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From YouTube: Leeds City Council - Adults, Health and Active Lifestyles Scrutiny Board - 7th September 2021
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A
A
As
such,
it
is
a
remote
consultative
meeting
of
the
adults,
health
and
active
lifestyle
security
board.
The
consultative
status
of
today's
meeting
means
that
some
of
the
usual
formalities
will
not
take
place
at
the
start
of
the
meeting
and
well.
It
also
means
that
the
board
will
not
be
in
a
position
to
take
any
formal
decisions.
A
A
A
B
A
A
A
Members
agreed
to
maintain
a
watching
brief
in
terms
of
the
ongoing
development
of
the
local
ics,
and
so
the
board
is
to
receive
a
further
update
at
today's
meeting,
which
will
be
in
the
form
of
a
powerpoint
presentation
that
has
been
provided
by
nhs
leads
clinical
commissioning
groups.
I
will
now
invite
all
participants
to
introduce
themselves
at
this
point,
and
I
will
start
with
is
counselor
arif
here
now.
C
A
A
K
Okay,
next
slide
so
summary
of
main
changes
over
the
next
six
months,
ccgs
will
cease
to
exist
by
april
2022
and
be
replaced
by
integrated
care
systems.
Integrated
care
systems
really
have
four
constituent
paths.
One
is
an
integrated
care
partnership,
which
is
a
wide
range
of
partners
across
the
system
who
set
the
strategy
for
the
ics
and
maintain
the
focus
on
health
inequalities
in
wider
health
systems.
K
You've
also
got
an
integrated
care
board,
which
is
the
statutory
arm
of
the
ics
which
effectively
takes
care
of
making
sure
that
we
deliver
all
the
national
nhs
priorities
along
with
making
sure
it
aligns
with
the
ics
strategy
at
place
level.
We've
got
place-based
partnerships.
People
may
know
that
these
were
originally
called
integrated
care
partnerships,
but
because
of
the
integrated
care
partnership,
it's
been
renamed
place-based
partnership.
These
are
generally
co-termers
with
local
authorities,
not
in
all
places,
but
within
west
yorkshire
and
based
on
the
legislation.
K
They
can
have
different
levels
of
delegation
based
on
what's
agreed
with
the
ics
and
then
on
top
of
that
we've
got
more
formally
provided
collaboratives,
so
these
are
sort
of
collaboratives
between
different
providers
across
the
ics.
So
some
of
you
may
be
familiar
with
wire
west
yorkshire,
acute
trusts
collaborative
this
is
that
sort
of
thing
across
the
patch.
You
could
include
things
like
mental
health,
collaboratives
and
community
collaboratives.
All
the
moment,
although
the
main
one
at
the
moment
is
the
west
yorkshire
queue.
K
It
also
allows
for
collaboratives
at
place
between
different
sectors
because
of
those
collaboratives
and
because
of
the
changes.
The
ics
signals,
move
away
from
the
internal
market
and
one
of
the
key
things
about
this.
Is
it's
not
now
just
the
ccgs
that
would
be
responsible
in
the
ics
for
population,
but
also
providers
within
the
systems,
and
therefore,
decisions
need
to
be
taken
jointly
with
providers
and
the
ics
around
making
sure
we
look
look
after
our
patients
and
public
next
slide,
please
so
west
yorkshire.
This
is
a
summary
of
where
we
are
at
the
ics
level.
K
K
We're
then
working
through
setting
up
the
icp,
the
icb,
rather
the
indicator
care
board.
We've
got
a
proposal,
initial
proposal
around
what
that
would
look
like
in
the
membership,
but
the
idea
is
that
sits
at
the
sort
of
ics
level
and
the
pcbs
will
be
delegated
responsibilities
from
that
icb
board.
The
intention
is
to
delegate
all
the
budgets
so
we'll
be
sit
in
a
similar
place
to.
K
We
are
now
with
the
budgets
and
responsibilities
to
place
and
instead
of
having
the
ccgs
that
delegated
responsibility
will
now
have
a
committee
that
includes
partners
providers,
vcs,
we've
we've
established
a
set
of
governance,
principles
and
requirements,
and
building
independence
and
transparency
across
the
system.
As
an
outline
of
ic
constitution,
there's
a
first
draft
of
the
icb
membership.
It
has
people
from
third
sector,
it
has
people
from
providers,
but
that's
going
through
a
number
of
iterations
and
that's
our
consultation
at
the
moment.
K
K
So
this
is
just
details
of
where
we
are
in
terms
of
timetable
and
the
next
steps.
So
the
chair,
the
advert
for
the
chair
as
it
has
gone
out
and
the
intention
is
to
him.
Oh
gosh.
I've
got
the
word
to
appoint
a
chair
and
chief
exec
september
early
october,
the
chair
interviews,
the
first
panels
for
the
chair
of
this
week
and
the
interviews
will
take
place
next
week.
We
don't
anticipate
will
be
announcement
for
two
or
three
weeks,
because
obviously
they
have
to
go
up
to
the
secretary
of
state
for
approval.
K
After
that,
the
the
adverts
are
out
for
the
chief
exec.
I
think
it
closed
on
about
the
27th
of
september
and
interviews
are
expended
so
that
we'll
have
an
appointment
in
october,
mid-october,
there's
a
there's,
a
range
of
things
that
are
going
on
at
the
moment,
like
the
development
of
the
ics
constitution,
the
operating
model
and
working
through
the
icb
membership
and
over
the
next
month
or
two
we'll
be
expected
to
have
new
iterations
of
those
things.
K
K
It's
recognized
that
leeds
already
works
well
as
a
partnership.
So
the
only
change
that
we're
expecting
in
the
next
few
months
is
that,
rather
than
the
ccg,
we
have
a
place-based
partnership
board
that
will
take
responsibilities
stated
earlier
for
the
budget
that
we
have,
which
is
1.4
billion,
and
the
delivery
of
the
statute
is
associated
with
the
health
and
well-being
strategy.
K
It's
proposed.
This
board
is
a
subcommittee
of
the
icb,
with
full
dedicated
responsibility
for
its
members
and
the
mirror
of
the
icb
with
independent
members,
so
representation
of
nhs,
these
city,
council,
public
health,
voluntary
sector
and
icb
offices
and
workers
underway
to
develop
a
collaborative
agreement
to
underpin
this
next
slide.
Please.
K
I
think
it's
important
to
note
that
the
place-based
partnership
isn't
just
the
integrated
care
board
or
the
leads
on
this
slide.
It
says,
leads
integrated
care
partnership.
That's
now
place
based
partnership
committee,
but
the
place-based
partnership.
It's
all
of
those
things
within
that
diagram,
and
this
just
describes
where
things
are
new
in
blue
and
how
they
fit
into
the
wider
system
as
a
whole.
K
And
just
just
a
sort
of
update
on
the
key
next
steps:
place-based
partnership,
pro
proposals,
we've
got
a
collaborative
agreement
being
developed
for
the
end
of
september
for
consultation.
This
will
include
the
membership
of
the
the
partnership
board.
How
we're
going
to
work
responsibility
is
the
functions
of
that
board.
That's
obviously
dependent
on
how
the
icb
and
the
sort
of
responsibilities
are
delegated
relationship
with
the
existing
leads
partnership,
infrastructure
and
relationship
with
the
leads
health
and
well-being
board
scrutiny.
K
Although
we've
got
a
sort
of
populated
board
at
the
moment,
we'll
need
to
be
making
that
more
formal
so
be
recruiting
and
populate
the
pcb
board
and
subcommittees
by
the
end
of
october,
and
rather
like
the
integrated
care
board,
we'll
be
operating
shadow
form
from
november
onwards,
with
the
final
version
following
the
consultation
fully
operational
way.
22.
A
F
Know
them
already,
and
there
were
a
couple
of
things
I
was.
I
was
amazed
at
the
budget.
1.4
billion.
Is
that
right
and
that's
the
lpb
that
actually
has
the
determination
on
where
that
money
is
spent,
but
you
also
mentioned
independence
and
transparency,
independent
from
whom,
because,
obviously,
the
makeup
of
your
board,
if
it's
going
to
be
independent,
shouldn't,
have
specific
groups
on
there
and
you
would
maybe
want
to
encourage
other
people
who
haven't
thought
about
joining
a
board
who
are
independent
to
come
onto
that
board.
So
how's
that
going
to
be
done.
K
K
So
voluntary
and
community
sector
representation,
so
we
have
that
on
the
current.
What's
called
the
development
programme
board
and
we've
also
got
patient
public
representation,
but
very
very
you
know
one
person
representing
those,
and
it
is
quite
challenging
to
when
you
think
of
all
the
partners
that
are
involved
in
that
board
so
to
make
it
manageable
but
sort
of
be
inclusive,
and,
as
I
said,
I
don't
think
it's
just
one
of
the
one
of
the
key
things
that
I
think
is
important
here.
Is
it
it's
not
just
that
board?
That
is
the
partnership.
K
F
I
understand
correct
me:
if
I'm
wrong
is
the
lpb,
because
you
know
I
I've
been
engaged
with
organizations
where
there's
one
main
body
that
makes
the
decisions
and,
if
you're
lucky,
if
you're
in
various
groups,
you
might
be
on
one
of
the
advisory
bodies
that
sits
on
the
side
of
that
so
is.
Is
that
how
this
is
going
to
work.
K
So
just
go
back
to
1.4
billion.
First,
that's
that's
effectively
the
nhs
budget
at
the
moment
for
leads,
so
that's
what
the
ccg
would
generally
be
managing
within
its
own
commissioning
arrangements
that
doesn't
so,
for
example,
leads
teaching
hospital
as
a
has
a
similar
size
budget
of
1.3
1.4
billion,
but
obviously
that's
money
that
comes
in
from
services
from
outside
of
leeds,
if
that
makes
sense
like
specialist
services
and
things
like
that.
F
K
And
there
are
challenges
around
how
that
works
at
the
moment,
because,
obviously,
when,
when
you
have
a
commissioner
like
a
ccg
that
that
effectively
is,
is
the
broker
for
the
decision
making.
That
makes
decisions,
for
you
know
whether
we
invest
in
the
teaching
hospital,
whether
we
invest
in
primary
care,
whether
we
invest
in
mental
health.
When
you
have
all
those
partners
on
there,
then
then
we've
got
to
have
ways
of
looking
at
how
how
they
play
into
those
decisions,
because
they'll
be
members
of
that
board.
K
F
If,
if
I
can
just
come
back
for
one
final
time
chair
this,
this
is
a
really
interesting
question.
Isn't
it
because
my
mom
used
to
say
prevention
is
better
than
cure
and
there's
got
this
balance?
Isn't
there
between
dealing
with
the
issues
you've
got
now,
but
potentially
looking,
maybe
even
not
at
the
services
that
you
provide.
I
mean
poor
housing,
for
example,
leads
to
lots
of
issues,
mental
health
issues
and
and
health
issues.
F
A
low
low
educational
attainment
might
actually
result
in
or
from
the
fact
that
young
people
aren't
getting
access
to
the
computers
and
so
on.
So
it's
looking
at
a
city
as
a
whole,
as
opposed
to
an
individual
service,
is
quite
a
difficult
thing
to
do,
and
I
sometimes
wonder
when
you
talk
about
unwieldy
bodies,
how
much
we
take
notice
of
what
is
actually
going
on
in
the
in
the
sort
of
real
world.
But
it's
it's
just
a
conversation
piece
and
not
a
question
really
for
you,
john
sorry,.
A
D
Just
a
couple
of
points
which
I
have
to
say,
I
think
in
west
yorkshire
and
harrogate
are
a
vast
improvement
on
the
draft
bill
which
is
currently
before
parliament
and,
of
course
it
may
be
changed.
It
went
its
way
through
the
committee
and
other
structures
within
the
houses
of
parliament,
but
firstly,
as
I
understand
it,
and
I'm
sure
john
will
correct
me
if
I'm
incorrect.
D
First
of
all,
there
is
the
principle
of
subsidiarity.
That
is
that
decisions
will
be
made
at
the
most
appropriate
local
level,
and
I
think
that
is
absolutely
right.
The
other
thing
relates
to
the
place
based
partnerships
committee
and
two
things
on
there,
although
not
a
statutory
requirement
at
that
level.
D
I
understand
that
it
is
the
intention
the
director
of
public
health
will
be
a
member
of
that
committee
and
again
I
think
that
is
right.
I
can't
see
how
that
committee
can
do
its
work
properly
if
public
health
is
not
represented
at
the
table
and
secondly,
on
that
I
also
understand
and
again
please
correct
me
if
I'm
wrong,
that
that
meeting
will
be
in
public,
and
I
think
that
is
very
important-
that
the
public
do
have
access
to
the
deliberations
that
that
committee
will
be
making
so.
K
So
on
subsidiarity,
yes,
you're,
absolutely
right!
The
idea
is
that
decisions
are
made
at
the
lowest
possible
level
that
they
can
be
made
in
terms
of
membership
and
role.
There's
a
paper:
that's
come
out
friday,
that's
sort
of
new
guidance
and
it's
on
the
nhs
england
website.
I
can
share
that
with
angela
later.
That
gives
some
sort
of
update,
and
that
gives
a
sense
of
the
expectations
of
people
that
will
be
on
place-based
partnership
boards,
which
includes
dphs,
re
members
of
voluntary
community
sector
and
and
others.
K
So
there
are
sort
of
gradually
papers
coming
out
that
sort
of
make
recommendations.
Although
they're
not
you
know
mandatory
about
what
is
expected
from
those
place-based,
partnerships
and
those
local
place-based
arrangements
which
does
include
dph
and
does
include
others,
so
I
can
I'll
share
those
with
andrew.
Actually,
the
link.
A
G
G
K
K
G
K
So
that
so
there's
question
about
how
much
representation
that
I
will,
when
you
see
the
guidance,
that's
come
on
place-based
arrangements.
It
does
make
suggestions
that
I
can't
know
what
they're
called
local
local
care
partnerships
these
days
or
are
members
of
that
board
now.
It
suggests
multiple
on
this
in
the
document,
but
I
don't
know
how
they
will
engage
on
that
specific
board,
whether
they
nominate
or
whether
they
work
together
to
inform
the
working
of
that
board
or
whether
there's
a
number
of
seats.
K
But
that's
in
that
new
recommendation
now,
one
of
the
interesting
things
about
this
about
places
is
what
we
have
to
recognize
is
within
the
ics
is
natural
nationally,
our
ics
is
very
big
and
in
many
places
leeds
itself
would
be
bigger
than
many
ics's.
So
the
number
of
gps,
for
example,
lhcs
that
we
have
in
league,
is
far
bigger
than
many
of
those
other
ics's.
So
it
makes
it
harder
to
gain
that
much
representation
in
a
place
like
leeds,
but
that's
the
intention.
K
That's
in
the
guidance
in
terms
of
local
authority
playing
on
they
local
authorities
are
on
the
board,
but
the
pbp
as
we
call
it,
which
is
hard
to
say,
but
the
idea
is
that
the
pbp
takes
account
of
the
national
statutory
requirements
of
the
nhs
but
also
aligns
itself
to
the
health
and
well-being
board
strategy.
So
it
looks
two
or
three
ways
in
terms
of
what
it's
responsible
for
delivering
in
the
place,
so
it
does
have
an
lch
person.
G
J
Thank
you
chair.
I
I
just
wanted
to
comment
really
collectively
on
the
the
the
issues
that
have
been
raised
by
councillor
dallas
and
dr
beale
and
and
councillor
latte,
because
I
think
they're
absolutely
the
right
issues
that
we
we
need
to
be
cited
on
and
be
kind
of
actively
having
debates
on
in
the
city.
So
the
issue
counselor
dowson,
made
around
where's
prevention
in
this,
and
how
does
it
join
up
to
the
work
we
want
to
do
on
improving
health,
not
just
delivering
services?
J
You
know.
I
think
that
the
reality
is
that
you
know
it.
It
is
a
subcommittee
of
the
nhs
and
makes
decision
on
nhs
resources
and,
and
the
bit
that
we
need
to
still
do
locally
is
build
those
partnerships.
So
we
can
bring
the
whole
of
the
system
together
and
acknowledge
particularly
the
role
of
elected
members
and
the
local
authority
in
improving
public
health
and
delivering
social
care
and
children
services.
J
So
that's
the
bit
that
this
group
doesn't
do
and
we
have
to
build
so
I
I
would
just
support
the
comments
that
counselor
colleagues
have
made
and
dr
beale,
because
this
is
the
stuff
that
we
do
absolutely
need
to
grapple
with.
Otherwise
we
have
a
very
narrow
board
that
just
looks
at
healthcare
services,
so
thanks
chair,
hope.
That's
helpful.
G
K
Individuals,
I
think
the
guidance
is
suggesting
at
pcn
level,
so
primary
care
networks,
because,
as
victoria
says,
it
is
a
an
nhs
slightly
focused
place-based
partnership
board.
So
the
expectation
from
the
guidance
is
the
primary
care
networks
are
playing
into
that
board
as
opposed
to
local
care.
Partnerships,
which
I
know
is
a
wider,
wider
sort
of,
and
maybe
not
a
line
necessary
to
pcns,
always
primary
care
networks.
G
K
So
I
think
the
the
consultations
are
ongoing.
I
think
the
idea
is
over
september
and
october,
it's
all
pending
different
guidance
coming
out,
obviously,
because
things
move
a
bit,
but
I
would
say,
probably
three
months,
two
or
three
months
before
we
really
know
where
we
are
with
some
of
the
sort
of
consultation
like
constitution,
there's
an
operating
model,
that's
being
put
forward
about
how
how
the
board
the
nhs
board
effectively
at
the
integrated
care
board
links
to
pbsp
boards,
our
local
boards.
How
does
that
work?
And
how
do
our
staff
align
within
that?
K
A
A
Okay,
no
problem
hello.
Thanks
for
coming,
we
truly
appreciate
it
just
before
he
goes.
Anyone
have
a
question
for
john
all
right
thanks
john,
for
coming
and
have
a
lovely
day.
Thank
you.
Thank
you,
okay!
So
we're
moving
on
to
the
next
agenda
and
that's
for
same
day
response
services
in
leeds,
and
I
believe,
the
guests
that
we
have
on
there
who
haven't
introduced
themselves.
I
A
Okay,
so
when
countries
cons
when
we
were
considering
priority
areas
of
work
for
this
forthcoming
municipal
year,
the
board
had
expressed
an
interest
to
understand
how
the
covid19
pandemic
has
impacted
same-day
response
services,
including
the
effects
of
coming
out
of
lockdown,
and
to
consider
the
actions
being
taken
to
address
search
impacts.
The
nhs
leads
clinical
commissioning
group
has
therefore
led
on
providing
a
brief
paper
on
this
matter,
which
is
provided
within
the
agenda
pack.
You
all
have
got
so.
H
H
That
meant
the
use
of
triage
and
assessment
services
has
increased
over
that
time,
and
obviously
some
of
the
data
we've
we've
shown
throughout
the
different
services
shows
the
pre-pandemic
period
during
certainly
the
the
kind
of
height
during
2020
and
then
the
significant
shift.
That's
happened
as
we
as
we've
gone
into
2021
and
the
increased
demand
that
we
have
seen,
particularly
and
certainly
from
a
primary
care
point
of
view.
Significant
sharp
increases
around
march
and
2021.
H
H
Ideally,
first
time
as
well,
I
think
you
know
we
recognize
that
there
is
confusion
for
patients,
sometimes
in
terms
of
knowing
which
is
the
right
service,
and
so
we've
got
to
support
patients
to
to
make
that
choice,
but
also
yeah
make
it
as
easy
as
possible
for
them
as
well.
You
know,
I
think
it
goes
without
saying
some
of
the
challenges
that
that
we
need
to
to
recognize
specifically
thinking
about
workforce
and
and
that's
not
a
short-term
fix
that
we
can
put
put
workforce
in
place
tomorrow.
E
E
At
the
moment,
I'm
just
wondering
how
much
data
we
have
on
people
who
have
been
looking
to
book
a
standard
future
appointment
that
haven't
been
able
to
that
have
then
become
a
person
that
needs
that
same-day
response
or
an
urgent
response,
so
that
I'm
thinking
of
that
in
terms
of
general
medical
conditions
which
they
may
just
want
to
book
a
forward
appointment,
but
they
haven't
been
able
to
also,
particularly
in
areas
of
dental
health,
that
I'm
seeing
more
and
more
often
people
are
struggling
to
get
appointments.
Thank
you.
H
H
So
we
know
that
the
pandemic
shifted
to
a
turtle
triad,
but
actually
what
we
need
to
start
introducing
is
that
ability
to
pre-book,
because
I
think
yes,
the
risk
is
that
that
you,
you
can't
pre-book,
potentially
and
and
then
something
happens,
and
it
does
turn
into
a
more
of
an
acute
need,
and
so
I
think
that's
the
work
that
we
need
to
to
do
with
our.
You
know
our
gp
colleagues,
our
practice,
colleagues,
and
to
really
see
what
that
balance
is
and
going
back
to
ability
for
pre-booking.
H
B
H
I
don't,
unfortunately,
so
linking
back
to
john's
presentation
in
the
delegation
of
functions.
Nhs
dentistry
still
sits
with
nhs
england.
So
again,
I'm
happy
to
work
with
colleagues
and
to
get
a
position
around.
You
know
waiting
times
for
dentistry
and
apologies.
I
forgot
to
answer
that
in
the
the
previous
questions,
but
so
yeah,
I
don't
have
those
details
but
again
happy
to
to
to
explore
that
a
bit
further
with
nhs,
england,
colleagues.
H
D
Yes,
thanks,
chair,
first
of
all,
healthwatch
leads
has
been
doing
a
study
looking
at
the
difficulty
that
the
patients
have
been
receiving
and
getting
immediate
care.
It's
currently
in
draft,
I'm
sure
they'll
be
being
sent
to
the
ccg,
but
I
would
be
very
happy
also
to
make
sure
that
it
comes
to
this
board
as
well,
which
outlines
some
of
the
see
some
of
the
issues
and
feedback
from
patients.
If
I
can
just
pick
up
a
few
of
those.
D
First
of
all
the
lack
of
clarity
about
what
the
options
are,
I
mean
kirsty
said
it
includes
and
then
gave
us
a
list,
and
you
know
if
you
ask
whoever
out
there,
they
don't
know
what
is
available
and
they
don't
know
which
is
the
most
appropriate
one
for
their
particular
need.
So
I
think
there
is
a
need
to
provide
information,
and
maybe
one
one
one
first
actually
contacting
111
and
getting
some
information
on
what
is
appropriate
for
them
with
their
particular
issue
I
don't
know
but
but
that
that
might
be
the
way
forward.
D
Secondly,
there
are
have
been
a
number
of
cases
where
gp
has
not
been
available
or
not
offered
a
face-to-face
appointment
for
patients
who
really
feel
they
need
a
face-to-face
appointment.
They
are
not
happy
about
digital,
whether
it's
by
phone
or
video,
and
end
up
going
to
the
emergency
departments,
the
hospital,
a
e
for
situations
which
aren't
really
appropriate
for
the
emergency
departments.
D
The
fourth
thing
was
the
dentistry
issue
and
just
to
say,
kirsty,
west
yorkshire
and
harrogate
have
currently
had
a
working
group.
Looking
at
the
issue
across
the
whole
of
this
region.
I
was
on
that
working
group
and
there
is
a
sort
of
draft
report
coming
out
there
so
and
I'm
sure
emma
wilson
will
have
access
to
that.
So
it
would
be
useful
to
find
out
because
not
only
are
people
people
not
able
to
get
nhs
dental
care,
but
also
some
of
the
urgent
care
being
carried
out
is
not
clinically
not
appropriate.
D
D
It's
not
appropriate
treatment
and
it
contravenes
the
guidance
on
inappropriate
use
of
antibiotics
as
well
and
just
one
other
particular
question
in
the
paper
which
we
had
looking
at
the
future.
It
talks
about
expanding
the
number
of
gps.
Well,
I
wish
we
know
the
government
have
increased
the
number
of
medical
students.
It
takes
a
long
time
before
they
come
out
as
gps,
but
you
have
to
offset
that
against.
D
The
existing
gps
are
going
to
be
retiring
and
if
you
look
at
the
age
cohort
quite
a
lot
of
our
gps
and
leads
are
going
to
be
retiring
in
the
next
few
years.
There
is,
I
understand,
a
move
towards
increasing
early
retirement,
so
age
doesn't
always
dictate
when
people
are
going
to
retire
and
gps,
who
basically
are
stressed
out
and
go
part-time
rather
than
working
full-time.
So
I
just
wonder
how
realistic
it
is
to
be
talking
about
increasing
the
number
of
gps.
H
I
think
the
more
we
can
do
that
that
the
better
and
use
the
information
that's
already
there.
I
think
I
think,
where
there's
those
examples
where
things
don't
seem
quite
right,
I
think,
as
a
team
again
through
our
business
as
usual
quality
process,
we're
happy
to
pick
those
up.
So
the
examples
about
you
know
receptionist,
inappropriately
signed
person.
If
that's
because
you
know
we'd
always
want
to
explore
those
further,
so
I
suppose
that's
just
to
reiterate.
A
B
You
chair
kirsty
that
there's
a
couple
of
things
really
I'm
touching
on
what
dr
beals
just
said.
Do
we
know
how
many
vacancies
there
are
for
gps
across
leeds,
because
that
that
might
be
quite
shocking
for
people
to
see
how
many
there
are
and
again
it's
it's?
What
plans
are
there
to
recruit
over
the
next
three
to
five
years
to
replace
retirement?
So
it's
really
quite
worrying.
B
We
have
two
part-time
doctors
in
one
of
our
surgeries
and
if
one
of
those
decides
to
leave,
we
are
absolutely
in
a
tragic
situation
really,
and
the
other
question
I
have
is
that
I
was
always
under
the
impression
that
was
supposed
to
be
a
designated
gp
and
name
gp
for
all
older
patients.
I
don't
know
whether
it's
over
70
or
80,
but
my
father's
95.
He
hasn't
actually
seen
a
gp
for
three
years
now
because
he
hasn't
been
called
to
be
seen.
B
So
it's
what
are
they
doing
about
reintroducing
that
who
are
you
know?
They've
got
patients
who
are
chronic
patients
with
long-term
diseases,
they're
not
being
reviewed,
yes,
they're
having
a
pharmacy
review
of
their
drugs
and
they
sort
of
say
to
him.
Oh,
are
you
feeling
all
right
is
that
okay,
you
know
whatever,
but
they
aren't
actually
being
seen
by
a
doctor
and
then
looking
at
the
patient
and
him
seeing
the
color
or
you
know
how
the
guy's
presenting
himself
or
anything
else.
So
I'm
really
concerned
about
how
we
get
that
back.
B
But
what
communication
are
we
actually
giving
as
a
local,
a
local
area
about
how
those
teams
work
so
that
patients,
when
they're
told
actually
your
call,
is
going
to
be
what
is
triage?
It's
going
to
be
triage
and
will
decide
what
the
best
option
is,
and
that
may
well
then
get
away
from
this
thing
about
needing
the
same
day.
Appointment,
because
if
they
understand,
if
they
talk
to
the
pharmacist
or
the
practice,
they
don't
need
to
see
a
gp.
For
that.
B
H
So
I
hope
I
remember
all
of
these
questions,
so
so
the
provision
of
an
gp
is
still
there
within
the
contract.
So
to
use
the
example
at
some
point
that
that
name,
gp
should
have
been
given
and
and
if
providing
that's,
not
changed,
then
then
that
should
still
be
in
place.
The
provision
within
the
contract,
about
being
seen
within
three
years
is
very
specific
in
that
it's
if
a
person
hasn't
been
seen
by
anybody.
H
I
think
I
think
you
point
about
communication
and
are
we
communicating
sufficiently?
I
think
I
think
it's.
It's
probably
the
right
one,
and
I
think
it
goes
back
to
a
point
got
to
be
all
made
around.
I
suppose
the
choice
and
and
how
do
we
actually
make
sure
patients
know
what
what
the
right
and
the
right
services?
H
I
think
I
think
part
of
this
was
started
around
the
you
know
how
the
roles
were
changing
in
primary
care,
pre-pandemic
and
obviously
it's
got
lost
slightly
because
because
of
the
shift
or
because
of
the
the
pandemic
is
obviously
taken
resources
elsewhere.
I
suppose
the
points
that
you're
making
about
workforce.
H
A
Thank
you
very
much,
kirsty
yeah.
I
will
be
interested
in
knowing
the
figures
as
well,
especially
for
in
terms
of
the
numbers
of
gp,
based
on
how
many,
how
many
you
know
in
terms
of
the
delays
that
we're
receiving
reports
on
people
trying
to
get
through
to
their
gp,
so
that's
very
important
norma.
What
I
would
like
to
ask
is
obviously
with
your
dad
at
95
and
has
not
been
seen
for
three
years.
I
take
it
he's
in
he's
been
in
very
good
health.
A
B
B
You
just
need
to
talk
to
the
pharmacist
about
that,
but
there
are
some
things
that
yes,
he
would
like
to
go,
but
in
you
need
to
get
him
face
to
face
with
the
person,
and
that
has
been
difficult
so
yeah
it's
been
oh,
we
can't
do
it
at
the
moment
because
of
covid
and
those
kind
of
things
so,
and
I
know
that
that'll
it'll
get
better.
I
know
it
will,
but
it
just
just.
B
It
was
just
to
demonstrate
the
point
that
there
must
be
an
awful
lot
of
older
people
who
maybe
are
in
worse
health
than
my
father
is
who
really
really
are
worried
about
the
fact
that
they
haven't
seen
anybody
and
they
may
well
be
going
with
with
undiagnosed
issues
that
are
then
going
to
become
something
quite
urgent.
That
was
all
really
yeah.
F
Dental
dentists
are
professionals
if
they
refer
somebody
to
the
dental
hospital.
You
would
assume
that
that
is
a
case
that
needs
to
be
seen
by
the
dental
hospital
and
yet
I'm
getting
reports
back
that
those
referrals
have
been
turned
away
and
also
the
relationship
between
a
person's
doctor
and
their
dentist.
H
Yeah,
it's
a
it's
a
good
question
and
where's
dr
beale
gone,
because
I
wonder,
if
he's
better
to
to
answer
the
question
around,
is
it
if
it's
a
long-standing
query?
I
I
I
wouldn't
I'm
happy
to
take
it
away
and
explore
that
with
the
nhs
england
in
terms
of
the
queries
around
referrals
and
to
the
dental
hospital,
I
think
with
you
know
the
changes
that
john's
been
talking
around
around
partnership
dentists
as
providers.
Actually
I
don't
know
where
that
conversation
is
around.
You
know.
H
H
F
Nice
to
have
this,
the
statistics
kirsty
just
how
many
people
that
have
been
referred
by
a
professional
to
the
dental
hospital
are
subsequently
getting
turned
away.
That's
a
specific
question,
and
I
would
like
those
figures
please
the
rest,
then
obviously
that'll
come
with
time,
but
this
is
a
very
specific
question
for
this
particular
time
postcovid.
Thank
you.
F
A
G
Thank
you.
Yes,
nothing
to
do
with
dentistry
at
all.
Just
occurs
to
me
that
when
I
asked
my
questions
earlier
on
about
who
was
going
to
be
controlling
in
the
nicest
sense,
the
the
general
practices
of
the
city,
and
it
would
appear
that
what
we're
talking
about
now
is
is
the
form
of
control.
I
just
wonder
whether
there
is
going
to
be
the
opportunity
for
setting
some
new
standards
for
general
practice.
G
G
Then
none
of
them
work
a
full
week
and
of
course
they
don't
work.
We
know
they
don't
work
evenings
and
nights
nowadays
they
don't
don't
have
to
do
house
calls-
and
this
is,
you
know,
absolutely
essential,
so
it
in
lots
of
ways
it's
a
lousy
job,
but
in
lots
of
other
ways
you
know
it's
not
it's
not
as
bad
as
it
used
to
be,
and
I
just
wonder
whether
we
we
might
be
able
to
address
it
through
this
new
form
of
nhs
management.
Thank
you.
H
Yeah-
and
I
think
I
think
the
I
suppose,
general
practice
has
changed
significantly
over
the
years
and
the
expectation
from
a
sense
of
what,
what
the
contract
and
and
let's
be
really
honest
about
it.
This
is
a
nationally
set
contract.
That's
nationally
negotiated,
so
some
of
the
expectations
on
them
is
nationally
set,
which
is
difficult
for
us
to
control.
As
you
put
it,
I
think
where
we
do
have
the
opportunities
on
our
local
commissioning.
H
H
And
you
know
it's
how
we
use
that,
so
that
patients
have
a
better
experience,
I
suppose,
just
in
in
defensive,
you
know
general
practice
and
and
primary
care
the
the
the
expectation
around
the
level
of
service
that
they
provide
is
is
far
greater
than
it
was.
You
know
I've
done
this.
For
you
know,
25
years
now,
we've
got
to
think
about
the
the
safety
and
quality
of
service
that
is
now
expected.
H
You
know,
we've
got
cqc
requirements,
etc
so
that
the
days
of
being
able
to
to
operate
a
general
practice
out
of
your
front
room
and
still
doing
the
house
calls
you
know
at
midnight,
it's
not
there
and
again,
that's
not
necessarily
the
gps
choice.
It's
because
again
the
contract
was
changed
and
so
that
out
of
hours
was
delivered
in
a
very
safe
and
you
know
measured
way
in
terms
of
the
callback
provision,
etc.
So
I
you
know,
I
I
do
hear
what
you're
saying
around
it's.
H
G
If
the
level
of
service
was
acceptable,
we
wouldn't
be
having
this
conversation
and
not
just
me,
but
several
people
have
been
they've
been
saying
it,
but
I
do
take
your
point
but
then
again
go
back
to
my
practice.
There
are
about
nine
doctors
there
and
the
council
is
seeing
the
same
one
twice
on
the
truck.
Is
it's
about
the
same
as
it
was
going
to
mars?
So
I
just
leave
you
with
that
thought.
H
Yeah
now
and-
and
I
know
the
the
issue
but
but
again,
I
think
the
the
positives
of
of
gps
working
part-time
means.
They
also
have
interest
in
other
areas,
which
also
then
heightens
the
or
kind
of
it
brings
some
specialism
potentially
to
their
practice
as
well,
which
benefits
their
patients.
So
I
you
know
I
I
again,
I
hear
what
you're
saying,
but
I
think
we've
also
got
to
to
recognize
that
the
workforce
is
looking
at
wanting
to
have
portfolio
careers
and
have
interest
in
other
areas
as
well.
H
I
think
again
recognizing
the
the
the
pressures
that
practices
are
under
our
individuals
actually
having
that
ability
to
have
a
varied
career
and
work
life.
Balance
as
well
means
that
people
will
stay
longer
as
well
and
so
yeah.
I
think
I
think
it's
how
we
get
get
the
balance
right.
Isn't
it
between
patients
having
a
good
experience,
yeah
yeah
I'll,
stop.
B
B
It's
only
if
you
say
I'll
see
anybody,
because
I'm
ill
that
you
will
manage
to
get
an
appointment
on
that
day
and
I
just
wondered
if
that
was
generally
throughout
our
practices
or
whether
it
was
just
specific
ones
in
our
city
that
have
that
sort
of
service
and
even
during
the
pandemic,
the
surgery
has
been
okay
for
nurses
to
use.
But
yet
you
couldn't
have
a
face-to-face
appointment
with
the
gp,
and
I
just
wanted
to
throw
some
explanation
as
to
why
that
was
happening
and
why
a
gp
couldn't
see.
H
So
I
I'll
take
the
the
first
query
first,
which
was
about
turn
off,
so
I
think
I
think
that's
linked
to
the
wider
workforce
that
we've
discussed.
So
I
don't
have
those
figure
figures
to
hand.
So
that's
that's
something
we
we
can
explore.
I
suppose
the
we
need
to
be
really
clear.
Face-To-Face
appointments
have
been
available
throughout
the
whole
of
the
pandemic
and
some
routine
services
throughout
you
know
the
whole
of
2020.
H
You
might
not
have
been
able
to
see
a
nurse
because,
because
certainly
a
lot
of
routine
services
were
stopped
during
part
of
that
time,
and
I
think
the
the
difference
between
nursing
services
and
gp
services
are
a
lot
of
nursing
services.
You
do
have
to
do
face-to-face
and
there
isn't
a
you
know
there
isn't
a
remote
way
that
you
can
do
you
know
a
smear
test.
For
example,
you
absolutely
need
to
be
face
to
face
similar
vaccinations.
H
I
think
we've
got
to
set
it
in
that
context
around
we
have
seen
you
know
a
peak
in
demand
that
needed
to
be
addressed,
and
if
everybody
had
just
been
seen
face
to
face
and
we
would
have
been
dealing
with
even
more,
you
know
longer
waits
as
well.
Again,
I
think
I've
said
earlier.
I
think
we
need
to
get
a
balance
right
and
the
ability
to
pre-book
where
it's
it's
obvious.
H
B
Yeah,
can
I
just
come
back
check,
so
I
don't
think
that's
been
happening
throughout
the
city
and
I
think
some
patients-
I've
spoken
to
in
my
ward,
have
found
it
rather
difficult
to
explain
over
the
phone.
What
exactly
was
wrong
with
them,
because
they
they
couldn't
use
the
body
language
to
express
or
show
the
doctor.
They
might
have
been
showing
the
doctor,
but
he
couldn't
see
or
she
couldn't
see
where
they
were
pointing
to
on
their
own
bodies
because
of
the
language
being
used,
and
they
found
it
difficult
to
express.
H
H
Forward,
no,
I
agree,
I'm
really
sorry
as
well
as
I've
just
you've
just
triggered
another.
I
think
the
issue
you
raised
as
well
about
specific
doctors
wanting
to
be
seen,
I
think,
there's
always
a
favorite
if
we're
being
completely
honest
within
specifics,
is
where
you
know
all
patients
might
want
to
see
that
individual
and,
I
think,
that's
that's-
been
kind
of
the
the
nut.
B
I've
just
been
interested
in
the
turnover
of
staff,
because
I
know
that
some
gps,
you
get
a
letter
saying
which
gp
are
designated
so
but
before
you
have
a
chance
to
even
meet
them,
they've
moved
on
and
I'm
just
wondering
if
there's
some
sort
of
unrest
among
doctors
themselves
among
gps.
That's
creating
this
huge
turnover
of
staff.
H
H
I
mean
I'm
happy
to
pick
this
up
separately
if
this
specific
practice,
because
sometimes,
if
they're
training
practices,
whilst
you
might
not
just
mean
it
could
be
that
they're
moving
on
through
their
training
program.
So
you
do
see
that
turnover
within
some
specific
practices,
but
it's
actually
because
they're
part
of
that
that
training
bit
so
but
yeah.
If
there
are
specific
concerns
about
you,
know
particular
practices,
then
I'm
I'm
happy
to
pick
up
outside
and
have
a
conversation.
Definitely
thank
you.
D
D
It
does
hidden
away
in
the
small
print
somewhere
talk
about
the
primary
care
networks,
including
dentists,
pharmacists
and
opticians,
and
I
have
raised
that
with
our
local
british
dental
association
committee
for
west
yorkshire
that
I'm
a
member
of-
and
we
have
a
new
chair
of
the
leeds
local
dental
committee,
who
I
I
didn't
know
before.
But
I've
had
one
telephone
conversation
with
him
and
it
is
on
my
list
of
things
to
raise
with
him,
because
I
think
it's
going
to
be
very
important.
D
That
dentists
play
a
part
in
the
pcns,
the
primary
care
networks.
There
is
the
issue
of
you
know
if
they're
out
of
the
surgery
they're
not
getting
paid,
but
it's
not
beyond
the
width
of
of
the
system
to
to
be
able
to
make
arrangements
to
provide
some
finance.
So
they
can
do
that.
So
I
think
that
is
a
good
point
that
we
need
to
make
sure
is
not
dropped
out
of
the
health
and
care
bill,
as
it
goes
through.
Parliament.
A
Definitely
dr
bill.
Thank
you
very
much
kirsty.
There
are
a
few
questions
that
need
answering
from
this
agenda.
So
myself
and
our
principal
scrutiny
advisor
will
work
with
you
if
that's
okay
and
try
as
much
as
we
can
to
get
all
the
answers
of
which
we
will
now
bring
back
to
the
board,
because
sometimes
some
of
the
answers
we
receive
will
trigger
more
questions,
so
we
would
need
to
now
arrange
for
another
time
to
bring
back
all
the
responses
that
we
will
get
from
yourselves
back
to
the
board.
Is
everyone?
A
A
G
H
H
You're,
absolutely
right-
and
I
suppose,
during
during
the
pandemic,
the
work
on
that
development
of
new
urgent
treatment
centers
for
the
city
was
unhurled
and
that's
absolutely
part
of
those
longer
term
strategies
that
we
we
want
to
get
back
up
and
running,
and
so
so
absolutely
that's
part
of
the
next
bit
of
work,
which
is
what
what's
the
future
direction
for
urgent
treatment.
Centers
now,
what's
the
data
telling
us?
How
have
patient
behaviors
changed?
You
know
easiest
leads
the
the
right
place,
so
we
just
need
to
refresh
all
of
that.
H
So
absolutely
we'll
we'll
come
back
out
to
a
nurse
through
the
work
that
we're
doing
around
east
leeds
extension
and
future
provisions
that
we'll
be
picking
up
those
conversations
as
well.
So
it's
absolutely
on
our
radar
so
just
to
give
you
that
assurance
I'll
hand
over
it
again
and
just
to
see
if
she
wants
to
sum
up
now.
I
Thanks
kirsty
under
yeah
thanks
councillor
jenkins,
for
it
for
asking
me
to
comment.
I
think
it's
clear
is
it
that
we've
still
got
a
big,
a
big
gap
between
people's
experience
of
of
of
being
able
to
access
the
care
that
they
need
versus
some
of
the
things
that
we
feel
are
being
developed
and
put
into
place
in
the
system
to
address
some
of
it.
I
But
unless
we
describe
that
properly
to
the
public,
the
people,
don't
you
know,
people
don't
understand
that.
Actually,
that's
a
better
offer
and
there's
a
real,
sound
rationale
behind
it,
which
is
about
the
right
person.
Seeing
you
at
the
right
time
with
the
right
condition,
plus
also
it
does
address
the
issue
of
like,
say
we're,
not
getting
the
numbers
and
coming
into
into
gp
training
that
maybe
the
government
would
we
know
it.
I
You
know
puts
out
that
the
targets
in
terms
of
increasing
the
number
of
gps,
but
unless
we
get
a
medical
student
that
wish
to
go
down
that
that
line,
then
we're
never
going
to
recreate
the
num.
You
know
recruit
the
numbers.
I
think
the
business
model
for
general
practice
that
we've
heard
about
before
in
terms
of
you
know
gps
becoming
partners
in
a
business.
That's
not
necessarily
attractive
to
younger
doctors,
entering
gp
training
and
entering
the
the
gp.
You
know
general
practice
arena.
I
I
I
Isn't
around
somebody
being
nosy.
It's
not
around
somebody
trying
to
prevent
you
getting
somewhere.
It's
around
somebody
trying
to
navigate
you
to
the
best
place.
You
know
the
first
time
but
again,
unless
we
describe
these
things
in
the
right
way,
with
the
right
rationale:
the
right
explanation:
they
don't
land
in
the
way
that
is
intended-
and
I
think
one
of
the
benefits
of
having
a
gp
confederation
in
the
city
now
is
that
for
the
last
two
years
we've
been
able
to
bring
together
gp
practices.
I
So
you
know
currently:
we've
got
94
different
individual
private
businesses
that
deliver
general
practice
care
in
the
city
and
for
the
like,
I
said
over
the
last
two
years,
we've
been
increasingly
working
with
those
94
practices
in
their
19
pcns.
To
say
how
can
we
bring
you
together?
How
can
we
share
good
practice?
I
You
know
pre-screening
face-to-face
only
where
it's
clinically
necessary
in
order
that
we
protect
that
work
fast
and
ensure
that
practices
are
are
resilient.
So,
like
I
said,
there's
a
number
of
factors
here,
but
I
think
the
work
of
the
gp
confed
in
partnership
with
the
ccg
means
that
we
are
in
a
place
where
we
can
work
together
with
those
practices
in
their
pcns
in
the
context
of
the
local
care
partnership.
I
F
F
Does
every
gps
practice
have
a
social
prescriber,
because,
often
when
you
see
your
gp,
it
is
necessarily
a
physical
issue
or
it
might
be
a
physical
issue
that
would
be
helped
by
exercise
or
helped
by
a
yoga
class
or
something
that
we
fund
often
as
counsellors.
You
know:
we've
just
funded
a
pain
clinic
in
our
area,
linked
to
the
gp's
practice,
but
I
think
we
do
need
to
know
who's
getting
referred
and
is
the
referral
from
the
doctor
or
somebody
else.
I
I'm
happy
to
pick
that
up
and
so
counselor
davison.
Just
in
response
to
that
specific
question
does
every
gp
practice
have
social
prescribing?
Yes,
so
there
is
a
city-wide
service
in
place.
The
contract,
I
think,
changed
to
the
current
provider.
I
think
it's
probably
about
18
months
ago
now
in
which
that
contract
bought
brought
together
a
city-wide
provision
from
what
had
been
a
number
of
different
social
and
prescribing
providers
and
again
that
linked
to
some
national
changes
around
the
requirement
for
social
prescribing.
So
it's
a
city-wide
service.
I
Now
it's
a
service,
that's
delivered
through
a
partnership
of
those
previous
providers
and
there
is
provision
into
every
pcn
into
every
practice
for
for
social
and
prescribing
over
and
above
the
city-wide
contract.
There
is
the
ability,
through
the
primary
care
network,
enhanced
role
scheme
that
we've
mentioned
before,
which
is
the
scheme
whereby
we've
seen
the
growth
of
different
professionals
in
primary
care.
I
There
is
the
opportunity,
through
that
and
scheme,
as
well,
for
practices
to
add
to
the
citywide
provision
and
have
people
who
are
in
in
very
similar
roles
to
the
city-wide
social
prescribers,
so
that
there
can
be
increased.
You
know
increased
capacity
at
at
practice
level
and
there
is
a
city-wide
social
prescribing
steering
group
that
will
receive
the
sorts
of
performance
information
that
you're
interested
in
counselor
dalton
in
terms
of
numbers
of
referrals,
sources
of
referral
outcomes
for
those
referrals
and
quality
metrics
as
well.
I
F
Would
I'd
be
really
grateful
gainer
because
it
is,
it
is
of
concern
to
me
that
I've
got
people
who
I
perceive
would
be
best
served
by
helping
the
community
through
social
prescribing
to
local
voluntary
sector
organizations
who
aren't
getting
those
referrals
who
aren't
even
being
told
there
is
a
social
prescriber
in
the
practice.
So
those
statistics,
I
will
find
very
useful,
get
me
as
many
as
you
can
and
I
will
pour
over
them.
A
Thank
you
very
much
councillor
dowson
right.
We
need
to
move
on
to
our
next
agenda
to
all
the
counselors
who
have
got
their
cameras
switched
off.
Can
you
give
me
a
thumbs
up
virtual
one
so
that
I
know
you're
there,
so
the
ones
who
have
their
cameras
on
you're
good,
no
problem,
the
ones
who
have
their
switched
off
you've
got
your
camera.
Can
I
say
a
thumbs
up
from
all
of
you.
You
can
give
me
a
virtual
one.
Counselor
cunningham.
Are
you
there
counselor?
A
Are
you
there
councillor
kidja?
Are
you
there?
That's
very
good
look
at
all
of
them
doing
well.
So
thank
you
right.
Moving
on
to
agenda
five,
it's
the
restart
and
prioritization
plans
for
delivery
of
the
nhs
program.
I
believe
we
have
offices
who
will
need
to
introduce
themselves
now.
The
report
from
the
director
of
public
health
focuses
on
the
impact
of
copy
19
on
nhs
health
check
program
delivery
throughout
2020
and
2021,
and
the
steps
being
taken
to
plan
for
the
restart
and
recovery
of
this
program
gainer.
A
B
C
Thank
you
chair.
Just
forgive
me
my
internet's
a
tad
bit
weak.
I
can.
I
can't
everybody
else
is
frozen
other
than
the
person
who's
talking,
so
I'm
trying
my
best
to
keep,
and
but
I
can
hear
everything
which
is
good
chair.
This
paper
provides
an
overview
and
an
update
on
the
nhs
health
check
program
within
leeds,
including
the
impact
of
the
code
pandemic
and
on
delivery
and
the
planning
being
undertaken
to
support
a
program
of
recovery.
C
C
The
nhs
health
check
is
currently
delivered
through
gps
in
in
primary
care,
and
the
present
provider
is
the
leads
gp
confederation.
Obviously,
we've
got
gainer
in
attendance
today.
The
paper
highlights
how
the
pandemic
has
significantly
impacted
on
the
nhs
health
check
delivery.
For
example,
only
18
of
the
total
nhs
health
checks
delivered
in
2019-20
were
delivered
in
20,
20
and
21
that's
effectively,
meaning
significantly
fewer
people
have
been
identified
as
high
risk
of
developing
cardiovascular
disease.
C
This
obviously
is
in
the
context
of
reduced
staff
capacity
in
primary
care,
with
the
prioritization
of
the
covered
19
vaccination
program
and
other
primary
care
restart
priorities.
A
decision
to
extend
the
nhs
health
check
contract
with
the
current
provider
leads
gp
confederation
from
the
31st
of
march
2022.
Invoking
a
two-year
extension
was
recently
approved.
The
rationale
for
this
was
to
help
avoid
disruption
and
ensure
focus
on
restart
and
recovery.
C
Public
health
has
been
working
with
the
gp
confederation
to
plan
for
re-restarting
and
catching
up
in
2021-22
working
alongside
the
lead,
ccg
colleagues,
who
are
co-commissioners
of
primary
care.
An
options
paper
has
been
produced
in
inform
to
inform
these
conversations,
as
you
can
see
in
in
the
paper.
In
addition,
the
leads
gp
confederation
have
engaged
with
gp
practices,
to
gauge
capacity
to
deliver
nhs
health
checks
now
and
over
the
next
six
to
12
months.
This
will
inform
a
detailed
restart
and
recovery
plan
currently
being
developed
by
the
gpcon
federation
chat.
C
A
I
Very
much
over
to
you
again
thanks
chair
and
thanks
counselor
for
that
introduction,
I'm
conscious
that
you've
had
in
your
pack
two
detailed
papers.
So
what
I
wanted
to
do,
if
that's
okay,
is
just
share
a
brief
set
of
slides.
So
I
can
pick
out
the
salient
points
to
give
us
so
hopefully
to
provide
assurance,
then,
to
the
to
the
group
that
we're
taking
this
restart
as
seriously
as
we
need
to
be
doing
so
just
bear
with
me.
While
I
share
my
screen,
as
has
my
screen
shared.
I
I
Lifestyle,
behavior,
lifestyle,
behavior
change,
so
this
table
was
included
in
the
paper,
but
it
was
just
really
to
give
some
context
that
pre-pandemic
we
were
doing
really
well
across
leeds
with
uptake,
and
we
had
one
of
the
highest
upticks
in
in
the
country
really
or
certainly
across
the
coast,
cities
where
we
were
seeing
that
our
uptaking
lead
was
ten
percent
higher
than
the
than
the
national
average.
So
you
know
great
to
look
back
to
see
where
you
know
the
baseline
that
we
had
pre-pandemic,
but
actually
we
need
to
be.
I
We
need
to
be
well
aware
now
of
the
impact
of
covid
which,
as
as
we've
we've
heard
in
the
introduction
in
2019
2020
43
of
the
eligible
population,
received
an
nhs
health
check
which
you
said
come.
If
we
look
at
that
on
the
the
data
on
the
previous
table
did
put
us
some.
You
know
well
in
advance
of
some
of
the
other
comparative
places,
but
in
20
20
21.
So
far,
we've
only
got
7.6
of
the
eligible
population.
I
I
What's
the
current
situation,
compass
capacity
of
the
practices
within
that
pcn,
and
how
can
we
really
help
the
pcns
to
have
what
we
call
a
forensic
spotlight
so
that
they
really
drill
down
into
the
data
to
understand
who's
eligible
who's,
not
had
a
health
check
and
how
they
should
be,
how
they
should
be
using
their
available
capacity
to
really
focus
and
offer
nhs
health
checks?
But
we
know
that
won't
be
the
same
level
of
capacity
and
consistency
right
across
our
practices
across
the
19
pcn.
I
So
there's
other
other
overlaying
elements
that
we
want
to
do
to
the
restart
plan,
which
is
to
offer
extra
clinics
via
our
extended
access
service.
So
the
leash,
gp
comfort
currently
holds
a
citywide
contract
to
provide
extended
access,
which
is
access
to
appointments
during
the
evening
and
the
weekend.
So
again,
we
really
want
to
look
at
that
profile
of
appointments
and
balancing
the
needs
to
have
some
of
that
extended
access
linking
to
same
day
demand,
but
also
having
some
of
those
appointments
offering
capacity
for
nhs
health
checks.
I
So
again,
we'll
work
with
each
pcn
to
say
this
is
what
you
might
be
able
to
do
through
your
practices.
How
can
we
then
build
on
that
by
offering
additional
capacity
within
your
extended
access
hubs
and
then,
over
and
above
that,
the
third
element
will
be?
Can
we
actually
re
recruit
a
sessional
team
to
almost
do
some
some
waiting
list,
some
waiting
list
work
so
that
again,
looking
at
that
data,
we
can
say:
where
are
the
proto
groups
who
who's
missed
an
nhs
health
check
in
the
last
12
months?
I
If
I
can
just
share
this
slide,
which
I
appreciate.
Sorry,
it's
quite
busy,
but
I
do
hope,
you'll
be
able
to
see
it
on
screen,
because
what
I
wanted
to
to
share
with
you
is
that
that
forensic
spotlight,
or
that
four
elements
of
the
plan
that
I've
described
to
you
there
we've
actually
had
real
real-life
experience
of
using
that
approach
over
the
last
year.
I
You
can
see
that
red
line,
which
was
the
target
of
the
nhs
england
set
to
the
national
gdp
contract
for
67
of
those
eligible.
Having
had
their
nhs
health
check.
You
can
see
with
the
blue
bars
where
previous
performance
was
at
across
each
pcn,
which
are
listed
across
the
bottom,
so
in
march
2020,
the
blue
line.
Now
you
can
see,
for
example,
in
the
middle
we've
got
one
one
pcn,
which
is
lsmp
and
the
light
in
2020
their
their
achievement
was
only
13.3
of
their
eligible
learning
disability
population.
I
Having
received
an
nhs
health
check
through
the
work
that
we've
done,
you
can
now
see
that
in
march
2021,
that
pcn
has
now
achieved
a
75
uptake
there'll
be
various
numbers
behind
the
percentage.
But
I
think
what
this
graph
illustrates
is
the
impact
that
we're
hoping
to
have
through
this,
a
really
clear,
far-pronged
approach
and
real,
clear
focus
to
working
with
our
pcns
on
the
on
the
restart
of
the
nhs
health
check.
I
We
hope,
with
everything
that
we've
heard
around
the
context
and
the
reset
of
other
services
and
the
backlog
of
other,
like
long-term
condition,
checks
and
face-to-face
access.
That
say,
concerns
have
been
raised
earlier
on
in
a
meeting.
We
hope
to
return
to
pre-pandemic
levels
of
activity
during
2022-23.
I
There
is
a
but
to
this,
which
unfortunately,
I
do
need
to
raise,
which
again
counsellors
and
colleagues
may
be
aware
of-
is
that
we
are
in
the
middle
of
a
global
shortage
of
blood
bottles
and
nationally.
That
is
now
leading
to
direction
into
the
nhs
that,
across
all
elements
of
the
nhs,
so
acute
care
primary
care,
mental
health
care.
The
no
non
urgent
blood
samples
samples
should
be
should
be
taken
and
progressed
at
the
moment.
I
I
For
so
that
we
can
then
recalibrate
our
projections,
and
we
are
also
looking
at
whether
there's
other
technology
that
we
can
introduce,
such
as
point
of
care
testing,
which
means
that
a
blood
sample
can
be
taken
doesn't
require
to
be
put
into
a
bottle
and
sent
to
a
lab.
But
it
allows
us
to
at
that
point
of
care
and
interaction
with
the
patient.
It
allows
us
to
check
things
like
cholesterol
and
blood
sugar
levels.
So
again,
there's
some
elements
of
the
nhs
health
check
that
we
can
take
forward
in
a
different
way.
I
A
F
Right,
sorry,
sorry,
we've!
We
talked
about
this
quite
a
lot
because
prevention,
as
I've
already
said,
is,
is
better
than
cure,
and
this
is
one
of
the
major
things,
especially
with
statins
and
and
so
on
and
cholesterol.
It
is
important
and
some
of
the
drugs
you
give
for
cholesterol.
You
can't
actually
give
if
you've
if
you've
got
liver
problems,
so
it's
quite
important
sometimes
that
you
get
those
two
tests
done
together,
but
totally
appreciate
that
the
cholesterol
one
can
be
done
independently.
F
So
how
many
doctor
surgeries
will
have
this
ability
to
do
the
point
of
care
testing
of
certain
elements
of
that
and
speaking
as
one
of
the
40
000
that
haven't
been
invited
for
my
tests
yet
and
bearing
in
mind
what
you've
said
about
the
blood
bottles?
What
is
the
projection
going
forward
as
to
and
obviously
it's
how
long
is
a
piece
of
string?
So
I
do
realize
this
is
going
to
be
a
guesstimate
absolutely,
but
you
said,
22
23
and
you've
got
more
people
come
into
that
category
during
well
from
now
till
23..
F
I
I
think,
in
relation
to
the
to
the
impact
of
the
shortage
of
blood
bottles,
I
think
you
write
counselor
dalton
in
terms
of
it's.
How
long
is
a
piece
of
string
but
like
so?
What
we
are
doing
is
trying
to
understand
how
we
can
mitigate
that
point
of
care.
Testing
like
say
for
cholesterol
and
blood
sugar
would
be,
would
be
one
way
of
doing
that
that
won't
be
available
in
every
surgery,
because
the
kit
for
point-of-care
testing
isn't
necessarily
available
in
every
surgery.
I
If
the
blood
bottle
shortage
goes
on
and
on
and
on
which
again,
let's
say
we
we're
not
really
sure
we're
relying
on
kind
of
international
and
national
supplies,
then
it
would
be
more
more
prudent
that
we
did
look
at
whether
there
is
the
need
to
do
that.
Point
of
care
testing
in
every
in
every
surgery
and
what
that
might
look
like
and
how
might
we
and
how
might
we
be
able
to
do
that?
I
I
think
there's
a
catch-up
to
do,
as
you
say
in
terms
of
you
know,
we
need
to.
We
need
to
invite
those
people
that
have
missed
their
nhs
health
check,
and
I
think
what
we
want
to
do
is
by
the
point
we
get
to
20,
22,
23,
so
sort
of
april
of
next
year.
I've
done
as
much
of
that
catch
up
as
we
possibly
can
do
so
that
we're
then
starting
again
from
a
you
know
from
a
baseline.
I
So
you
know
we
are
you
know
we.
We
we
hit
a
milestone
several
weeks
ago
now
of
having
over
a
million
vaccines
being
given
in
our
city,
which
is
absolutely
fantastic,
but
I
think
it's
worth
saying
just
by
way
of
context
that
three
quarters
of
those,
so
over
700
000
of
those
vaccines,
have
been
given
in
gp
practices
so
as
well
as
running
normal
services,
trying
to
run
normal
services
and
trying
to
respond
to
all
of
their
all
of
the
requirements.
I
I
So
I
know
that
sorry,
slight
of
that
tangent,
but
I
just
think
it's
worth
adding
that
into
the
into
the
context
of
everything
else.
So,
just
coming
back
to
the
catch-up
furniture's
health
checks,
we
will
have
to
create
additional
capacity
that
sits
outside
of
practices
to
do
the
catch-up,
which
is
where
we
need
to
use
the
extended
access
service
and
again
balance
that
between.
I
If
we
used
all
of
that
capacity
to
do
nhs,
health
checks
we'd,
then
be
creating
an
issue
around
same-day
access
or
access
to
other
services
that
people
can
book
in
on
an
evening
or
a
weekend.
So
there's
a
balance
as
well
as,
like
I
say,
talking
to
potentially
another
provider,
is
whether
we
can
work
in
partnership
with
them
to
put
on
some
additional
sessions
to
do
some
catch-ups,
focusing
on
the
people
who
are
most
at
risk.
First,
so
people
who
smoke
people
who
are
overweight,
people
who
live
in
our
most
deprived
communities,
okay,.
E
Thanks
chair
thanks
gaynor,
my
question
is
really
around:
who
performs
the
nhs
health
checks?
Is
it
always
a
gp
and
also
then
linking
into
just
asking
a
bit
more
about
the
kind
of
the
advertising
of
the
importance
of
those
sessions,
because
I
don't
think
that
I've
seen
very
much
around
you
know
that
tells
me.
If
I
get
this,
then
it's
an
important
thing
to
do.
Okay,
thank
you.
I
I
You
know
it
is
offered
in
the
spirit
of
it
being
a
partnership
conversation
between
the
between
the
practitioner
and
the
and
and
the
person,
and
so
it's
it's
very
much
like
say
what
matters
to
you
like.
So
how
do
we
have
a
better
conversation?
So
it's
a
it's
a
coach
and
it's
an
empowering
conversation
as
opposed
to
it
being
a
you
know,
a
a
kind
of
medical
or
a
medicalised
intervention,
and
I
think
you're
right
in
terms
of
the
publicity
and
again
I
think
we
have
discussed,
I
mean
lucy's
nodding,
we've.
I
Certainly,
we've
certainly
discussed
in
the
nhs
health
check,
contract
meetings,
the
need
to
publicize
and
the
timing
of
publicizing.
In
terms
of
again,
we
need
to.
We
need
to
make
sure
that
we've
got
that
additional
capacity
ready
to
go.
We
can
then
advertise
and
publicize,
because
if
we
do
the
advertising
and
the
publicizing
first,
then
what
we'll
do
is
we'll
cause
a
load
of
traffic
to
gp
surgeries
and
then
we'll
get
the
gp
surgery
saying
we're
not
offering
them
at
the
minute.
I
We
haven't
got
capacity
to
do
it
and
then
we'll
get
people
who
feel
very
frustrated.
That
they've
been
offered
something
that
then
they
can't
have.
So
we
need
to
understand.
Where
is
that
capacity?
How
can
we
make
available?
Then?
Actually
your
health
check's
really
important.
This
is
why
you
should
have
it,
and
this
is
where
you
can
have
it,
and
so
we
will
do
all
of
that
together,
but
certainly
the
the
comms
and
the
publicizing
was
something
that
we've
absolutely
touched
on.
I
Yeah,
I
think
that's
a
really
really
good
point
and
I
think
we'll
have
more
flexibility
like
that
if
we
like,
if
we're
working
with
working
alongside
another
provider,
to
create
some
of
that
capacity,
I
think
because
traditionally
nhs
health
checks
had
been
have
been
well.
I
think
two
things.
I
think
that
the
contract
is
with
the
gp
confed,
and
then
that
means
it's
delivered
through
gdp
practices.
I
So
I
think
this
is
where
the
work
that
we
do
with
practices
in
their
pcns
with
wider
partners
in
terms
of
the
local
care
partnership,
where
there's
some
benefits
to
understanding
actually
for
a
gp
practice
to
let
their
healthcare
assistant
go
to
a
community.
Cafe
and
spend
an
afternoon
there
they're
more
likely
to
get
a
better
uptick
and
more
likely
for
people
to
have
a
better
experience
and
a
better
outcome.
There's
benefits
to
that
that
outweigh
the
disadvantage
of
not
having
your
healthcare
assistant
in
your
building
for
that
afternoon.
I
A
D
Thank
you.
Thank
you,
chair,
I'm
just
trying
to
understand
how
it
actually
works.
I
know
that
the
rules
are
set
nationally,
but
it's
for
people
between
the
age
of
40
and
74,
who
don't
have
one
of
a
number
of
chronic
conditions.
So
how
does
that
work?
Does
the
computer
go
through
the
electronic
records
delete
anyone
who's
got
one
of
those
conditions
and
then
put
the
others
down
for
being
called
for
a
health
check.
D
Secondly,
I
accept
entirely
that
there
are
groups
which
need
to
be
identified
as
priorities.
My
question
is,
I
know
you
won't
believe
this
chair,
but
I
am
actually
over
40.
and
like
a
counselor
like
counselor
dalson,
I
I've
never
been
invited
for
a
health
check.
In
fact,
the
only
one
I
had
was
when
I
phoned
the
practice
and
said
I
believe
I'm
entitled
to
to
one,
and
they
said
oh
well,
yeah,
if
you
want
to,
you,
can
come
in
and
have
it
so.
D
D
Councillor
dowson's
dad
might
well
benefit
from
a
periodic
health
check,
so
why
does
it
finish
at
the
age
of
74
and,
lastly,
on
page
30
and
it
was
the
table
which
gainer
showed
us
in
her
presentation?
There
are
five
columns
and
I
understand
three
of
them,
but
I
don't
understand
column
two
and
three
in
particular.
D
I
I
It
is
the
question
to
to
that,
and
I
think
that
with
the
approach
that
was
agreed
as
part
of
the
reset
plan,
where
we're
really
going
to
drill
down
into
the
data
for
each
practice
in
each
pcn,
it
will
give
us
the
opportunity,
like
we
did,
with
the
learning
disability,
annual
health
checks
to
understand
each
practice's
position
and
then
and
then
the
position
for
each
pcn.
So
I
think,
with
this
approach
that
we've
agreed,
we
will
have
like.
I
I
said
much
much
more
focused
and
targeted
discussions
where
we
see
evidence
of
a
practice,
that's
not
inviting
and
their
their
eligible
population
and,
like
I
say,
if
they're,
in
a
position
where
they
feel
they
have
the
current
capacity
to
do
it,
then
we
can
offer
those
patients
in
that
practice
a
different
way
of
accessing
the
nhs
health
check.
What
it
means
to
that
practice
is
that
then
they
don't
generate
the
income.
So
it's
like
the
nhs
health
check
to
gp
practices
is
like
lots
of
elements
of
the
gp
contract.
I
It's
an
item
of
service
fee.
So
if
they
don't
perform
an
nhs
health
check,
they
don't
they
don't
receive
the
income
for
it.
So
there
is
some
financial
incentive
to
to
practice
it,
but
that
financial
incentive
like
they
need
to
be
offset
with
do
they
have
the
capacity
to
do
it
in
the
capacity
to
do
it
well
and
if
they
don't,
like,
I
say,
we'll,
make
alternative
provision.
I
I
think
going
back
to
the
to
the.
How
are
people
identified
so,
yes,
there
are
qualities,
sorry
searches
within
the
data
quality
kind
of
sphere
and
that
are
run
through
the
gp
registered
list,
which
is
why
there's
an
advantage
to
having
this
in
in
primary
care,
because
those
searches
can
be
run
very
quickly
once
they're
all
set
up
by
the
technical
wizards
where
it
does
identify.
I
C
Thank
you
chair
just
following
him
from
councillor
cunningham's
point
and-
and
I
absolutely
agree,
I
think
we
need
to
also
look
at
how
we
go
about
being
in
our
communities,
as
the
vaccination
program
has
proved.
You
know
people
like
to
be
to
go
to
their
trusted
local
venues
and
I
think
that's
that's,
perhaps
learning
we
ought
to
take
and
slightly
think
outside
of
the
box.
Can
we
tag
it
along
to
another
well-being
session?
That's
that's
happening
in
the
local
community.
Maybe
raise
awareness
there.
C
The
other
point
I
wanted
to
make
was
about
communication,
and
one
of
the
priority
groups
are
individuals
that
are
being.
Are
we
looking
at?
How
we're
communicating
do
we
have
when
we're
sending
the
letter
out?
Is
it
or
a
phone
call?
Is
it
perhaps
there
might
be
individuals?
I
know
who
may
not
understand
english
and
how
we're
communicating
to
them.
Is
that
something
that
we're
aware
of
as
well?
So
just
a
couple
of
those
things
I
wanted
to
bring
up
chair.
Thank
you.
I
So
again,
I
think,
as
part
of
what
what
lucy
is
the
lead
public
health
commissioner,
on
victoria's
behalf,
will
require
a
voice
of
our
reset
is
to
really
reflect
all
of
that
in
the
comms
plan,
so
that
it's
not
just
we're
just
going
to
do
what
we
did
before,
which
may
be
what
we've
learned
now
is.
We
can
do
better
and
again
going
back
to
the
forensic
spotlight
and
the
example
of
the
learning
disability
annual
health
check.
I
think
we,
I
think
we
can
do
better
going
forward.
G
Thank
you
chairman.
Just
a
couple
of
quick
questions,
one
this
business
of
not
everybody
taking
up
the
offer
or
a
lot
of
people
not
taking
up
the
office
are
people
invited.
I
mean
in
my
experience.
It's
just
been
a
text
saying.
Please
ring
the
surgery
and
make
an
appointment
for
a
health
check,
and
the
explanation
came
after
you'd
run
the
surgery.
G
I
Yeah,
thank
you
and
again,
I
think
it.
It
will
probably
vary
practice
to
practice.
In
terms
of
that,
initial
invite
lots
of
practices
will
reply
on
that
on
that
initial
text
out
message
to
say
you're
eligible
for
a
for
a
health
check.
You
know
please
contact
the
practice
and
like
say
that
that
works
for
some
individuals
in
in
some
communities
but
doesn't
doesn't
work
for
all.
So
again.
I
think
that
look
pcm
by
pcn
practice
by
practice.
I
I
That
will
be
something
that
we
will
look
to
build
in
and
hopefully
be
able
to
bring
back
to
this
group.
Should
you
wish
it
in
terms
of
these
are
the
number
of
people
that
have
been
screened.
These
are
the
number
of
people
where
there's
been
issues
found.
These
are
a
number
of
people
who
have
they're,
not
then
gone
on
to
have
referrals
to
all
the
services,
or
you
know,
start
medication
or
whatever
we'll
look
to
see
how
much
of
that
data
we
can.
We
can
collect
and
present
back.
G
Thank
you,
and
just
just
quickly
now
that
we've
got
this,
this
wonderful
new
future
for
the
nhs
and
the
local
authorities
moving
forward.
Perhaps
there
might
be
the
opportunity
to
get
sort
of
parody
across
the
hill
across
the
whole
piece
that
everybody
does
it
the
same
way
or
invites
people
in
in
a
more
alluring
way
than
just
coming
for
a
health
check.
You
know
yeah.
I
Yeah,
I
think,
there's
absolutely
opportunity
to
do
that.
Council
latte
the
they
often
the
challenge
that
we
work
with.
I
think
so
I've
mentioned
before
that
you
know:
gpps
are
all
individual
businesses,
so
there's
there's
different
ways
that
we
can
require
gp
practices
to
do
things.
One
is
through
the
contractual
route,
so
either
it's
in
the
national
contract
or
it's
something
that's
locally
commissioned.
So
therefore,
there's
an
incentive
or
a
contractual
requirement
for
them
to
do
something
in
the
same
way,
the
other.
The
other
way
is,
is
influence.
I
And
again,
I
think
that's
where
the
gp
confed
comes
in,
where
we
can
influence
by
the
way
of
saying
this
is
what's
happening
over
here,
and
this
is
really
good
practice,
and
this
has
had
this
impact,
and
this
is
really
easy
to
do
it
like
this.
So
why
don't
all
of
our
94
practices
in
our
19
pcns
start
to
do
it
this
way,
and
we
can
then
change
behavior
change.
I
A
A
I
So
we've
got
some
consistency
there
and
then
the
other
approach
will
be
to
say
you
say
with
all
the
learning
that
we've
had
like
I
said
during
the
pandemic
and
with
the
learning
disability,
health
checks
will
be
to
say
if
we
present
the
data
back
to
practices
in
their
pcns,
it
says.
Actually,
this
is
the
size
of
your
eligible
population
and
we
do
some
of
that
work
on
their
behalf
at
the
comfed
level.
So
it
makes
it
easier
for
them.
We
say
we
present
you
with
the
data
which
says
this
is
your
eligible
population.
I
This
is
how
many
people
have
have
had
a
health
check.
These
are
where
we
think
that
your
more
targeted
communities,
our
individuals,
are.
How
can
we
help
you
reach
them?
Is
that
something
that
you
can
do
within
your
surgeries?
Or
is
this
something
that
you
want
to
do
within
extended
access
or
with
some
additional
clinics
that
we
can
put
on
for
the
nhs
health
check
and
then
what
we'll
do
is
understand
how
best
to
communicate
with
people-
and
you
know,
what's
worked?
Is
it
a
text
message?
Is
it
a
letter?
I
I
J
Thank
you
chair.
It
was
just
a
comment
and
lucy
and
kyle
and
gainey
may
want
to
say
a
bit
more
about
this,
but
it
was
a
comment
around
the
conversation
about
why
under
75
and
how
does
it
line
up
with
the
other
health
checks,
and
I
think
it's
important,
because
people
might
remember
that
we
had
a
target
around
reducing
preventable
death
and
the
and
the
the
way
that
that
was
defined
was
was
was
deaths
under
75,
because
we
already
had
an
over
75
annual
health
check.
J
Now
from
previous
conversations
in
this
meeting,
we
know
that
actually
that
that
isn't
happening
as
it
should
be
at
the
moment.
But
but
at
the
time
there
was
a
statutory
annual
over
75
health
check
and
there
was
health
checks
for
people
in
particular
groups
such
as
people
with
learning
disabilities,
as
gainers
mentioned
people
with
severe
and
enduring
mental
illness.
So
this
was
seen
to
fill
a
gap
and
be
the
preventative
sort
of
general
population.
J
Health
check
that
was
added
to
the
rest
and
what's
happened
in
the
meantime,
is
some
of
that
rest
has
fallen
away
and
what's
also
happened
with
this.
Is
that
since
it
was
set
up
and
the
budget
for
this
health
check
has
been
reduced,
you
know
we've
had
to
make
savings
through
public
health
cuts
for
how
we
deliver
and
prioritize
within
this
health
check.
J
We
know
right
through
covert
and
before
that,
engaging
gps
and
primary
care
in
in
prevention.
Work
with
communities
is,
is
good
for
the
city,
it's
central
to
how
we
work
and
and
reflects
some
of
the
previous
conversations
we
had
earlier
around.
You
know:
how
can
we
really
build
this
into
what
gps
do
and
support
the
gp
workforce
of
the
future?
So
there's
all
sorts
of
reasons
for
for
why
we
have
the
modeling
leads
and
the
credibility
and
the
respect
of
gps
too.
J
We
really
want
to
build
this
back
up,
but
but
there's
limited
resource
and,
as
gainer
said,
there's
limited
capacity
and
other
other
competing
demands,
but
we
do
want
to
do
it
in
the
best
possible
way
to
reach
the
people
who
would
most
benefit,
because
we
know
that,
sadly,
the
number
of
deaths
that
we've
had
through
pandemic
really
reflects
the
the
level
of
health
general
health
in
the
population.
Those
underlying
conditions
that
make
people
more
susceptible
to
impact
of
covid
or
you
know
whatever
comes
next.
J
G
A
G
B
Thank
you
chair.
I
just
wanted
to,
and
I
think
it
is
in
the
paper,
but
just
to
mention
that
there
is
a
national,
a
nhs
england,
public
health,
england,
review
of
the
nhs
health
check
and
that
what
is
delivered
is
nationally
prescribed.
So
they
are
looking
at
this
they're.
Looking
at
whether
the
age
should
be
lowered,
they
weren't
talking
so
much
about
the
age
being
hired,
but
they
were
looking
at
whether
the
age
should
be
lowered
and
about
whether
other
conditions
should
be
should
be
put
into
this
too.
A
Thank
you
very
much.
I
mean
if
we
look
at
how
we
went
about
the
vaccines,
especially
locally
victoria,
I
mean
I
would
say
for
leads.
You
know
you
did
a
fantastic
job
with
that,
especially
with
the
flexibility
you
know.
He
said
it
very
stringent
at
the
beginning
and
then
gradually
you
know
there
was
more
flexibility
to
it.
A
So
I
think
if
we
can
also
work
and
use
that
kind
of
flexibility
in
terms
of
this
health
check
and
meeting
the
demands,
especially
of
our
older
people,
councillor
jenkins,
what
would
be
interesting
to
hear
from
you
you're
the
older
person's
champion,
and
I
believe
it's
all
the
people's
week
from
next
week
as
well.
So
I
come
from
a
culture
where
we
do
not
mess
without
all
the
people
at
all.
You
know
their
goal
does
to
us.
So
it's
the
same
thing
and
they
really
really
need
that
care.
A
So
it
will
be
interesting
to
hear
from
that
cohort
of
people,
especially
with
response
to
gp
surgeries.
One
good
thing
that
has
also
come
out
of
the
pandemic
with
older
people,
their
computer
skills
is
amazing.
You
know
so
obviously
a
lot
of
them
who
are
not
able
to
get
through
to
surgeries
on
their
own.
A
A
A
A
H
Thank
you
chair.
So
the
last
item
relates
to
the
board's
forthcoming
work
schedule.
So
the
latest
version
of
the
work
schedule
I
set
out
an
appendix
one
for
members,
consideration
just
to
say
I
will
work
with
the
chair
to
reflect
on
the
board's
discussions
today
in
terms
of
scheduling
in
follow-up
sessions
where
this
has
been
agreed
already,
but
members
are
invited
at
this
stage
to
also
make
any
other
comments
on
the
work
schedule
so
I'll
pass
back
to
you
now
check.
Thank
you.
A
Okay,
thank
you
very
much.
If
nothing
else
just
to
let
you
know
that
our
next
meeting
will
be
the
fifth
of
october,
it's
a
tuesday
and
that's
planned
to
be
a
face-to-face
meeting.
But
if
anything
is
different,
we
will
let
you
know
with
good
enough
notice.
If
that's
okay,
anybody
else
got
anything
else
to
say,
comment,
questions
remember!
If
anything
comes
to
your
mind,
that
needs
urgent
attention.
A
You
do
not
need
to
wait
till
the
next
scrutiny
meeting,
please
pop
an
email
through
to
myself
or
to
angela,
and
we
would
look
into
it
anything
else
from
anyone
to
all
our
guests
who
have
joined
us
today.
Thank
you
very
much.
Thank
you
for
your
input.
Your
contribution
information
updates,
we're
truly
grateful.
Jin
nelson.
What
did
you
say
I'll
see
you
yeah
see
you
see
you
jane.
Thank
you
very
much
anything
else
from
anyone
right
have
a
lovely
afternoon.
You
all.