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From YouTube: Leeds City Council - Adults, Health & Active Lifestyles (SB) Consultative Meeting 190722
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A
A
very
good
afternoon
to
each
and
every
one
of
us
and
thank
you
for
joining
us
this
lovely
sunny
afternoon
and
welcome
to
the
scrutiny
board
of
adults,
health
and
active
lifestyle.
Abigail
marshall
catching
is
my
name
and
I
chair
the
board.
Do
excuse
me
when
you
see
me
floating
between
two
devices.
At
the
moment
I've
got
a
bigger
screen
and
that's
what
I'm
using
right
now.
So
at
this
point
I
would
like
to
point
and
clarify
that.
Well,
this
meeting
has
been
webcast
live
to
enable
public
access.
A
A
The
next
formal
public
meeting
of
the
scrutiny
board
for
approval,
so
I
would
like
to
invite
board
members
to
introduce
themselves,
but
I
would
like
to
remind
everyone
to
please
mute
their
microphone
after
they
have
spoken
throughout
the
meeting.
I
would
now
like
to
invite
members
of
the
scrutiny
board
to
kindly
introduce
themselves,
and
we
would
love
you
to
do
that,
following
the
alphabetical
order
of
counselor
anderson.
C
Good
afternoon
I'm
john
peel,
I
chair
healthwatch
leads
and
I'm
a
co-opted
member
of
this
board.
A
Thank
you,
councillor
burke,
hello,
everyone
I'm
castle
scharenberg
and
I
represent
middleton
parkward
thanks
for
joining
us
councillor,
farley.
A
E
A
E
Okay,
counselor
mohammad
iqbal
consulate
and
riverside
ward
apologies
for
lateness.
A
Thank
you
very
much.
I
would
also
like
to
all
let
you
know
that,
just
in
case
I've
got
any
difficulties
technically
counselor
james
gibson
will
take
over.
Whilst
I
try
to
join
you
again,
but
hopefully
fingers
crossed,
I
should
be
fine.
Okay.
So
thank
you
all
again
and
straight
to
agenda
item
number
one
declaration
of
interest
from
board
members.
Please
we
got
any,
can
you
not
properly,
so
I
can
see
you
on
the
screen.
A
A
F
Yes,
chair
just
a
general
update
just
to
advise
members
just
in
terms
of
the
implication
or
implementation
of
the
social,
health
and
social
care
act
2022.
The
briefing
note
that
I've
provided
to
members
has
been
circulated,
and
also,
and
in
relation
to
minute,
number
nine.
It's
not
specifically
related
to
this
board
chair,
but
for
members
information
there
have
been
some
changes
to
terms
of
reference
for
other
boards,
so
they
specifically
relate
to
the
functions
of
the
director.
F
Resources
that
relate
to
civic
enterprise
leads
and
keep
the
community
infrastructure
levy,
and
both
those
elements
have
been
removed
from
the
remit
of
the
environment,
housing
and
communities
board
and
put
within
the
remit
of
the
strategy
resources
board
and
the
infrastructure,
investments
and
inclusive
growth
board
respectively.
Chair.
A
Excellent
okay.
Thank
you
very
much,
stephen
right.
We're
moving
straight
on
to
agenda
item
number
three
for
all
those
who
have
joined
us
who
are
non-members.
Please,
if
you
are
feeling
uncomfortable,
do
send
a
private
message
to
myself
or
just
put
it
on
the
chat
or
myself
we'll
pick
that
up.
Okay,
and
if
you
need
two
minutes
to
go,
get
water
because
you
all
need
to
remain
hydrated
all
right.
It's
very
very
important
at
this
time!
So
please
do
let
us
know
if
you
need
a
glass
of
water.
A
F
Thank
you,
chair
yeah.
So
during
the
previous
municipal
year,
the
glass
scrutiny
board
identified
the
viewing
visiting
policies
and
patient
advocacy
arrangements
within
local
health
care
settings
and
care
homes
as
a
specific
topic
for
the
success
of
board.
So
the
report
that's
been
presented
and
its
appendices
present
a
range
of
details
provided
by
health
and
care
providers
and
other
partner
contributions
across
leeds,
and
these
include
the
the
city
council
leads
teaching
hospitals,
trust.
F
These
are
new
york,
partnership
foundation,
trust,
lee's,
community
health
care,
nhs
trust,
saint
general's,
hospice,
sue,
ryder,
wheat
fields,
hospice,
martin
house,
children's
hospice,
leads
care,
association,
carers
leads
and
health
watch
leads,
and
we've
got
a
number
of
representatives
to
provide
some
provide
an
update
to
to
members
of
the
board.
It
might
be
helpful
at
this
point
chair
to
ask
those
president
just
to
introduce
himself
briefly
and
then
give
a
brief
introduction
to
the
report.
Chair.
A
C
A
J
K
A
Thank
you
very
much
for
joining
us.
We've
got
heather
hi.
N
Hello,
I'm
andrew
patterson,
I
best
described
as
a
service
user.
My
wife
is
resident
in
a
care
home
needs.
A
Thank
you
for
joining
us,
andrew
from
leeds
association.
We've
got
michelle.
A
F
P
A
P
F
It
is
for
this
item
chair
just
to
confirm
that
dr
everett's
attending
for
the
the
next
item.
Not
this
particular
item.
A
Okay,
excellent.
Thank
you
all
for
joining
us
right.
Okay.
I
would
now
call
on
caroline
to
introduce
the
information
presented
to
us
in
our
path
over
to
you,
caroline.
M
D
J
Okay,
I
didn't
know
whether
counselor
jenkins
wanted
to
to
come
in
first
but
happy
to
otherwise.
C
Okay,
thank
you
chair,
so
this
report
outlines
the
approaches
taken
across
the
health
and
care
sector
in
leeds
during
the
course
of
the
pandemic
in
relation
to
visiting
arrangements
for
people
who
have
been
impatient
in
a
health
care
setting
or
residence
in
a
care
home
setting,
the
arrangements
for
visiting
have
been
kept
under
constant
review
and
have
been
revised
and
updated,
as
the
guidance
has
changed
through
the
past
couple
of
years.
A
Okay,
is
there
anyone
else
from
on
this
agenda
item
that
would
like
to
take
over
and
then,
if
we're
able
to
reconnect
with
caroline
I'm
sure
she
can
come
back.
D
Sorry
yeah,
I
think
it
seems
like
caroline's,
got
having
an
issue
with
with
her
internet
connection.
I
was
just
wondering
if,
if
we
could
get
dial
in
via
a
phone,
maybe
that
would
provide
a
better
would
at
least
be
able
to
hear
her.
A
A
I
am
happy
for
any
any
of
the
other
officers
or
staff
from
the
lead
kitchen
hospitals,
if
you
want
to,
if
you
want
to
speak
now
and
we're
happy
for
you
to
speak
before
we
move
on
to
the
leads
on
your
partnership
offices.
So
anyone
here
joe
or
rob.
P
Well,
I
was
just
gonna
say
so
so
joe
as
a
director
of
nursing
has
led
lots
of
our
visiting
arrangements
and
be
able
to
talk
through
the
the
process
and
the
decision-making
process
of
for
our
policies
throughout
the
pandemic.
If
that
would
be
helpful.
O
Okay,
thank
you.
So
you
love
you'll,
have
read
the
the
paper
that
outlines
at
least
teaching
hospital
trust.
We
had
quite
a
robust
arrangement
and
throughout
the
pandemic
in
terms
of
visiting.
So
as
rob
said,
I
I
led
on
some
of
the
aspects
of
visiting
and
reviewed
the
national
guidance
that
came
out
and
from
the
national
guidance.
O
We
followed
that,
but
all
the
changes
to
any
guidance,
whether
it
was
either
to
relax
the
visiting
or
to
actually
restrict
the
visiting
further,
depending
on
on
where
we
were
with
curvid
and
anything
that
was
suggested,
actually
went
through
our
clinical
advisory
group,
which
was
the
group
that
was
held
weekly
in
the
trust
and
on
the
membership
on
there
was
our
chief
nurse
and
our
chief
medical
officer.
So
ever
all
the
guidance
specific
to
leeds
teaching
hospitals.
Trust
was
agreed
through
that
process
through
our
clinical
advisory
group.
A
Will
anybody
else
like
to
add
to
that
and
could
I
also
ask
board
members
as
you
listen
to
what
they're
saying
please
kindly
pay
attention
to
that
because
whatever
they
will
be
presenting
to
us,
we
would
like
to
see
if
there's
anything
more,
we
would
like
to
pick
up
in
our
scrutiny
activities
for
the
rest
of
the
year.
If
that's
okay,.
A
P
A
P
I
I
I'm
conscious
of
the
other
people
other
attendees
that
would
have
so
we
obviously
have
inpatients,
who
might
also
want
to
comment
following
on
from
joe's
update
but
happy
to
take
questions
just
to
ltht.
If
that
would
be
helpful,
I
guess
just
to
well
to
reiterate
what
was
said
at
the
beginning
and
joe's
comments,
just
to
emphasize
how
difficult
it's
been
and
how
sensitive
a
topic
this
has
been
and
how
how
much
uncertainty,
joe
and
the
team
have
been
working
under
throughout
it's.
P
It
was
certainly
uncertain
at
the
start,
and
it's
coming
it's
not
as
if
what's
happening
with
the
pandemic
has
got
any
more
certain
as
it's
progressed.
So
it's
been
a
a
hugely
complex
thing
to
to
manage,
and
also
we've
tried,
as
a
trust
to
be
as
as
flexible
as
we
can.
So
during
times
in
the
pandemic,
where
infection
rates
have
increased
and
infection
rates
have
dropped,
we've
attempted
to
to
change
our
visiting
policies
as
appropriate.
P
Mindful
of
the
the
risks
of
doing
so
too
soon
or
too
late
could
bring.
A
J
J
So
what
I
was
saying
was
that,
right
from
the
start
of
the
pandemic,
we
came
across.
We
came
together
as
a
health
and
care
system,
but
also
and
really
importantly,
with
our
third
sector
organizations
and
our
care
and
support
providers.
J
We
set
up
various
command
meetings,
gold,
silver
and
bronze,
and
we
had
a
bronze
command
meeting,
specifically
around
support
to
care
providers
and
care
homes
in
helping
them
in
managing
the
cobia
virus
by
reducing
infections.
J
So
infection
control
prevention
measures,
but
also
supporting
them
with
the
guidance
as
guidance
changed
throughout
the
lockdown
periods
and
then
out
of
the
lockdowns
and
part
of
that
included,
support
in
relation
to
supporting
family
and
carer
visiting
in
care
home
settings.
J
We
we
did
a
whole
range
of
work
in
terms
of
accessing
funding
from
central
government,
specifically
around
digital
access.
We
allocated
ipads
to
various
care
homes
and
also
put
in
the
support
to
help
them
with
connectivity
with
families,
and
that
was
particularly
important
during
the
the
height
of
the
lockdowns,
when
face-to-face
visits
were
not
permitted
very
quickly.
After
that
we
supported
care
homes
around
window
visiting
and
then
outdoor
visiting,
setting
up,
shelters,
etc.
J
We
took
a
lot
of
advice
from
our
health
colleagues
at
ly,
pft
around
the
care
and
support
needs
of
people
with
dementia
and
how
we
could
support
them,
particularly
in
accessing
visiting.
So
just
really
an
example
that
was
of
how
we
connected
together
in
supporting
care
homes.
J
We
also
had
access
to
the
infection
control
fund
and
that
that
the
various
rounds
of
the
infection
control
fund
was
allocated
to
our
care
providers
so
that
they
could
increase
their
staffing
to
help
with
the
whole
requirements
around
facilitating
the
the
the
visiting
arrangements,
the
rigorous
testing
of
people
who
were
coming
into
the
setting
you
I'm
sure
you
will
appreciate
that
this
put
an
extra
layer
of
responsibility
and
burden
on
care
homes
because
they
themselves
were
keen
to
allow
visiting
wherever
possible,
but
also
very
mindful
of
not
enabling
any
form
of
transmission
of
the
virus,
because
we've
seen
quite
horrendous
circumstances
where
a
number
of
residents
had
become
seriously
ill
or
had
passed
away
because
they
had
contracted
the
virus
so
really
important
to
have
connected
with
the
care
homes
to
support
them.
J
In
enabling
the
visiting
to
happen.
We
also
put
in
place
a
a
a
bulletin,
an
information
bulletin
that
went
out
to
the
care
homes
twice
a
week
and
then
reduced
once
a
week,
and
now
it's
still
available
once
a
month.
But
that
was
giving
information
as
soon
as
information
was
being
made
available
in
terms
of
guidance
changing,
and
that
was
all
sorts
of
guidance
in
terms
of
managing
the
pandemic,
but
also
very
specifically
around
visiting
as
well.
J
So
I
have
to
be
honest,
it's
really
important
to
say
how
valuable
we
found
our
network
with
our
third
sector.
Organizations
with
healthwatch
with
carers
leads
with
a
range
of
other
third
sector
organizations,
but
also
equally
with
our
care
homes
in
coming
together
and
working
together
to
you
know,
promote
the
well-being
of
those
people
that
were
resident
in
care
homes
and
that,
I
think,
has
put
us
in
really
good
stead
going
forward.
J
We've
built
really
strong
relationships
with
our
care
providers
in
a
very
supportive
way,
always
with
the
focus
on
those
people
that
are
resident
and
also
their
their
family
and
loved
ones
in
the
community,
so
I'll
stop
there.
I
know
that
some
people
have
already
provided
updates
from
their
health
care
sector
perspective,
happy
to.
A
Take
any
questions,
thank
you
very
much,
caroline,
and
thank
you
for
that
update.
I
mean
we
all
of
us.
He
sat
here
today.
We
do
know
the
hot
times
and
difficult
times
with
care
homes
I
mean
we
were
hearing
on
the
tv
we
were
hearing
from
friends.
It
was
just
very,
very
heartbreaking
and
there's
nothing
as
as
heartbreaking
as
painful
knowing,
especially
with
elderly
people,
who
are
unable
to
help
themselves
if
they're
in
a
care
home.
A
There
is
a
there's,
a
reason
why
they're
there
and
just
knowing
what
happened,
especially
over
the
last
two
and
a
half
years
still
I
mean
when
I
think
about
it.
I
still
feel
really
really
sad,
but
to
hear
some
of
the
interventions
that
were
provided
to
our
care
homes.
I
would
say
thank
you
very
much
and
well
done.
I
know
lot
still
needs
doing
lots
of
answers.
We
still
have
not
been
able
to
get
so
today
is
about
talking
about
those
times
and
what
we
can
do
going
forward.
A
So
it
will
be
nice
to
actually
hear
from
the
care
services
themselves.
I
know
on
the
agenda.
We
have
the
leeds
community
healthcare
trust
first,
but
I
would
want
to
bring
in
michelle
if
that's
okay,
if
michelle
can
speak
to
us
first
and
then
we'll
go
back
to
the
hospital
trust.
O
I
think
it
has
been
really
really
difficult
for
the
care
homes
they're
still
not
out
of
the
woods,
and
I
think
we
need
to
remember
that
the
testing
restrictions
have
now
been
lifted
for
visitors,
as
I'm
sure
that
you're
all
aware,
however,
that
poses
further
challenges
for
the
care
homes
in
terms
of
still
trying
to
keep
kobe
out
of
the
care
homes.
Some
visitors
are
asked
if
there
were
face
masks
in
communal
areas.
O
We
have
visitors
that
don't
want
to
comply
with
that
request,
so
it
is
still
really
really
difficult
for
the
care
homes
they're
still
trying
to
manage
visitor
numbers,
because,
especially
for
those
care
homes
where
you've
got
smaller
care
homes
that
don't
have
a
large
set
of
ways,
it's
really
difficult
to
don't
want
lots
of
people
coming
into
the
care
homes
all
at
the
same
time.
So
whilst
they're
trying
to
enable
visiting
to
go
ahead,
it's
not
still.
You
can
just
turn
up
to
the
camera.
We
know
with
some
of
the
cows.
O
They
still
are
asking
people
to
ring
first
and
make
sure
it's
okay
and
then
distilled
they've
got
to
manage
the
care
home.
If
there
is
an
outbreak
as
well
within
the
care
home,
so
things
are
still
really
difficult
for
the
care
homes
still
getting
changing
guidance,
and
can
I
just
say
big
thanks
to
everybody,
that's
been
on
the
work
in
group.
Sync,
there's
been
a
lot
of
really
positive.
O
Work
come
out
that
working
group,
and
certainly
the
bulletins
that
have
been
produced
and
sent
around
the
cows
have
been
really
really
well
received,
especially
when
there's
been
changing
guidance
in
those
bulletins,
because
sometimes
guidance
was
published
on
one
day.
Two
days
later,
you've
got
changes
to
that
guidance,
so
it's
safe
to
care
homes
having
to
build
up
trolling
through
all
the
guidance
on
a
daily
basis
when
they
knew
that
they
would
get
the
updates
through
from
the
city
council.
So
a
big
thank
you
for
that,
so
care
hubs
are
trying
to
enable
visiting.
O
You
know
they
have
gone
through
so
much
they
didn't
like
restricting
visiting
in
the
first
place.
They
are
trying
to
enable
visiting
to
happen
now
so
and
hopefully,
as
things
progress,
more
and
more
people
are
getting
back
into
the
care
house
to
visit
the
loved
ones.
A
B
Yeah,
thank
you
for
that.
Well,
so
I
think
we've
been
relatively
lucky
as
a
small
organization.
We
can
make
decisions
and
share
those
decisions
really
quite
quickly
and
quite
easily,
and
we
have
a
very
restricted
number
of
bed
bases
with
20
beds
available
for
the
or
half
of
the
city.
B
So
throughout
the
pandemic,
we've
been
able
to
we've
met
daily
on
weekly
and
visiting
has
been
talked
about
for
the
last
two
and
a
half
years
every
single
week,
because
we
know
it's
such
an
important
part
of
palliative
end
of
life
care
for
families
and
needs
and
was
often
their
part
of
their
decision
about
whether
they
wanted
to
come
into
the
as
an
inpatient
into
the
hospice
or
not,
and
with
really
good
communication
across
late
teaching,
hospitals
and
the
community
teams,
and
that
we
work
with
really
closely
to
ensure
that
we
met
the
needs
of
patients
and
their
families.
B
As
best
we
can,
and
we
also
were
able
to
secure
a
really
good
supply
of
ppe
very
early
on
in
the
pandemic.
And
then
we
worked
together
with
the
rest
of
the
city
around
the
city-wide
supply,
which
provided
us
with
the
opportunity
to
ask
all
families
to
wear
ppe
whilst
they
were
coming
into
the
organization.
B
We
were
able
to
have
some
visitors
at
all
times
throughout
the
pandemic
and
we
are
currently
with
open
visiting
it's
completely
back
to
normal
and
despite
the
current
state
of
our
code
levels
in
the
city,
obviously
we
tested
it
as,
as
everyone
else
did,
we
all
relatives
tested
all
family
visitors
tested
until
the
restrictions
were
lifted
on
testing,
and
that
is,
as
michelle's
just
said,
one
of
our
challenges
going
forward
about
how
we
in
ensure
their
security
around
covert
transmission
when
there's
no
testing
regime
in
the
system,
but
so
we're
really.
A
Okay,
thank
you
very
much
for
that
heather.
I
will
now
call
on
sarah.
K
Thank
you.
I
don't
want
to
repeat
some
of
the
challenges
and
the
approaches
that
colleagues
have
outlined,
because
there's
lots
of
similarities
just
to
share
some
of
the
specifics
really
from
a
mental
health
learning,
disability
provision.
Point
of
view
and
really,
despite
you
know,
kind
of
working
in
challenging
circumstances
and
national
policy
directives.
K
Avoiding
blanket
restrictions
and
blanket
policies
was
important
to
us,
because
this
huge
variability
in
terms
of
the
420
beds
that
we
operate
from
young
people's
services
through
to,
I
think,
as
caroline
described
people
with
quite
severe
cognitive
impairment
and
a
significant
proportion
of
people
that
are
in
our
inpatient
wars
are
there
under
the
mental
health
act.
So
there's
that
whole
additional
complexity
in
terms
of
the
legal
framework
supporting
people
with
their
rights
and
not
wanting
to
add
to
their
mental
health
distress
for
them
feeling
isolated
for
long
periods
of
time.
K
We
do
still
have
small
numbers
of
outbreaks,
but
again
that's
taken
a
very
individual
response
to
only
managing
the
outbreak
and
not
having
those
blanket
restrictions
on
any
visiting.
So
now
it
is
around
visitors
contacting
the
ward,
making
those
arrangements
either
to
come
into
the
ward
area.
K
Only
if
the
service
user
can't
go
off
the
ward
and
otherwise
those
visits
could
take
place
elsewhere
or
our
service
user
can
go
on
leave
to
visit
with
their
family
members,
so
yeah
I'll,
not
say
anymore,
because
it
might
be
that
there
are
other
specific
questions
that
members
have
got
relevant
to
our
services.
Thank
you.
A
Thank
you
very
much,
sarah.
I
will
now
ask
steph
if
you
think
everything
has
been
said
and
it's
a
repeat,
I'm
happy
to
move
on
to
healthwatch.
If
that's.
M
John,
are
you
happy
for
me
to
speak?
Yes,
please
harriet,
yeah,
fine,
and
so
we
did
quite
a
bit
of
work
during
the
pandemic
to
hear
people's
views
that
were
living
in
care
homes
and
their
relatives
specifically
around
the
thing,
and
I
think
one
of
the
key
things
that
came
out
of
both
reports
that
we
did
and
was
the
variation
across
care
homes.
So
there's
something
like
140
care
homes
in
leeds
and-
and
there
was
just
a
really
big
variation
in
terms
of
how
how
the
guidance
was
being
implemented.
M
So
blue
city
council
do
a
really
good
job
of
interpreting
it
and
sending
it
out,
but
actually
on
the
ground
there
was.
There
was
a
big
variation
and
that
was
that
was
you
know
even
sort
of
later
on
in
the
pandemic.
That
was
happening,
and
so
of
course,
then
that
will
impact
both
residents
and
relatives,
experience
and
sort
of
determine
whether
they
have
a
good
or
bad
experience.
M
And
so
we,
you
know,
we
heard
that
whole
spectrum
of
people
who
who
were
able
to
see
their
family
and
people
who
weren't,
and
I
think
that
we
can't
forget
the
devastating
impact
that
that
had
on
residents
and
their
family
members,
both
both
mentally
and
physically,
actually
because
families
play
such
a
kind
of
important
advocacy,
a
role
as
well.
You
know
informal
advocacy,
you
know
his
meetings,
also
looking
at
advocacy
so
sort
of
moving
on.
M
We
were
part
of
the
working
group
set
up
and
you
know
there
was
you
know
we
met
very
regularly
during
the
pandemic.
I
think
at
one
point
it
was
every
couple
of
weeks
or
it
might
have
been
every
week
and
just
because
it
was
such
an
ever-changing
situation
and
just
trying
to
kind
of
hear
what
was
going
on
on
the
ground.
You
know
we
were
feeding
in
and
as
we
care
as
leads
what
we
were
hearing
from
people
that
you
know,
family
members
that
were
using
services.
M
You
know
maybe
after
this
we
could
hear
from
andrew
who,
who
actually
sat
on
the
working
group
as
well
and
andrew's,
wife
and
again
and
again,
the
theme
was
the
same-
that
in
the
working
group.
We
would
hear
this
kind
of
variation,
both
from
how
care
homes
were
kind
of
catching
up
with
the
guidance,
because
it
was
changing
so
frequently
that
there
was
this
lag
and
some
care
homes
were
were.
You
know,
able
and
had
the
resources
to
act
quickly
and-
and
you
know
even
now-
that
is
the
case.
M
It's
still
variation
around.
You
know,
like
michelle,
said
that
some
people
were
booking.
You
know
taking
bookings
and
expecting
people
to
ring,
whereas
other
people
are
managing
to
return
pretty
much
to
business
as
usual
and
and
have
this
kind
of
much
more
open
visiting,
which
you
know,
helps
people
to
feel
like
it's
their
home,
essentially
so
that
the
working
group
actually
stopped
meeting
quite
recently.
M
But
the
last
thing
that
we
did
was
put
forward
and
put
together
some
sort
of
key
messages,
really
that
that
that
we
wanted
the
city
to
remember
and
to
kind
of
take
forward.
I
suppose
so
that
you
know
with
the
view
to
the
you
know
those
early
days
of
the
pandemic,
those
experiences
that
people
had,
that
they
never
happen
again,
and
so
those
messages
have
been
shared
with
chair,
I
mean
I'm
happy
to
kind
of
very
briefly
run
through
them.
If
that's
helpful,
yes,
please
yeah.
M
So
that
idea
that
this
is
people's
home
and
that
we
we
mustn't,
forget
that
and
and
all
those
things
around
having
family
when
you
want
want
to
make
it
feel
like
home.
Number
three
was
just
like
I
touched
on
before,
but
recognizing
that
families
are
an
absolutely
integral
part
of
a
person's
care.
You
know,
and
they
are
they're
often
reason
to
be
alive
still.
You
know
they
are
they're
linked
to
the
world.
They
are
often
their
memory
they're.
Their
advocate
they're
often
very
much
a
practical
support.
M
You
know
they
know
that
person
like
no
other
person
doesn't
can
support
them.
You
know
in
the
best
way
and
and
and
the
visit
any
any
future
visiting
restrictions.
They
just
need
to
have
that
at
the
forefront.
I
think
so,
I
think
sometimes
during
the
early
days
of
the
pandemic,
the
weight
had
shifted
more
over
into
infection
control
for
understandable
reasons,
but
it
felt
that
in
the
very
early
days
that
that
value
of
family
was
was
not
there,
it
was.
It
was
not
recognized.
M
Number
four
is
to
get
the
messaging
from
public
health
right
as
a
city,
especially
going
into
winter,
with
another
and
or
increasing
numbers.
So
again,
that
sort
of
narrative-
and
there
was
just
a
very
strong
narrative
and
focus
on
numbers
and
statistics,
and
but
that
needs
to
be
balanced
with
the
importance
of
well-being
and
what
we,
what
we
need
to
do.
M
On
the
other
hand
as
well
and
the
lastly,
just
around
monitoring
really
and
to
ensure
that
monitoring
around
is
maintained
and
to
ensure
that
care
homes
are
complying
with
current
guidance
and
that
just
comes
back
to
the
variation
that
some
care
homes
have
done.
Well,
and
some
haven't
done
so
well.
And
how
do
we
know
what
is
happening
in
those
104
homes.
A
Harriet
sorry,
I
had
a
blank
moment
that
and
thank
you
very
much
for
that,
and
just
being
there
and
being
a
big
brother
for
us
honestly
has
really
helped
us
know
lots
of
the
experiences
that
a
lot
of
people
have
faced
over
the
pandemic
and
and
and
ordeal
they
went
through
with
trying
to
visit
loved
ones.
A
I
can't
tell
you
how
difficult
it
has
been,
but
when,
when
you
hear
from
those
people
who
have
actually
who
are
the
ones
feeling
the
brunt
of
this,
you
will
you
will
just
have
tears
in
your
eyes.
So
thank
you
for
putting
that
to
us.
I
do
know
you
have
a
relative
representative
here
and
I
really
would
like
to
hear
from
you.
A
For
me,
the
message
and
what
we
do
every
day
is
for
that
common
man.
That's
out
there
that
have
not.
They
do
not
have
the
privilege
to
sit
around
the
table
like
we
have,
so
I
am
very,
very
interested
in
hearing
experiences
first-hand
from
people
on
the
experiences
they
had
with
the
care
home.
So
I
believe,
andrew
you
will
have
some
information
for
us
so
over
to
you.
N
N
I
can't
describe
how
awful
it
was
on
march,
the
22nd
two
years
ago,
when
I
was
wrenched
apart
from
my
wife,
not
knowing
whether
whether
I
would
ever
see
her
again
on
the
day
that
lockdown
started
visiting
was
closed.
Absolutely
happily,
she
is
still
with
us,
and
I
have
some
and
I'm
visiting
her
regularly.
N
I
acknowledge
that
the
policies
were
largely
driven
by
central
guidance
from
nhse
and
department
of
health,
but,
as
harriet
has
already
pointed
out,
everything
was
directed
at
suppressing
covet
at
the
expense
of
all
other
considerations
and
some
of
the
guidance
that
emerged.
There
was
frankly
wrong
and
misguided
and
little
or
no
considerations
given
to
the
unintended
consequences
of
the
measures
that
were
imposed
and
again
harriet
has
emphasized
the
well
basically
social
deprivation
of
all.
N
If
the
resident
is
in
on
on
an
upper
floor
window
visits
are
impossible
and,
as
is
the
case
for
my
wife,
the
use
of
a
telephone
or
an
ipad
to
communicate
was
hopeless.
N
You
know
the
level
of
her
dementia
made
that
frankly,
impossible
happily
visiting
has
slowly
been
reintroduced
and,
let's
hope
that's
what
we
went
through
then
is
history.
It
can't
happen
like
that
again
from
at
the
outset,
and
so
many
of
the
measures
I
mean
I
was
invited
to
join
the
healthwatch
group.
That
sat-
and
I
hope
I've
made
some
valid
contributions
to
that,
and
I
think
that
the
way
that
things
have
moved
has
been
constructed
and
I
think
that's
what
I
have
to
say.
A
Absolutely
andrew,
thank
you
very
much.
We
can't
do
it
the
way
we
did
it
previously,
and
hopefully
this
never
happens
and
pleased
to
hear
that
your
wife
is
still
with
us.
Okay.
So
let's
take
comfort
from
that
and
you
you'll
look
after
her
for
us.
Wouldn't
you
of.
N
Course
I
I
will
say
one
other
thing
which
the
there's
a
sort
of
grading
of
family
visiting.
So
if
I
describe
when
I
had
my
wife
at
home,
I
pursued
I'm
now
retired.
So
I
wasn't
going
to
work
during
the
week,
but
I
would
pursue
interests
that
she
wasn't
involved
in,
for
perhaps
let's
say
at
a
guest
12
hours
a
week
and
the
rest
of
the
week
I
would
spend
in
her
company.
I
was
her
and
for
that
matter
she
had
some
interests
of
her
own
yeah.
N
A
N
So
I
was
perhaps
visiting
her
most
days
of
the
week
for
three
or
four
hours,
maybe
20
hours
a
week
and
the
other
140
hours
a
week.
She
was
deprived,
that's
slightly
different
from
say,
a
family
member
who's,
a
son
or
a
daughter
who
might
visit
their
parents
mother
who
lives
independently
a
couple
of
times
a
week,
maybe
and
then
they're
going
to
care
home,
and
they
can
continue
to
visit
a
couple
of
times
a
week.
N
But
for
me
it
was
an
absolute
transformation
from
nothing
sorry
from
from
20
hours
a
week
to
nothing
and-
and
there
are
grades
of
visitors,
if
you
like.
A
Yeah
yeah,
thank
you,
andrew
for
sharing
that
experience
with
us
and
yeah.
We.
We
do
understand
that.
Whilst
we
have
all
of
you
here,
especially
the
executives,
can
I
ask
if
you
have
any
input
into
any
inquiry
about
the
national
any
and
if
you
have
any
input
into
the
national
inquiry
handling
of
the
pandemic,
especially
with
care
homes?
Can
I
ask
if
any
one
of
you
has
got
any
input
with
that?
C
I
said
I
think
that
there
shouldn't
be,
and
we
should
do
that-
I'm
not
sure
about
the
terms
of
the
terms
of
terms
of
reference
for
that
inquiry.
Yet,
but,
okay,
maybe
sarah
can
offer
something.
K
Right,
sarah,
yes,
so
the
terms
of
reference
for
the
national
covert
inquiry
have
been
agreed
and
they
are
very
broad
and
we've
all
just
been
advised
to
not
dispose
or
destroy
any
records
and
that
as
that
inquiry
gets
underway,
then
the
the
inquiry
panel
will
seek
evidence.
K
But
my
understanding
is,
it
will
include
the
whole
of
the
response
to
and
support
and
guidance
to
the
care
homes,
as
well
as
the
nhs
response
as
well
as
I
was
recently
copied
into
a
letter.
I
think
it's
from
this
region
requesting
that
it
also
included
the
approach
to
establishing
the
nightingale
hospitals
too.
So
it
is
very
comprehensive.
A
Q
Thank
you
chair.
Well,
partly
on
the
last
question
to
echo
sarah
responds
so
we're
very
much
ready
for
any
contribution
to
the
national
inquiry.
Q
We've
obviously
been
all
all
along
kind
of
and
making
sure
that
we're
we're
very
we're
very
clear
about
how
we
have
kept
a
a
a
strong
record
of
of
all
that
local
action
throughout
the
the
pandemic
period
we
haven't
been
asked
to.
We
haven't
been
called
as
a
lead
system
to
to
contribute
yet,
but
that
that
may
well
come
or
it
may
well
be.
We
contribute
to
a
regional
response
and
feed
in
that
way.
We
just
don't
know,
but
we're
very
prepared
and
ready
for
that.
Q
I
think
my
only
two
overall
comments
on
everything
that
colleagues
have
described
is
to
fully
abs,
as
director
of
public
health,
to
fully
support
and
endorse
all
the
efforts
that
we've
gone
to
as
a
local
system,
within
the
restraints
of
national
guidance
and
within
a
very
dynamic
situation
to
to
do
everything
we
possibly
can
to
to
balance
the
risks
to
health
in
a
broader
sense.
Q
So
you
know
very
very
clearly
that
it
was
a
it
was.
I
mean
what
reflecting
back
with
colleagues,
I
think
one
of
the
the
most
challenging
times
of
the
pandemic
was
when
we
were
seeing
so
many
care
home
deaths.
You
know
we
cannot
under
kind
of
state
the
the
seriousness
of
the
of
the
of
the
of
the
risk
to
the
our
most
vulnerable
citizens.
Q
You
know
at
that
point
in
the
pandemic,
so
clearly
things
were
very
challenging,
but
at
every
opportunity
I
know
that
the
public
health
team
infection
control
team
and
all
colleagues
and
did
everything
we
could
locally
to
support
and
people's
wider
health
and
well-being
and
and
and
would
still
remain,
would
still
keep
that
approach
to
today
and-
and
that
applies
to
other
settings,
whether
it's
closing
schools
or
or
any
any
any
kind
of
reasonable
balance
that
we
could
achieve.
So
I
do
think
I
agree
with
harriet's
comment
around.
Q
We
really
need
to
learn
the
lessons
nationally
around
that
balance,
because
you
know,
I
think,
with
hindsight
we
we
would
want
to
do
things
differently
next
time,
but
you
know
given
the
dynamic
position
through
the
pandemic,
you
know
there
was
a.
There
was
a
very
live
response
which,
which
we
were
all
doing
everything
we
could
to
balance.
Well.
I
think
that
the
in
terms
of
ongoing
risk
and
colleagues
have
commented
around
ongoing
challenges
and
clearly
the
the
vaccination
has
been
a
game
changer
in
this.
Q
In
terms
of
that
balance
of
risk
and
the
protection
people
have
from
vaccinations.
So
we
know
we've
got.
I
think
the
last
number
of
infections
in
care
homes
was
we've,
got
23
care
homes
with
it
with
with
cases,
but
we
don't
have
anybody
severely
ill
at
the
moment,
which
is
very
good
news.
Q
So
I
think
that
it's
just
a
very
different
scenario,
with
the
protection
of
the
vaccine
going
forward
managing
that
risk,
as
opposed
to
people's
wider
health
and
well-being,
emotionally
and
and
and
socially,
and
thankfully
we're
in
a
much
stronger
position
now.
So
I
think
that
we
need
to
take
all
of
that
into
account.
Q
And
my
final
point
is,
you
know:
steph's
very
involved
in
heading
up
the
service,
but
one
of
the
things
that
I
know
I
feel
very
proud
of-
and
a
lot
of
colleagues
feel
very
proud
of-
is
that,
because
we
went
into
the
pandemic
with
a
very
strong
infection
prevention
and
control
service
and
through
the
pandemic,
we
we
further
strengthened
the
capacity
of
that
service
within
the
city.
It
meant
that
we
were
able
to
provide.
Q
We
were
able
to
provide
really
intensive
and
very
specific
support
by
care,
home
or
other
institution
in
the
way
that
other
places
wouldn't
have
been
able
to
because
of
the
quality
of
that
team
and
also
the
the
the
capacity
it
gave
us
across
the
city.
So
I
think
in
terms
of
our
local
learning
and
being
very
mindful
of
how
we
keep
ourselves
safe
for
the
future.
Q
One
of
the
really
important
things
I
think
it's
useful
to
recognize
is
that
we've
intentionally
made
sure
that
we
we
put.
We
protect
that
that
that
really
valuable
team
and
that
really
valuable
function
which
sits
in
leeds
community
health
and
trust
and
is
commissioned
by
the
council
and
because,
without
it
we
would
be
in
a
a
much
worse
place,
and
I
think
we
we
need
to
sort
of
recognize
our
local
strengths
and
how
we
we
build
on
that
going
forward.
Q
So
I
just
wanted
to
to
recognize
all
the
great
work
of
those
local
teams
thanks
chair.
Thank.
A
You
very
much
victoria
excellent,
as
always,
and
I
love
the
futuristic
plans
as
well
as
andrew
said.
Never
again,
we
cannot
turn
back
the
hands
of
times,
that's
for
sure,
but
obviously
going
forward,
ensure
that
you
know
we
put
things
in
place
for
not
just
for
what
has
happened,
but
for
any
other
any
other
time
in
our
lives
where
our
elderly
and
anybody
in
in
care
homes
or
in
hospitals
are
duly
safeguarded
and
protected.
A
I
do
know
that
one
of
our
board
members
had
a
direct
experience
during
covid,
because
obviously
I
did
receive
an
email
and
that
was
escalated
to
the
chief
ex
of
the
council.
Iqbal
are
you
there?
Would
you
like
two
minutes
just
share
with
us
what
you
went
through
and
what
feedback
you
got
back
from
the
hospital
with
the
experience
from
one
of
your
relatives,
please.
E
Yeah
hi,
the
problem
is
that
we've
got
there's
been
an
arrangement
with
coroners
to
prioritize
release
to
prioritize
postmortems
and
sort
the
paper
out.
A
A
E
Okay.
Okay,
sorry,
forgive
me
to
be
honest:
it's
not
loud
enough
and
I'm
hearing
part
of
the
conversation,
but
with
the
fun
on
as
well
yeah.
E
The
the
the
visiting
issue
is
that
there's
the
language
issue
that
certain
community
elderly,
especially
elderly
members,
who
cannot
communicate
and
explain
to
nurses
what
they
need,
what
their
requirements
are,
and
sometimes
as
simple
as
going
to
the
toilet
and
it's
I
got
a
complaint
from
one
of
the
constituents
and
the
daughter
was
very
worried
because
the
mom
could
not
explain
anything
and
he
heard
that
she
started
deteriorating
health
wise
until
her
daughter
who
works
for
nhs
and
was
very
forceful
in
a
polite
way.
To
argue
and
present
the
case.
Look
my
mom's
got
problem.
E
She
needs
explaining.
She
needs
comfort
and
you,
unfortunately,
because
of
the
language
barrier
because
of
the
cultural
barriers,
you
will
not
be
able
to
understand
that
and
thankfully
the
the
the
staff
agreed
and
we
have
the
greatest
deal
of
respect
for
the
staff
and
the
difficulties
they're
going
through.
E
But
it's
you
have
to
balance
each
case
for
its
own
merits
and,
as
a
result,
she
was
able
to
go
there
and
it
was
as
simple
as
the
lady
not
being
able
to
explain
that
she
wants
to
go
to
toilet.
She
needs
water
and
things
changed
and
it
was
very
comforting
and
reassuring.
So
the
concern
was
to
you
know:
we
need
to
find
a
balance
rather
than
just
a
straightforward
policy
of
not
allowing
anybody.
E
A
F
Yeah
just
quickly
to
pick
up,
I
think,
on
what
mr
patterson
was
saying
towards
the
end.
I
was
a
sort
of
an
assistant
carer
for
my
elderly
mum
who
gets
residential
care
in
her
own
home
and
during
the
starts
the
pandemic.
F
Just
as
we
all
were,
you
know
we
were
all
learning
what
this
new
disease
was
and
what
its
implications
were
and
this
severity-
and
you
know
it
felt
a
very
uncertain
period
in
the
early
part
of
2020,
and
I
effectively
put
her
into
self
quarantine
that
I
stayed
away
until
kind
of
you
know
lecturing
later
in
the
summer,
and
then
she
went
into
hospital
after
a
fall
in
november
and
came
came
down
with
curvy
a
week
later,
which
kind
of
made
me
think
that
I
wish
I
kind
of
stuck
her
in
witherspoons
to
catch
it
in
the
first
wave
and
get
it
over
and
done
with,
but
I'm
always
struck
by
something
yeah
to
those
who
say
we
shouldn't.
F
You
know
we
overreacted,
we
underreacted.
I
think
there
are
two
things
one.
I
think
there
needs
to
be
a
hierarchy
of
visitors.
You
know
mr
patterson
and
others
who
have
a
long
history
of
plus.
I
think
we
need
to
find
some
way
of
having
tiered
access
to
people
if
there
is
another
pandemic
or
some
similar
event
and
the
you
know
the
the
other
thing
is,
I
think
you
know
we
need
to
kind
of
just
be
very
mindful
that
we've
all
learned
a
lot
during
this.
A
B
I
played
this.
My
videos
off
my
internet
was
playing
up,
so
I
froze
at
one
point,
so
it
seems
to
be
okay.
Since
I
take
my
video
well
so
yeah
my
name
is
casper.
I
am
the
exhibit
of
public
health
and
active
lifestyles.
A
couple
of
I
suppose,
observations.
Following
from
what
counselor
iqbal
has
also
said.
I
think
I
had
to
join
the
pandemic.
As
elected
members,
I
had
a
good
wrenching
conversation
with
the
son
who
was
looking
after
his
mum
of
90
years.
B
He
was
the
care,
wasn't
able
to
see
mum
and-
and
it
was
just
a
really
really
difficult
time
and
I
think
they
ought
to
be
in
certain
circumstances,
some
some
flexibility,
but
as
counselor
heartbroken
said,
that
is
a
whole
thing.
What
I
did
want
to
do
was
just
share
my
experience.
Actually
I
may,
on
the
back
of
what
robin
rob
said
earlier
and
joe
my
mum
was
admitted
to
hospital
a
couple
of
weeks
ago,
mom's
a
renal
transplantation.
B
She
didn't
communicate
in
english
very
well
on
day,
one
of
her
being
admitted,
we
missed
the
conversation
with
the
there
was
some
medication
that
had
to
be
altered
and
because
we
missed
that
conversation,
I
very
kindly
asked-
and
this
was
during
not
during
visiting
times
I
I
asked
if
it
was
possible,
if
I
could
be
there
the
following
day
and
if
that
exception
could
be
made,
and
actually
it
was
brilliant.
What
the
nurse
said
to
me
was
look.
B
Every
case
is
different
and
you
know
we're
willing
to
show
that
flexibility
and
it
made
such
a
wonderful
difference
to
us
because
it
meant
I
was
able
to
communicate
with
the
consultant.
Have
the
conversation
we
need
to
have
as
a
family
to
discuss
someone's
plan,
and
I
just
really
really
want
to
thank
ltht
for
that
approach.
You
know
it
really
made
a
massive
difference
in
terms
of
anxiety
on
what
was
happening.
B
So
please
continue
with
that
approach
where,
in
certain
circumstances,
there
will
be
instances
where
families
may
need
that
need
to
be
there
sooner
and-
and
I
just
I
I'm
so
so
grateful
honestly
for
that.
It
just
made
a
massive
difference
to
us,
so
just
a
big
thank
you
really
to
to
joe
and
her
team
for
helping
with
that.
A
Thank
you
very
much
counselor
ari
for
sharing
your
experience
and
that's
very
positive
and
comforting
for
those
listening
from
outside
ltht
stands
for
leads
teaching
hospital
trust.
So
thank
you
very
much
for
sharing
that
with
us
councillor
arif
councillor
anderson
and
we're
taking
questions
now
as
well,
and
I'm
just
you
know
if
you've
got
any
comments,
please
do
not
hesitate
to
put
your
hands
up.
I
can
see
you
all
on
my
screen
and
I'll
call.
You
thanks.
B
Thank
you
chair,
and
I
just
wanted
to
say
thank
you
to
mr
patterson
for
coming
to
the
board.
Today.
It's
really
important
that
we
hear
from
people
who
have
had
a
lived
experience.
So
I
really
do
appreciate
that,
and
I
am
very
sorry
to
hear
that
he
has
you
know
such
an
awful
time
not
being
able
to
see
his
wife.
B
I
am
concerned
to
hear
that
we
do
still
have
restrictions
in
place
in
some
care
settings,
and
I
do
think
it's
so
important
now
that
we
actually
balance
the
health
benefits
of
people
being
able
to
have
visitors
against
the
potential
for
catching
covered,
because
we
know
when
victoria's
said
this.
Older
people
now
in
the
main
have
had
four,
sometimes
five
jabs
and
they
are
not
getting
seriously
ill
with
covid,
it's
not
as
bad
as
colds
or
even
flu.
We
didn't
never
have.
B
We've
never
had
a
vaccine
for
the
common
cold
and
that
can
lead
to
all
sorts
of
problems.
So
we
you
know
we
need
to
be.
We
need
to
balance
this
out
a
bit
better
and
I
would
like
assurance
that
we
are
working
with
all
our
care
settings
to
get
back
to
some
kind
of
normality
to
allow
you
know
it
is
far
more
important.
I
think
now
that
people
can
see
their
loved
ones
when
they
want
to
and
not
be
tied
up
in
various
restrictions.
B
Can
I
just
ask
mr
patterson,
if
he's
willing
to
share
with
us,
have
you
noticed
a
deterioration
in
your
wife
over
the
last
two
or
three
years?
I
know
that
with
dementia
that's
normal,
but
and
it
may
be
difficult
for
you
to
say,
but
do
you
think
that
her
not
having
you
there
led
to
a
more
you
know
more
deterioration
than
you
would
normally
have
expected.
N
Yeah,
obviously
I
reflect
on
that
myself
and,
as
you
say,
dementia
is
a
slowly
progressive
disease.
So
some
sort
of
deterioration
would
be
expected
over
that
time
course.
What
I
can
tell
you
is
that
in
the
first
two
months
of
lockdown
she
just
stopped
eating
and
drinking
and
she
lost
half
a
stone
weight
and
it's
impossible
for
me
to
accept
that
that
was
anything
other
than
the
fact
that
she
had
been
cut
off
from
the
rest
of
the
world.
A
B
Yeah
yeah,
I
mean
I
have
got
a
few
friends
whose
wives
have
suffered
with
dementia
and
they've
been
looking
after
them.
You
know
in
their
own
homes
and
and
they've
had
trouble
with
people
not
wanting
to
eat
and
drink,
and
you
know
it
has
led
to
a
vast
deterioration,
but
thank
you
for
sharing
that
with
us.
Thank
you
for
coming
today.
A
Thank
you
very
much,
which
obviously
is
one
of
the
reasons
why
we
have
this
on
the
agenda
today,
because
we
do
know
the
impact
of
of
of
the
national
policies
and
guidelines
that
were
given
to
nursing
homes
and
care
homes
and
the
impact
he
had
on
on
residents
in
the
care
homes,
as
well
as
their
families,
and
we're
really
hoping
that
we
never
ever
see
this
again.
So,
okay
I'll
call
on
dr
bill
and
then
councillor
harrington.
C
C
I
think
that
there
are
many
people
who
deserve
our
thanks
for
all
the
care
they
delivered
to
the
community
and
leads.
The
first
question
is
for
either
or
caroline
or
michelle,
bearing
in
mind
that
in
the
care
home
sector
in
particular,
there
are
numerous
staff
shortages
and
a
large
turnover
of
staff.
C
So
could
you
tell
us
what
ongoing
training
there
is
for
the
managers
and
the
staffing
care
homes
to
ensure
that
they
are
all
familiar
with
the
latest
advice
and
recommendations
and
the
second
question-
and
I
may
be
accused
of
being
too
political,
but
I'm
talking
to
a
load
of
politicians,
so
I
will
go
ahead.
C
My
understanding
is
that
there
are
lots
of
homes
which
were
set
up
by
individuals
or
small
organizations
who
actually
wanted
to
do
something
to
help
some
of
the
most
vulnerable
people
in
our
society,
and
they
set
up
a
single
or
sometimes
a
small
group
of
care
homes
providing
that
service-
and
you
know
all
part
of
their
elbow
they're
running
small
businesses
and
they
do
deserve
to
make
a
fair
return
on
their
investment.
C
But
my
understanding
is
that
there
are
other
care
homes
which
are
part
of
long
large
chains
set
up
by
financial
imp
institutions,
and
I
conclude
from
that
that,
basically
they
weren't
in
it
for
the
the
service
they
were
providing.
They
were
in
it
for
a
quick
buck
from
what
was
an
expanding
sector
of
provision.
So
my
question
is-
and
I
guess
it's
probably
to
caroline-
is
there
any
evidence
that
the
way
in
which
small
care,
homes
or
small
groups
of
care
homes
behave
differently
from
the
larger
institutions?.
J
J
Okay,
so
in
relation
to
the
first
question,
the
training
that
is
available
to
care
homes
that
has
been
available
to
care
homes
around
managing
the
pandemic
has
been
run
by
our
infection
prevention
control.
Colleagues
at
lch
that
support
is
still
readily
available,
bearing
in
mind
and
recognizing
that
there
are
workforce
challenges
and
staff
turnover
and
also
actually
to
add
that
a
lot
of
care
homes
have
lost
their
registered
managers.
You
know
the
managers
just
had
more
than
enough
and
have
decided
that's
it.
J
You
know
a
lot
of
them
are
in
their
latter
years
of
their
careers.
So
and
for
a
time,
especially
after
the
first
year
of
the
pandemic,
we
saw
care
homes
losing
their
registered
managers
and
all
the
leadership
that
goes
with
that.
So,
yes,
there
is
still
a
massive
recruitment
retention
staff
turnover
instability
in
our
care
homes.
J
This
is
not
unique
to
leeds
it's
a
national
issue,
an
issue
that
we're
constantly
raising
with
the
department
of
health
and
social
care
and
also
nhs
england,
so
that
continues,
regardless
of
that,
the
support
that
was
available
to
care
homes
during
the
course
of
the
last
two
and
a
half
years
continues
and-
and
I'm
sure
steph
will
tell
you
that
the
ipc
team
continues
to
do
an
absolutely
fantastic
job
in
supporting
care
homes.
That
aside,
we
also
have
the
we
care
academy.
J
We
have
the
leeds
health
and
care
academy
across
our
system,
and
that
also
offers
a
range
of
training
and
support
not
just
related
to
infection,
management
and
control,
but
a
whole
range
of
things
that
support
our
independent
sex
workforce.
So
that
will
continue.
J
O
O
Only
thing
I
would
add,
caroline
as
well,
is
around
the
support.
That's
been
available
through
skills
for
care
during
the
pandemic,
because
they've
put
quite
a
lot
of
information
out
there
training's
being
available
to
registered
managers
and
other
staff,
and
I
think
it's
also
safe
to
say
a
lot
of
the
training
provision
is
being
moved
from
sort
of
classroom
based
training
to
zoom
or
microsoft
teams,
just
to
ensure
that
that
training
could
still
be
carried
out
and
the
staff
could
still
keep
up
to
date
with
the
most
recent
training.
O
J
Thank
in
terms
of
your
second
question,
then,
is
there
a
difference
between
the
way
in
which
larger
national
care
homes
are
organized
to
run
compared
to
smaller
homes?
And
often
the
difference
is
in
relation
to
infrastructure
support,
so
the
large
national
organizations
will
have
their
own
significant
hr
departments,
policy
departments
they
set
their
own
guidance
for
their
staff.
J
J
Apart
from
that,
there
is
a
huge
amount
of
difference
in
terms
of
training,
recruitment
retention.
In
fact,
what
we
find
often
is
the
smaller
homes
are
able
to
retain
their
staff.
Well,
they
offer
a
lot
of
support.
They
focus
on
local
staff
that
live
nearby,
who.
O
J
You
know
who
have
been
with
the
organization
for
years
and
years,
so
in
some
instances
their
staff
turnover
is
probably
lower
than
for
some
of
the
larger
organizations,
but
in
reality
we
we
need
care
home
capacity.
J
There
are
pros
and
cons
with
smaller
organizations
relative
to
larger
organizations,
the
larger
organizations
national
organizations
are
able
to
offer
us
more
capacity,
usually
because
they
own
large
purpose-built
buildings
compared
to
the
smaller
homes.
There
is
room
in
the
market
for
both
I'm
not
going
to
answer
the
element
of
your
question
that
is
around
their
finances
and
how
their
finances
work,
because
I
think
that
is
quite
a
political
question.
J
Obviously
they're
all
independent
businesses
in
the
main,
some
are
charitable
organizations,
but
in
the
main,
they're
profit-making
organizations
and
there's
an
element
of
profit
that
is
built
into
their
business.
You
expect
that,
whether
it's
a
small
local
home
or
it's
a
national
home,
I
hope
that
gives
some
indication
in
terms
of
answering
your
question.
A
C
A
B
Thank
you,
chad.
I
agree
totally
with
almost
everything
that
dr
beale
said
about
thanking
that
the
staff
that
have
been
working
through
this
horrendous
time.
It's
been
awful
and
I
know
from
the
six
care
homes
plus
the
three
or
four
assisted
living
places
that
are,
in
my
ward
alone,
how
difficult
staff
retention
has
been.
One
of
the
concerns
that
I
have
is
that
cqc
don't
appear
to
have
been
doing
very
much
during
the
pandemic.
B
They've
been
guidelines
and
they've
paid
some
kind
of
adherence
to
that,
but
they,
if
you
go
from,
if
you
went
from
one
to
the
other,
there
was
quite
a
lot
of
things
that
were
different
and
I'm
concerned
that
cqc
are
going
to
have
an
awful
lot
of
catching
up
to
do
to
see
actually
what's
been
happening
in
those
care
homes
during
those
two
years,
and
are
we
ready?
B
Are
we
ready
for
the
implication
that
several
of
those
care
homes
are
going
to
be
reduced
on
their
levels
and
they
will
be
going
from
good
to
requires
improvement
and
what
support
mechanism
we
then
have
as
a
local
authority
to
support
them
to
bring
them
up
to
a
reasonable
standard.
Thank
you.
Thank.
A
You
very
much
counselor
harrington,
very
good
question
council
folly.
D
Thank
you,
chair
yeah,
I
mean
I'd
just
like
to
to
echo
my
colleagues
in
passing
on
kind
of
you
know,
passing
on
cleo
my
thanks
and
thanks
of
I'm
sure
many
people
right
across
the
city
to
our
health
and
care
staff,
the
incredible
job
that
they've
done
over
the
past
past
two
years.
I
think
it
is
important
to
to
remember
that.
Obviously,
covid
is
still
with
us.
You
know
it
hasn't.
D
It
hasn't
magically
gone
away
with
with
the
restrictions
and
with
with
this
in
mind,
given
given,
obviously
the
current
rate
of
of
covered
infections
and
the
potential
the
potential
of
of
the
virus
to
to
mutate
and
obviously
become
more
more
more
virulent,
more
more
dangerous
and
the
potential
threat
of
it
being
vaccine
evasive.
D
I
suppose
my
question
would
be
is
for
both
our
health
and
care
providers
you
know
is:
is
there
the
potential
for
visitors
being
restricted
in
the
future,
outside
of
national
guidance
and
with
your
indulgence
chair,
quite
specifically,
for
our
health
for
our
nhs
providers
and
obviously,
as
we
go
into
winter,
we
may
be
expecting
more
more
cases
of
co-fed.
D
Obviously,
we've
got
a
different
testing
regime
than
what
we
had
last
winter,
but
what
what
will
be
you
know
what
measures
are
being
taken
to
stop
the
stop
the
spread
of
of
covered
from
visitors
within
within
both
the
queue
and
community
settings
and
what's
and
mental
health
settings,
and
would
we
will
will
this
impact
on
on
patient
flow?
D
Will
we
be
looking
at
greater
restrictions
going
back
into
back
into
hospital
environments
in
terms
of,
and
then
obviously
what
impact
will
that
mean
for
for
delayed
discharge
and
the
impact
on
on
other
patients?
That's
clear.
A
Thank
you,
counselor.
Okay.
We
would
like
to
start
first,
so
we've
got
councillor
harrington's
question
on
cqc.
J
Thank
you.
Yes,
in
terms
of
the
cqc
inspections,
the
they
did
stop.
Of
course,
during
the
a
couple
of
years
of
the
pandemic,
however,
they
have
reinstated
their
visiting
their
inspections,
but
it
is
very
reactive.
J
They
are
targeting
their
c
their
in
inspections
in
to
those
care
homes
that
have
previously
been
rated,
as
requires
improvement
or
in
the
very
small
number
where
they
have
identified
that
they
are
inadequate
rated
so
and
also
in
response
to
either
complaints,
concerns
or
safeguarding
inquiry.
So
where
we
as
a
local
authority
or
other
healthy
care,
people
have
been
going
into
care
homes
where
family
and
carers
have
been
going
into
campus
and
have
raised
concerns
about
quality.
J
They
have
been
flagged
up
with
the
cqc
and
that's
when
cqc
inspectors
have
gone
out
and
visited,
so
they
are
absolutely
removing
themselves
from
doing
their
annual
visiting
or
two
yearly
visiting
that
they
were
doing
pre-covered
and
they
are
focusing
their
regime
and
their
activity
in
in
relation
to
those
care
homes
that
have
been
identified
as
having
some
difficulties
and
some
problems.
Wherever
those
concerns
are
raised.
J
At
the
moment,
the
cqc
is
out
to
consult
with
the
public
around
changing
their
previous
inspection
regime,
they're
consulting
with
care
homes
as
well
about
that.
So,
to
be
honest
with
you,
we
don't
foresee
them
going
back
to
inspecting
in
the
way
that
they
were
doing
pre-covered
so
where
care
homes
have
been
identified
as
a
good
rating
or
an
outstanding
rating.
J
A
Okay,
thank
you.
There
was
questions
from
councillor
farley.
A
J
I
don't
know
whether
that
was
it
in
relation
specifically
to
care
homes
or,
more
so
in
terms
of
health
care
settings
yeah.
So
certainly,
I
can
respond
in
terms
of
care
home
settings
and
that
is
we
will
absolutely
abide
by
the
guidance
that
is
issued
by
nhsc
by
uk
health
security
agency,
and
we
will
enforce
and
implement
that
guidance
we
have.
J
As
victoria
said
I
mean
only
last
week,
there
were
33
care
homes
in
leeds
where
there
was
a
covered
outbreak
now,
fortunately,
not
all
of
those
care
homes
had
to
close
to
admissions,
so
even
people
being
discharged
from
hospital
that
the
care
homes
were
able
to
accept
people
some
were
closed.
If
the
numbers
of
residents
affected
was
high,
it
didn't
stop
visiting
the
care
homes
were
still
enabling
visiting,
and
that
was
with
all
the
precautions
that
are
in
place
around
testing
around
good
use
of
ppe.
J
So,
as
victoria
has
already
explained,
we're
we're
really
fortunate
at
the
moment
that
there's
been
a
really
good
level
of
uptake
of
vaccinations
and
boosters
by
residents,
and
that
is
reducing
the
risk
to
residents.
I
understand
councillor
farley
that
you
were
saying.
Well,
you
know
if
the
different
strains
and
variations
become
resistant
to
the
boosters
and
to
the
vaccinations,
then
what
will
the
situation
be?
And
all
I
can
say
at
this
stage
is
that
we
will
have
to
be
minded
by
national
guidance.
A
P
You
asked
about
the
potential
for
more
restrictions
and
potentially
to
be
outside
the
national
guards.
I
guess
to
to
reiterate
what
caroline
says:
we
would
continue
to
follow
national
guidance
now
throughout
the
pandemic
we
followed
national
guidance
and
it
also
encouraged
staff,
discretion
and
judgment,
and
I
guess,
as
the
pandemics
progressed,
which
joe
could
probably
say
better
than
me,
but
some
more
confidence
among
staff
to
to
take
some
judgment,
calls
and
actually
picking
up
what
councillor
arif
has
said.
P
That's
been
supported
by
and
have
been
appreciative
of
of
counsellors,
some
on
this
board
raising
issues
to
us
as
a
trust
and
then
us
being
able
to
learn
from
cases
that
that
have
been
escalated
to
us.
So
appreciate
that
also
on
your
point
council
folly.
So
at
the
moment
today,
we've
got
over
250
coded
positive
patients
in
our
wards,
so
we've
we're
experiencing
a
surge
in
covered
patients.
P
We
continue
to
have
some
restrictions
on
our
visiting
less
than
we
did
at
other
points
and
less
than
we
did
at
other
points.
We
had
so
many
covered
patients
in
at
previous
points
in
the
pandemic.
P
That
is
obviously
having
an
impact
on
the
flow
of
on
our
hospital
occupancy
and
therefore
the
timeliness
of
care
that
we
can
provide
to
people
because,
wherever
possible,
we
work
to
keep
those
coveted
positive
patients
together
so
as
not
to
spread
coded
throughout
the
hospital
as
much
as
possible.
But
joe
may
want
to
add
some
detail
on
that.
O
Thanks
rob,
I
don't
think
I
think
you've
said
most
of
it
there.
I
think
the
thing
there
for
me
is
the
confidence
and
the
comfort
staff
and
confidence
that
they're
confident
has
grown
in
risk
assessing
some
of
our
visiting
restrictions.
O
However,
now
obviously
we're
back
to
visiting
as
we
were
before,
but,
like
you
say,
for
the
patients
that
we
do
have
that
are
positive.
We
are
still
risk
assessing
for
those
visitors
for
those
patients.
Q
Thank
you
chair,
I'm
really
mindful
of
time
so
I'll
keep
it
brief
and
just
add
to
the
comments
from
robin
caroline,
just
two
things:
a
councillor
valley
raised
again
around
the
point
that
raised
the
point
around
local
risk,
local
new
restrictions
and
where
we
might
not
follow
national
guidance
and
we
we
would
we
wouldn't
we
wouldn't
not
follow
national
guidance
and
and
bring
in
any
local
restrictions
and
and
haven't
done
right
through
the
the
pandemic.
So
we
would
absolutely
stick
to
that
approach.
Counselor.
Q
I
think
we're
also
really
close
to
national
colleagues
on
on
the
things
that
would
trigger
any
change
to
that
national
guidance.
So
there's
a
there's,
there's
some
red
flags
in
the
system
that
they
look
to
so
this
is
chris
whitty
and
his
team
would
look
to
which
would
make
them
worried
in
enough
to
change
the
national
guidance.
Q
So
one
of
them,
as
you
quite
rightly
say,
is
because
we
keep
looking
at
the
variance
of
concern
and
we
and
the
the
surveillance
there
around
checking
that
they
are
not
evading
the
vaccine.
Now,
if
there
was
strong
evidence
that
we
did
have
a
variance
of
concern,
that
was
evading
the
vaccine,
that
would
be
a
red
flag
to
consider
changing
national
guidelines.
Q
Another
red
flag
would
be
robs
mentioned.
We
do
have
around
250
people
in
hospital
with
covid
at
the
moment,
but
predominantly
they're
people
with
covet,
not
primarily
because
of
covid
and
being
severely
ill
because
of
covid.
But
if
that
pattern
started
to
change
and
people
were
severely
ill,
primarily
with
covid,
that
would
be
another
red
flag
to
change
national
restrictions.
Q
So
we
really
close
we're
really
close
to
that
kind
of
surveillance
of
those
things
that
the
system
is
most
worried
about,
and
but
we
wouldn't
make
local
decisions
outside
of
any
of
that,
we
would
always
go
with
the
national
judgement.
Q
So
that's
one
thing
and
then,
secondly,
just
briefly
in
terms
of
future
approaches
and
and
the
change
in
risk,
I'm
sure
you're
all
aware
we're
now
in
this
period
of
life
that
we're
calling
living
with
covid,
which
really
reflects
the
fact
that
kobit
now
isn't
what
covid
was
at
the
height
of
pandemic.
Q
Before
we
have
the
vaccine
as
the
as
the
strongest
line
of
defense,
so
the
big
messages
that
we
will
continue
to
get
out
there
to
keep
our
citizens
as
safe
as
possible
is
that
everyone
needs
to
take
up
the
vaccine
when
it's
offered,
and
particularly
those
people
who
are
being
offered
boosters
now
to
to
absolutely
take
that
because
they
are
proving
to
be
the
most
effective
defense.
Q
It's
not
too
late
for
people
who've
not
even
had
a
first
vaccine
to
come
forward
and
get
it
so
the
evergreen
offer
will
be
there
right
through
the
through
the
autumn
and
winter
and
then,
finally,
because
we
don't
have
community
testing
anymore,
the
whole
approach
of
people
treating
covid
as
as
a
respiratory
illness
in
the
way
that,
if
they're,
coughing
and
sneezing
with
anything
else,
we
wouldn't
want
them
to
go
to
school
or
work
or
visit
relatives
in
a
hospital
or
care
home.
Q
So
it's
very
much
around
sort
of
sensible
sort
of
basic
public
health
advice
to
hand
wash
and
just
just
show
that
common
sense
really
away
from
the
really
strict
regimes
of
restrictions
and
and
testing
that
we've
had
in
the
past.
So
I
think
it's
just
getting
people
used
to
making
those
judgment
calls
now
we're
in
that
different
phase.
Thanks
chair
thank.
A
H
Chair,
I
have
no
questions
for
these
amazing
people.
I
just
want
to
thank
each
and
every
one
of
them
listening
to
harriet
and
andrew,
but
for
the
work,
what
the
care
home
did
over
the
pandemic.
Is
I
just
gratitude
to
these
people
and
I'm
grateful
and
also
victoria?
If
it
wasn't
people
like
victoria,
I'm
only
speaking
on
leads
at
the
moment,
we
would
be
doomed
because
the
ml
secretary
at
the
time
and
our
so-called
outgoing
prime
minister,
he
did
not.
They
did
not
think
for
one
moment
of
the
elderly
in
care
home.
H
They
just
expect
the
prime
minister.
He
have
an
elderly
father
and
he
did
not
think
he
should
have
said.
Thank
god,
my
dad
is
in
this
age
and
he's
in
good
health,
but
the
elderly
who
was
in
the
care
home.
There
was
our
generation
and
brought
us
to
where
we
are
today,
and
I
just
I'm
gratitude
for
the
cajon
thank
you
harriet
and
others,
accounting
team
and
andrew.
Thank
you.
I
was
very
surprised
listening
to
councillor
anderson
axing
andrew.
Did
he
notice
his
wife
deteriorating?
H
I
don't
know
if
she
wants
to
blame
it.
This
is
what
happened
to
demonstrate
people
one
minute
they
are
with
us
and
next
second
they're,
not
with
us,
and
to
lock
them
away
in
the
care
home.
That
was
totally
totally
wrong.
You
know
if
the
care
home
staff
wasn't
there,
who
would
these
people
see?
Because
we
know
the
men
shall
live
in
the
past
and
it's
the
people
and
the
things
from
the
past
that
benefit
them
more.
H
So
I
just
want
to
thank
you
all
again
and
thank
you
victoria,
because
these
people,
like
you
and
across
the
city,
not
the
government
that
bring
us
back
to
where
we
are
and
they're
talking
about
it,
get
us
out
of
the
pandemic.
It
did
not
get
us
out
of
the
pandemic,
the
good
lord
listen
to
our
prayer
and
sorry
for
the
people
and
he's
dependent,
but
we
just
need
to
be
more
careful.
A
Thank
you.
Thank
you
very
much
councillor
taylor,
councillor
caja,.
G
Hi
I've
listened
to
all
of
what
you've
said.
My
experience
goes
back
to
the
beginning
of
the
covered.
I
lost
a
brother
in
a
care
home
in
leeds
in
leeds
area
at
the
beginning
of
coverage
april
20,
and
at
that
time
we
weren't
aware
of
what
was
what
we
didn't
know,
but
you
know
I
mean
they
said
from
the
death
certificate
that
said
that
my
brother
died
of
he
had
dementia
he'd
lost
his
mobility
and
I
just
think
personally
it
given
up.
You
know
it.
G
It
was
time
to
go
kind
of
thing,
but
the
staff
in
this
carer
was
absolutely
unbelievable.
Yes,
they
said
we
couldn't
go
in
then
at
the
end,
when
it
was
you
know,
the
end
was
near.
We
could,
but
we'd
have
to
be
gowned
up
and
everything
I
was
asked.
If
I
wanted
him
to
go
to
hospital
and
as
I
was
being
his
part
of
it
and
everything
I
said
no,
I
thought
it
was
safer
there,
but
this
caring
was
absolutely
unbelievable
and
be
unbelievable,
and
you
know
a
few
meetings
ago.
G
G
Now,
when
I
lost
my
brother,
I
my
brother
were
in
there
what
three
years-
and
I
know
that
those
staff
members
felt
my
out
that
that
the
bereavement
as
much
as
we
family
did
you
know,
and
this
is
where
they
are
so
so
fantastic
at
what
they
do
now.
I
know
and
I'm
not
going
to
say
what
kerim
it
was,
and
I
know
there
was
some
something
in
the
media
about
something
not
being
allowed
to
to
visit
and
blah
blah
blah,
and
then
I've
just
recently
been
drawn
someday.
G
This
particular
case
of
this
particular
person
not
being
allowed
in
to
the
home
has
blown
up
and
it's
led
to
the
the
the
cqc,
maybe
branding
them
that
they
weren't
right.
Do
you
understand
what
I'm
saying-
and
I
just
think
you
know
it's
such
a
shame-
that
such
caring
people
are
getting
right
and
it's
true
the
carers.
You
know
they've
done
so
much
through
all
this
pandemic
and
we've
all
been
blind
to
what's
gone
on.
You
know
not
known
it's
hit
us
like.
G
You
know
like
a
boat
out
a
lot
of
lightning
kind
of
thing,
but
I
do
think
the
care
homes.
You
know
we
were
clapped
for
the
nhs
but
and
I'm
not
knocking
that,
but
I
don't
think
there's
been
enough
done
for
the
carers
and
I
just
I
just
wanted
to
share
that
with
you.
You
know
it
was
a
very
upsetting
time
for
me
and
my
family,
but
I
will
be
eternally
grateful
to
those
carers.
G
You
know-
and
I
do
think
it's
sad
that
they're
probably
on
basic
money,
but
for
what
they
do.
Thank
you.
A
Thank
you
very
much.
Counselor
kidja
and,
on
behalf
of
the
board,
accept
our
sincere
sympathy
on
the
loss
of
your
brother.
We
pray.
He
saw
continue
to
rest
in
peace
and,
yes,
you
know
like
so
many
others.
You
know
that
have
lost
the
air
once
we
will
carry
this
for
a
very
long
time,
most
of
it
for
as
long
as
we
live,
and
I
believe
we're
sat
around
this
table
today.
A
I'm
saying
table
not
literally,
but
you
understand
what
I
mean
to
make
sure
that
what
happened
in
the
past,
which
we
can't
change,
doesn't
happen
in
the
future.
A
You
know
that
even
if
we
lose
our
family
or
if
we're
going
to
lose
anyone,
we
don't
lose
them
in
the
way
that
we
lost
them
over
the
last
two
and
a
half
years
and
hoping
that
you
know
the
government
listens
to
people
and
that's
why
we're
here
so
that
the
ordinary
man
on
the
streets,
people
who
have
lived
experiences
like
yourself,
come
here
and
tell
us
what's
going
on,
and
we
can
relay
that
to
people
who
make
decisions
about
our
everyday
lives.
A
So,
really,
really
I'm
sorry
to
hear
that
class
picture
and
we
pray
for
god's
comfort
for
you
in
terms
of
getting
into
the
cq.
I'm
not
you
know,
I
don't
think
we
need
to
get
into
that,
because
we
do
not
know
why
they
got
the
rating
that
they
got
so
yeah.
You
couldn't
leave
that
outside
of
that
now,
but
okay
I'll
tell
you
what
we're
gonna
do.
I
will
give
us
a
three
minutes
break
if
that's!
A
A
F
Thank
you
chair,
so
this
this
item
is
to
provide
members
with
a
a
brief
update
on
details
that
members
considered
previously
in
the
previous
municipal
year
to
provide
an
update
on
the
leads
maternity
strategy,
work,
the
grant
position
around
leeds
facility
iv
service
and
the
implications
of
the
oculum
review
findings
and
how
any
recommendations
are
being
taken
forward
across
the
local
maternity
system
in
leeds.
F
So
there's
some
specific
details
in
relation
to
the
oculum
review
attached
to
the
paper,
and
so
members
will
have
seen
that
and
the
report
that
went
to
the
leads
board,
the
at
least
teaching
us,
which
was
board
and
the
response
that's
been
made
in
relation
to
those
recommendations
and
we've
got
a
number
of
colleagues
from
lee's
teaching
hospital
trust
and
also
from
the
integrated
care
board
in
leeds
in
relation
to
commissioning
arrangements
present
at
the
meeting
to
be
able
to
update
members
on
on
progress
on
the
other
items.
Chair.
A
Excellent.
Thank
you
very
much
steven.
I
was
muted
right.
Okay,
thank
you
for
all
the
partners
who
have
joined
us
this
afternoon,
and
I
would
like
you
to
just
kindly
introduce
yourself
it's
the
last
item
in
terms
of
those
who
have
been
invited
to
speak
and
I'll
start
with
counselor
eric.
Please.
A
Thanks
for
joining
us,
as
always
claire
you're
here,
I
am.
L
A
You
for
coming
dr
everett.
P
Hello
again
correct
item
this
time,
I'm
tommy.
First,
I'm
the
lead
clinician
of
the
maternity
services
and
consultant
obstetrician.
A
L
No
unfortunately,
she's
having
to
be
on
the
wards
because
of
the
extreme
heat
we
she's
actually
covering
people's
brakes,
so
they
can
make
sure
they
get
their
water
bless
her
okay,
we've
also
brought
along.
I
hope
you
don't
mind
two
colleagues
from
the
icb
for
the
maternity
strategy
update
emily
griffiths
and
liz
wigley.
R
L
So
our
colleagues
from
the
icb
are
going
to
start
with
the
maternity
strategy
and
then
tom
and
I
may
heckle
as
we
go
along,
then
I'm
going
to
pick
up
the
fertility.
L
I
R
Okay,
well
I'll
make
a
start.
So
the
committee
will
be
aware
of
some
of
the
changes
that
we
have
been
implementing
across
health
and
caring
leads
over
the
last
few
months.
I'm
sure
you've
had
multiple
presentations
on
the
slightly
different
approach
that
we
are
trying
to
take
post
covered
to
the
way
we
govern
health
and
care,
and
the
crux
of
that
is
to
join
together
health
and
care
in
a
partnership
across
the
city,
taking
a
population
health
management
approach.
R
So
that
means,
rather
than
looking
at
individual
services
and
considering
how
we
are
doing
for
people
during
the
time
frame
within
which
they're
using
our
services
and
focusing
on
those
experiences,
but
perhaps
not
seeing
beyond
that
in
that
person's
life
journey.
So
what
happens
when
they
leave
what
happens
before
they
come
to
us?
R
We
are
trying
to
take
a
life
journey
and
a
think
family
approach,
so
really
working
to
understand
people's
lives
and
how
the
wider
determinants
of
health
impact
on
their
health
outcomes
and
to
also
understand
the
roles
of
the
partners
in
the
system
and
how
we
can
best
work
together
to
use
our
collective
resource
to
deliver
the
best
outcomes
for
the
city.
So,
within
that
maternity
is
very
well
placed
for
this
agenda,
we
have
actually
had
a
partnership
forum.
R
That's
been
guiding
the
delivery
of
the
maternity
strategy
for
a
number
of
years
in
the
city,
and
the
committee
has
received
previous
updates
on
that.
But
the
consolidation
of
this
approach
in
the
city
means
we
now
have
a
number
of
other
boards
related
to
other
aspects
of
healthcare.
Deliver
that
delivery
that
can
support
and
work
with
the
maternity
strategy
group
to
take
that
forward.
So
this
will
talk
you
through
a
couple
of
high
level
updates
on
the
work
streams
that
sit
within
the
maternity
strategy.
R
We've
not
lost
those
during
this
update,
but
we
are
refreshing
and
reinforcing
them
and
trying
to
think
about
that
population.
Health
management
approach
they
think
about
what
are
the
long-term
outcomes
for
mums
and
for
families
and
for
babies
within
the
city,
and
where
do
we
want
to
improve
and
particularly
having
a
mind
on
health
inequalities
essential
to
that
and
using
this
opportunity
of
learning
and
reflection
after
clovid
to
enhance
that
work?
Shall
I
hand
over
to
this.
I
Yeah,
thank
you.
So
we
just
wanted
to
give
you
some
examples
of
some
things
that
have
happened
over
the
last
year,
which
we
think
are
really
good.
Examples
of
this
partnership.
Work
like
emily
just
talked
about
so
one
of
our
key
work
streams
under
the
maternity
strategy
was
reconfiguration
and
supporting
the
centralization
of
maternity
services
to
the
lgi.
I
That's
really
exciting
development
for
us
in
terms
of
our
perinatal
mental
health
work
stream,
we've
consid
we've
continued
to
expand
the
funding,
that's
gone
into
our
specialist
prenatal
mental
health
service,
so
we're
now
able
to
support
more
women
and
families
with
moderate
to
severe
pronatal
mental
health
issues.
We've
also
worked
across
west
yorkshire
to
develop
a
pilot.
What
we're
calling
a
maternal
mental
health
service
and
that
service
is
supporting
people
who
wouldn't
traditionally
be
supported
within
perinatal
mental
health
services.
I
We're
working
through
our
leads
wide
health
inequalities
framework
to
develop
a
work
plan
for
that.
We've
also
got
a
really
rich
source
of
data
now
within
ltht
with
something
that's
called
applix
dashboard,
and
that
enables
us
to
have
a
look
at
lots
of
different
factors
about
what's
influencing
people's
outcomes
so
that
all
the
changes
we
make
can
be
really
evidence-based
and
in
terms
of
preparation
for
parenthood,
we
have
some
really
exciting
public
health
joint
initiatives
that
we've
done
over
the
last
year.
I
So
we've
just
started
the
process
of
employing
some
new
stop
smoking
advisors
that
are
specifically
dedicated
to
maternity.
So
they
can
work
really
closely
with
our
maternity
services
and
hopefully
influence
rates
of
smoking
at
the
time
of
delivery,
which
we
know
is
one
of
the
biggest
modifiable
factors
for
our
still
birth
rates
in
the
city.
R
A
L
L
They
described
themselves
as
being
very
happy
with
the
clinic
and
with
the
care
they
were
receiving,
but
they
thought
they
were
improvements
that
could
be
made
with
communication,
the
administration
of
the
service
and
the
fact
that
we
weren't
yet
able
to
provide
some
of
the
patient
apps
on
the
phone
and
digital
applications
that
support
people
going
through
their
ivf
journey
and
other
competitors
were
much
further
along
in
being
able
to
offer
that
kind
of
digital
information
and
stuff
to
improve
the
patient
experience.
L
We
received
a
high
quality
bid
from
a
company
called
care
fertility
who
are
big
providers
in
the
uk
of
this
of
ivf
care,
and
we
did
an
index
quality
and
financial
analysis
of
the
next
10
years
and
we
compared
the
care
bid
against
continuing
them
to
run
the
clinic
ourselves
versus
and
using
some
information
that
we've
gleaned
from
other
cities.
L
Looking
at
how
what
happens
when
private
clinics
come
into
the
cities
and
what
happens
to
activity
and
what
we
decided
when
we
were
doing
this
and
was
that
the
best
option
was
to
award
the
contracts
to
care
fertility,
and
we
decided
that
for
three
reasons
really
and
we
felt
that
they're
a
really
high
quality
organization
and
they
deliver
very
high
quality
care.
So
we
didn't
believe
there
would
be
any
concerns
regarding
what
care
patients
would
provided
would
receive
there,
and
we
felt
that
financially
for
us
as
an
organization,
it
was
the
least
bad
option.
L
I
just
want
to
emphasize
that
none
of
the
options
we
looked
at
meant
that
these
teaching
hospitals
made
money
from
any
of
these
options.
This
is
the
least
bad
one
for
us
as
an
organization,
and
we
also
felt
that
care
fertility
had
a
really
good
focus
on
the
patient
experience,
which
was
something
that
we
knew.
Patients
were
saying
that
we
could
do
more
about
and
they
have
a
really
good
patient
information,
digital
applications
that
support
patients
through
their
care.
L
So
we
awarded
the
contract
to
care
fertility
in
february
of
this
year
and
staff
who
had
worked
for
us
to
peed
over
on
their
nhs
terms
and
conditions
the
unions
and
were
fully
involved
in
that
process.
The
consultation
with
staff
was
undergone,
and-
and
so
we
wanted
to
update
you
what's
happening
now
for
the
clinic,
so
there's
very
little.
L
If
you're
a
patient,
there's
not
a
great
deal
of
change
that
you
will
have
noticed
as
a
result
of
the
change
beyond
the
fact
that
care
are
now
the
provider
of
that
service,
so
nhs
patients
still
access
their
care
from
that
clinic.
The
team
who
look
after
you
are
the
same
team
that
did
it
before
and
there's
continuity,
because
the
nhs
consultants
who
continue
to
work
for
leeds
teaching
hospitals
do
a
little
bit
of
their
time
at
the
care
clinic
and
they
see
and
treat
the
patients
who've
been
referred
there.
L
So
the
patient
remains
under
the
same
consultant
as
well.
The
same
all
the
contracts
mean
that
the
same
number
of
patients
we're
expecting
to
see
are
treated
in
the
care
clinic,
and
for
this
I
ask
the
care
clinic
to
provide
me
with
some
patient
experience
data
to
see
what
patients
were
saying
about
their
care.
It's
almost
universally
excellent,
really
high
quality
and
they're
really
happy
with
the
quality
of
care.
They're
happy.
L
They
are
happier
with
the
way
it's
administrated
now
than
they
were
at
the
time,
and
we've
noticed
a
reduction
in
some
of
the
waiting
times
for
some
key
tests
that
care
have
done
on
our
behalf,
which
has
really
helped
us
because,
as
you
know,
in
the
nhs
we've
got
very
long
weights
and
backlogs,
there
are
still
some
backlogs
for
tiller
for
fertility.
Outpatient
appointments
at
leeds
teaching
hospital,
but
as
soon
as
the
patients
are
transferred
over
to
the
care
clinic
they're
seen
very
swiftly,
and
we
have
no
concerns
at
all
about
waiting
times.
A
Okay,
thank
you
very
much
claire,
and
I
do
remember
that
meeting,
obviously
with
the
fertility
clinics.
What
I
would
like
to
ask.
Obviously
the
takeover
has
only
been
very
recent,
so
it's
a
very
short
time
when
you
said
you,
you
know
you've
asked
certain
patients
questions.
How
many
did
you
trial
in
terms
of
asking?
What's
the.
L
Data,
okay,
so
the
data
is
that
care
asks
do
a
questionnaire
for
every
single
patient,
nhs
or
private
that
they
treat
and
they've
provided
me
with
about
a
month's
worth,
but
we
are
just
about
to
start
doing.
We
have
regular
contract
meetings
with
them
because
we
have
a
contract
with
them
to
provide
that
care,
they're
expected
to
provide
their
patient
experience
data
for
the
every
month
that
we
have
it
every
single
time
we
meet.
L
It's
been
built
into
all
of
the
core
contracts
we
have
with
them
that
we
expect
what
level
of
quality
we
expect
and
we
require
detailed
information
about
patient
experience,
patient
complaints,
any
issues
so
that,
basically,
we
can
ensure
that
any
issues
or
concerns
are
flagged
and
are
being
dealt
with
appropriately.
A
Speak
last
year,
I'm
still
trying
to
remember.
We
did
speak
because
women
are
entitled
to
only
so
many
cycles,
depending
on
your
circumstances.
Yeah.