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From YouTube: Leeds City Council-Scrutiny Board (Adult, Health & Active Lifestyles) Consultative Meeting -15/06/21
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A
I
would
like
to
again
welcome
everyone
and
all
board
members
to
our
new
municipal
year
for
2021
and
20.
I
would
like
to
clarify
that,
while
this
is
a
meeting,
there's
been
webcast
live
to
enable
public
access,
it
is
not
being
held
as
a
public
region
in
accordance
with
the
local
government
act
of
1972.
A
As
such,
it
is
a
remote
consultative
meeting
of
the
adults,
health
and
active
lifestyle
scrutiny
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
C
A
D
A
E
E
A
E
A
A
Thank
you
very
much.
You're
also
welcome.
Thank
you.
Everyone
could
I
at
this
point
just
let
you
know
that
just
in
case
I
lose
any
connection.
The
board
has
nominated
councillor
latte,
who
will
take
over
from
myself
if
that
happens.
So
thank
you
very
much.
Council
latte
right
we're
going
straight
to
the
agenda
now
agenda,
one
declarations
of
disposable,
peculiary
interests.
Can
I
now
invite
invite
board
members
to
declare
any
disclosable
petinary
interest?
Have
we
got
any.
A
Okay,
I
take
your
silence
as
a
note.
Thank
you
very
much.
Draft
minutes
of
adults,
health
and
active
lifestyle
scrutiny
board
meeting
was
taken
on
the
16th
of
march
2021
and
has
been
provided
for
information
purposes
only.
These
are
to
be
formally
approved
at
the
next
formal
public
meeting.
However,
if
there
are
any
issues
stemming
from
these
minutes
that
members
would
like
to
raise
at
this
point,
then
please
do.
A
G
Thank
you
chair,
so
in
relation
to
item
three,
this
report
provides
guidance
to
the
scrutiny
board
when
seeking
to
appoint
co-opted
members,
so
the
scrutiny
goal
procedurals
within
the
constitution
outlines
the
options
available
to
all
scrutiny
boards
in
relation
to
appointing
corrupted
members.
The
appointment
of
non-voting
co-opted
members
to
represent
the
voice.
Patients
and
service
users
has
been
a
long-standing
approach
adopted
by
this
particular
scrutiny
board
and
since
2014,
the
board
has
appointed
a
long-standing
non-voting
co-opted.
Member
representative
from
healthwatch
leads.
G
This
organization
again
welcomes
such
arrangements
to
continue
this
municipal
year
and
as
such,
we've
again
identified.
The
chair
of
healthwatch
leads
dr
john
beale
as
its
nominated
representative,
so
this
approach
itself
doesn't
preclude
the
appointment
of
any
further
non-voting
co-opted
members,
and
so
the
views
of
board
members
are
being
sought
today
in
terms
of
whether
to
explore
representation
from
other
potential
areas
too,
either
as
a
standing,
co-opted
member
or
in
terms
of
alternative
options
available
to
the
board.
G
For
example,
the
board
may
wish
to
consider
a
more
ad
hoc
approach
in
terms
of
the
appointment
of
prompted
members
linked
to
a
particular
scrutiny
inquiry
where
organizations
would
be
able
to
nominate
a
representative
best
suited
for
that
specific
purpose.
So
the
views
of
board
members
during
today's
meeting
will
be
used
to
inform
a
decision
on
the
appointment
of
court
members
at
the
board's
next
formal
meeting.
So
I'll
pass
back
to
you
now
to
discuss
this
further.
A
A
G
G
G
So
it's
therefore
proposed
that
similar
arrangements
are
established
again
for
this
municipal
year
and
so
draft
terms
of
reference
surrounding
the
health
service
developments
working
group
are
attached
to
this
report
for
members,
consideration
and
again,
the
views
of
members
today
will
inform
the
position
for
approval
at
the
board's
next
formal
meeting
in
relation
to
joint
health
scrutiny.
Local
authorities
are
also
required
to
appoint
mandatory
joint
health
scrutiny
committees
where
nhs
bodies
need
to
consult
more
than
one
local
authority's
health
scrutiny
function
about
substantial
proposal.
G
But
I
would
like
to
draw
a
particular
attention
to
the
existing
west
yorkshire
joint
health
scrutiny
committee
that
was
established
back
in
november
2015,
as
a
discretionary
committee
often
referred
to
as
the
josque.
So
the
jos
primarily
maintains
oversight
for
developing
west
yorkshire
and
harrogate
health
and
care
partnership
across
a
range
of
program,
areas
and
other
matters,
and
more
recently
the
josque
has
been
working
with
the
partnership
to
consider
the
potential
impact
of
new
legislative
proposals.
That's
linked
to
the
forthcoming
health
and
care
bill
and
we'll
be
maintaining
an
overview
of
this.
G
As
proposals
for
the
new
integrated
care
system
for
west
yorkshire
has
continued
to
be
developed,
which
is
also
also
includes
a
key
focus
around
what
the
potential
future
of
the
role
of
scrutiny
will
be
as
part
of
that
system
too.
So,
while
this
scrutiny
board
will
be
kept
up
to
date
on
the
work
undertaken
by
josk,
it
doesn't
preclude
it
from
undertaking
its
own
work
on
key
matters
such
as
the
forthcoming
legislative
changes,
and
should
he
wish
to
do
so.
G
G
So
members
are
there
for
us
to
consider
the
board's
representatives
on
joss
for
this
municipal
year,
while
also
recognising
that
such
arrangements
may
well
be
subject
to
further
review
linked
to
the,
as
I
say,
the
legislative
proposals
in
the
forthcoming
health
and
care
bill.
So
the
views
of
members
of
today's
meeting
regarding
representation
on
just
will
inform
the
position
for
approval
at
the
board's
next
formal
meeting
so
again,
I'll
pass
that
to
you,
chair
for
discussion
on
those
two
particular
areas.
A
G
A
G
A
A
Okay
board
members:
are
we
happy
to
have
counselor
letty
and
myself
from
the
just
board?
Is
that
thumbs
up?
Sorry,
you
see
with
online
meetings.
If
we
don't,
if
you
don't
show
me
the
hands
off
of
the
eyes,
it's
very
difficult
to
know
what
you're
thinking
so
a
thumbs
up
will
always
be
great
for
me
to
know
that
you're
we're
all
together.
So
thank
you
very
much
so
yeah
house,
loletti
and
myself
are
delighted
to
serve
again
for
another
year
on
the
just
forward.
Angela.
A
A
Thank
you,
chad,
okay,
excellent
right,
so
moving
on
to
the
report,
we're
going
to
go
into
item
six,
which
is
sources
of
work
for
around
the
scrutiny
board.
This
report
provides
information
and
guidance
on
potential
sources
of
work
and
areas
of
priority
within
the
world's
term
of
reference.
Members
are
asked
to
consider
this
information
when
discussing
potential
areas
of
scrutiny
work
for
the
forthcoming
municipal
year.
It
has
been
custom
for
relevant
directors
and
executive
board
members
to
share
their
views
and
to
contribute
to
the
board's
discussions
surrounding
potential
areas
of
scrutiny
board.
A
Given
that
this
board
does
include
the
council's
statutory
health
scrutiny
function,
an
invitation
was
also
extended
to
senior
representatives
of
local
nhs
organizations
to
provide
an
opportunity
for
them
to
also
share
their
views
and
contribute
to
the
board's
discussion.
I
will
now
invite
all
participants
to
kindly
introduce
themselves,
and
I
will
start
with
council
venner.
H
I
A
Excellent,
thank
you
and
you're
welcome
right.
I
will
now
invite
our
executive
members
to
firstly
provide
an
overview
of
their
key
priorities
for
the
forthcoming
year
and
to
share
their
views
on
where
scrutiny
could
potentially
add
value.
So
I
will
pass
that
I
will
pass
now
to
council
vanna
and
you
all
have
got
five
minutes
each.
If
you
don't
mind,
okay,.
H
H
It
is
starting
to
be
seen
now
in
terms
of
increased
demand,
in
particular
parts
of
the
system
like
at
the
front
door
and
a
huge
increase
in
in
demands
for
home
care.
So
my
suggestion
will
be
that
we
do
a
regular
report.
We've
done
it
quarterly
on
children's
scrutiny
right
through
the
pandemic,
in
terms
of
a
report
on
them
of
the
impact
of
covered
on
different
parts
of
the
children's
directorate.
So
my
suggestion
will
be
that
you
get
a
regular,
ie,
quarterly
or
six
monthly
report
on
the
ongoing
impact
of
coverage.
H
That's
what
I'm
suggesting,
if
you
did
want
to
look
at
marmot
and
how
we
do
build
back
pharah.
It
might
make
sense
to
that
joint
jointly
with
children's
another
area.
I
don't.
I
think
this
might
have
been
looked
at
previously,
but
in
this
scrutiny
board
before
I
was
exec
board
member.
But
transitions
is
a
priority
for
the
city
at
the
moment.
It's
a
priority
in
the
future
in
mind,
strategy,
which
is
the
children,
young,
people's
mental
health
and
well-being
strategy,
and
it's
also
priority
in
the
all-age
mental
health
strategy.
H
In
that
context,
it's
looking
primarily
at
transitions
between
cams
and
adult
mental
health
services,
which
I
think
this
board
has
looked
at
previously,
but
I've
I've
become
aware
that
it's
equally
challenging
for
parents
of
children
with
disabilities
and
additional
needs
transitioning
from
children's
to
adult
services.
So
there
is
quite
a
lot
of
work
happening
anyway
in
the
city
around
transitions.
H
And
finally
I
mean
this.
This
could
be
very
much
linked
to
the
impact
of
covid
there's
the
issues
around
the
backlogs
in
the
nhs
in
terms
of
treatment
and
whether
you
wanted
to
look
at
that
and
the
impact
I
mean.
I
know
healthwatch
have
recently
done
a
survey
about
the
impact
on
individuals
of
waiting
for
appointments
and
waiting
for
care
and
treatment.
So
I
don't
know
if
you
want
to
consider
that
as
well.
So
those
are
my
suggestions
in
terms
of
areas.
H
A
B
B
H
So
that's
the
other
thing
we're
consulting
on
and
again
for
the
people
that
would
affect
that
would
be
financially
assessed.
The
consultation
is
just
starting
this
week
and
it's
for
two
months
until
august
and
after
that
a
report
would
go
to
executive
boards
with
the
outcome
of
that
consultation,
I
don't
know
cath.
If
there
was
any.
I
don't.
I
don't
know
if
there's
a
plan
at
any
point
to
bring
that
to
scrutiny.
J
It's
not
scheduled
to
come
to
scrutiny,
but
if
scrutiny
board
members
wanted
to
comment
on
the
process,
we
would
be
happy
to
receive
any
feedback.
If
you,
if
there's
things,
we
could
do
to
enhance
the
consultation
process
we're
going
through
and
obviously,
if
it,
when
it
goes
to
executive
board
and
decision
is
made.
There
is
the
ability
to
call
it
in
as
well.
H
No,
so
I
didn't
mean
to
interrupt
you,
the
documents
I've
sent
out.
They
are
very
comprehensive
in
terms
of
those
covering
email
from
me.
This
is
control
members
today
and
then
there's
a
leaflet.
That
is
what
will
go
to
people
who
are
in
receipt
services,
which
is
really
clear.
It's
deliberately
written
to
be
obviously
understandable.
People
who've
got
care
needs
and
there
are
a
number
of
different
ways.
People
can
contribute
to
the
consultation
and
we've
involved
different
organizations
like
anthonette,
for
example,
just
to
directly
support
people
who
may
be
affected.
H
It
affects
a
relatively
limited
number
of
people
in
terms
of
the
people
that
currently
have
two
carers,
but
only
charge
for
one
and
people.
You
know
yeah
and
people
who
are
paying
the
up
to
the
cap,
but
the
information
is
going
out
to
all
people
in
receipt
of
non-residential
social
care.
So
it's
quite
a
wide
consultation
to
get
a
lot
of
different
people's
views,
even
though
it
affects
a
relatively
small
number
of.
C
C
A
B
Thanks
chad,
thank
you,
councillor
venna,
yes,
within
the
areas
of
the
covid
impact
and
health
inequalities.
The
other
group
that
I
would
like
to
add
is
people
with
learning
disabilities
into
that,
and
also
separate
from
that
and
more
both
the
impacts
of
covered
and,
more
generally
and
dental
healthcare
inequalities
around
the
city.
H
Yeah,
sorry,
I
was
just
trying
to
love
you.
Yes,
absolutely.
I
agree
with
the
points
that
have
been
made
in
terms
of
the
impact
of
covid.
One
of
the
things
that
we've
become
aware
of
this
is
as
much
as
a
ward
councillor
as
in
my
executive
board,
role
is
neighborhood
networks
and
other
groups
working
with
older
people
like
leeds
older
people's
forum,
are
raising
huge
concerns
about
the
a
really
large
number
of
older
people.
H
Who've
lost
a
huge
amount
of
mobility
and
confidence
in
the
last
15
months,
because
they've
been
at
home
all
the
time.
So
you
know
people
who
were
doing
their
own
shopping
once
a
week
who
were
getting
that
done.
You
know
by
by
volunteers
or
by
friends
or
neighbours
and
as
a
as
a
result
of
of
needing
to
stay
at
home
because
of
the
pandemic
have
just
lost
yeah,
a
huge
amount
of
confidence
and
mobility,
and
that
feels
it
feels
as
much
of
a
tsunami
as
the
tsunami
in
mental
health
in
adolescence.
H
Obviously,
the
impact
on
care
homes
is
very
much
in
the
news,
and
people
are
aware
of
that.
I
think,
there's
a
kind
of
hidden
impact,
which
is
you
know,
thousands
literally
thousands
of
older
people
who
have
lost
a
lot
of
mobility
and
confidence.
A
really
heartbreaking
thing,
one
of
our
neighborhood
networks
and
kirkster
said,
was
that
last
summer,
when
there
was
a
window
and
they
could
bring
people
back
together
when
they
brought
groups
of
older
people
back
together,
they
couldn't
talk
to
each
other.
H
They'd
literally
lost
the
art
of
conversation,
which
seems
really
heartbreaking
and
staff
had
to
be
much
more
interventionist
in
keeping
conversations
going,
because
people
had
sort
of
almost
got
settled
in
isolation
and
used
to
not
talking
to
anyone.
So
I
think
in
terms
of
both
physical
health
mobility,
isolation,
confidence.
You
know
the
world
looks
really
different.
Going
to
supermarket
now
looks
really
different
and
I
think
that's
a
really
concerning
impact
of
covert
that
we
would
want
to
cover.
H
E
I
I
So
from
my
perspective,
it
was
really
important
that
the
korea
vaccine
got
to
our
communities
and
into
the
heart
of
our
communities
and
and
actually
just
looking
back
and
reflecting
back
over
the
last
few
months,
some
of
the
success
stories-
and
you
know
I
I
was
driving
past
bilal
center
and
even
today
there
was
you
know
that
there
was
cues
and-
and
that
goes
to
show
that
there's
a
lot
of
work
that
normally
parts
of
those
communities
that
we
are
it's
difficult
to
get
into.
We
managed
to
to
to
really
get
into
it.
I
I
You
know
looking
at
some
data
early
this
morning,
the
the
well-being
centers,
the
usage
in
inner
cities
are
very,
very
low,
as
opposed
to
the
more
affluent
areas
and
and
how
we
make
sure
we
build
that
confidence
in
our
communities
to
be
able
to
be
active.
The
pandemic
has
obviously-
and
I'm
sure
this
will
be
mentioned
later-
on.
Inactivity
levels
have
gone
down
in
in
within
the
pandemic
and
that's
something
we
need
to
work
on,
but
fundamentally
going
forward,
it's
it's
for
me.
I
It's
really
important
that
any
work
we
do
in
terms
of
health
inequalities.
We
take
our
communities
with
us
and
we
work
with
them
and
there's
various
different
barriers
and
in
our
communities,
and
it's
important
that
we
learn
from
the
lessons
that
we've
learned
from
the
corbid
vaccine
in
terms
of
going
to
our
community.
So
there's
a
lot
to
do
and
it
will
be
a
challenging
year
as
counselor
and
as
dr
veal
has
said,
but
you
know
I'm
excited
and
I
think
for
me
this
is
a
a
challenge,
but
also
an
opportunity
as
well.
A
J
Priorities
for
the
suggestions
for
scrutiny
board.
I
just
want
my
yes.
Well,
I
think
councillor
venner
covered
a
lot
of
them.
The
the
extra
things
I
would
suggest
is
looking
again
at
the
role
local
care
partnerships
play
as
a
real
building
block
in
the
city
for
health
and
care
to
come
together
and
wide
a
local
government
services
in
terms
of
our
vision
for
the
city
for
health
and
well-being,
they're,
absolutely
key
and
the
other
thing
I
would
possibly
have
a
look
at
as
we
are
refreshing.
J
And
if
we
look
at
our
demography
and
our
aging
population,
do
we
have
the
the
right
housing
strategy
in
the
city
or
housing
with
care
strategy
and
increasingly,
what
are
what
are
the
right
models
of
support
in
terms
of
housing
for
working
age,
adults,
so
we're
very
comfortable
and
confident
with
extra
care.
But
we
don't
do
that
for
working
age,
adults
with
very
valid
reasons,
but
then
what
should
be
the
right
models
and
to
bring
some
sort
of
thinking
and
get
some
challenge
back
from
scrutiny
board
around
that.
J
Otherwise,
I
think,
but
maybe
a
bit
later
on
in
the
year,
you
might
want
to
have
a
look
at
the
liberty
protection
safeguards
that
will
be
introduced
as
legislation
is
changing
and
how
that
is
enacted
and
the
implications
of
that.
So
I
think
that
those
would
be
my
three
suggestions
in
addition
to
what
counselor
bennett
has
suggested.
A
E
Thank
you,
chad.
I
just
want
to
say
thank
you
for
pat
for
raising
lps
and
changeover
from
community
dolls.
I
just
wondered
whether
or
not
it
would
be
the
place
of
this
board
to
have
a
look
at
the
impact
of
that
change
of
legislation
on
our
workforce
and
workflows
and
how
it
will
be
practically
implemented.
K
Thank
you
councillor.
Sorry,
I
was
just
saying
that's
in
my
phone,
so
I
really
echo
the
comments
that
have
been
made
so
far
by
both
councillor
venom
and
council,
arif
and
kath.
I
would
just
maybe
add
a
couple
of
of
additional
comments
to
that
from
my
perspective
and
I
guess
to
to
mirror
the
suggestion
from
council
level
around
looking
into
the
development
of
the
integrated
care
system
and
what
it
means
for
leads
and
we're
also
going
through
a
very
significant
period
of
reform
to
public
health
services.
K
So
public
health,
england,
nationally
and
locally
and
other
parts
of
the
public
health
system
are
going
to
well,
are
already
changing
pretty
fundamentally
so
I
think
it
will
be
useful
to
to
have
scrutiny
and
an
oversight
of
of
that
and
and
how
it
impacts
on
us
as
a
lead
system.
So
I
I'd
certainly
highlight
that
to
the
scrutiny
board.
K
I
guess
it's
it's
helpful
to
make
the
point
that
we
often
we're
often
talking
about
impact
of
covid
in
in
the
past
tense,
and
we
know
that
we're
very
much
still
in
the
present
tense
with
covid.
Certainly
this
week
and
even
beyond
the
now
magical
date
of
the
19th
of
july,
we
still
will
be
living
with
coved.
K
So
I
think
it
feels
important
that,
as
a
scrutiny
board,
there
are
ongoing
conversations
around
how
we
continue
to
respond
and
and
manage
kind
of
life
with
the
virus
and
the
impact
on
health
outcomes
and
health
inequalities,
because
we
know
that
it.
You
know
it
won't
be
in
the
past
tense
for
a
very
long
time
and
also
how
how
that
relates
to
other
infectious
diseases,
how
it
links
in
with
things
like
the
flu
programme,
etc.
K
As
a
council,
and
often
some
of
the
areas
that
are
very
specialized
but
often
quite
overlooked,
are
the
services,
the
clinical
services
that,
as
a
council,
we
commission
and
for
the
people
of
leeds,
which
include
our
sexual
health
services,
both
in
the
hospital
community,
trust
and
primary
care,
other
services,
health
checks
and
other
services
in
primary
care,
gp
practices
and
also
the
health
visitor
school
nursing
up
to
19
service,
which
is
which
are
critical
nhs
services.
But
they
are
commissioned
by
ourselves
as
a
as
a
public
health
service
of
the
council.
K
So
just
to
be,
it
would
feel
useful
to
have
an
interest
in
how
that
how
those
services
can
be
further
developed.
Given
all
the
changes
we
have
in
the
system
to
ensure
that
we're.
You
know
providing
the
best
services
for
the
people
of
leeds,
so
they
would
be
my
kind
of
three
additions
to
the
conversation.
A
D
Yes,
you
you,
in
the
in
the
last
sort
of
a
little
bit,
you
did
victoria,
you
mentioned
health
checks
and
in
the
pre-meet
we
did
discuss
the
reports
that
had
come
through
with
regard
to
access,
post,
covid
or
or
the
new,
the
new
normal,
as
they
say,
to
gps
and
to
services
in
hospitals.
There
are
huge
waiting
lists.
D
There
are
lots
of
people
who
haven't
been
seen
or
potentially
should
have
been
seen
by
their
gp
and
on
page
134
of
the
thing
it
actually
gives
a
doom
laden
scenario
of
premature
death
in
future
years
through
lack
of
delivery
by
gp
practices,
especially
down
to
the
health
checks.
So
I
think
that,
with
regard
to
covid
access
to
services,
be
it
dental
services
and
so
on
the
inequalities
of
opportunity
to
visit
your
gps
in
different
communities,
etc.
I
think
that's,
maybe
something
we
can
look
at.
A
A
K
D
I'm
quite
happy
to
leave
it
victoria.
It's
just
you
were
talking
about
that
in
your
report,
and
it
is
something
that
I
I
personally
would
like
to
look
at,
how
we're
going
to
re-engage
with
those
services
as
part
of
our
workload
going
forward.
So
it
just
seems
like
an
opportune
moment
to
mention
it.
Yes,.
E
As
councillor
arief
has
pointed
out,
there's
a
differential
impact
in
that
and
we
do
recognize.
There's
a
real
need
to
make
sure
that
quite
a
lot
of
effort
and
a
lot
of
focus
is
on
those
areas
with
the
greatest
inequalities.
And
that's
probably
what
I'd
suggest
was.
Oh
sorry,
sorry
about
that.
I
seem
to
turn
my
video
off
halfway
through
there
and
that's
probably
what
I'd
suggest
was
the
key
priority
for
active
leads
in
in
relation
to
the
board.
B
E
Phil
and
kaiser
aretha
kind
of
covered
the
main
priorities
really
for
active
leads,
and
that
kind
of
needs
to
consider
it
again.
It's
clear
that
the
inequalities
in
terms
of
physical
activity
and
as
we
kind
of
talk
on
the
performance
report
in
the
next
part,
is
we
really
do
have
to
kind
of
address
those
kind
of
intercourses
that
have
existed
over
this
covered
time
and
how
we
kind
of
move
forward
on
that
is
going
to
be
really
important
that
we
kind
of
start
to
address
some
of
those,
but
again
as
phil
kind
of
outlined.
E
A
L
Thank
you.
A
lot
of
what
I
was
going
to
say
is
already
being
covered,
as
I've
had,
which
is
good,
because
that
sounds
like
we've
joined
up
system,
but
I
I
suppose
what
I'll
do
is
I'll
just
set
out
a
few
of
our
priorities
and
then
perhaps
make
suggestions
as
we
go
through
around
where
within
that
there
might
be
specific
focuses
from
the
scrutiny
committee
and
point
of
view.
L
So
I
suppose
I
think
it's
pretty
worth
saying
right
at
the
beginning,
there's
not
a
huge
amount
of
major
service
reform
planned
if
any,
partly
because
the
nhs
is
running
on
a
very
short-term
set
of
budgets.
So
I
know
the
budget
till
the
end
of
september.
I
have
no
idea
what
my
budget
is
for
the
second
half
of
the
year,
which
makes
that
kind
of
forward
planning
almost
impossible.
L
There
are
some
financial
challenges
in
the
system,
but
we're
confident
we'll
get
through,
certainly
the
first
six
months,
as
I
say
no
idea
about
the
second
six
months,
so
there's
no
no
need
for
sort
of
service
reduction,
type
changes,
but
equally
there
is
no
confidence
to
make
major
service
changes
in
the
opposite
direction,
so
at
the
moment
we're
in
a
little
bit
of
a
stasis
really.
Having
said
that,
we've
also
got
a
huge
amount
going
on
and
a
huge
amount
of
pressure.
L
So
it's
probably
in
some
ways
helpful
that
we
can
focus
on
the
here
and
now
and
not
plan
to
turn
the
world
upside
down
too
much.
So
in
terms
of
the
the
sort
of
key
areas
of
focus,
we've
mentioned
the
legislative
change,
both
the
creation
of
ics's,
I
suppose.
Well,
I've
not
really
heard.
I
think
it's
really
important.
L
It
comes
directly
through
the
ccg
which
won't
be
here
next
year,
so
we
need
to
make
sure
we've
got
the
right
structures
at
the
right
degree
of
transparency
and
independence
and
scrutiny
of
that
process
of
processes
and
about
how
that
money
is
utilized
and
allocated.
So
that's
certainly
one
area,
that's
quite
large
on
our
agenda.
I
think
much
of
the
local
change
within
that
legislation
is
really
helpful.
The
timing
of
it
is
not,
but
that
is
where
we
are
at
the
moment
in
terms
of
services.
L
A
lot
of
this
is
really
about
covid.
The
pressure
on
the
same
day,
services
in
the
system
is
huge.
I'm
sure
I
might
get
some
questions
around
primary
care,
I'm
very
happy
to
discuss,
but
I
I
would
focus
I
would
think
broader
than
just
whether
it's
gps
or
a
e
front
door,
it's
really
a
same-day
response.
L
L
Another
thing
that's
already
been
mentioned
is
around
the
sort
of
plan,
the
care
and
the
backlogs
backlogs
in
primary
care
around
things
like
screening,
but
also
backlogs
clearly
in
elective
surgery.
Those
are
going
to
test
us,
probably
certainly
in
the
latter,
for
a
few
years
to
come
within
both
those.
I
do
wonder
and
would
appreciate,
probably
a
focus
through
a
health
inequality
lens
are.
Are
these
challenges
that
we're
facing
in
terms
of
immediate
demand
and
backlog
worsening
or
or
yeah?
Are
they
worsening
our
health
inequalities
and
in
what
way?
L
And
what
are
we
doing
as
a
service
to
and
adjust
as
best?
We
can
to
that?
The
third
area
really
to
mention
is
around
mental
health,
just
as
everywhere
else
is
seeing
increased
demands.
We're
seeing
that
there
really
pleased
about
the
suggestion
around
transitions.
One
of
the
pieces
of
work
that
we've
set
up
to
test
the
value
of
working
in
more
integrated
ways
at
a
sort
of
structural
level
is
a
set
of
programs.
L
Development
projects
which
will
sort
of
intensive
oversight
of
them,
and
one
of
those
is
the
transitions
between
cams
and
adult
mental
health
services.
So
I
think
that
that
is
absolutely
an
area
where
we
might
want
to
focus.
There
are
other
other
areas,
we're
seeing
around
mental
health
and
demand,
particularly
in
crisis,
so
again
that
same
day
aspect,
but
also
things
like
eating
disorders.
So
there's
some
real
challenges
in
those
areas
as
well,
which
you
might
want
to
take
a
look
at
two
other
two
other
areas.
L
Possibly
cath's
already
mentioned
local
care
partnerships
and
the
role
they're
playing
they've
carried
on
running
and
working
throughout
this
pandemic
really
effectively
in
many
ways
contributing
both
to
our
direct
pandemic
response,
but
also,
I
think,
building
a
sort
of
strong
basis
for
future
development.
So
that's
something
we
wouldn't
want
to
lose
sight
of,
and
then
finally,
on
this
really,
I
would
we
just
had
another
announcement
about
more
funding
coming
in
for
long
covert.
So
these
are
people
who
have
particular
complications.
L
Having
had
covered
we've
got
so
well,
I
think
almost
I'd
say
a
world
beating
service
in
leeds,
at
least
that's
what
we'd
like
to
think,
but
that's
going
to
need
to
be
developed
and
maintained
over
a
number
of
years
at
the
very
least,
and
is
something
that
we
would
be
focused
on
in
terms
of
its
development
over
this
next
12
months.
So
those
are
sort
of
some
of
the
quick
cover
of
the
highlights.
L
I
think
the
dental
inequalities
one
is
really
interesting,
because
dental
funding
is
controlled
outside
of
leeds.
At
the
moment.
Many
of
you
may
well
have
raised
through
letters
to
me
what's
happening
with
dental
services
and
quite
often
the
answer
is
I'm
trying
to
find
out
from
nhs
england
because
I'm
not
quite
sure
there
are
conversations
going
on
at
west
yorkshire.
L
If
I,
if
I
was
to
say
anything,
I
might
suggest
that
might
be
something
that
joss
might
want
to
look
at,
because
dental
services
tend
to
be
commissioned
at
a
broader
level
than
just
in
leeds
and
certainly
the
moment
as
a
ccg.
We
have
no
commissioning
function
for
and
responsibility
directly
for
dental
services,
but
I
know
they
are
a
considerable
problem.
L
I
don't
think
I'll
say
more
than
that.
I'm
very
happy
I've
just
given
some
facts
and
figures
around
the
situation
in
primary
care
which
which
may
prove
useful,
but
I
don't
always
rather
just
give
you
those
highlights
of
where
our
priorities
are
and
some
hints
about
what
you
might
want
to
be
looking
at
this
year.
A
Thank
you
very
much
tim
and
priorities
sound,
very,
very
spot
on
from
our
previous
discussion
as
well,
and
obviously,
for
me
long
covered
from
what
we
can
see
right
now
is
something
that's
coming
through
with
lots
of
reports
and
lots
of
people,
not
knowing
exactly
why
that
is
so
good
research
and
where
we
are
with.
That
will
be
very,
very,
very
helpful.
So
I
am
happy
to
take
questions
as
well
from
what
team
has
just
outlined
to
us.
Dr
bill.
C
I'm
sure
tim
riley
would
put
me
right
there,
but
I
did
suggest
at
that
meeting
that
we
set
up
a
working
group
to
look
at
access
to
dental
care
across
west,
yorkshire
and
harrogate,
and
that
group
has
now
been
formed.
I
am
a
member
of
it,
so
I'm
very
happy
to
keep
members
scrutiny
board
up
to
date
with
what
we're
finding.
D
D
You
know
you
get
discharged
at
10
or
your
doctor
tells
you
you
can
leave
at
10
o'clock
in
the
morning
and
you're
still
waiting
at
six
o'clock
for
your
tablets
to
turn
up
in
your
bed.
Often
well.
You
are
at
the
moment
because
I
understand
that
the
suites,
where
you
would
normally
sit,
is
closed.
But
you
know
the
pharmacy
service
does
seem
to
cause
a
bit
of
a
backlog
in
discharging
patients,
and
I'm
just
wondering
whether
that
is
something
and
obviously
it
seems
quite
minor
when
we're
talking
about
such
huge
issues.
D
L
Yeah,
sorry,
I'm
struggling
to
hear
rob
rob
newton
may
want
to
comment
as
well.
I
think
really
supportive
of
the
dental
piece,
absolutely
that's
where
it
should
be
sat
and,
interestingly,
they
came
back
to
all
the
places
and
asked
for
contributions
from
the
places
around
the
dental
pieces,
as
if
we
did
have
those
people
doing
that
work.
L
And
what
I
think
we
would
all
say
collectively
is
is
two
things
one
every
part
of
the
system
knows
it
could
and
should
continue
in
an
improvement
journey,
and,
secondly,
every
single
part
of
the
system
and
some
of
the
delays
and
so
on
are
very,
very
interconnected
and
so
to
talk
about
one
aspect
in
isolation
doesn't
really
solve.
It
sometimes
creates
additional
problems
further
around
the
system.
L
So
there
is
a
group
and
sam
as
well
may
well
want
to
talk
about
this
because
she's
involved,
if
need
be
on
that
the
piece
around
discharge
and
flow
to
refer
to
its
flow,
because
it's
more
than
just
the
moment
of
discharge.
It's
the
whole
setting
in
terms
of
the
community
as
well
as
what's
happening
in
the
hospital
and
and
the
connections
between
the
two.
But
but
yes,
we're
we're
aware
of
a
number
of
multiple
issues
that
will
need
to
be
continually
worked
on.
D
Just
come
come
back
on
that
chair
because,
as
many
of
you
will
know,
I
was
in
hospital
myself
in
january,
undergoing
cancer
surgery,
and
three
of
us
were
in
in
the
same
ward
and
all
three
of
us,
it
was
a
ward
of
six
beds.
Three
of
us
were
in
a
similar
position
of
having
to
wait
an
awfully
long
time
and
at
a
time
when
you
just
know,
people
are
desperate
to
have
surgery
and
get
into
hospital.
D
That
seemed
to
be
the
one
thing
that
we
could
put
our
hands
up
and
say:
it's
happened
to
us
because
we
were
all
waiting
to
get
our
meds
to
actually
leave
and
the
more
people
I
talk
to
the
more
that
is
mentioned
again
and
again.
So
I
can
quite
understand
him
saying:
yes,
it's
a
matter
of
flow
and
often
with
older
people.
You've
got
to
get
care
in
place
and
all
sorts
of
things,
and
maybe
it
isn't
for
this
particular
scrutiny
board
to
look
at
this
particular
time.
D
A
F
M
Thinking
of
discharge,
just
specifically
within
the
host
like
within
the
hospital
timeliness
of
medication,
would
is,
is
big
on
our
list,
amongst
other
things,
but
it's
an
important
issue
and
there's
been
a
lot
there's
a
lot
of
focus
on
it
for
us
as
an
organization
on
two
parts,
really,
firstly,
in
our
how
we
use
our
quality
improvement
method.
So
there's
a
a
lot
of
improvement
of
pro.
We
continually
trying
to
improve
our
our
processes
and
then.
Secondly,
it's
just
from
a
technological
point
of
view.
M
There's
been
quite
a
lot
of
upgrades
in
terms
of
the
automation
of
some
of
our
pharmacy
services
internally.
To
make
sure
the
medications
are
provided
in
a
more
timely
way,
so
yeah,
I
would
I'd
echo
both
things
both
that
it's
a
it's
a
it's
an
important
thing.
It
does
cause
backlogs
within
the
trust
and
it's
an
important
thing
within
the
wider
and
discharge
and
flow
issues
that
we
have
across
the
system.
A
Okay,
excellent,
thank
you
very
much
as
long
as
you
all
know
that
these
are
issues
that
we
would
like
to
discuss
as
the
year
goes
on
and
have
people
further
information
as
people
along
with
the
year.
So
I
would
now
call
on
sarah
monroe.
Sarah
are
you
here
now
you
were
not
here
when
we
did
the
introduction.
So
could
you
kind
of
introduce
yourself.
N
So
later
this
year
we
will
be
opening
at
the
st
mary's
hospital
site
in
armley,
a
brand
new
22-bedded
child
and
adolescent
inpatient
unit,
which
will
be
16,
general
adolescent
beds
and
six
psychiatric
intensive
care
beds.
So
a
big
step
forward
in
terms
of
capacity
for
west
yorkshire,
but
with
all
things
considered
and
especially
the
covered
impact,
and
I'm
sure
some
will
be
able
to
share
more
around
the
pressures
that
are
being
seen
in
community
cams.
N
Demand
is
certainly
on
the
increase,
similar
themes
in
terms
of
the
impact
from
mental
health
and
ld
point
of
view
that
others
have
shared
the
code
impact
in
terms
of
increased
demand,
backlog
in
some
of
our
diagnostic
services
and
the
challenge
within
our
inpatient.
Environments
of
meeting
coverage.
Requirements
for
cohorting
isolation
and
management
of
an
outbreak
means
that
we
do
anticipate
an
ongoing
increased
likelihood
of
some
people
needing
to
go
out
of
area
for
inpatient
stay
simply
because
we
won't
have
sufficient
inpatient
capacity
within
leads
and
we're
not
on
our
own
in
that
situation.
N
So
that's
another
piece
of
work
for
us
a
couple
of
other
areas,
I'll
share
so
as
part
of
us
changing
our
model
of
provision,
especially
within
our
community-based
services,
and
using
more
digital
and
virtual
means
of
offering
alternatives.
We
do
do
a
significant
amount
still
face
to
face,
because
it's
right
and
proper
to
do
so.
N
What's
really
important
for
us
is
the
whole
issue
around
digital
poverty
and
inclusion
and
working
with
partners
to
make
sure
that
we
don't
create
any
unintended
access
issues
on
the
theme
of
access.
We
continue
to
be
part
of
again
with
many
colleagues
sat
around
this
table
at
what's
called
the
synergy
collaborative
so
those
of
you
that
aren't
aware
of
that.
That's
work
that
we've
been
doing
with
with
public
health,
with
the
ccg
with
pramica
and
many
other
colleagues
on.
N
How
do
we
really
fix
in
the
best
ways
of
working
in
an
integrated
way
and
learn
the
lessons
of
where
it's
gone
well
and
where
it's
not
gone
so
well,
so
I'll
pause
there
in
case
there's
any
questions,
then
apologies.
If,
once
I've
answered
the
questions
chair,
I
will
need
to
to
leave
to
go
to
this
next
meeting.
A
F
You're,
muted,
yes
I'll
do
my
best
to
answer
sarah's
questions,
but
we
might
need
to
go
back
back
to
her.
So
I
think
one
of
the
things
I
was
going
to
say
as
part
of
my
priorities
was
the
just
to
note
just
the
surge
that
we've
had
in
referrals
for
both
the
cams
service
and
the
lease
mental
well-being
service
and
and
how
we
prepare
ourselves
to
make
sure
that
we
can
meet
that
need.
So
it
echoes
and
what
sarah
said
really.
A
M
M
M
There
is
across
the
system
about
the
undiagnosed
health
needs
people
that
may
have
been
otherwise
been
picked
up
at
screening
or
being
see
their
gp
or
other
things.
So
that's
still
a
big
unknown
for
us.
You
know
continually
we'll
we'll
yeah
we'll.
We
will
see
continued
sort
of
more
late
presentation
of
illness
in
the
hospital
that
otherwise
would
have
been
managed
better
earlier
on
and
then
also
in
that
planned
care.
Elective
care
is,
is
it
perhaps
people's
experiences
of
so
we've
established
lots
more
digital
services?
M
M
So
so
the
estate
challenges
and
the
reconfigurations
as
well,
of
sort
of
restoring
our
services
and
yeah
bringing
services
the
longer
term
home
for
some
of
our
services
and
then
obviously
within
that
is
this
is
perhaps
more
longer
term.
But
but
current
as
well
is,
is
our
new
hospitals,
the
lgi
and
the
new
pathology
laboratory
at
austin
james's
site.
M
So
we
are
next
week
going
to
be
launching
the
the
new,
the
some
of
the
new
designs
for
that
hospital
and
they'll,
be
obviously
scrutiny
board
have
been
involved
in
a
maternity
consultation.
There'll
be
there'll,
be
more
more
things
to
do
with
that
huge
project
over
the
coming
years.
So
that's
that's
the
state,
thinking
practically
and
then
then.
Fourthly,
and
lastly,
is
just
some
of
our
strategic
considerations.
M
And
then
our
you
know
ongoing
challenges
about
that
brought
from
democratic
demographic
changes.
Our
workforce
pressures,
all
those
things
that
that
have
been
on
our
minds
and
in
our
strategy,
but
covid
is
amplified
and
and
made
even
more
important
as
if
they
weren't
important
beforehand
and
then
two
more
things
within
that
wider
strategy.
Piece
we've
not
mentioned
this
yet,
but
really
important
for
us
to
trust
is
our.
M
So
last
year
we
launched
our
green
plan
looking
at
the
impact
of
the
the
impact
of
the
trust
on
the
green
agenda
and
sustainability
and
loads
of
things
within
there,
and
also
our
role
as
a
big
employer
and
and
spender
of
of
public
money.
As
an
anchor
institution
as
well,
perhaps
is
of
relevance
and
then
finally,.
M
Our
lessons
learned
from
covid
and
implementing
our
you
know,
new
ways
of
working
and
whatever
the
new
normal
is
from
covid
the
way
that
people
access
our
services
and
also
the
way
that
we
manage
our
services
beyond
a
pandemic
as
we
go
into
the
endemic
stage
of
covid.
That's
a
very
long
list,
but
they're
they're,
some
of
the
things
that
are
important
to
us
as
the
trust,
I'm
sure.
There's
things
I've
left
off
as
well.
A
F
Thank
you
very
much,
and
so
there's
a
significant
overlap
with
previous
contributors,
but
four
areas
from
me
and
there's
effects
of
covered
so
in
terms
of
backlog,
but
also,
as
I
said
previously,
about
the
surge
this.
The
services
that
we're
seeing
with
additional
demand
because
of
pent-up
demand
and
changes
in
circumstances
and
I've
also
put
in
in
that
in
that
area
and
talking
about
the
community
long
covered
rehabilitation
service-
that's
just
newly
established
in
the
last
year
and
where
that's
going
and
discussion
on
that
will
be
good.
F
Second
area
is
around
system
resilience?
Are
we
ready
for
a
further
surge
of
covert?
If
that
comes,
are
we
ready
for
winter
and
do
we
know
what
winter
is
going
to
look
like
this
year
and
are
we
prepared,
as
part
of
that,
there's
a
national
initiative
that
we
need
to
implement
this
year
and
that's
around
a
two-hour
response
for
community
services?
F
And
if
we
look
at
the
the
suite
of
data
that
is
collected
at
the
moment,
the
importance
of
community
services
isn't
always
visible,
and
I
think
that
the
introduction
of
the
two-hour
response
target
will
mean
that
community
services
have
a
bigger
profile
as
other
parts
of
the
system.
So
you
may
want
to
understand
about
that.
A
A
Right,
okay,
we
have
two
options
for
the
next
agenda.
We
either
have
a
five
minutes
break
because
we
finished
well
before
the
time
so
well
done
to
everyone.
Who's
been
talking
through
their
priorities
to
us,
they've
done
very
well
and
in
good
timing
as
well.
If
we
can
either
have
a
five
minutes
break
and
come
back
for
performance
update
from
our
exact
members
and
the
directors
or
we
go
straight
into
it
and
finish
earlier,
what
would
we
like
if
you
give
me
a
thumbs
up?
That
means
you
want
five
minutes
break.
A
Right
we're
going
to
continue
fantastic,
okay,
no
problem.
Next,
we
have
performance
update
and
the
report
provides
an
overview
of
outcomes
and
service
performance
related
to
the
council
priorities
and
services
within
the
remedy
scrutiny
board.
The
report
is
presented
in
three
distinct
sections:
reflective
of
council
accountabilities.
These
are
public
health,
adult
social
care
and
active
lifestyle.
A
While
these
are
commonalities
in
how
these
relate
to
the
citizens
of
leeds
the
appendices
are,
in
effect,
district
reports
with
recovery
report
offering
an
introduction.
It
is
therefore
proposed
that
the
board
considers
the
three
distinct
reports
to
help
structure
the
discussions
that
we're
going
to
have
in
the
next
hour.
Have
we
got
peter's
story
in
peter?
Are
you
here.
I
H
Thank
you,
chair
I'll,
just
make
a
few
brief
points
and
then
cass
will
have
more
detail.
Obviously,
the
pandoric's
had
a
really
huge
impact
on
services
and
and
on
the
data
that
that's
been
collected
compared
to
last
year.
Requests
for
support
are
are
down
by
18
for
to
64
year
olds
and
35
for
over
65s,
but,
as
I
mentioned
earlier,
that
that
there
is
at
the
moment,
like
a
particular
demand
in
in
some
places,
including
at
the
front
door.
H
The
overall
number
of
long-term
service
users
in
in
social
care
has
been
broadly
in
line
with
the
previous
year,
with
a
three
percent
increase
in
1864
year
olds
and
a
two
percent
reduction
for
over
65,
the
reduction
in
older
people
is,
is
due
to
a
reduction
in
those
supported
in
care
homes.
That's
been
offset
by
an
increase
in
people
supported
in
the
community,
so
a
feature
of
last
year,
which
was
happening
pre-pandemic
but
was
accelerated
by
the
pandemic,
is
less
older
people
being
supported
in
cairns
and
much
much
increased
demand
for
home
care.
H
The
pandemic
has
prevented
the
gathering
of
surveys
for
the
adult
social
care
outcome,
framework,
metrics
and
they've.
Also
been
changes
during
the
year
in
terms
of
demand
patterns
of
demand,
operation
of
services
trends-
all
that's,
obviously
being
monitored,
but
you
know
you
know
it's
been
an
extraordinary
year
and
and
a
very
challenging
year,
and
that
is
reflected
in
in
the
data
to
end.
On
a
positive
note,
for
me,
it
is
encouraging
that
both
the
employment
and
settled
accommodation
metrics
for
people's
learning
disabilities
have
continued
to
improve,
despite
despite
the
challenges.
K
B
J
J
As
things
picked
up,
we
saw
a
real
change
in
the
pattern
of
of
where
people
chose
to
receive
their
support,
with
a
real
fear
about
going
into
care
home
care.
I
think
some
of
that
was
about
the
restrictions
that
were
in
place
for
families
and
friends
to
be
able
to
visit
so
people
very
much
say
no,
if
at
all
possible,
I
want
to
stay
at
home
because
at
least
that
way
I
know
that
I
can
have
support
from
my
loved
ones.
J
So
we
have
seen
a
marked
diminution
in
the
number
of
people
admitted
to
long-term
care
to
be
supported
in
a
care
home.
An
increase
in
the
number
of
people
who
require
a
home
care
package,
but
also
the
intensity
of
those
home
care
packages
has
been
increasing.
So
the
number
of
people
who
now
have
40
plus
hours
has
gone
up
which,
when
you
think
well
the
alternative
was
they
would
have
gone
into
residential
care.
I'm
not
surprised
by
that
intensity.
J
I
suppose
it
remains
to
be
seen
in
this
year,
whether
any
of
that
settles
back,
but
just
to
give
you
an
idea
of
the
the
sort
of
sheer
numbers
we're
talking
about.
It's
not
in
the
report,
but
the
number
of
excess
deaths
we've
seen
compared
to
2019,
which
would
be
our
sort
of
last
ordinary
year,
was
480
people
now.
Not
all
of
that
may
be
attributed
to
covid,
but
that's
sort
of
how
we
can
measure
the
difference.
J
J
What
was
happening
at
the
hospital
made
a
big
difference
in
terms
of
flows
into
the
enablement
service,
which
was
impacted
both
by
store
shops,
staff
shortages
with
staff
having
to
to
to
isolate.
We
had
staff
off
sick
as
well.
So
not
only
did
we
not
get
the
volume
of
referrals,
but
we
didn't
have
the
staff
group
necessarily
always
to
respond.
J
J
J
We
are
seeing
now
cqc
picking
up
the
pace
on
in-person
inspection,
so
I'm
hoping
over
this
next
12
months.
That
percentage
will
improve
in
terms
of
referrals
for
safeguarding
again
in
that
first
three
months
of
lockdown,
our
referrals
really
dropped,
which
did
worry
us
but
then
come
to
the
summer
months
they
actually
rose
and
they
rose
above
the
2019
baseline
and
what
we
did
see
is
on
screening
those
referrals
that
didn't
then
convert
into
an
increased
volume
of
safeguarding
inquiries.
A
K
K
Obviously,
this
is
this
is
the
the
standard
set
of
indicators
that
we've
previously
brought
to
scrutiny
board,
and
it
is
a
very
small
selection
of
high-level
indicators
for
public
health
outcomes,
which
are
broadly
split
into
the
population
indicators,
which
are
often
more
longer
term.
So
life
expectancy
would
would
come
under
that
and
then
more
operational
indicators
of
how
the
public
health
system
is
delivering
and
which
are
more
kind
of
in
real
time.
K
K
It
does
often
mean
that
we
get
a
figure
that
that
would
be
different
if,
if
we
took
it
down
to
a
very,
very
local
level,
so,
for
example,
for
life
expectancy,
we're
looking
at
just
under
a
five
year
gap
for
our
male
and
female
life
expectancy,
which
is
the
gap
between
leads
as
a
whole
and
that
10
most
deprived
leads.
Obviously,
if
we
took
that
to
a
more
localized,
even
ward
level,
we
would
get
a
greater
difference
in
life
expectancy.
K
So
it's
it's
just
to
highlight
that,
even
though
that
doesn't
seem
as
as
large
as
is
often
described,
it
is
the
difference
between
the
whole
and
that
most
deprived
10.
So
again,
I'm
happy
to
have
that
conversation
with
with
the
board
and
new
members
in
particular
I'll,
just
highlight
a
couple
of
things
from
the
content
and
then
happy
to
take
questions
and
comments
in
terms
of
the
the
the
key
message
for
me
to
relay
to
you
around
the
population,
health
indicators
and
absolutely
in
that.
K
K
K
So
I
just
wanted
to
highlight
to
the
board
that
this
is
very
much
the
baseline
of
where
we
start
the
pandemic
and
obviously,
in
future
scrutiny
of
where
that
figure
goes.
It
will
start
to
give
us
that
longer
term
impact
on
on
that
gap
in
life
expectancy,
so
just
to
pull
that
one
out
and
then
the
last
thing
I
was
going
to
highlight
was
just
pulling
out
a
couple
of
things
from
the
operational
indicators
which
I
know
council
dawson
might
want
to
have
further
conversation
around
the
health
check
one.
K
But
the
report
shows
the
real
difference
in
the
impact
of
the
pandemic
on
the
delivery
of
public
health
services
and
the
nhs
health
check,
and
the
fact
that
that
was
really
thrown
off
course
and
the
the
the
service
was
highly
impacted
by
kovaid,
because
it
is
delivered
through
mainly
through
gps
in
primary
care,
and
we
can
see
that
that's
actually
meant
that
that
service
has
has
delivered.
You
know
much
less
activity
than
than
we
would
expect,
and
there
is
a
plan
to
put
that
back
on
track.
A
B
J
What
I
would
say
in
terms
of
adult
social
care
is
that
we
we've
never
stopped
working
in
social
work.
We
might
have
adapted
the
way
we've
worked,
but
we
still
have
our
rapid
response
teams
working
we're
screening
the
calls-
and
we
do
have
been
going
out
doing
in-person
visits
where,
on
the
on
the
basis
of
the
knowledge
that
we
have,
we
think
there
is
a
risk
toward
the
individual
and
we
need
to
see
them
in
person,
but
I'll
I'll
go
back
to
heads
of
service
and
provide
a
note
following
this
meeting.
J
B
Thanks
chair,
my
question
is
different,
but
I
can
certainly
account
for
the
fact
that
the
services
do
respond
when
there
are
situations
that
are
raised
in
need,
as
has
been
happening
in
my
ward
over
the
last
couple
of
weeks.
So
thank
you
to
the
adult
social
care
team
for
those
responses,
so
my
query
is
regarding
the
the
life
expectancy
inequalities.
B
K
Yes,
of
course,
we
can
certainly
share
the
the
ward
based
life
expectancy,
in
fact,
there's
all
sorts
of
different
ways
of
cutting.
It
now
isn't
the
counselor
coming
and
we
can
do
healthy
life
expectancy
overall
it
so,
but
we'll
certainly
look
at
that
on
award
basis
and
happy
to
either
do
that
as
a
one-off
or
we
can.
We
can
include
that
in
our
in
our
regular
updates.
K
I
think
just
on
the
just
on
the
causes
of
death
as
well.
I
think
certainly,
the
suicide
data
is
included
in
headline
terms
in
the
in
the
report.
Councillor
cunningham
and
it's
it's
broadly
stable.
It's
gone
up
within
the
percentage
for
that.
So
it's
there's
a
there's,
a
slight
overall
rise.
It's
not
statistically
significant.
K
We
are
doing
a
lot
of
work
to
to
look
underneath
that
overall
number
in
terms
of
different
groups
of
people,
either
by
age
or
sex
or
part
of
the
city
as
part
of
the
work
of
the
ongoing
suicide
prevention
partnership
group,
so
yeah
more
than
happy
to
to
share
any
of
that
in
any
detail.
If
that's
helpful.
B
C
Thank
you
chair.
If
I
may,
through
you
a
request
to
kath
roth
in
the
past,
she
has
made
available
the
cqc
figures
for
both
care
homes
and
home
care
on
a
regular
basis,
and
that
has
been
very
useful
but
scrutiny
because
we've
been
able
to
monitor
changes
over
a
period
of
time
and
as
she's
mentioned,
there
had
been
an
improvement
in
the
cqc
ratings
which,
unfortunately,
because
of
copied,
maybe
has
dropped
off.
C
C
They
are
a
reflection
of
what
michael
marmot
found
in
his
10-year
review
published
earlier
last
year.
So
my
question
is
no
one
comment.
First,
I
mean
we
are,
of
course,
trying
to
reduce
reducing
gender
inequalities,
but
that's
by
improving
the
life
expectancy
of
males,
not
by
reducing
it
in
women.
It's
going
in
totally
the
wrong
direction
in
women
from
the
more
deprived
areas.
K
Me
to
come
back
on
that
chair.
Thank
you,
john
thanks
very
much
yeah.
I
think
it.
I
think
it
is
really
important
for
us
to
distinguish
kind
of
pre-covered
trends
and
and
then
impact
of
covert
on
top
of
that
and
you're,
absolutely
right
that
the
the
report
that
professor
michael
marmot
wrote
to
try
to
explain
what
was
happening
with
life
expectancy
for
the
first
time
in
a
hundred
years,
pre-covered
stalling.
K
It
was
a
shame
that
that
report
kind
of
was
published
february
2020
and
was
kind
of
overtaken
by
covid.
So
it
was
overlooked
to
some
degree.
So
I
think
it's
really
important
that
we
don't
lose
sight
of
those
findings
and
because
the
report
that
he
produced
then
was
a
real
analysis
of
10
years
on
from
when
we
first
set
at
the
national
strategy
around
health
inequalities.
K
I'm
sure
you
know
all
this,
but
just
as
a
reminder,
it
was
an
evaluation
of
the
impact
of
all
our
interventions
and
what
had
worked
and
what
hadn't
and
some
of
the
reasons
underneath
it
so
we're
very
keen.
I'm
very
keen-
and
I
know
partners
are
very
keen
to
revisit
that
february.
2020
report.
So
we
don't
lose
the
learning
for
leads,
as
well
as
the
impact
of
covid.
K
We
do
both
at
the
same
time
and,
as
I'm
sure,
you're
aware
the
overarching
findings
of
that
work
that
michael
marmot
led
to
look
at.
Why
have
things
got
worse
over
the
last
10
years,
particularly
for
deprived
women
and
reflect
reflected
so
those
wider
social
and
economic
determinants
more
generally,
and
so
because
the
gap
in
inequalities
generally
in
economic
inequalities
and
people's
kind
of
like
living
conditions
outside
the
health
and
care
system,
and
that
was
seen
to
be
the
the
biggest
single
factor
in
health
inequality.
K
A
C
No
just
to
thank
victoria
for
her
comments
and
saying
there
may
not
be
a
lot.
We
can
do
as
a
scrutiny
board
on
that,
but
we
do
need
to
use
our
influence
both
within
the
city
council
generally,
because
a
number
of
those
policies
are
relevant
to
other
things.
The
city
council
does,
but
also
in
our
discussions
with
people
responsible
on
a
national
basis
with
industry
with
government
and
so
on,
to
improve
those
social
determinants
of
health.
D
Yeah,
I
must
say
I
found
that
last
question
really
really
interesting,
because
health
food,
what
we
eat
and
and
so
on,
all
reflect
in
our
health
in
in
the
long
term,
not
necessarily
how
many
times
you
visit
your
doctor,
albeit
victoria,
I'm
now
going
to
come
on
to
my
favorite
subject,
and
that
is
doctors
are
there
to
pick
up
early
and
to,
I
think
part
of
their
remit.
Now
is
prevention
of
illness
as
well,
by
introducing
anti-smoking
schemes
and
so
on
and
so
forth.
D
So
I
do
think
that
starting
in
some
way
to
try
and
reintroduce
the
health
checks,
face-to-face
health
checks,
I'd
I'd
love
to
know
how
we're
going
to
do
that.
I
mean
I
went
through
a
whole
year
and
never
saw
my
doctor.
I
did
it
all
on
on
my
mobile
phone
point.
It
here
show
me
that,
and
I
could
do
that
because
I
had
the
relevant
equipment,
but
when
you
have
a
digital
divide
such
as
we've
got
in
leeds
people,
some
people
cannot
do
that.
D
So
totally
recognize
all
the
problems
and
and
all
the
issues.
But
we
need
to
get
over
that
as
a
city
and
actually
work
out
how
we're
going
to
get
people
back
into
a
venue
like
their
doctors,
whether
they
see
the
doctor,
the
nurse
or
whoever,
where
people
can
actually
have
a
face-to-face
conversation.
D
Look
at
those
people
in
the
eye
and
see
if
there
are
any
issues.
Because,
often
when
you
go
to
the
doctor,
you
might
go
with
one
thing:
that's
wrong
with
you!
But
really
you
want
to
talk
about
something
completely
different.
That's
worrying
you
and
you
can't
do
that
when
you're
on
a
on
a
five
minute,
digital
conversation
with
your
doctor
so
totally
recognize
some
gp
surgeries
who
want
to
do
it.
Some
won't
but
I'd
love
to
know
what
the
direction
of
travel
is.
D
A
K
Yes,
if
I
could
just
briefly
come
back
chair
and
to
thank
councillor
dowson
for
very
helpful
comments-
and
I
I
agree
with
everything
you've
said
to
councillor
towson,
just
very
briefly-
we
in
leeds
we
we
chose
to-
we
have
a
mandated
function
as
public
health
in
the
council
to
deliver
on
nhs
health
check
checks.
Different
local
authorities
do
that
in
different
ways.
So
not
everybody
does
that
through
gp
practices
and
primary
care
in
leeds,
we
chose
to
to
to
commission
gp
practices.
K
So
we
pay
them
to
do
the
health
checks,
because
we
felt
it
was
the
best
way
of
delivering
a
holistic
service
for
for
our
people.
What
what
what's
happened
in
the
pandemic
is
that
because
the
gps
gps,
have
actually
been
told
centrally
nationally
to
de-prioritize
local
authority,
public
health
commission
services
and
to
prioritize
their
covered
response,
including
vaccination,
which
is
entirely
understandable
and
we
get
and
work
with
them
through
all
of
those
pressures.
K
K
Despite
that
mandate
from
central
government
and
we've
kept
about
a
third
of
them
going
in
the
city,
which
is
nowhere
near
where
we
want
obviously-
and
we
are
working
now
with
every
single
gp
practice-
we
commission
and
the
gp
confederation
to
come
up
with
a
plan
for
not
only
how
they're
going
to
get
back
to
100
delivery,
but
how
they're
going
to
work
through
the
backlog
of
people
they
didn't
cover.
So
we
nee
in
this
next
period
we
need
to.
K
You
know
they
need
to
deliver
more
than
100,
because
it's
picking
up
all
of
the
people
that
haven't
been
picked
up
so
far
and
so
we're
we're.
We
recognize
the
pressure
they're
still
under,
but
we
are.
We
are
kind
of
holding
them
to
account
to
still
have
full
delivery,
because
we're
really
concerned
that
if
we
don't
get
that
early
identification
and
prevention
of
as
rob
was
saying
in
the
hospital
things
that
will
cause
us
more
problems
down
the
line,
it's
in
nobody's
benefits.
So
we
are.
K
D
Now,
thank
you.
Yes,
if
I
could
just
come
back
briefly,
I
think
that
was
absolutely
an
excellent
explanation
of
where
we
are,
and
I
think,
just
as
a
as
a
group
as
a
board,
we
would
potentially
if
it's
agreed
like
to
look
at
what
that
plan
is
going
forward.
So
totally
recognize
the
issues
totally
recognized,
covid,
totally
recognized
where
we
are,
but
where
do
we
go
from
here
to
get
to
where
we
want
to
be?
Is
I
think
what
we'd
like
to
know?
D
F
K
K
So
I
fully
support
that
council
harrington
in
in
terms
of
the
homeless,
population
and
rough
sleepers,
and
also
migrants
to
the
city
in
leeds.
We
do
have
a
service
that
not
everywhere
has
in
that
we
commission,
a
company
called
bevan
healthcare
to
work
specifically
and
with
people
in
these
groups
so
happy
to
bring
something
back
with
more
detail
on
that
and
through
through
covid.
K
A
I
So
in
relation
to
lifestyles
and
the
figures
close
show
that
the
impact
of
the
pandemic
of
the
it
hasn't
increased,
the
inactivity
levels
locally,
but
also
nationally
as
well,
it's
absolutely
essential
and
that
physical
activity
is
at
the
heart
of
the
recovery
process
to
improve
the
overall
health
and
people
in
leads.
Just
a
couple
of
things
that
I
I
want
to
highlight
chair
so
in
terms
of
the
positive
steps
that
were
taken
during
the
panzer
pandemic.
I
Active
leads,
delivered
a
physical
activity
toolkit
to
deprived
areas
and
leads
providing
activities
for
children
to
do
at
home,
such
as
live
gymnastics
sessions
in
the
garden.
We
also
run
outdoor
fitness
classes
running
cycling
activities
as
well
as
targeted
outdoor
classes.
Over
90
000
calls
were
carried
out
two
members
in
all
programs,
with
a
focus
on
contacting
actually
older
age
groups
to
provide
exercise,
advice
and
support,
including
ensuring
that
they
had
access
to
the
essential
equipment
and
check.
I
Staff
have
really
shown
a
significant
amount
of
flexibility
during
this
period.
There's
been
a
real
team,
leads
approach
from
the
service
that
has
redeployed
and
has
been
redeployed
across
the
the
organization
over
the
last
12
months
occurring
rules
as
diverse
as
acting
as
current
marshals
working
at
household
waste.
I
A
Thank
you
very
much
councillor
arif,
and
I
I
cannot.
I
can
only
add
to
that
because
I
I
I
do
on.
I
do
know
in
terms
of
some
sports
centers
around
the
city,
especially
the
sports
center,
where
I
coach,
which
is
the
lead
city,
athletics
club,
and
I
know
how
difficult
it
was
over
the
over
the
last
over
the
last
one
year
really
in
terms
of
trying
to
coach
young
people
with
lots
of
the
centers
being
shot,
and
we
couldn't
just
make
use
of
our
buildings.
A
And
then
we
start
for
two
months
and
then
we
get
shut
down.
And
then
we
come
back
after
that.
And
luckily
it's
been
open
since
the
29th
of
march,
and
I
can't
tell
you
the
excitement
on
the
faces
of
our
young
ones,
just
knowing
that
our
sports
centers
are
are
open
and
obviously
with
with
the
active
life
active
lifestyle
team
and
what
they
have
done
to
make
that
possible.
I
personally
want
to
say
thank
you,
because
that
has
put
a
lot
of
smiles
on
a
lot
of
children's
faces.
D
To
be
here,
sorry
me
again,
I
just
wanted
to
say
a
big
thank
you
to
active
leads,
because,
obviously,
because
I
was
I
had
to
be
at
home
for
so
much,
I
had
really
enjoyed
the
online
classes
that
active
leads,
put
on
and
and
trust
me.
You
probably
see
on
the
screen-
I'm
not
one
of
the
slimmest
people
in
the
world
for
those
of
us
who
are
overweight
for
people,
perhaps
culturally,
who
don't
want
to
mix
with
other
other
sexes
or
whatever,
when
they're
doing
their
exercise.
E
Not
not
really
chair,
but
we're
grateful
for
the
comments
of
members
and
we'll
make
sure
that
the
staff
generally
are
are
informed.
That
members
are
appreciative
of
what's
gone
on,
the
only
thing
I'd
probably
add,
and
it's
not
related
to
the
quarter.
Foreign
end-of-year
position
that's
reported
here
is
just
to
sort
of.
Let
members
know
that
we
still
continue
to
operate
the
services
under
some
restrictions,
so
we
do
have
limited
capacities.
We
do
have
issues
about
access
and
egress
and
ventilation
issues
so
just
bear
with
us.
E
L
E
G
Thank
you
chair,
so
this
report
presents
a
draft
work
schedule
for
this
municipal
year,
which
is
appended
appendix
one
for
the
board's
consideration.
Clearly,
there's
been
a
number
of
suggested
key
areas
that
the
board
may
wish
to
explore
this
year.
Should
members
want
to
drill
down
into
any
of
these
areas
in
detail?
G
That's
been
undertaken
for
that
to
be
made
available
for
this
success
by
early
june,
so
that
board
members
can
determine
appropriate
next
steps.
This
additional
information
has
now
been
circulated
to
board
members
and,
as
such,
it's
now
being
proposed
by
this
board
that
it
utilizes
its
planned
meeting
on
the
5th
of
october
to
consider
the
future
vision
for
stroke
services
and
leads
more
generally
and
in
doing
so,
the
board
will
also
receive,
at
that
point,
an
updated
position
regarding
the
development
of
the
adult,
inpatient
strawberry
evaluation
service
and
the
community
neurological
rehabilitation
service.
G
You'll
also
note,
within
the
work
schedule
appendix
one
that
it
does
set
out
future
meeting
dates
for
this
board.
The
next
meeting
is
scheduled
to
take
place
on
13th
of
july
at
1
30
p.m.
The
status
of
that
particular
meeting
will
be
confirmed
closer
to
the
meeting
date
itself,
but
will
be
made
clear
on
the
council's
website.
G
So,
reflecting
on
all
the
information
that's
being
presented
today,
members
are
now
being
asked
to
consider
if
there
are
any
particular
areas
that
they
would
like
to
prioritize,
and
after
today's
meeting
I'll
then
work
with
the
chair
to
look
at
how
best
we
can
reflect
those
into
the
voice
work
schedule
for
the
forthcoming
year
and
we'll
bring
in
doing
so,
we'll
bring
an
updated
version
of
the
work
schedule
back
to
the
board's
next
meeting.
Thank
you.
A
C
E
C
E
All
right,
yeah,
just
just
a
quick
one-
I
don't
know
if
it
falls
within
the
remit
of
this
committee,
but
obviously
around
leeds.
We
have
some
fantastic
kind
of
third
sector
voluntary
groups
that
pick
up
a
lot
of
the
supplementary
healthcare
work,
whether
it
be
mental
health
or
other
issues.
I
don't
know
if,
if
the
scrutiny
of
that
or
the
understanding,
what
network
exists
across
leeds
sits
within
this
group,
but
I
would
my
own
view
is
that,
with
you
know,
the
stretch
on
gp
services
stretch
on
hospitals
and
the
nhs
in
general?
E
I
think
I
personally
think
there
is
a
bigger
role
within
society
for
groups
that
can
offer
you
know
almost
like
lower
level
kind
of
pre-contact
mental
health
support.
You
know
kind
of
support
groups,
but
also
kind
of
you
know.
Other
groups
that
are
kind
of
for
for
you
know
for
activities,
so
it'd
be
good
to
understand
the
topography
that
exists
already
across
leeds
and
where
there
are
opportunities
to
kind
of
learn
from
what
is
best
practice
and
model
that.
G
Yes,
chad
just
to
explain,
I
know
in
in
terms
of
pieces
of
work
that
we
have
undertaken,
or
this
board's
undertaken
where
we
do
get
the
views
across
the
health
and
social
care
sector.
We
do
very
much
try
and
engage
with
the
third
sector
as
well
so
depending
on
the
obviously
these
areas
that
the
board
wish
to
reflect
in
its
work
schedule.
I'm
quite
happy
to
engage
and
get
the
voice
of
the
third
sector
as
part
of
pieces
of
work
that
this
board
does.
A
Thank
you
very
much
and
councillor
to
also
add
to
that.
I'm
not
sure
we
could
have
survived
as
a
council
without
our
third
sectors
over
the
last
12
13
months.
It's
just
been
unbelievable.
How
helpful,
selfless
and
tireless
our
third
sectors
have
been,
especially
you
know,
just
reaching
out
to
vulnerable
people
from
caring
for
vulnerable
people
from
food
from
donations
from
mental
health,
so
you
know
organizations
just
just
name
them.
Yeah.
E
F
F
So
again
it's
it's
possibly
looking
at
a
list
of
yeah
you,
you
have
a
list
of
the
third
sector
organizations
that
are
dealing
with
issues,
but
how
they
link
into
the
local
care
partnerships
across
the
city.
So
some
some
lcps
are
further
advanced
than
others
in
that
area,
but
certainly
we
are
encouraging
people
from
the
third
sector
organizations
in
our
air
to
actually
be
part
of
the
lcp
process.
F
K
It
was
just
a
quick
comment
to
support
the
comments.
Council
has
just
made
around
third
sector,
and
I
I
I
just
wanted
to
add
that
often
certainly
for
our
public
health
services
across
the
city
they're
very
much
at
the
center
of
delivery,
rather
than
just
supplementary
to
the
to
the
statutory
sec
sector.
So
you
know
many
of
our
public
health
sector.
We,
you
know,
we
we
actively
choose
the
the
third
sector,
as
you
know,
the
best
providers
for
for
what
we
want
to
deliver.
H
So,
whether
that's
you
know,
we've
got
the
power
to
remove
children,
we've
got
the
power
or
the
whole
health
network
has
the
power
to
remove
people's
liberty,
and
we
have
the
power
to
evict
people,
and
the
third
sector
doesn't
have
any
of
those
powers,
and
so
it
doesn't
carry
that
baggage
and
obviously
there's
a
lot
of
historical
issues
as
well
around
structural
oppression.
But
all
of
that
combined
means
that
third
sex
services
can
be
just
much
more
accessible
and
have
much
better
reach
into
communities.
H
A
Right,
okay,
I
just
want
to
say
a
very,
very
huge
thank
you
to
all
of
you.
It's
been
a
long
day
since
some
of
you
have
been
here
since
one
o'clock.
So
thank
you.
What
I
would
like
to
say
now
is:
we
have
listened
to
all
the
various
suggestions,
all
the
areas
of
priorities
that
you
would
like
us
to
consider.
We
will
go
about
myself
and
the
principal
officer
will
come
back
to
you
at
our
next
meeting.
A
You
know
with
the
next
work
schedule
of
what
we
would
be
looking
at
throughout
2021
to
2022,
but
in
the
meantime
you
don't
need
to
wait
until
july.
If
you
have
anything
on
your
any
area
that
you
would
like
us
to
consider,
please
just
send
an
email
through
or
just
pick
up
the
phone
and
just
give
me
a
ring,
and
we
will
do
our
very
best
to
see
what
we
could
do
to
improve
that
onto
our
agenda.
So,
yes
from
all
of
us
on
the
board
for
everyone,
who's
joined
us.
A
Thank
you
very
much
to
all
our
exec
members
for
all
your
own
contributions
and
answering
all
our
questions
to
the
directors
as
well.
We
want
to
say
thank
you
to
we.
We
also
have
dr
jenkins
who's
actually
observing.
Today,
I
believe,
is
that
correct.
So
thank
you
for
joining
us.
Dr
jenkins.
Come
all
the
way
from
seacroft.
That's
really
far
away.
So
thank
you,
dr
jenkins,
councillor
jenkins
for
joining
us,
and
we
also
have
counselor
renshaw
who's
subbing
for
councillor
taylor.