and
it's
at
that
point
that
then
an
individual
may
choose
to
seek
an
assessment
from
an
alternative
provider.
J
And
and
if
the
individual
kind
of
has
been
waiting,
you
know,
are
they
able
to
go
to
the
alternative
provider
kind
of
within
that
period
or.
M
What
sort
of
how
do
we
review,
whether
this
is
working
when
we
give
people
these
grants?
How
are
we
making
sure
that,
what's
being
done,
is
leading
to
the
outcomes
that
we
want?
Thank
you.
P
So
there's
two
two
ways
really
so
the
grant
funding
is
being
led
jointly
by
Leeds,
Community,
Foundation
and
Forum
Central.
So
they've
got
a
thorough
evaluation
process
in
place
around
that
and
then
we're
also
evaluating
the
whole
of
the
Community
Mental
Health
transformation
program.
P
It's
part
of
a
West
Yorkshire
evaluation
over
two
years,
so
so
on.
Bar
sauce
fronts
will
be
looking
at
the
effectiveness
of
those
grants
and
the
value
for
money
and
the
impact.
M
The
outcomes
are
written
down
so
that
we
can
maybe
review
them
at
some
point
to
say
that
you
know
this
number
of
people
were
helped
and
we've
seen
less
people
coming
through
to
need
more
serious
interventions,
and
you
know
things
like
that.
P
So
we
for
that,
for
the
grant
specifically
I
can
request
that
information,
if
that's
helpful,
and
we
can
pass
that
through
in
terms
of
their
evaluation
framework
for
the
program.
Overall,
we
have
the
spec
in
terms
that
we've
got
some
outcomes
that
were
co-designed
and
there's
a
series
of
indicators
under
that,
and
then
we've
got
the
information
about
what
Niche
the
evaluation
provider
will
be
doing
so
I'm
happy
to
pick
up
with
yourself
around
whatever's
needed
to
be
passed
on
in
terms
of
information.
F
Thanks
chair
as
councilor
Anderson
lost,
my
questions
I've
been
asked
and
said
well
I'm,
just
going
to
comment.
I,
don't
expect
an
answer
from
these
questions.
What
I'm
going
to
say
you
talk
about
you
work
with
agency.
The
agencies
I
was
expecting
you
to
work
with,
is
Universal
Credit,
housing,
environmental,
because
those
is
a
thing
that
triggered
mental
health.
Counselor
Gibson,
councilor
Richie
highlighted
housing.
All
these
10
sectors
are
amazing.
F
I
support,
territor,
there's
110,
but
their
sessions
is
just
for
an
hour
half
an
hour
two
hours
per
session
when
they
go
back
home
in
housing,
they've
got
dams,
they've
got
mice,
they've
got
whatever
going
on
their
mental
health
kicked
in
back.
You've
mentioned
food
banks.
When
we
didn't
have
food
banks,
I
will
never
have
food
banks.
How
would
they
cope?
These
are
the
things
I've
worked
in
mental
health
all
my
time
as
it
changed
I,
don't
think
so.
The
only
difference.
F
What
I
think
is
we
talk
about
it
more
and
there's
so
many
ideas
in
black
and
white,
but
it's
not
in
action
for
those
individuals
and
I
honestly
think
we
need
to
look
at
the
agencies
that
we
work
in.
We
need
to
look
at
housing,
Universal
Credit.
That
was
a
big
issue.
I've
got
two
young
people
that
that
came
to
me
and
it's
a
shame
to
see
where
they
live,
how
it's
going
ring
Universal
and
that
make
it
worse.
F
They
came
out
as
people
they
went
in
in
a
state
and
they
came
back
home
in
the
state
and
those
are
the
issues
we
need.
As
councilor
Anderson
says,
we
are
spending
so
much
money
and
these
agencies
we
need
to
look
at
the
environment.
We
are
locating
them
in
housing
in
the
private
area,
for
instance
chapeltown
Aerials,
where
they
can
get
drugs
alcohol.
What
contributed
to
mental
health?
We
need
to
look
at
the
environment
where
we
put
in
these
individual.
F
If
we
need
to
help
them
and
yeah,
we
just
need
to
do
more
for
what
we're
doing,
especially
to
our
young
people.
Just
be
careful
where
you
putting
these
young
people
to
live
the
environments
they're
around
and
so
on.
Thank
you.
O
Well,
only
briefly
to
thank
councilor
Taylor
for
a
comments.
I
I
think
this
is
the
conversation.
It's
really
helpful
to
have
the
conversation
to
look
at
the
the
way
we
we
look
at
mental
health
and
and
which
would
inform
the
way
we
respond
to
it.
Karen
in
her
introduction
talked
about
really
understanding
the
protective
factors
that
we
know.
O
We
we
we
need
this
joined
up
approach
of
of
all
the
things
that
councilor
Taylor
has
just
outlined
because
we're
we're
over
medicalizing
the
the
agenda
and
and
we'll
never
will
never
solve
the
problem
by
over-medicalizing.
The
agenda
so
I
do
welcome
those
comments
which
feed
into
the
work
that
we're
trying
to
do
as
a
council
and
all
the
things
that
we
can
affect
that
make
a
difference
to
all
those
protective
factors.
So
I
know
it's
a
huge
agenda,
but
thank
you
for
your
comments.
R
Yeah
I
think
I.
Think
one
thing
that's
been
really
interesting
to
to
reflect
is
the
amount
of
times
that
housing
has
has
come
up
actually,
in
this
conversation,
so
I
think
we've
we've
discussed
the
previous
scrutinies
when
we've
gone
through
things
like
health
and
well-being
strategy,
how
we
prioritize
in
housing
and
health.
R
We've
got
breakthrough
program,
it's
part
of
the
Marmot
work,
but
it's
not
brought
out
really
clearly
in
in
the
current
mental
health
strategy,
even
though
there
are
a
number
of
actions
around
mental
health
and
housing
and
additional
support
and
working
with
third
sector
organizations.
So
it's
maybe
one
thing
we
can.
We
can
take
back
to
the
mental
health
strategy
group
and
and
actually
refocus
on
on
that
as
an
area
and
be
clearer
about
some
of
the
things
that
we're
doing
so
likewise
and
thank
councilor,
Taylor
I
know
the
people
for
that
that
comment.
R
Housing
is
so
important
at
the
moment
and
it's
such
a
a
challenge.
Isn't
it
not
just
sort
of
paying
for
it,
but
the
quality
of
housing,
The,
Damp
and
and
the
condition
that
a
lot
of
people
are
living
in,
particularly
in
deprived
areas.
A
Okay,
thanks
very
much
I
think
I'm
gonna
sort
of
summarize
and
try
and
wrap
this
item
up
a
little
bit
now.
Do
you
have
you
into
sorry,
I
didn't
see
an
indicator.
Sorry.
L
James
all
right,
thank
you.
I
have
a
question
around
what
the
strategy
is
doing
to
make
sure
that
cross
Authority
work.
You
know
what
what
what
work
is
being
put
into
that
as,
for
example,
mirrored
Council
services
to
make
sure.
For
example,
if
someone
is
in
Bradford
and
they've
recently
moved
from
Bradford
I
I'll
use
an
example
of
a
constituent
of
mine
who
I
mean
guys
named
Ryan,
which
is
very
close
to
the
border
of
Bradford.
L
This
person
needed
Crisis
Support
and
they
had
previously
been
in
contact
with
myself,
but
they
moved
just
off
the
border
into
the
Bradford
Authority,
and
we
put
everything
in
place,
got
in
touch
with
it
or
you
know
referred
them,
and
then
we
got
an
email
back
to
say
that,
because
they
were
still
registered
with
a
Leeds
GP,
then
it
kind
of
you
know
it
it.
L
Just
in
respect
to
the
the
term
people
being
bounced
around
the
system,
I'm
just
wondering
what
places
what
work
is
being
put
in
place
to
make
sure
that
the
council
services
that
are
mirrored
with
neighboring
authorities,
what
what
work
is
going
into
those
to
make
sure
that
they
are
working
together
in
the
best
they
can
be.
Thank
you.
E
We
depend
on
having
good
relationships
across
the
borders
with
our
local
Authority
colleagues
and
our
NHS
colleagues
in
order
to
try
and
resolve
these
situations
around
individuals,
I
I,
if
I'm
honest,
I,
can't
answer
with
any
Authority
right
now
about
any
specific
pieces
of
work
that
are
looking
at
kind
of
those
cross-border
issues.
E
And
what
I
do
know
is
we
sort
of
quite
a
few
of
them
out
on
an
individual
basis,
but
I'd
be
happy
to
go
away
and
have
some
conversations
with
colleagues
in
the
local
Authority
well
within
Leeds
city,
council
and
Bradford
to
find
out?
If
there's
any
specifically
I,
don't
know
if
Caroline
might
be
aware
of
any
specific
initiatives.
S
It's
certainly
from
a
commissioning
perspective.
We
work
together
with
Commissioners
across
the
region
around
any
benefits
there
might
be
to
working
to
manage
the
market
and
develop
the
market
for
provision
so
equally
for
mental
health
services
supported
living
type
Arrangements,
so,
but
probably
less
so
the
community-based
and
preventative
Services.
S
To
be
honest,
we
will
work
with
our
local
community
organizations,
but
not
across
boundaries,
but
if
we
think
that
there
might
be
smaller
numbers
of
people
who
need
more
complex
packages
of
support,
then
we
absolutely
do
work
across
the
boundaries.
S
L
Thank
you,
I
think,
just
to
pick
up
on
a
point
just
there
that
was
made
in
the
initial
answer:
I
guess
living
in
the
Border
areas.
If
life
can
be
complicated,
I
guess
we
don't
want
to
make
it
more
complicated
for
people
whose
lives
are
already
significantly
complicated.
So
if
there
was
any
scope
to
look
at
that
how
we
work
together
better
because
I
mean
in
this
instance,
it
was
someone
who
needed
quite
quick
assistance,
so
sometimes
time
can
be
critical
in
these
instances.
Thank
you.
A
Thank
you
very
much
for
that.
Yes,
I'm
going
to
try
and
wrap
it
up.
Take
two
just
like
to
comment.
Also
supporting
the
the
comments
have
been
made
about
housing
and
Victoria
I
think
spoke.
Well
was
if
you
get
sent
back
to
where
what's
making
you
that's
not
going
to
solve
the
problem,
we've
seen
some
trial
stuff
around
prescribed
Heating
in
parts
of
my
award
and
again
we're
seeing
that
kind
of
level
of
I.
Guess:
deprivation:
I,
don't
like
the
word
but
yeah.
A
A
My
question
I
had
a
question
around
resource
the
challenges
and
the
first
one
is
resources
and
I.
Think
the
likelihood
of
this
plan
being
achieved
is
all
about
whether
the
resources
are
there
and
so
I
guess.
The
challenge
for
both
public
health
and
the
NHS
is
to
keep
this
as
a
as
a
as
as
a
priority
and
I
think
we'll
see
later
on
with
additional
paper,
which
is
one
of
those
challenges.
Why
why
it
happens?
A
I
think
I
think
we've
agreed
to
get
some
extra
data
after
the
meeting
we
talked
about
something
around
assessment
for
children,
new,
diverse
challenges,
I
think
that's
really
important.
I
think
we've
with
like
some
data
around
the
cross-border
issues.
I
think
that's
that's
also
really
important
and
then
I
think
there's
probably
something
around.
A
So
if
you've
talked
earlier
on,
councilor
Gibson
talked
about
specialist
beds.
Was
there
anything
data
wise?
That
would
be
helpful
for
their
counselor
Gibson.
Sorry
to
put
you
on
the
spot,
yeah.
G
I
think
if
there's
any
what
data
you
use
to
analyze,
that
we
have
enough
beds,
specialist
beds
for
learning
disabilities
and
people
with
say
neurodiversity.
But
you
know
complex,
autism,
ASD
and
any
decision
papers
you've
made
about
about
that.
So
some
analysis-
and
you
mentioned
as
well-
that
you're
increasing
essentially
the
intensive
support
services
or
intensive
support
teams
and
and
that's
a
name
that
I
came
into
contact
with
when
I
worked
in
neighboring,
Authority
I'm
sure
you
know
they
may
have
different
names.
But
you
know
and.
G
A
Yeah,
so
that's
the
third
point
and
then
the
fourth
point
was
Council
Anderson's
point
about
data
on
how
we
measure
our
third
party
supplier,
so
I
think
probably
set
quite
a
bit
of
additional
limit
there.
So
I
appreciate
your
time.
We've
been
going
for
an
hour,
40
minutes,
so
I'm
gonna.
Suppose
we
have
a
five
minute,
Comfort
break
that
we
also
need
to
swap
some
chairs
around.
So
please
be
back
in
your
seats
and
ready
to
go
in
in
there
five
minutes.
Thank
you.
A
Okay
thanks
everyone
welcome
back,
we
are
live
again.
So
the
second
substantive
item
of
today's
meeting
is
the
healthy
leads
plan.
Okay,
very
pleased
that
this
is
coming
this
today,
I
had
thought:
Tony
was
going
to
introduce
it,
but
I
don't
think
he
is
so.
Can
we
start
by
the
the
new
people
at
the
table?
Can
you
introduce
yourselves
and
then
I'm,
assuming
one
of
you
will
introduce
the
paper?
Assume
we've
already
read
it,
but
if
there's
anything
you
want
to
draw
out,
please
do.
U
Thank
you
very
much
and
thank
you
for
inviting
us
today
to
talk
through
the
healthy
leads
plan.
My
name
is
Catherine
Sunter
I'm,
head
of
population
health
planning
at
the
Leeds
Office
of
the
ICB,
and
this
is
my
colleague
Joe.
U
As
I
say,
thank
you
very
much
for
inviting
us
along
today
we're
just
going
to
outline
fuba
key
aspects
of
the
healthy
leads
plan
and
the
paper
and
then
obviously
welcome
comments
and
questions
afterwards.
U
I
think
it's
really
important
to
set
out
what
is
the
healthy
leads
plan
and
the
healthy
leads
plan
sets
out
the
Health
and
Care
contribution
towards
delivery
of
a
vision
in
the
health
and
wellbeing
strategy
for
leads
to
be
a
healthy
and
caring
City
for
all
ages,
where
people
who
have
a
poorest
improve
their
health.
The
fastest
and
I.
U
Think
that
context
really
important
to
understand
the
health
and
well-being
strategies
is,
is
wired
by
necessity
and
covers
a
number
of
areas,
including
Community
safety
Etc,
whereas
this
is
the
the
Health
and
Care
plan,
release
Health
and
Care
partnership
contribution
towards
delivery
of
that
health
and
well-being
strategy,
which
equally
is
in
the
process
of
being
refreshed.
U
The
plan
sets
out
our
high
level
Ambitions
for
improving
Health
outcomes
for
both
the
people
of
Leeds.
So
our
two
goals,
which
you
will
have
seen
within
the
paper
and
in
the
plan
and
at
a
population
level
through
our
population
outcomes
framework
and
in
that
sense
it
might
look
slightly
different
to
kind
of
traditional
health
plans
that
you
might
have
seen.
U
That
might
perhaps
be
structured
more
in
terms
of
points
of
access,
such
as
Primary
Care
Etc,
rather
than
population,
which
is
a
perspective
that
our
plan
in
Leeds
takes
in
line
in
in
line
with
our
system,
commitment
to
a
focus
on
populations
and
population,
health
planning
and
by
population
level.
I
know
population
will
mean
lots
of
different
things
to
to
different
people
around
this
table
and
I
mean
our
nine
mutually
exclusive
segments
in
leads.
U
Health
leads
plan
doesn't
describe
everything
we
do
as
a
Health
and
Care
partnership,
so
there'll
be
Improvement
plans
and
change
programs
within
each
individual
organization
and
sector.
But
what
it
does
describe
is
what
we
come
together
collectively
as
a
leads
Health
and
Care
partnership
and
system
to
achieve,
and
it's
been
developed
with
support
from
many
people
and
across
the
system
and
again
and
I
always
want
to
thank
everybody
for
their
time
and
energy
and
and
support
over
the
past
few
months.
U
In
developing
the
plan
a
cover
you
have
received
a
copy
of
the
draft
plan
and
an
a
cover
report
and
the
draft
plan
was
signed
off
by
the
Leeds
Committee
of
a
West
Yorkshire
ICB
last
Tuesday,
and
it's
going
to
the
health
and
wellbeing
board.
Next
Thursday
Joe
will
go
into
the
detail.
The
plan
is
part
of
a
whilst
it's
something
that
we
do
in
Leeds.
U
Our
healthy
leads
plan
has
also
had
a
dual
role
of
our
submission
to
West
Yorkshire
as
a
joint
strategic
plan,
and
so
we've
been
really
under
kind
of
time.
Pressure
to
complete
this
also,
but
any
comments
from
today
any
comments
from
the
ICB
that
we
received
last
week
and
any
comments
from
the
from
the
health
and
well-being
bar
next
week.
We
have
been
given
some
additional
time
for
my
shelter
to
be
able
to
make
those
those
amendments,
if
necessary.
U
U
U
We
meant
measures
that,
as
a
system,
we
were
looking
to
have
an
impact
on
and
and
Achieve
and
let
last
November
when
we
reviewed
the
approach.
We
recognized
that
these
weren't
working
as
well
as
we'd
hoped
they
weren't
really
supporting
us
as
a
system
in
prioritizing
as
much
as
we
might
have
liked.
U
In
addition
to
that,
as
you've
picked
up
through
the
through
the
healthy
leads
plan,
we
have
a
number
of
population
and
Care
delivery
bonds
and
a
number
of
measures
of
those
measures
have
now
been
subsumed
into
the
populations
outcomes
Frameworks
so,
and
we
recognize
that
these
weren't
supporting
us
in
prioritization
at
a
system
level
as
much
as
we
want
and
didn't
necessarily
feel
owned.
So
this
was
one
of
the
first
areas
that
we
needed
to
to
focus
on.
U
In
addition
to
that,
when
the
health
Elites
plan
was
agreed
in
2021,
following
that,
we
had
some
engagement
with
the
public,
also
on
on
the
nature
of
the
strategic
indicators
and
which
were
able
to
feed
into
those
conversations
and
also,
at
the
same
time,
we
were
having
conversations
with
the
public
on
at
a
population
level,
on
population
outcomes
and
what
were
important
for
those
populations,
so
that
they've
all
really
contributed
towards
the
shaping
of
our
shared
system
goals.
U
The
one
thing
that
everybody
said
to
us
across
the
system
was
that
we
actually
have
too
many
goals.
We
have
too
many
things
that,
as
an
NHS
is
asterism,
which
of
those
things
many
of
those
things
come
down
from
a
national
level
and
actually,
if
we're
setting
out
what
we're
looking
to
achieve
in
Leeds,
it
needs
to
be
really
clear.
U
It
needs
to
be
earned
and
it
needs
to
be
something
that
we
can
all
understand
and
and
will
apply
to
all
partners
and
really
supporters
in
prioritization,
which
is
why
we've
moved
from
a
significant,
quite
significant
number
of
strategic
indicators
to
two
system
goals
and
we
work
with
a
number
of
Partners
boards
groups
Etc
in
in
developing
these
goals
and
as
you've
seen
from
the
paper
as
well.
U
It
was
we're
also
shipped
by
some
International
evidence,
looking
at
particularly
at
the
work
of
the
Staten
Island
system
that
that
actually
quite
significant
success
at
having
a
smaller
number
of
system
goals
and
that's
something
that's
based
on
kind
of
international
and
National
evidence.
U
But
it
was
also
important
to
us
that
the
goals
reflected
the
financial
climate
that
we're
in
and
through
focusing
on
areas
of
unplanned
utilization
that
drive
high
cost.
We
feel
that's
probably
one
of
the
more
a
much
more
realistic
approach
to
take
in
this
plan
and
also
our
original
healthy,
leads
plan.
Some
of
the
comments
we
had
was
it
wasn't
explicit
enough
on
how
we're
going
to
reduce
Health
inequalities,
which
clears
is,
is
important
to
us
as
a
system
at
the
heart.
U
What
we
do
so
one
of
the
things
we've
done
is
is
focus
these
goals,
particularly
on
IMD
one.
So
is
that
really
clear
link
to
health
inequalities?
U
By
very
reminder
that
goals
are
reduced,
unplanned
care
utilization
across
sorry,
reduced
preventable,
unplanned
care
utilization
across
Health
settings
and
in
terms
of
measures
we're
looking
at
unplanned
utilization
in
bed
days,
early
attendances,
mental
health
and
planned
bed
days
and
right
crisis
attendances
taking
in
a
population
approach,
that's
focused
on
identifying
root,
cause
the
root
causes
and
also
a
second
goal
of
increasing
early
identification
and
intervention
focus
on
the
26
of
a
population
living
over
10,
most
deprived
areas
nationally.
U
So
now
I'm
going
to
hand
over
to
Joe
who's
going
to
talk
who's
going
to
talk
us
through
the
broader
purpose
of
the
plan
and
the
next
steps.
T
Thank
you,
Catherine,
and
so,
as
Catherine's
mentioned,
the
health
release
plan
does
have
that
dual
purpose.
So
not
only
is
it
our
Health
and
Care
System
plan,
but
it's
also
our
contribution
to
the
West
Yorkshire
joint
forward
plan
and
that's
stipulated
within
the
NHS
National
planning
guidance
for
22
23
24,
and
that
places
a
statue
Duty
on
West
Yorkshire
to
produce
a
joint
forward
plan
incorporating
local
plans
on
how
we
intend
to
meet
National,
regional
and
local
priorities,
and
we
felt
it
was
really
important.
T
Current
thinking
from
NHS
England
is
that
the
joint
forward
plan
will
need
to
be
refreshed
on
an
annual
basis.
We
envisage
within
leads
that
the
Strategic
element
of
the
plans,
the
goals-
should
remain
for
the
next
three
to
five
years,
unless
there's
a
real
reason
to
change
and
that
the
activity
to
meet
those
goals,
the
priority
areas
that
have
been
identified
and
the
activities
to
support
that
will
be
reviewed
on
an
annual
basis.
T
T
But
we
also
know
from
partners
that
a
partnership
home
plan
doesn't
necessarily
always
get
the
traction
that
we
might
have
hoped,
because
we
just
do
try
and
do
too
many
things.
T
Often
we
set
plans
and
strategies
and
don't
robustly
measure
our
progress
toward
towards
achieving
them.
So
we're
really
doing
some
work
in
terms
of
the
data
to
understand
what
that
Baseline
is
and
setting
that
Target
reduction,
which
is
really
important
to
focus
as
a
system
on
what
we
need
to
achieve
a
suitable
Target.
T
In
terms
of
for
that
goal,
one
so
we're
looking
at
the
difference
in
Health
and
Care
activity
between
the
most
deprived
deciles
within
Leeds
and
the
rest
of
the
population,
we're
looking
at
what
other
systems
have
achieved
and
such
as
the
work
of
Staten
Island,
we're
drawing
on
other
work,
that's
currently
underway
and
being
delivered
in
leads
such
as
the
Community,
Mental,
Health
transformation
and
the
home
first
program,
and
then,
finally,
and
and
quite
importantly,
is
the
communications
plan,
and
particularly
aimed
at
people
working
across
health
and
sector
partnership
within
leads,
and
we
want
to
create
a
really
clear
document
for
them,
and
we
also
want
to
create
an
easy
read
version.
T
So
it's
accessible
to
all
people
within
leads,
and
we're
also
aware
that
the
plan
doesn't
focus
on
goal
two,
the
early
intervention
identification,
which
is
a
significant
priority
as
well.
We
want
to
take
the
learning
from
goal
one
and
the
work
that
we've
done
to
help
us
inform
our
approach
to
understanding
goal
two.
We
also
have
been
working
with
population
and
Care
delivery
boards,
which
have
got
outcome
Frameworks
for
each
their
populations.
Much
of
that
work
focuses
on
early
identification
and
prevention.
So
it's
really
bringing
the
two
together.
T
A
Thank
you
very
much
for
that
really
interesting.
Your
point
about
point
two,
because
I
I'd
picked
up
there
wasn't
a
data
for
point
two
like
you
put
in
for
point
one.
So
thanks
for
clarifying
that
one
of
the
sort
of
really
key
things
for
this
sort
of
system
plan
is
who's
paying
for
what
and
it's
it's
not
a
nice
conversation
to
have.
But
it's
something
that's
sort
of
the
nitty-gritty
reality
of
how
that
works,
especially
when
it's
cross
service,
I,
guess.
A
The
question
is:
how
do
how
do
we
manage
that
in
terms
of
the
system,
because
I
I
guess
there's,
there's
the
council
and
there's
a
number
of
NHS
trusts
offering
different
services
and
what
some
services
offer
don't
offer
effects
what
other
services
can
and
can't
offer?
So
welcome
your
thoughts
on
that.
U
Yeah
I
think
that's
it's
always
a
challenging
area
for
a
system
and
I
think
what
we'd
like
to
say
is
we
focus
on
the
leads
pound
and
making
making
sure
we
make
the
best
use
of
a
leads
pound.
U
What
we
have
in
place
is
a
a
series
of
population
and
Care
delivery
boards
that
have
representation
from
across
the
system,
including
third
sector
and
and
citizens
also,
and
when
we
look
at
making
an
intervention
and
a
change
in
line
with
population
outcomes.
I
think
the
really
important
thing
is
to
understand
where
the
impact
will
be
so,
as
we
said
in
relation
to
goal
one,
we
know
that
unplanned
utilization,
not
only
is
it
not
good
for
a
person,
it's
not
good
experience.
U
U
So
what
we
need
to
do
is
to
is
to
do
some
work
on
those
initiatives
to
really
understand
where,
where
those
kind
of
changes
will
be
made,
what
the
impact
would
be,
what
the
costing
is
and
to
look
to
do
what
in
population
health
planning
would
call
allocative
efficiency
rather
than
technical
efficiency.
So
where
can
we
put
the
leads
part?
Where
can
we
put
the
pound
that
will
have
the
biggest
impact
in
terms
of
addressing
addressing
the
root
cause
of
what
the
challenge
is?
U
We
started
to
have
some
of
those
conversations
around
those
boards.
It's
not
easy
and
I'm
not
going
to
pretend
it
is,
but
but
there
is
a
commitment
to
to
do
that
and
that's
why,
in
this
plan,
particularly,
we
talk
about
a
smaller
number
of
system,
priorities
to
really
start
to
test
that
approach
and
to
take
Partners
on
the
journey
with
us,
and
we
also
talk
about
kind
of
small
scale.
U
Pilots
testing
Etc
to
really
build
confidence
in
what
the
impact
of
those
things
could
be,
because
that
will
be
required
if
we're.
If
in.
If
we
get
to
the
stage
where
you
can
obviously
shift
resources
more
Upstream,
the
first,
the
first
plan
talked
a
lot
about
in
about
investment
Upstream,
whereas
this
plan
I
think
is
much
more
realistic
in
in
how
we
try
to
get
those
resources
to
move
Upstream
through
really
addressing
the
unplanned
utilization
and
understanding
cost.
A
K
Hi
I
just
want
thanks,
chair
I
just
wanted
to
dig
into
the
kind
of
the
priority
areas
as
you've
identified
and
I'm
looking
at
well,
it's
page
19
on
your
report,
but
it's
page
92
on
in
our
agenda
pack
and
you'll,
see
there's
a
very
small
subset
of
areas
within
leads
that
are
highlighted
orange
as
the
areas
that
are
most
most
deprived
and
I
always
get
worried
when
I
see
things
like
this
because
leads
a
very,
very
diverse
City
and
there
are
significant
pockets
of
deprivation
in
most
worlds
and
I
worry
that
in
simplifying
like
this.
N
U
U
Don't
we,
whereas
actually,
like
you
say,
there's
areas
across
most
of
our
Wards
pcns,
whatever
geography
you're
you're,
using
that
that
actually
sits
in
in
IMD,
one
I
think
what
we
really
need
to
do
is
to
when
we,
when
we
identify
well
I
suppose,
firstly,
what's
quite
important
to
say
is
that
we
do
if
you
do,
there's
a
lot
of
evidence
that
if
you
do
live
in
our
most
deprived
areas
in
I,
am
in
IMD
one
you're
way
more
likely
to
have
an
unplanned
admission,
an
unplanned
utilization.
U
So
when
you
actually
look
at
the
data,
it's
actually
like
a
step
with
IMD
one
at
the
bottom
right
up
to
10..
When
you
look
at
planned
care,
it's
it's
the
inverse.
It's
the
inverse
care
law
you're
way
more
likely
to
have
a
planned
intervention
if
you
live
in
IMD
10
versus
IMD
one.
So
that's
one
that's
really
about
of
of
looking
at
IMD
one,
but,
as
you
say,
there
are
pockets
of
IMD
one
across
these
pockets
of
deprivation
and
kind
of
having
worked
in
areas
like
Molly
and
Rothwell.
Myself.
U
I've
worked
on
those
Estates
where
I
know
that
often
they
can
feel
forgotten,
because
people
presume
that
IMD
one
is
is
is
is
is
solely
in
in
central
Leeds.
So
when
we
identify
our
priority
areas
of
focus,
we
will
be
looking
at
IMD
one
across
Leeds
and
identifying
those
areas
that
we
will
that
we
can
work
with
working
through
local
care
Partnerships
as
well
to
do
that
and
yeah
and
and
really
taking
that
approach.
U
I
think
the
other
area
to
not
forget
as
well
are
the
other
plus
groups
as
well,
which
we
are
groups
that
we
know
are
disadvantaged
from
a
health
perspective
not
because
of
wherever,
but
because
of
various
factors,
so
gypsies,
Travelers
Etc.
So
equally,
this
plan
will
look
to
to
those
plus
groups
also
who
who
who
live
throughout
these,
not
necessarily
9d1.
K
U
In
in
IMD
2
to
10
you
mean
yeah,
I
mean
I,
guess
I.
Think,
what's
really
important
to
say
is
that
this
plan
isn't
everything
that
organizations
and
sectors
have
their
own
Improvement
programs
that
aim
to
improve
services
for
for
everyone
and
what
they
do.
U
I
guess
what
this
plans
really
aimed
at
is
particularly
as
a
particular
focus
on
reducing
Health
inequalities,
and
we
know
that
where
we
work
with
a
with
with
a
popular
with
population
and
gets
it
right
for
an
area
in
IMD
one,
but
the
learning
from
that
then
then
filters
out
to
be
other
areas,
but
that's
but
yeah.
So
so
I
guess
his
plan
is
really
focusing
our
resources
on
the
on
the
people
who
we
know
experience
the
most
health
inequalities.
U
I
Thank
you
and
thank
you
both
for
your
presentations
as
well.
I
just
I
may
have
got
this
wrong.
I
hope
I
have.
But
if
not
just
a
plea
you
mentioned
about
creating
an
easy
read
version,
can
we
make
sure
that
they're
launched
at
the
same
time
rather
than
it
sounds
like
an
afterthought?
I
may
have
got
that
wrong.
I
hope
I
have,
but
if
not,
please
add
yourself
to
the
launch.
At
the
same
time,
the
easy
read
and
the
other
version
yep.
T
So
we're
planning
to
launch
the
strategy
in
line
with
the
refreshed
health
and
wellbeing
strategy,
so
they
go
together
with
that
will
be
an
easy
read
version:
we're
working
with
they're
being
well
partnership
with
learning
disability
partnership
group
in
developing
that
document
as
well
excellent.
I
That's
good
to
hear
now
the
question
I
was
going
to
ask
and
I
will
ask
now.
Is
this
state
in
Island,
when
I
saw
that
I
thought
wow?
That's
that's
an
interesting
and
then
I
looked
over
on
page
71
and
saw
our
projections,
which
seemed
contrary
to
what
was
achieved
under
the
Statin
Island
system.
Now
initially
I
thought
we'd
introduce
that
and
I
were
expecting
a
drop,
but
clearly
we
haven't,
but
I
had
to
look
it
up,
but
it's
New
York
in
it
it's
New,
York
I,
don't
get
out
much
I'm,
not
tagged.
I
T
Yes,
it
is
a
really
different
Health
System,
but
what
we're
looking
at
is
the
methodology
that
they
used
in
terms
of
a
data-led
approach.
So
what
they
were
able
to
do
is
really
drill
into
their
data,
and
it
was
a
really
interesting
process
in
terms
of
taking
a
real
health-led
approach
and
Target
and
goal
similar
to
what
we've
done,
but
actually
when
they
followed
that
root
cause
right
down
and
we've
talked
about
it.
I've
heard
you
talk
about
it
earlier
around
housing
is.
T
When
you
you
look
at
the
children's
pediatric
example,
and
they
really
looked
at
those
root
causes.
It
wasn't
a
health-based
cause.
It
was
housing.
It
was
working
with
people
to
get
mattress
protectors
out
to
people.
It
was
working
to
get
vacuums
into
people's
Apartments.
It
was
working
with
Pest
Control.
They
were
all
the
much
wider
determinants
of
health
and
that's
the
real
focus
of
this
plan
is.
We
want
to
be
able
to
take
that
methodology
and
use
it
the
same.
T
Yes,
our
data
capabilities
aren't
quite
matched
to
Staten
Island,
but
we're
working
on
those
we're
developing
them
and
we
would
love
to
be
able
to
drill
right
down
into
this
data.
We're
getting
there
and
be
able
to
look
at
it
by
Street,
by
Street,
by
neighborhood
and
by
blocks
of
flats
and
be
able
to
really
drill
down
and
understand,
People's
Health
needs
and
then
follow
that
root
cause
all
the
way
along.
U
I
think
the
projections
you've
seen
have
a
kind
of
I'm
going
to
say:
do
not
do
nothing
position.
I,
don't
really
mean
that,
because
all
our
partners
are
doing
lots
to
manage
unplanned
utilization,
but
we're
just
the
the
projections
that
you
see
are
if
we
take
population
growth
as
is,
and
continue
to
grow
at
the
rate
that
we're
going
at
the
moment,
that's
what
it
would
look
like.
U
What
we're
looking
to
do
now
is
to
work
with
the
system
to
understand
what
our
goal
is
going
to
be
and
you've
seen
in
the
paper
and
then
that
we're
we're
really
kind
of
looking
at
what
a
realistic
goal
for
the
system,
but
a
stretching
goal
would
be
at
the
same
time
and
and
and
how
we
set
that
goal.
U
So
the
the
projections
there
are
the
kind
of
population
growth
and
what
will
happen
if
population
kind
of
grows
at
the
rate
it
is
and
if,
if
our
growth
in
unplanned
utilization
remains
what
we're
looking
to
now
agree
in
working
with
system
partners
and
looking
at
evidence
is
what
are
what
we're
going
to
be
aiming
for
as
a
system
I
think
in
an
in
an
absolute
Ideal
World.
We
would
have
done
that
before
before
the
document.
U
It's
the
national
kind
of
deadline
of
getting
the
document
in
and
not
wanting
leads
to
have
two
plans
that
which
is
where
we
are
where
we
are,
but
we
have
work
ongoing
with
that,
we're
we're
quite
close,
but
I
think
certainly
kind
of
working
in
the
ICB.
We
want
to
make
sure
we've
worked
with
system
Partners
Etc
on
on
a
green
that
kind
of
shared
system
Target,
so
it
so
it's
earned.
A
Yeah,
thank
you
because
I
think
I'd
ask
for
that
date
to
be
in
there,
because
I
thought
it's
helpful
for
us
to
then
know
if
there
is
an
improvement
from
the
from
the
from
the
process,
so
it
sort
of
sets
a
benchmark
as
well
is
the
way
I
see
it
I'm
getting
nods.
So
that's
good.
Thank
you
very
much.
I'm
going
to
bring
in
Dr
be
our
next.
C
Thank
you,
chair
can
I
ask
for
an
explanation
as
to
what
you're
saying
on
page
114
under
the
national
NHS
National
priorities
and
it
first
of
all
talks
about
being
able
to
get
an
appointment
within
two
weeks
or
if
it's
an
urgent
appointment
needed
same
day
or
the
next
day.
And
then
it
goes
on
that.
The
third
bullet
point
increase.
The
workforce
brackets
recruit
26
000
next
brackets
515
whole
time
equivalent
for
leads
additional
roles,
reimbursement
scheme
by
March
2014.
So
what
is
this
additional
roles?
C
Reimbursement
scheme
and
what
are
these
515
whole
time
equivalent
for
leads
actually
going
to
be
and
do
and
then
ask
a
more
general
question
and
you
might
not
have
the
information
at
your
fingertips,
but
we
are
constantly
told
by
the
ministers
that
the
there's
been
an
increase
in
the
number
of
GPS
in
this
country.
But
we
also
hear
from
the
BMA
that
an
increasing
number
of
GPS
are
working
part-time
and
are
not
full-time.
C
But
more
importantly,
how
many
hold-time
equivalent
GPS
are
that
in
Leeds,
because
if
we're
going
to
be
able
to
achieve
this
National
priority,
we're
going
to
have
to
have
the
right
number
of
GPS
and
I
suspect,
because
in
in
the
right
hand
column
there,
it
suggests
that
we're
not
meeting
that
requirement
that
we
can
we're
going
to
need
more
GPS
in
order
to
to
to
meet
the
requirements
in
the
future.
So
let's
ignore
what
the
ministers
say.
Let's
look
in
terms
of
hold
time.
Equivalence
rather
than
head
counts.
T
Thank
you.
Thank
you,
so,
just
touching
on
the
the
third
bullet
point
in
that
document
and
I'm
going
to
apologize
that
there's
acronyms
in
there
so
we'll
address
that
and
take
those
out,
and
so
these
are
the
National
priority
indicators
set
by
NHS
England,
so
our
national
level,
and
so
one
of
in
the
recently
published
GP
recovery
plan,
and
there
is
a
commitment
in
there
that
everyone
needs
to
increase
their
Workforce
within
primary
care
and
that's
on
nationally
26
000
roles.
And
so
when
you
break
that
down
for
leads,
it's
515
hold
time
equivalents.
T
So
that's
as
a
as
a
place.
We
can
decide
on
what
those
roles
are
so
within
a
remit
within
that
scheme
and
but
there's
different
things
that
they
could
be
such
as
social
prescribers.
There
could
be
mental
health
support
workers.
They
could
be
paramedics
within
a
GP
practice,
but
it
is
that
Primary
Care
Workforce.
So
it's
based
on
the
needs
of
each
place,
what
they
would
like
those
additional
roles
to
be
in
terms
of
the
numbers
of
GPS.
We
have
I,
don't
have
that
to
hand,
but
we
can
absolutely
get
that
for
you.
J
Thank
you
chair.
Yes,
it
was.
It
was
just
just
just
following
on
from
from
Dr
beale's
point
with
regards
to
GPS.
Obviously
we
can.
We
can
increase
the
number
of
GPS,
but
if
the
population
increases
by
a
much
greater
degree,
how
do
we
aim
to
maintain
that
level
of
proportionality
and
to
ensure
that
actually,
we've
got
an
increase
against
population
population
expansion?
T
So,
yes,
through
the
recent
reviews,
the
Fuller
review,
the
stock
tape
review
all
of
the
and
the
GP
recovery
plan
is
it's
about.
How
do
we?
How
do
we
use
our
Primary
Care
Workforce?
It
isn't
my
special
area,
so
forgive
me,
but
we
we
can
get
it
any
information
that
I
miss
out,
but
in
terms
of
those
roles,
it's
about
thinking
differently,
that
we
know
Primary
Care,
have
a
real
role
and
should
be
able
to
focus
on
those
people
with
complex
needs
that
need
those
regular
contact
with
the
same
GP.
T
So
it's
a
continuity
of
care
within
their
Primary,
Care,
Service
and-
and
we
know
you
know
in
long-term
conditions,
but
also
be
able
to
have
that
prevention
Focus.
We
also
know
that
what
they're
dealing
with
is
that
unplanned
care
utilization
so
that
people
phoning
up
and
wanting
on
the
day
or
needing
on
the
day
services
and
that's
actually,
how
is
that
best
offered
within
leads
for
some
people?
They
need
to
see
a
face-to-face
clinician
on
that
day.
For
other
people,
it
might
just
be
a
phone
call
with
a
repeat
prescription.
T
So
it's
thinking
about
different
and
innovative
ways
to
to
serve
our
population
based
on
what
their
needs
are,
but
recognizing
there
are
some
people
that
absolutely
need
that
continuity
of
carer,
whereas
others
are
happy
to
be
more
Innovative,
used
online
use
text
messaging.
The
NHS
app
and
things
like
that.
J
Thank
you,
I
suppose
I
mean
this.
Might
this
might
be
a
bit
of
a
something
more
tricky
question,
but
it's
it's.
Where
do
you
believe
kind
of
the
current
weaknesses
in
the
system
lie
because
ultimately,
this
is
a.
This
is
a
partnership
between
between
all
the
health
providers.
It's
the
the
the
ICS,
the
ICB
and
the
council,
vertex
Partners
and
obviously
kind
of
with
you
know.
While
we're
talking
about
kind
of
what
ministers
have
to
say,
the
line
that
always
comes
about
is
oh
well.
J
J
So
so
how
you
know?
Where
are
the
weaknesses?
How
do
we
intend
as
a
system-
and
this
might
be
for
Council
colleagues
also
to
to
address
these
challenges
that
that
are
already
in
place.
U
The
areas
that
we've
found
challenging,
but
is
that
are
those
kind
of
gapped
between
services
and
that's
one
of
the
reasons
really
why
we've
set
up
our
population
and
Care
delivery
bonds
to
bring
providers
together,
setting
outcomes,
measurable
outcomes
for
what
they
want
to
achieve
for
their
population
and
recognizing
that
I
think
kind
of.
U
Following
on
from
that
mental
health
presentation,
we've
had
earlier
that
these
are
really
complex,
challenging
problems
that
actually
just
looking
at
mental
health
from
a
perspective
of
Mental
Health
Trust
isn't
going
to
isn't
going
to
solve
a
problem,
so
I
think
I'm,
not
sure
I
could
use
the
word
weakness,
but
I
think
one
one
thing
we're
looking
to
strengthen
is
our
work
between
organizations
and
how
people
move
through
the
system
and
I.
Think
if
you
consider
our
priorities,
one
of
them
is
our
is
home
first
and
and
I.
U
Think
that's
absolutely
that
that's
one
example
of
where
we're
looking
to
really
streamline
how
hospital
social
care
Etc
work
closely
together
around
the
needs
of
a
person
and
I.
Think
that's
where
our
population
approach
really
kind
of
stands
out.
That
he's
around
the
needs
of
people
and
not
and
not
setting,
and
that's
really
the
direction
we're
working
in
as
a
system
I,
don't
know.
If
colleagues
have
other
views.
O
I
guess
I'll
just
make
a
brief
comment:
I
guess
on
the
question
around
sort
of
collective
challenge,
I
mean
I.
Suppose
in
essence,
we
know
that
that
the
the
demand
for
services
is
higher
than
ever.
O
We
know
that
Health
needs
lots
of
indicators
have
been
going
in
the
wrong
direction
for
the
past
decade,
but
the
the
pandemic
has
exacerbated
that
and
given
an
even
greater
level
of
challenge,
so
Health
needs
in
the
city
are
kind
of
more
demanding
than
ever,
and
our
health
services
are
dealing
with
with
backlogs.
O
You
know
as
a
priority,
so
in
order
to
sort
of
get
ahead
and
then
prioritize
more
preventative,
work
or
more
proactive
work
to
you
know
in
communities
around
some
of
the
stuff
we've
talked
about
today
is
a
challenge
at
them.
I
think
we're
all
finding
it's
a
challenge
at
the
moment,
just
because
of
the
pressure
on
clearing
backlogs
and
I.
Think
that
that
feels
like
the
reality
of
where
we
are
so
to
make
the
case
for
resources.
Sort
of
more
Upstream
is
really
challenging
at
the
moment.
J
That
thank
you,
yeah
I
mean
I.
Suppose
again,
this
is
at
the
moment
quite
a
lot
of
the
discourse.
Around
kind
of
both
Health
and
Social
care
is
around
Ai
and
the
idea
that
technology
is
just
going
to
swoop
in
and
save
us
all
now.
J
I
I
might
be
a
little
bit
cynical
on
this,
because
I
think.
Actually
we
we've
been
trying
to
use
different
different
Technologies
for
a
protracted
period
of
time,
but
going
forwards,
and
again
this
was
one
of
the
real
real
issues
with
the
Health
and
Social
Care
Act
in
2012.
it
was
the
fragmentation
of
I.T
systems
across
the
NHS
so
that
you
ended
up
with
kind
of
you
went
to
clinicians
using
like
Windows
XP
like
20
years
after
it
was
first
introduced.
J
How?
How
do
we?
How
do
we
as
a
system,
aim
to
remove
those
discrepancies
and
differences
between
kind
of
the
technology
that
that's
being
used
on
a
day-to-day
basis?
And
what
is
what
are
the
technological
options
on
the
horizon
that
that
you
know
will
bring
Partners
together
to
sort
of
smooth
out
this
process.
R
Technology,
that's
a
really!
It's
a
really!
It's
a
really
good
question,
and
where
do
you
start
with
that?
There's
a
lot
of
different
initiatives
that
are
going
on
in
that
area.
So
there's
a
new
office
for
data
analytics
which
sits
across
Health
and
Social
care,
I
think
that
will
be
a
really
really
important
development
development
in
terms
of
pulling
some
of
those
challenges
together.
So
the
population
Health
work
that
Catherine
mentioned
will
be
a
key
part
of
that.
R
There's
also
a
nice
side
by
side
with
the
office
for
data
analytics.
A
new
digital
strategy
that
is,
is
pretty
much
half
the
Press
at
the
moment
actually,
and
that
includes
I
guess
the
ambition
that
we've
got
around
digital
in
in
in
in
the
city.
More
generally,
it
is
a
bit
wider
than
Health
and
Social
care,
as
you
might
imagine,
but
more
importantly
also
discusses
digital
exclusion
and
inclusion,
which
is
a
huge
issue,
particularly
in
terms
of
GP
access.
R
We
know
that
not
everybody
can
use
those
digital
tools,
so
there's
a
number
of
initiatives
that
sit
under
this
strategy
that
a
number
of
Partners
have
have
funded.
So
the
the
library
lending
Services
is
part
of
that.
Some
of
the
initiatives
in
the
community
social
prescribing
some
of
the
public
health
work
are
very
much
focused
on
upscaling
people
around
digital,
but
you're
right,
I.
Think
the
the
promises
of
AI
is
something
that
I
think
we
can.
We
can
look
at.
It
has
been
used
in
some
initiatives.
R
So
the
conversation
we
had
at
last
scrutiny
around
the
academic
Health
Partnership
work
the
pinpoint
project,
for
example
around
earlier
identification
of
of
of
cancer
users,
that
type
of
Technology
uses
machine
learning,
but
it
is
pretty
much
in
its
infancy
at
the
moment.
So
there's
there's
lots
to
do
and
I
think
it
would
be
an
area
probably
for
for
scrutiny
to
absolutely
keep
an
eye
on,
because
again
there
are
issues,
I
guess
with
data
and
people's
use
of
data.
Obviously,
we've
got
gdpr
as
a
as
a
fact
as
well.
O
All
right,
yeah,
just
to
add
and
I'm
sure
everyone
in
the
room
is
incredibly
well
sighted
on
this,
but
we're
we're
just
incredibly
mindful
of
how
fast
that
agenda's
moving
and
how
how
it,
how
any
development
needs
to
have
people
at
the
heart
of
how
we
Design
Services,
which
sometimes
isn't
the
case
when
we're
in
some
of
the
conversations
about
what
tech
can
do
so
I
know
Health,
healthwatch,
Partners
and
others
are
keeping
a
really
close
eye
on
this,
because
we
know
that
most
people
who
use
health
services
are
older,
with
multiple
with
multiple
conditions
and
what
might
work
for
a
kind
of
a
20-something
professional
who
just
needs
a
quick
consultation
about
something
easily
resolvable
is
is
mostly
not
the
case
for
a
lot
of
people
with
more
complex
issues
and-
and
we
you
know
one
of
the
major
lessons
from
the
pandemic.
O
We
we
learned
is
that
we
we
have
to
design
our
services
around
our
communities
and
what
they
trust
and
will
access.
So
you
know
so
you
know
it.
We
will
kind
of
fail
to
learn
that
lesson
at
our
Peril.
O
Really
so
I
think
I
know
customers
when
I,
you
know,
have
got
many
examples
of
of
learning
that
we'd
want
to
keep
embedded
at
the
heart
of
the
conversation
and
and
I
think
that
I'm
sure
colleagues
will
you
know
understand
that
it
sometimes
when
the
pressures
are
on
to
clear
the
appointments
and-
and
you
have
a
very
kind
of
firm
system-
focused
conversation
about
what
works
best
for
it
for
a
for
a
system
and
I
think
our
challenge
is
always
to
ensure
that
it
works
best
for
communities
and
for
people
and
and
and
I
know,
that's
an
obvious
thing
to
say,
but
but
it
there
are
many
many
examples
of
where
that's
not
happening
at
the
moment.
J
Sorry,
sorry,
it's
just
more
of
it
more
of
a
comment
for
For
the
Rest
for
yourself
and
the
rest
of
the
board
and
I
think
Kelly
around
around
kind
of
the
question
of
Technology
and
day
I
I
think
it'd
be
really
worthwhile
sort
of
like
keeping
a
watching
brief
of
on
this
subject
over
the
next
of
the
coming
months
and
years,
I
I
again,
I
am
I.
Am
it
has
yet
to
be
sold
to
me,
the
the
google.com
and
the
private
sector
is
going
to
save
our
health
system.
J
Perhaps
Perhaps
it
can't
be
sold
to
make
unlike
those
systems
but
I
think
it's
definitely
something
that
we
need
to
keep
an
eye
on
over
the
over
the
coming
years.
Thank
you.
Thank.
A
H
Thank
you
just
a
quick
one,
while
there's
desire
to
increase
the
number
of
GPS
to
reflect
the
number
of
population
in
the
city.
But
what
are
we
doing
about
GPS
leaving
NHS
system
GPS,
leaving
and
going
on
low
comp
there's
some?
This
satisfaction
for
some
reason:
I've
spoken
to
a
couple
of
GPS
and
they
says
the
system's
not
working,
there's
something
wrong
and
they
are
disappointed
because
they've
done
a
profession
to
help
and
serve
people,
but
there's
something
wrong.
So
what
are
we
doing
to
retain
them?
A
Just
just
to
say
you
can
answer
briefly.
If
you've
got
a
response,
we
are
hoping
to
have
GPS,
come
in
September
GP,
improving
access
to
General
practices
in
a
September
item.
But
if
you
want
to
make
a
comment
now
as
well
and
Angela,
definitely
make
a
note
of
your
question:
cancel
no.
T
A
I'm
hoping
to
have
a
GP
representative
here
as
well
from
from
their
perspective,
okay,
is
that
okay
Council
like
well
yeah,
good,
okay,
Council,
Anderson.
M
M
Something
I
always
struggle
with
with
these
plans
is
there's
lots
of
Ambitions
in
here
and
there's
lots
of
nice
words
about.
We
will
increase
the
years
of
life
that
people
lead
in
good
health.
How
are
you
going
to
measure
all
these
things?
There's
nothing
about
measurement
and
what
those
measures
are
and
how
you're
going
to
achieve
this.
There
are
some
statistics
about.
M
We
will
reduce
suicides
by
10,
which
doesn't
really
sound,
very
ambitious
and
we're
gonna
shorten
the
years
of
life
expectancy
between
the
most
deprived
and
the
the
best
areas
by
10
again
for
a
five-year
plan.
If
you
measure
that
in
the
amount
of
months
then
at
10
is
only
six
months,
it
doesn't
really
sound
very
ambitious.
M
So,
where
are
the
measures
and
I
can't
see
anything
in
here
about
signposting
people
to
what
I
think
is
quite
an
easy
thing
to
do
and
might
reduce
a
lot
of
a
e
admissions
people
using
pharmacies?
First,
thank
you.
T
If
you'd,
like
a
copy
of
that
in
terms
of
the
detail
that
sits
with
that
and
then
in
terms
of
the
measurements
and
that
I
aligned
to
the
outcomes
for
the
different
populations-
and
there
is
an
outcome
framework
that
sits
with
each
population
which
has
got
clear
outcome
measures
and
then
process
measures
that
sit
alongside
that.
So
the
process
measures
are
in
place
to
understand
that
short
term.
M
Might
be
somewhere,
you
could
maybe
allude
to
where
the
measurements
and
where
the,
where
that
can
be
found.
U
It's
one
thing:
when
we
were
working
our
population
in
care
delivery
bonds.
We
were
quite
insistent
on
with
outcomes
Frameworks,
that
each
outcome
has
something
that
we
can
measure,
not
something
that
we
are,
that
we
perhaps
could
measure
in
different
circumstances,
but
has
some
data
that
we
can
measure
it
by
so
so
absolutely
right.
We
we've
got
that
principle
and
we
can
share.
We
can
share
those
measures.
A
Okay,
I
can't
see
anyone
else
indicating
so
I'm
gonna
just
sum
up
again.
So
thanks
for
coming
really
interesting
discussion,
I
think
again,
we've
got
at
least
four
bits
of
additional
information
that
we
we
want
afterwards.
I
think
something
around
the
full-time
equivalent
to
GPS
in
Leeds
were
very
interesting.
A
That
and
the
where
we've
been
over
the
last
five
years,
I
think
that's
really
important
something
around
the
cost
of
how
we
do
cost
sharing
and
then
the
point
that
Council
Anderson
has
made
around
the
processing
measures
and
outcome
measures
and
then
also
something
around
the
West
Yorkshire
ambition.
So
hopefully
that's
all
okay.
A
Thank
you
very
much
for
coming.
I
really
think
this
is
helpful
and
I'm
sure
we'll
see
you
again
and
also
really
really
nicely
leads
us
on
to
the
next
item.
So
this
is
a
late
item
and
I'm,
hoping
that
we
won't
run
on
it
too
long
because
we
talked
about
it
in
a
working
group.
A
A
I
guess.
The
the
the
link
for
me
with
this
plan
is
that
on
page
69
of
pack,
our
first
Leeds
Health
Plan
priority
is
to
reduce
preventable,
unplanned
care
utilization
across
Health
settings
and
I.
Think
we've
talked
about
quite
clearly
previously
how
obesity
is
probably
one
of
those
factors
that
impacts
both
Health
inequalities
and
also
preventable,
unplanned
utilization
of
Health
Care.
So
hopefully
that
makes
sense.
Hopefully,
you've
read
it
I
think
the
plan
is
to
to
send
this
to
the
pg
and
I
guess.
A
I
can
see
some
nods,
that's
good!
Thank
you
very
much
when,
when
we
hear
back
I'll
feed
that
back
to
the
group
and
whether
we
need
to
bring
it
to
a
full
public
meeting
or
not
I
think
we'll
discuss
in
future
work
items.
So
that's
that's
super.
Thank
you
very
much.
I'm
gonna,
move
on
to
the
final
item
so
guests
that
we're
just
going
to
talk
about
work
items
now,
so
you
can
stand,
listen
if
you
want
or
not,
but
thank
you
very
much
for
coming.
A
Okay,
so
I'm
going
to
move
on
to
the
last
item,
which
is
a
work
schedule,
I
think
there's
one
thing:
I'm
I'm
I
meant
to
tell
you
to
where
we
paid
157
at
this
for
that,
so
the
in
September
we're
planning
to
move
forwards.
The
public
health
annual
report
to
the
September
meeting
as
well
I,
don't
know
if
that
means
we'll
need
to
put
considering
whether
we
put
Dental
Services
as
a
working
group
as
a
catch-up,
because
we've
you've
talked
about
it.
A
I
I
wasn't
in
the
board
last
year,
but
I
know
it's
talked
about
a
lot.
So
we
might
do
that
as
a
working
group,
because
each
item
does
tend
to
take
a
significant
amount
of
time,
which
is
good,
I'd
much
prefer
to
debate
it,
but
that's
what
I
wanted
to
update
you
on.
Are
there
any
other
questions?
Comments
about
the
work
plan.
M
Members
of
the
board,
who
are
here
probably
Dr
Beal,
will
remember
them
about
five
years
ago.
We
did
a
scrutiny
inquiry
into
kidney
patient
transport
and
it
might
be
useful
to
have
an
update
on
whether
that
has
got
any
better
when
people
came
that
were
using
the
service.
Give
us
real
life
experience.
Do
you
remember
that
yeah
yeah?
So
it
might
be
good
to
have
an
update
on
that.
A
Okay,
I
I'm,
not
aware,
that's
fine,
well,
I
think
it's
worth
doing
is
we
need
to
look
back,
see
where
we
are
and
then
even
we
need
an
update
to
be
written
to
us
and,
depending
on
what
that
says,
depends
on
whether
we
need
to
bring
it
to
this
to
screening
board.
But
I
appreciate
that.
A
Absolutely
and
it's
yeah
proof
is
in
the
pudding
as
they
say:
yeah
good,
thanks,
Council
Anderson.
Any
other
comments,
no
super!
Okay!
Thank
you.
Everyone
for
coming
I
think
we've
had
a
really
productive
meeting.
I
think
we've
covered
a
lot
of
a
lot
of
a
lot
of
a
lot
of
ground,
so
hopefully
people
enjoyed
it
and
look
forward
to
seeing
you
after
the
summer.
I
hope
people
get
some
rest
and
sunshine.
Okay,
goodbye.