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From YouTube: Leeds City Council - Adults, Health and Active Lifestyles Scrutiny Board - 18th October 2022
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A
Will
be
available
on
the
council's
website
later
so
other
people
can
still
catch
up.
We
have
also
got
a
special
group
of
people
here
today.
I
believe
we've
got
postgraduate
students
from
the
Leeds
back
at
University
and
they're.
Here,
with
their
lecturer
in
politics.
Can
we
see
your
hands
yeah?
Can
you
all
wave
to
them
and
say
welcome
okay,
good
to
see
you
all,
do
I
I,
take
your
also
around
students
in
politics.
Is
that
correct?
A
Oh
public
policy,
excellent,
wonderful
course!
Well,
I
hope
you
enjoy
our
meeting
today
right,
so
I
will
start
with
introductions
and
I
will
start
with
yourself
Council
today.
B
Councilor
James
Gibson
Crossgates
and
win
more
award,
councilor
Mohammed,
Iqbal,
City
consulate
and
Riverside.
He
keeps
changing
names
so
yeah.
D
I
Hi
I'm
cancer,
Salma
I
find
the
executive
member
for
public
health
and
active
Lifestyles.
Thank
you.
K
B
Afternoon,
everyone
Rob
Clayton
scrutiny
advisor
to
the
board
standing
in
for
my
colleague
Angela
today.
A
Thank
you
very
much
board
members
and
all
our
partners
here
today,
exec
members,
as
well
as
directors
of
the
different
services
that
we
have
so
you're,
all
very,
very
welcome
and
a
special
welcome
to
our
former
colleague
as
well.
I,
almost
called
you
counselor
I.
Guess
it's
hard
not
calling
you
that
Rebecca
childhood.
So
it's
great
to
see
you
and
welcome
back
to
council.
So
thank
you
all
for
coming
and
the
rest
of
you
out
there.
Thank
you
very
much
for
joining
us.
F
F
A
A
Thank
you
asking.
If
anybody
has
got
anything
to
say
and
to
approve
that
it's
a
correct
records
of
the
minutes
is
that
a
yes
can
I,
say
smile
and
a
nod.
Thank
you.
Members.
Excellent.
All
right
agenda
item
number,
seven,
local,
ICB,
Arrangement
updates
and
thank
you
to
all
the
partners
who
are
here
so
in
accordance
with
the
Health
and
Care
Act
of
2022
integrated
care
boards.
A
Icb
took
on
the
commissioning
responsibilities
of
clinical
commissioning
groups
from
1st
of
July
2022,
as
well
as
being
tasked
with
leading
the
integration
of
Health
and
Care
Services
across
the
area.
So,
following
the
work
undertaken
last
year,
this
board
agreed
to
maintain
a
watch
and
brief
on
the
evolving
local
ICB
arrangements,
and
today's
meeting
provides
an
opportunity
for
the
scrutiny
board
to
consider
the
latest
position
and
to
just
hear
from
them.
A
It's
really
great
to
see
you
all
today
and
I
have
actually
been
looking
forward
to
this,
because
we
are
Keen
to
hear
updates
about
what
you've
been
doing
and
where
we
all
are
going
with
the
IC
pay.
So
you
have
already
introduced
yourself,
so
I
don't
need
to
tell
you
to
to
do
that.
I'll
just
ask
the
exact
members.
If
any
one
of
you
would
like
to
say
anything
first
before
I
invite
team.
H
Yes,
I'll
I'll
make
some
introductory
comments
and
similar
counselor.
Thank
you
so
so
the
current
health
and
wellbeing
strategies
is
was
initially
from
like
2016
to
2021
and
it
was
extended
to
2023.
H
Obviously,
in
the
last
couple
of
years,
we've
had
other
things
to
attend
to
rather
than
updating
the
health
and
wellbeing
strategy,
so
we're
now
looking
at
developing
the
health
and
well-being
strategy.
Sorry.
H
No,
it's
fine,
I
didn't
have
the
papers
open
in
front
of
me.
I
looked
to
counselor
I
received
her
children's
misfred
what
she
was
reading,
okay,
so
the
integrated
care
board,
so
the
ACT
came
into
being
on
the
1st
of
July
and,
as
members
will
know,
there
was
a
report
that
went
through
general
purposes
committee
and
then
to
full
Council
outlining
the
changes
that
this
meant
for
the
council
Constitution,
which
was
a
bit
of
a
bureaucratic
process
we
had
to
go
to
because
the
changes
were
really
pretty
much.
H
Just
replacing
the
words
clinical
commissioner
group
with
leads
place-based
Committee
of
the
Integrity
care
board,
but
we've
been
through
that
process
and
the
report
today
is
providing
you
with
your
regular
updates
that
you've
had
periodically,
as
we've
been
going
through
this
process
of
the
development
of
the
West
Yorkshire
integrated
care
system
and
the
Leeds
place-based
committee
at
the
integrated
care
board,
and
it's
really
wonderful
to
have
Rebecca
with
us
today.
Who's
the
chair
of
the
Leeds
place-based,
Committee
of
the
ICB
and
from
our
perspective
in
the
council.
H
H
So
the
and
Rebecca
also
sits
on
the
health
and
well-being
board
and
I
think
I've
mentioned
before
at
this
meeting,
that
in
the
legislation
there's
no
formal
link
between
health
and
wellbeing,
boards
and
place-based
committees,
which
is
generally
I,
think
seen
as
a
weakness
in
the
legislation,
and
it's
been
discussed
in
a
number
of
meetings
that
I've
I've,
been
in
so
I
sit
on
the
board
of
Leeds
and
York
partnership,
Foundation
trust
and
we
had
a.
We
had
a
council.
We
had
a
council
have
given
us
meeting
recently
where
we
were
discussing.
H
We
were
discussing
this
that
it
is
generally
seen
as
a
weakness
that
there's
not
a
formal
Link
in
the
legislation.
However,
the
links
are
strong
in
West
Yorkshire
and
in
Leeds.
So
if
you
look
at
all
the
kind
of
diagrams
of
the
new
system,
it's
really
clear
that
in
all
five
places
in
West
Yorkshire,
we
are
seeing
the
role
of
the
health
and
well-being
board
as
very
important.
H
In
setting
G,
which
the
place-based
Committees
will
will
then
deliver
and
all
the
key
players
in
Health
and
Social
care
in
Leeds
sit
on
the
health
and
wellbeing
board.
So
that
includes
all
the
chief
executs
of
all
the
the
trusts
and
kathrov
as
the
director
for
adult
social
care
and
Victoria
is
director
for
public
health
and
there's
people
from
you
know
housewatch
and
third
sector.
So
it's
a
really
representative
board
and
we'll
have
a
key
role
in
delivering
the
health
and
wellbeing
strategy
which
we'll
come
on
to
talk
about
later.
H
At
the
same
time
that
we're
refreshing,
our
Australian
leads,
the
West
Yorkshire
strategy
is
being
is
being
refreshed
as
well,
but
we'll
talk
about
that
when
we
come
on
to
that
item,
but
they're,
just
mine
should
actually
comments
to
him
on
the
the
integrated
care
system.
Thank
you.
A
Thank
you
very
much.
Councilor
Fenner,
okay,
Team
I,
believe
you'll,
be
leading
on
this
presentation.
Is
that
correct
yeah
over
to
you.
E
Thank
you,
and,
and
thanks
for
the
opportunity
to
come
and
speak
about
where
we're
up
to
and
I'm
really
delighted
to
have
Rebecca
here
as
well
and
as
as
the
chair
of
the
leads
Committee
of
the
ICB
I
I,
don't
want
to
say
a
huge
amount,
because
you
have
the
paper
before
you
a
few
things
I'd
just
like
to
pick
up
on
which
councilman
has
just
mentioned,
the
refresh
of
the
West
Yorkshire
strategy.
E
That's
a
requirement
nationally
that
every
ICB
has
a
strategy
in
place
by
the
end
of
this
year.
Lee
West
yorkshire's
had
one
for
a
long
time
already,
and
what
we
see
this
is
is
primarily
an
opportunity
for
a
review
and
a
refresh
rather
than
something
brand
new.
E
That's
positive
for
two
reasons:
one:
it
shows
a
continuity
and
a
commitment
to
long-term
change
and
improvements
across
West
Yorkshire,
including
in
Leeds
and
and
secondly,
I
think,
really,
importantly,
that,
because
that
initial
strategy
was
created
before
icbs
were
a
statutory
function,
it
was
done
with
consent
and
and
partly
and
in
a
partnership
space.
So
I
think
that
continuity
is
really
important
because
it
shows
the
continued
desire
of
West
Yorkshire
to
operate
in
that
kind
of
way.
E
It
is
a
very
inclusive
development
approach,
absolutely
aligning
to
things
like
the
health
and
well-being
board
as
strategy
refresh
and
a
genuine
desire-
and
you
know,
a
number
of
people
from
Leeds
are
working
in
that
space
with
colleagues
from
other
parts
of
West
Yorkshire
to
develop
that,
and
indeed
I
can't
say
for
the
rest
of
the
meeting,
because
that's
where
I'm
going
next
to
the
West
Yorkshire
ICB
board
development
session,
which
is
looking
at
that
strategy.
E
So
that
is
one
really
important
connection.
We
want
to
both
influence
what
is
said
at
West
Yorkshire
in
so
that
when
West
Yorkshire
sets
out
its
strategy,
it
is
those
things
that
we
want
to
deliver
and
really
matter
to
us
as
a
city.
E
Second
thing
I
wanted
to
just
touch
on
is
the
Leeds
ICB
Arrangements,
that's
the
committee
itself
and
its
subcommittees
and
the
sort
of
connections
and
governance,
and-
and
we
mentioned
the
link
to
the
health
and
wellbeing
board.
Those
things
are
all
in
place.
The
committee
has
now
met
a
couple
of
times:
I've
had
a
development
session
and
also
the
subcommittees
are
meeting
and
all
the
positions
are
appointed
to
within
that
I.
Think
really
importantly,
there
are
independent
voices
as
well
as
Rebecca
as
chair.
E
We
have
three
in
and
John
from.
Healthwatch
is
also
on
that
committee.
We
do
have
two
other
independent
voices
as
well:
Yasmine,
Khan
and
Cheryl
Hobson,
who
pick
up
particular
leadership
roles,
one
around
sort
of
delivery
and
Health
inequalities,
and
the
other
around
Financial
investment
and
good
governance,
and
so
on.
So
really
two
really
key
roles
and
Rebecca
picks
up
around
quality
and
safety
and
patient
voice,
so
that
that
is
important.
It's
also
important
and
I
think
this
is
a
difference
from
ccgs.
E
There
are
some
aspects
that
are
the
same
and
some
aspects
are
carry
forward.
What
is
really
different
and
really
positive
is
not
only
the
Partnership
of
with
with
our
local
NHS
providers,
so
we
have
actually
have
them
in
the
room.
Helping
make
decisions
collectively,
but
also
colleagues
are
cath.
Roth
and
Victoria
sit
on
on
that
committee,
as
Representatives
officers
of
the
council,
so
I
think
I.
E
Think
that
is
a
really
positive
step
forward:
I'm,
not
always
the
greatest
fan
of
changes
in
legislation,
but
that
element
of
changing
legislation-
I'm,
really
supportive
of-
and
it's
already
beginning
to
bear
fruit.
So
I'm
pleased
about
that.
E
The
third
thing
that
you'll
see
in
the
paper
this
has
been
developing
over
a
time
in
Leeds
we've
had
a
whole
range
of
boards
of
various
types,
looking
together
in
Partnership
at
a
range
of
things,
whether
that's
mental
health,
end
of
life,
long-term
conditions,
a
significant
number
of
those,
and
that
has
been
really
useful
in
helping
us
develop
strategy
in
a
joint
way.
E
Obviously
it's
still
quite
early
days.
There
are
big
agendas
that
we're
going
to
have
to
wrestle
with,
as
indeed
I
know.
Colleagues
in
the
council
are
around
sort
of
the
finances
as
we
head
into
next
year
and
from
from
an
NHS
perspective
and
how
we
align
that,
particularly
to
adult
and
children,
social
care
and
public
health,
but
more
broadly,
so
that's
one
of
our
our
sort
of
challenges.
That
is
a
particular
responsibility
of
that
committee.
E
But
we
are
also
looking
and
made
very
clear
and
that
the
patient
voice
the
pub
voice,
the
people's
voice
is
right
at
the
heart
of
our
decision
making
and
we've
sort
of
made
that
a
standing
item
right
at
the
start
of
all
our
meetings
to
consider
in
one
form
or
another,
particularly
with
the
support
of
Health
watch.
E
What
the
public
is
saying
about
the
services
they
receive
from
the
NHS
and
social
care
across
the
city,
I'm
really
interested
in
I'm
sort
of
half
of
me,
hoping
you
haven't
noticed
much
difference
because
it
should
be
smooth
and
seamless.
Another,
Part
Of
Me
hopes
that
in
time
that
you
will
begin
to
see
a
difference
as
that
integration
agenda
improves,
but
I
I'm
develops
really.
I
am
interested
if
there
is,
if
there
are
any
observations
that
you've
had
of
how
those
things
have
gone
as
well
as
ours.
E
So
I'll
stop
there
I
don't
know
wreck
if
you
want
to
add
anything
very
welcome
to.
K
Oh
thanks
thanks
chair
and
thank
you
for
inviting
me.
It's
really
good
to
be
here,
nice
to
be
in
the
Civic
Hall
again
so
I'm
in
a
very
new
role
chairing
the
independently
chairing
the
partnership
and
it's
a
role
which
is
about
facilitating
the
partnership
in
the
meetings
it's
two
days
a
month.
So
it's
very
different
to
the
former
chair
of
the
ccg,
as
was
which
was
a
statutory
organization.
K
The
statutory
organization
part
is
now
at
West,
Yorkshire
and
Kathy
Elliott
shares
that
so
I
am
an
independent
chair,
so
I
suppose
I'm
providing
that
facilitation
role,
but
then
also,
hopefully,
a
knowledge
of
and
deep
understanding,
hopefully
of
all
the
different
institutions
and
ways
that
we've
worked
together
in
the
past
and
and
perhaps
opportunities
of
how
we
can
work
together
in
the
future
and
providing
that
external
challenge
to
the
board
itself
and
my
view
about
the
the
new.
K
The
essential
sort
of
new
thing
is
that,
whereas
before
a
clinical
Mission
group
is
about
commissioning
the
services
and
then
buying
those
services,
competition
was
a
big
part
of
that
in
the
legislation.
The
new
arrangements
are
moving
towards
a
more
collaborative
approach
of
commissioning
as
a
city
together.
So
I'm,
not
a
commissioner
I
facilitate
a
partnership
which
commissions
for
the
city
itself,
and
that
includes
all
the
partners
in
the
NHS
and
have
has
attendance
from
Council
as
well.
So
I
just
think
the
more
we
do
together
and
the
more
we
can
align.
K
What
we
do,
the
greater
the
benefits
for
the
population
and
the
services
that
we
can
provide,
and
that
goes
with
the
local
Authority
Services
as
well.
If
we
can
align
more
what
we
do
we
can.
We
should
get
better
outcomes
for
our
for
our
for
our
population
and,
as
we
know,
there's
always
pressure
on
public
sector
finances,
so
the
more
we
can
do
together,
hopefully
the
better.
We
can
protect
the
things
that
we
we
really
want
to
do,
and
working
on
health
inequalities.
K
The
central
role
to
that
and
I
know
that
members
here
really
care
about
that.
So
I'm
delighted
to
be
here
looking
to
see
you
and
thank
you
for
having
me.
A
Thank
you
very
much
Rebecca
and,
like
I,
said
earlier
great
to
have
you
thank
you
team
for
that
presentation.
I
know
towards
the
end.
You
did
say
you
hope,
there's
no
difference.
One
thing
I
am
certain
about
the
common
man
out
there.
They
don't
really
bother
about
whether
it's
called
ICS,
whether
it's
called
icbo,
it's
called
ccg.
All
people
want
to
know
is
that
we
are
working
towards
narrowing
that
inequality
Gap
and
making
sure
that
we're
delivering
the
services
that
we
say
we
will
deliver.
A
So
I
will
now
open
up
to
our
members.
If
you
have
any
questions
for
Tim
and
Rebecca,
based
on
what
you've
heard
and
based
on
the
paper
in
front
of
you,
bearing
in
mind
they're
coming
back
in
March
as
well,
because
obviously
that
would
have
been
good
enough
time
for
them
to
you
know
to
have
been
in
into
the
post
that
they
all
are
in
now
and
will
be
able
to
give
us
a
more
detailed
feedback
and
update
on
what
they
have
been
doing.
A
D
Thanks
chair
I'd,
just
like
to
pick
up
the
point
made
by
Council
levena,
because
I
would
agree
with
her
that
that
sort
of
non-direct
involvement
with
local
authorities,
I
think
is
somewhat
surprising.
Actually
because
the
integrated
care
board
is
is
part
of
the
whole
concept
of
integrated
care,
Partnerships.
Actually,
the
NHS
and
local
authorities
working
together,
Health
and
Social
care
working
together,
and
it
is
somewhat
surprising.
D
However,
we
were
already
basically
there
before
the
Act
was
passed
and
Tim's
quite
right
in
one
way,
you
won't
notice
the
difference,
because
we've
already
been
doing
it
for
several
years,
in
Leeds
and
and
indeed
in
much
of
West
Yorkshire
and,
for
instance,
the
changes
which
you
probably
will
see.
The
establishment
of
the
population
care
boards
would
have
happened,
I'm
quite
sure,
irrespective
of
the
legislation.
It's
not
because
of
the
legislation.
D
It's
because
leads
was
already
going
down
that
pathway
and
when
you
look
at
the
members
of
the
Leeds
committee,
for
instance,
the
director
of
Public
Health
was
not
a
mandatory
post.
We
chose
in
Leeds
to
have
the
director
of
Public
Health
as
part
of
the
committee,
but
we
didn't
have
to
and,
and
it
clearly
fitted
the
way
which
Leeds
wanted
to
work
so
yeah,
I
I
think.
Irrespective
of
the
legislation
we
are
building
on
what
already
existed
and
was
already
developing
in
the
city.
A
H
H
We
always
have
there's
also
a
layer
between
the
West
Yorkshire
boards
and
the
Leeds
board,
which
is
called
the
West
Yorkshire
partnership
board
and
I
sit
on
that
and
so
does
James
Lewis
our
leader
and
our
equivalents
in
the
other
authorities,
and
that's
chaired
by
councilor
Tim
Swift
he's
the
leader
called
Zale
and
as
as
Dr
Beale
said,
that
we
were
already
ahead
of
where
we
needed
to
be
and
that
we've
had
that
partnership
board
for
a
number
of
years.
H
So
we've
had
that
strong
partnership
working
across
West
Yorkshire
and
that
strong
involvement
by
local
authorities
but
I
think
the
point
that
Dr
Bill
made
it.
It
relates
to
a
wider
Point
as
well
that
I've
I've
referred
to
here
before
that
there
are
some
aspects
of
the
legislation
that
are
quite
concerning
you
know.
One
of
them
is
that
not
having
a
formal
link
between
health
and
well-being
boards
and
the
place
based
committees,
there's
also
it
there's
increased
powers
for
the
Secretary
of
State.
Should
they
choose
to
use
them?
H
The
one
I
was
always
lobbied
on
as
a
labor
counselor
was
the
private
sector
organizations
can
be
on
partnership
boards,
we've
chosen,
they
won't
be
in
West
Yorkshire,
but
that's
that's
the
choice
that
we've
made
and
I
think
the
point
that
Dr
Phil
finished
on,
which
is
irrespective
of
the
legislation
we
are
moving
forward,
would
be
my
take
on
the
whole
thing
really
that,
irrespective
of
so
some
of
the
challenges
in
the
legislation,
some
things
I
would
say
it's
problematic.
H
We
have
really
good
relationships
across
West
Yorkshire
people
are
really
committed
to
Services
being
delivered
at
place,
so
the
kind
of
threat
of
regionalization
is
minimized,
and
but
it
does
feel
as
though
the
strong
relationships
we've
got
and
our
commitment
to
the
way
we
work
together
is
mitigating
against
what
what
could
be
problematic
within
the
legislation.
Thank
you.
B
B
I
know
that
I
suspect
that
I
don't
know
if
you've
seen
it,
but
the
British
Medical
Association
have
been
quite
critical
of
some
of
the
icb's
Constitutions
I
suspect
that
the
that
won't
include
West
yorkshire's
actually
from
from
what
I'm
reading
at
the
moment,
things
like
well,
for
example,
that
only
two
icbs
guarantee
voting
positions
for
Public
Health
Specialists.
B
We've
already
said
that
we
do
in
in
West
Yorkshire,
so
I
think,
where
the
exception
to
the
rule,
but
presumably
there'll
be
pressure
from
from
trade
unions
and
and
other
interest
groups
like
the
British
Medical
Association
to
review
some
of
the
Constitutions
and
I'm
just
curious
as
to.
If
what
is
there
a
process
for
that,
because
we
seemed
quite
happy
with
our
constitution,
I
don't
want
it
to
change
so.
E
So
yes,
there
is,
there
is
a
pro.
There
is
a
process.
The
process
would
be
led
not
by
not
from
a
national
end.
It
would
be
led
by
the
ICB
concerned.
So
at
any
point
we
wanted
to
change
it.
We
would
we
would.
We
would
be
allowed
to
change
it.
We
would
have
to
demonstrate
we'd
consulted
widely
on
any
changes
that
we
were
proposing,
just
as
we
did
with
the
original
and
then
we
would
then
effectively
recommend
from
the
ICB
board
to
NHS
England
and
each
any
changes.
E
Our
intent
is
12
months
in
to
do
a
review
that
may
or
may
not
lead
to
any
changes,
but
we
felt
it
was
right
and
proper.
Given
this
new
legislation,
a
new
format,
we
ought
to
at
least
give
ourselves
that
responsibility,
I
suppose
to
review,
but
that
that's
that's
the
basic
basis
in
any
ICB
can
do
that.
E
I
think
we
are
unusual
not
just
in
terms
of
the
public
health,
but
we
also
got
GP
representation
and
either
of
those
were
initially
in
the
legislation,
and
we
I
suppose
we've
lobbied
quite
hard
on
some
of
the
legislation
and
have
had
some
impact,
but
there
are
still
areas
where,
where
I
suppose
we
could
be
a
cons,
we
could
be
concerned
and
we
ought
to
keep
a
watch
one
one
of
the
areas
if
I
just
pick
up
when
the
cancer
defender's
last
comment,
there
I
think
we've
done
really
well
to
date
in
the
sort
of
pro
and
Primacy
of
place,
the
dangers
of
sort
of
regionalization
of
decision
making
and
so
on.
E
That
is
that
is
much
more
to
me
about
behaviors
and
process,
rather
than
it
is
the
Constitution.
The
legislation
so
I
mean
I,
I,
think
I
would
say.
We
need
to
remain
quite
Vigilant
around
that
I.
Don't
think
that
those
will
go
away,
not
least
because
NHS
England
doesn't
see
the
world
quite
like
that.
It
recently
released
last
week
it's
operating
model
and
it's
very
clear.
E
It
sees
ICB
stroke
ICS
as
the
regional
level
that
it
will
work
to
and
therefore
there
are
some
challenges
around
that
going
forward
so
going
I
would
just
say
we
need
to
remain
Vigilant
on
that
the
Constitution's
fine.
But
it's
about
the
behaviors
and
processes
that
sit
around
that
foreign.
L
It
seems
clear
that
Leeds
is
starting
from
a
good
position
in
informing
this
and
I.
Think
picking
up
on
the
chairs
comments
that
for
some
this
will
say
you
know
it's
it's
a
technical
change
and
what
people
carry
around
is.
What
is
the
you
know
what
what
in
terms
of
the
Care
offering
or
tangible
changes
that
can
put
you
know
can
be
pointed
at
will
be
delivered
now.
You
know
again
the
the
group's
been
formed.
L
It's
been
formed
from
any
what
feels
like
an
evolution
in
Leeds,
because
it
was
similar
to
what
we
were
doing
already,
which
is
a
great
place
to
start
from,
but
it
is
still
forming
so
once
we
get
something
together
and
the
norming
and
the
storming
stage,
what
if
we're
sat
together
in
March
or
six
months
time
or
so,
what
kind
of
things
should
we
be
saying?
Actually
here
are
some
of
the
things
that
you
know.
Hopefully,
you've
already
had
start
to
identify
some
of
the
things
that
you
know
what
this
is.
L
These
are
the
priorities
for
programs
of
work.
These
are
the
changes
that,
where
we
think
we
can
Harvest,
you
know
signatures
and
get
the
best
out
of
things
just
so
that
we,
you
know,
we've
got
something
to
hold
the
feet
to
the
fire
from
in
six
months
time
today,
we'll
be
doing
that.
E
There
are
three
things
that
I
just
jotted
down
that
we've
already
discussed,
where
I
do
believe.
There
is
so
important
changes,
synergies
and
when
you
see
the
plans
for
leads
and
how
about
the
NHS
budget
and
so
on,
has
been
agreed.
Given
the
challenges
we
face,
that
I
would
I
would
be
expecting
you
to
to
ask
about
or
for
opportunities
as
well.
E
Clearly,
one
of
them
is
around
primary
care
and
access
to
general
practice,
and
that
remains
hugely
challenging,
not
not
because
we've
not
invested
in
increased
capacity,
there's
more
capacity,
but
that
is
not
feeding
through
and
we
know
it's
not
feeding
through
in
terms
of
experience,
and
that
was
one
of
the
important
conversations
we
had
coming
out
of
Health
watches
a
report
from
healthwatch
that
we
discussed
at
one
of
our
earlier
meetings
and
I.
Think
what's
different.
E
Now
is
that's
very
much
a
partnership
owned
issue
rather
than
a
very
sort
of
almost
in
a
corner
of
a
ccg,
which
is
how
it
was
before
it
is
delegated
to
us.
It
is
our
responsibility
so
that
that
is
one
area
and
also
there
will
be
some
questions
about
other
aspects
of
primary
care,
including
dentistry
and
Optometry,
and
going
forward
which,
how
West
Yorkshire
decides
to
take
on
those
responsibilities
and
delegate
them
or
not
and
is
still
to
be
worked
through.
E
I
think
the
other.
The
other
area
you'd
expect
us
to
be
talking
about
at
the
moment
is
winter
pressures,
but
we're
beyond
that.
We
are
in
the
process
of
working
to
really
review
the
whole
intermediate
tier
of
services
and
leads
that
mixture
of
home-based
and
bed-based
care
that
either
can
prevent
people
going
into
Hospital
unnecessarily
or
Aid
their
discharge
and
re-ablement
coming
out.
That's
a
major
piece
of
work
and
we're
in
the
sort
of
we've
got
ongoing
pieces
of
work
that
we
need
to
do.
E
Make
sure
that
we're
in
As
Good
As
position
as
possible
for
winter
and
it's
hugely
challenging
even
as
today,
but
also
we've
got
a
more
medium
term
piece
of
work
where
we've
been
with
the
Diagnostics
underway
and
will
be
completed
in
November
and
from
that
will
come
of
the
plan,
and
there
are
really
big
synergies.
There
I
think,
particularly
with
adult
social
care,
the
other
areas
around
Health
inequalities.
E
E
Basically,
it's
been
making
sure
that
we
focus
some
NHS
resources
in
NHS,
England,
World
to
the
20
most
deprived,
but
given
the
scale
West
yorkshire's
taking
the
position,
it's
10
most
deprived
parts
of
our
community,
but
also
into
a
number
of
and
that's
sort
of
five
bit
into
a
number
of
areas
where
clinical
areas
that
we
need
to
look
at,
but
also
not
to
lose
sight
of
specific
communities,
people
with
serious
mental
illness,
for
example
and
I.
Would
we
again
we've
already
discussed
that
as
a
committee?
That's
come
through.
E
Certainly
that's
one
of
the
subcommittee's
delivery,
a
subcommittee
and
health.
Sorry
delivering
Health
inequality
subcommittees
looked
at
our
plan
for
this
year.
I
do
think
going
forward.
That
again
is
an
area
we'll
need
to
be
really
closely
aligned
to
and
you
will
want
to
be
cited
on.
So
those
are
my
sort
of
initial
thoughts.
There
are
thick
pieces
of
working
children's
and
so
on
which
there
are
a
number
that
we
can
really
look,
look
at
and
will
be.
Those
are
my
initial
three.
C
Chair
and
not
only
is
this
the
best
city-
and
we
are
the
best
city
and
this
Council
are
working
really
hard
to
provide
for
each
and
every
one
I'm
going
to
sign
a
bit
cynical
here,
but
nothing
to
do
with
you
personally.
If
Tim
was
here
always
getting
team
and
page
12
poor
is
health
and
well-being,
inclusive
gut
and
zero
carbon,
but
further
down
it
mentioned
the
poorest
health
will
be
better
fast.
I
always
have
something
against
that.
C
C
So
if
we
are
going
to
be
honest,
we
have
to
say
the
way
we
are
expected
to
be,
but
if
a
poor
person
approach
is
a
doctor
today
and
a
rich
person
have
their
money
to
pay
that
rich
person
helped
will
assist
still
I
would
just
talk
introductive
bill
with
the
dentist.
If
you
have
money
you
can
go
to
the
dentist.
If
you
are
poor,
you
can't
go
to
the
dentist.
So
if
a
poor
person
approach
you,
how
are
you
going
to
explain
that
their
health
will
be
seen
to
First.
E
E
Really
importantly,
this
is
where
I
think
the
link
with
the
health
and
well-being
board
is
so
important
is
to
to
be
really
sharp
and
clear
about
what
it
is
that
the
broader
City
and
Society
needs
to
be
doing,
and
often
that
is
rightly
led
by
the
council
and
the
work
that
you
all
do
to
try
and
to
narrow
Health
to
narrow
inequalities,
because
we
know
that
that's
a
conservative
I
think
it's
probably
higher,
probably
80
to
85
percent
of
someone's
Health
outcomes
are
driven
by
those
wider
determinants
some.
E
Hence
the
conversations
later
about
the
moments
and
so
on.
What
is
really
important
from
an
NHS
perspective
is
that
we
play
our
part
under
your
Council
leadership
around
those,
so
I'm
thinking
things
about
the
anchor
institutions
and
the
way
he
leads
teaching
hospital,
for
example,
has
worked
in
its
Community
to
try
and
be
a
contributor,
rather
than
a
than
you
know.
E
What's
completely
separate,
I
was
remember
a
GP
in
when
I
worked
in
Stockport
across
the
other
side
of
the
penins
challenging
a
Consultants
at
the
world,
renowned
heart
and
heart,
Treatment
Center
at
wythenshaw
hospital,
pointing
out
that
within
Shaw
had
the
poorest
Health
heart
outcomes
of
any
place
in
England.
Despite
the
fact,
the
hospital
in
its
midst
had
the
very
best
and
was
seen
as
a
world-class
service.
E
There
is,
then,
that
15
to
20
percent
and
I
think
that's
where
the
health
inequalities
work
and
why
we've
deliberately
set
up
one
of
us
to
commit
our
subcommittees
as
a
committee
which
is
focused
on
delivery
and
health
inequalities
and
chaired
by
Yasmin
Khan,
whose
and
works
in
the
third
sector
background
and
has
a
real
passion
for
inequality.
E
So
are
we
there
yet?
No
we're
not
I
mean
we
know
we're,
not
there's
a
lot
of
work
that
needs
to
be
done.
I
was
really
pleased.
I
was
just
looking
at
a
report
from
West
Yorkshire
for
the
next
meeting.
E
I've
got
to
go
to,
and
there
are
a
number
of
areas
where
some
of
the
things
that
the
NHS
ought
to
be
doing,
for
example,
checks
on
key
health
issues
where
actually
we,
we
unusually
because
not
everywhere,
in
West,
Yorkshire
and
certainly
not
everywhere
in
England,
are
able
to
demonstrate
that
people
from
our
most
deprived
communities
or
from
very
vulnerable
communities
such
as
those
with
serious
mental
illness,
are
either
getting
the
same
access
to
those
key
secondary
prevention
and
pieces
of
work
or
better
than
the
population
as
a
whole.
E
We're
not
yet
quite
there
that
it's
routine
that
it's
better,
because
it
should
be
if
we're
serious
about
this
statement,
but
at
least
compared
with
most
places
we're
at
the
same
level
or
better
or
or
we
monitor
you
better.
So
I
I
can't
at
this
stage
say
for
definite
we're
going
we're
going
to
succeed,
but
I
do
think.
We've
set
up
within
leads
as
a
whole
and
within
the
committee
and
its
substructures,
and
our
commitment
to
looking
at
data
at
a
a
reward
level
rather
than
just
a
global,
leads
level.
E
The
processes
by
which
we
might
do
that
and
we
remain
committed.
It's
a
real
commitment
to
the
senior
leadership
of
the
NHS
as
I
always
smile
because
Lee,
it's
not
Julian
Hartley,
Chief
Executives,
probably
called
him.
Sir
Julian
Hartley,
the
chief
executive
at
ltht
I,
see
him
very
excited
about
lots
of
things.
But
one
of
the
first
things
I
ever
saw
I'm
excited
about
was
the
anchor
work
they
did
as
an
organization
that
is
really
unusual
for
a
chief
executive
of
an
acute
trust.
C
Totally
agreed
what
it
says:
it
is
a
challenge,
but
I
always
go
back
to
third
sectors.
Third
sectors
know
their
Community
I'm
just
coming
from
third
sectors,
events
and
it's
black
history
month,
and
they
have
got
so
many
different
agency
in
there
doing
blood
pressure,
all
different
things
and
I
was
really
happy,
but
one
lady
came
to
me
and
she
says:
I've
got
my
blood
pressure
check
and
it's
high
and
my
doctor
is
supposed
to
have
an
apartment
two
weeks
ago
and
I
didn't
get
an
appointment.
C
Now
is
the
third
sector
did
it
today
and
ancestor
will
get
in
that
and
don't
move
get
them
to
assess
your
medication?
So
these
are
the
things
I
don't
know
if
we
go
back
which
I
do
not
go
by
postcodes,
but
we
need
to
look
after
the
power
vulnerable
and
put
their
health
first
else.
I
don't
want
to
see
this
in
the
paper,
because
a
poor
person
will
come
to
you
and
says
you
told
me
my
health
is
going
to
be
first
into
and
it's
not
happening.
A
Thank
you
very
much.
Councilor
Taylor
I'll
call
you
Victoria
just
with
what
you
were
saying
team,
which
obviously,
in
terms
of
com,
your
commitment
which
is
great
for
us
to
know
and
say,
but
what
we
would
love
to
see
is
actually
the
practicalities
of
it
and
the
outcome.
So
obviously
we
do
know
that
you're
scheduled
to
come
back
in
March.
A
So
what
will
really
be
good
in
terms
of
us
in
in
terms
of
the
impact
this
has
had,
because,
obviously
we
do
know,
we've
got
coffee
to
deal
with
in
terms
of
the
effect
of
covet
long
covet,
and
obviously
we
now
have.
The
cost
of
living
crisis
can
I
ask
why
my
microphone
is
going
off
and
on
okay
and
the
cost
of
living
crisis
as
well,
which
will
be
hugely
impacted
in
in
terms
of
people's
healthy
health
and
well-being,
as
well
as
their
mental
health.
A
So
it
will
be
good
to
know
where
we
are
in
terms
of
data
and
statistics
and
then,
when
we
come
back
in
March
to
see
what
we
have
achieved
as
well,
because
that
will
help
and
guide
us
in
knowing
they
said.
The
Journey
of
a
Thousand
Miles
starts
with
the
day
step.
So
at
least
we
know
where
we
are
now
come
March,
which
is
about
what
six
months
seven
months
from
now,
then
we
can
kind
of
evaluate
and
see
where
we're
going.
It's
not
going
to
be
a
straight
turn
around
360..
A
We
do
know
that,
but
at
least
if
we
can
start
making
some
progress
from
the
report,
I
did
read
that
South
Leeds
Hansley
have
got
one
of
the
highest
maternal
death
in
the
country.
That's
in
our
city,
you
know,
and
that
really
hurt
me
just
reading
that
so
without
knowing
all
of
this.
What
are
we
doing
about
it?
How
are
we
combating
that?
So
these
are
the
kind
of
information
that
we
would
love
to
see
come
March.
A
Obviously
we
know
it's
still
new
you're
all
still
developing
a
lot
of
strategy,
but
we
would
love
to
see
real.
Real-Time
information
data
on
where
you're
at
come,
March,
2023.
L
A
Is
that
my
big
voice
blowing
into
it
all
right?
Okay,
Victoria,
please.
J
Thank
you
Chet,
so,
just
to
briefly
add
I
know
that
was
a
long
conversation,
but
in
terms
of
comment
on
councilor
Taylor's
comments,
it
does
feel
like
this
is
the
essence
of
what
we
want
to
be,
and
it
does
reflect
the
earlier
conversation
about
us
making
active
choices
to
join
this,
even
though
we
don't
have
to
we've.
J
We've
made
active
choices
to
do
that,
but
I
think
the
challenge
is
right
and,
and
certainly
in
the
conversations
that
we've
been
having
so
far
in
the
committee
and
as
and
as
Leaders
across
the
system
is
that
we
we
have.
We
have
to
continue
to
put
the
people
of
leads
at
the
center
of
all
of
our
collaborative
work
and
then
come
together,
as
as
the
new
Arrangements
take
shape
to
to
to
both
ensure
that
those
arrangements
are
absolutely
maximizing
everything
we
can
possibly
do
that.
J
That
is
within
our
power,
but
also
to
connect
them.
So
people
don't
see
those
joins,
so
it
in
a
sense
I
think,
there's
two
really
important
things
that
it
feels
that
we
we
want
to
keep
track
of
and
be
very
Vigilant
about
in
leads,
and
part
of
that
is
about
the
the
critical
role
in
terms
of
health
inequalities
that
the
NHS
plays
I
mean
Tim
mentioned
the
20.
J
We
understand
from
all
the
evidence
that
it's
around
you
know
for
the
things
that
affect
people's
health
and
health
inequalities
that
there's
about
20
contribution
from
from
the
NHS,
which,
which
obviously
is
a
is
a
is,
is
smaller
than
the
80
that's
out
with
the
NHS.
But
it's
still
incredibly
critical,
as
you
say
that,
but
everybody
can
get
access
to
see
a
GP
or
to
access
the
services.
They
need
that
those
services
are
culturally
appropriate
that
they're
delivered
in
the
way.
J
That
would
give
us
the
best
outcomes
for
communities,
and
we
know
the
learning
we've
had
not
just
through
covid
on
all
of
those
things
but
pre-covered
as
well,
about
trusted
organizations
and
about
working
in
a
way
that
that
that
that
works
with
people
to
give
us
the
best
outcomes.
So,
there's
a
huge
commitment
to
working
with
NHS
colleagues
to
make
sure
that
we
build
on
all
of
that
work
and
I.
J
J
So
there's
something
about
doing
everything
we
can
on
that
and
then
the
other
really
critical
thing
is
making
sure
that
all
of
that
work
actually
joins
up
with
the
80
of
all
the
other
stuff
that
the
rest
of
the
city
is
doing,
including
the
work
that
the
council
leads
to
keep
people
healthy
and
well
in
the
first
place.
So
so
I
see
that
it's
a
big
part
of
my
role,
but
also
colleagues,
roles
to
to
continue
to
join
that
up
across
the
city
and
not
have
duplication
and
silos.
J
Because
if
we're
not
Vigilant,
that's
what
will
happen
so
I
think
your
challenge
is
absolutely
right.
Councilor
Taylor
and
just
to
end
on
Tim
and
I,
have
had
some
really
positive
conversations
about
how
we
use
kind
of
a
shared
set
of
Ambitions
and
and
headline
indicators
on
progress
in
terms
of
those
population
outcomes.
So
how
are
we
doing
around
in
a
health
inequalities?
C
Is
very
helpful:
Victor
I
know
we
as
a
council
and
NHS
are
doing
what
we
can
to
help
outsides,
and
sometimes
some
of
them
need
to
take
responsibility.
I'm
not
fading
away
from
that.
But
what
I'm
saying
is
what
you
put
in
black
and
white
to
go
out
to
the
public.
We
should
accommodate
it.
We
are
the
one
that
out
on
the
street
campaigning
and
we
are
the
ones
that
get
in
these
commands.
You
know
I
can't
say
the
doctor
blah
blah
blah.
C
This
is
where
I'm
coming
from
someone
very
intelligent,
although
they
might,
you
know,
deprive
everything
says
when
you
have
it
here
in
black
and
white.
So
why
am
I
not
having
it?
And
this
is
what
I'm
saying
we
don't
promise
and
don't
deliver.
You
know,
but
I
don't
know
that.
There's
work
going
on
behind
the
scene.
Rebecca
did
a
good
job
and
she
was
exact
size
Fiona.
They
are
still
doing
a
good
job.
Working
alongside
you,
I'm
not
going
to
praise
NHS
all
the
way
for
since
pandemic.
I
think
they
have
slipped
away.
C
K
Thank
you
thanks
chair,
thank
you
for
that
discussion
and
it's
really
lovely
to
see
colleagues
again
and
and
who
familiar
arguments
being
made,
which
we
will
agree
with
just
Reflections
that
I've
got
from
my
time
when
I
was
in
the
health
of
my
being
board,
chair
role,
and
this
role
now
is
and
doing
covert
and
following
that
as
well
when
high
pressure,
when
pressure
was
exerted
on
the
system
when
there
is
a
difficulties
and
system
pressures
or
covered
or
whatever
those
pressures,
are
the
National
priorities
and
the
political
priorities
as
an
independent
person.
K
My
Reflections
are
that
it's
it's
it's
ambulance.
You
know
sorry
at
any
waiting
times
and
it's
GP
access
that
that
get
an
acute
sector
like
that,
the
pressure
to
fund
that
work
ranks
up
higher
and
quicker
than
any
other
pressure
and
it
in
times
of
great
demand
and
great
pressure
like
doing
covert
and
following
that
issues
that
we
know
are
really
difficult
for
our
city
around
mental
health
access.
K
You
know
Health
inequalities
are
are,
let
are
further
down
the
priority
list
in
a
national
way,
with
the
press
and
and
in
my
my
Reflections
on,
and
so
what
we
have
to
do.
K
Look
and
what
we
have
done
when
I
was
in
the
council
and
and
now
is
have
plans
that
to
prioritize
our
local
action
to
those
long-term
priorities
about
health
inequalities,
and
that's
why
you
see
plans
such
as
that
that
tie
our
partners
in
to
a
vision
that
we
have
together
of
health
of
the
poorest
the
fastest
and
improving
that
and
and
then
what
we
can
do
locally
is
is
refer
back
to
that
all
the
time
about.
K
This
is
our
plan,
regardless
of
the
headwinds
and
the
pressures
that
exist
at
which
they
do,
and
we
have
to
meet
those
pressures.
But
we
also
have
this
which
we've
agreed
to
so
we
have
the
healthy
leads
plan,
and
that
has
a
whole
set
of
outcomes
that
will
that
committed
is
to
work
and
the
system
to
working
together
to
address
those
issues,
and
it's
very
detailed
and
we're
working
on
it
in
development
daily
of
the
day.
K
K
A
L
Yeah,
just
a
a
short
observation:
I
completely
agree
with
what
Council
Taylor
was
saying
around
the
need
to
help
our
most
deprived
Access
healthcare,
because
often
they
are
the
ones
that
do
get
left
behind
I.
Don't
think
it
is
easy
to
kind
of
draw
postcode
Maps
around
leads
just
because
the
unique
geography
and
it's
one
of
the
things
I
love
about
Leeds,
is
that
there
are
very
few
postcodes
that
are
entirely
deprived
or
entirely
wealthy.
It's
quite
it's
quite
diverse
and
I
would
not
not
welcome
us.
L
For
example,
you
know
if
you
are
a
poor
person
living
in
what
is
perceived
as
an
affluent
and
get
disadvantaged,
that's
actually
a
double
blow
to
to
the
residents,
and
also
just
one
thing
on
on
the
GP
side
of
things
I'm
in
the
situation
from
a
personal
perspective,
where,
because
of
family
members,
that
I
support,
I
actually
interact
with
GPS
from
three
different
practices,
at
least
across
three
quite
different
bits
of
leads
and
anecdotally.
What
I
observe
is
the
ease
of
access.
L
A
G
Thank
you
chair
and
thank
you
Rebecca.
It
was
really
interesting
to
hear
your
perspective
and
I'm
sure
it's
a
perspective
that
we
all
share.
However,
Playing
devil's
advocate
resources
and
the
squeeze
on
resources,
particularly
our
mental
health,
will
impact
I'm
sure
everybody
will
agree
on
the
most
ambitious
of
plans
so
and
and
I've
read
the
plan
several
times,
and
it
would
be
amazing
if
we
could
achieve
everything
the
Royal
way.
G
So
is
there
a
contingency
plan
because
the
cost
of
living
impact
is
rising
disproportionately,
so
the
number
of
people
who
will
be
classed
as
deprived
in
the
truly
sense
will
increase,
so
that
will
obviously
impact
on
the
delivery
of
the
plans.
I
just
wondered
if
there
were
contingency
around
the
resources
and
funding
required.
E
So
if
I
can
respond
to
the
just
two
well,
three,
three
things
really
and
I'm
supposed
to
finish.
One
is
I.
I
know
we're
coming
back
in
March
around
the
ICB,
the
committee
and
the
development.
If
I'm
really
honest
I
suspect,
not
much
will
change
in
governancy
terms,
and
it
might
be
much
better.
We
bring
the
healthy
leads
plan
and
the
plans
for
next
year
back
and
have
a
proper
look
at
those.
E
Then
they're
the
things
that
are
owned
and
overseen
by
the
leads
Committee
of
the
ICB,
so
we're
getting
to
some
of
actually
what
it
does
rather
than
the
sort
of
governance
types
questions.
So
that's
just
a
proposal
and
suggestion
and
I
would
be
very
happy
to
do.
That
would
be
good
to
do
that.
I
think
then,
the
the
in
terms
of
GP
practice.
There
is
a
lot
of
work
being
done
on
variation
and
again
I'm.
Sure.
E
Colleagues,
at
some
point
will
want
to
talk
to
us
about
how
we're
working
with
GPS
and
we
can
share
some
of
that
because
you're
right,
it's,
the
variation
is
the
issue,
and
we
are
aware
of
that.
There
is
a
plan.
People
are
working
on
that
we
are
trying
to
share,
but
perhaps
best
practice
getting
those
GPS
understand
that.
Nevertheless,
there
are,
there
are
challenges
and
that
variation
is
not
driven
by
deprivation.
That
variation
is
driven
by
the
individual
practices.
E
We've
got
some
outstanding
practices
in
our
most
deprived
areas,
and
some,
not
so
great
ones
and
more
awful.
There
is
I,
won't
regain
leave.
My
anecdotal
stories
of
my
practice
and
I
do
live
in
one
of
the
more
affluent
parts
of
Leeds,
so
I
think
that
that's
a
legitimate
Challenge
and
what
we
are
working
out,
but
we
we
may
well
want
to
you
know
you
may
well
want
to
pursue
that
a
little
bit
more
in
terms
of
the
resources
and
the
challenge
local
authorities
have
been
through
I've.
E
You
know
lost
track
now,
many
years
of
unbelievably
challenging
Financial
position,
the
NHS
hasn't
done
as
badly,
but
hasn't
done
brilliantly,
and
we
are.
We
are
from
every
bit
of
observation
that
we
can
make
at
the
current.
E
The
current
position
is
we're
expecting
that
to
get
much
worse
next
year,
so
the
challenges
facing
us
as
a
as
a
Partners
NHS
local
Authority
third
sector
are
not
going
to
get
easy
when
it
comes
to
finances,
they
are
going
to
get
harder
and
therefore
the
the
key
thing
to
me
is:
are
we
prioritizing
those
resources
in
the
best
way
really
challenging
in
health?
Because
often
it
is
what
goes
wrong
that
ends
up
at
your
door,
and
you
have
to
deal
with
it.
E
It's
it's
immoral
to
turn
someone
away
because
they
don't
come
from
the
right
background
or
they
aren't
from
the
right
place.
You
you
need.
You
are
expected
to
treat
them
quite
rightly
so.
I
I,
wouldn't
say:
there's
some
sort
of
contingency
I
think
we've
stretched
our
contingency
as
far
as
possible.
The
key
is
going
to
be
getting
a
plan
that
balances
and
is
as
far
as
possible,
so
sat
in
line
with
the
local
Authority
plans
and
is
is
effectively
prioritized
to
those
things
that
matter
most
for
us
in
Leeds.
It
was
interesting.
E
You
mentioned.
You
mentioned
mental
health
at
the
moment.
The
biggest
challenge
for
our
Mental
Health
Partners
is
spending
the
money
because
there
isn't
the
workforce.
So
if
we
talk
about
resources,
we
can
talk
about
money,
the
probably
the
bigger
challenge
that
we're
most
nervous
about
in
the
NHS
and
indeed
colleagues
in
Social
care
is
the
workforce.
E
We
can't
actually
spend
the
money
sometimes
so
that
that
is
a
significant
challenge
or
it's
very,
very
expensive,
because
it's
agency,
so
the
the
in
terms
of
delivery
of
our
plans.
Is
it
money
or
is
it
Workforce?
Well,
it's
a
combination
of
both
we
could
have
all
the
money
in
world
and
not
have
the
workforce
or
if
we
managed
to
get
all
the
workforce
we
want.
We
might
be
a
bit
tight
on
money.
E
Those
two
together
are
very,
very
clearly
our
biggest
risks
in
our
system.
Currently.
A
Okay,
thank
you
very
much
to
Tim
and
Rebecca
and
obviously
Victoria
as
well
and
exec
members
on
that
agenda.
We
can
only
continue
to
ask
that
all
the
plans
and
our
Ambitions,
let
it
be
in
our
deeds
and
not
just
in
our
words.
So
we
look
forward
to
seeing
you
back
in
March,
so
we
might
not
see
you
until
actually
I
think.
Are
you
into
November's
meeting
I?
Don't
think
yeah
yeah?
There
will
be
some.
A
If
we
don't
see
you
thank
you
for
everything
and
have
a
Merry,
Christmas,
I'm
sure
I'm
the
first
to
wish
you
that
for
this
year,
so
thank
you
very
much.
You're
free
to
stay
for
the
other
items.
Well,
I
do
know
you've
got
another
meeting,
but
thank
you
very
much
for
coming.
We
appreciate
it.
Okay,
we're
going
straight
to
agenda
item
number,
nine,
I'm,
sorry,
eight
and
that's
leads
health
and
well-being
strategy.
N
Thanks
chair
Watson
for
always
Health
Partnership
manager
and
the
Leeds
Health
Partnership
team.
A
Thank
you
both
for
joining
us,
so
for
this
agenda.
Since
2012,
it
has
been
a
statutory
requirement
to
have
a
health
and
well-being
strategy
and
strategy
and
with
the
current
strategy
and
the
process
of
being
refreshed,
the
views
of
this
scrutiny
board
are
being
sought
in
terms
of
the
proposed
approach
and
the
refreshed
priorities,
as
set
out
in
the
report
within
within
your
agenda
pack.
So
I
will
be
asking
Wasim
now
to
is
it
you
to
start
or
will
it
be
team
or
counselor
Vena.
H
Definitely
on
the
right
definitely
on
the
right
paper
now
so,
as
I
have
already
said,
the
current
strategy
was
the
2016
to
21
that
was
extended
to
2023
and
so
we're
very
much
building
on
the
work
of
the
previous
strategy
in
reviewing
and
developing
this
new
strategy,
which
continues
to
be
person-centered
in
terms
of
well-being,
starting
with
our
residents
and
them
being
at
the
heart
of
everything
that
we're
doing
so.
H
The
strategy
is,
is
for
everybody
who
lives
and
works
and
visits
leads,
and
it
sets
priorities
for
partners
to
address
locally
to
to
meet
the
needs
of
our
population,
and
it
sets
out
the
long-term
strategic
direction
of
the
city
with
regard
to
health
and
well-being,
and
it's
for
a
broad
range
of
Partners
in
the
Health
and
Care
System,
but
also
beyond
the
Health
and
Care
system,
because,
as
Victoria
pointed
out,
only
20
of
the
elements
of
what
contribute
to
our
health
and
wellbeing
are
actually
within
the
health
system.
H
And,
of
course
it's
in
the
context
of
the
impact
of
a
global
pandemic
and
the
cost
of
living
crisis,
which
I
think
we
would
all
acknowledge
is
going
to
have
a
potentially
catastrophic
impact
on
people's
health
and
well-being,
and
we
know
that
Health
inequalities
are
inextricably
linked
to
poverty
and
the
more
people
are
going
to
go
into
property
over
the
next
few
months.
So
we're
very
much
in
that
very
sobering
context.
H
So
this
isn't
a
rewrite
of
the
current
strategy.
It's
it's
more
of
an
evolution
in
the
current
context,
so
much
of
what's
in
the
current
strategy
will
be
in
the
new
one.
So
it's
still
our
ambition
that
we
want
these
to
be
the
best
city
for
health
and
well-being.
We
want
it
to
be
a
healthy
City
and
a
caring
City
for
people
of
all
ages.
So
from
child
friendly
leads
to
age
friendly
leads
and
we
are
retaining
the
ambition.
That's
been
discussed
already
about
people
who
are
the
poised,
improving
the
health
fastest
and
I.
H
Think
Rebecca
gave
a
really
eloquent
description
of
why
that's
important,
and
why?
Having
that
as
a
written
Target
means
that
we
can
hold
people
to
it
and
that
it
kind
of
focuses
our
our
work
and
crystallizes
our
thinking
around
the
importance
of
targeting
people.
Who've
got
the
poorest
health
and
wanting
that
to
improve
the
quickest.
H
It
will
align
with
the
best
city
ambition,
and
you
know
we
still
have
the
three
pillars,
which
includes
inclusive
growth,
Health
wellbeing
and,
of
course,
the
climate
emergency
and
team
leads
is
really
really
Central
to
the
partnership
and
the
way
we
work
together.
I
think
our
work
as
a
city
through
covert
demonstrated
that
magnificently
in
terms
of
the
way
communities,
as
well
as
the
Health
and
Care
system,
came
together
to
help
our
population
through
that
crisis,
and
we
very
much
want
to
have
indicators
that
are
both
quantitative
and
about
people's
lived
experience.
H
So,
as
quantitative
and
qualitative
ways
of
of
measuring
the
work
that
we're
doing,
I
think
I'll
leave
that
there
and
hand
over
to
actually
I'll
say
a
bit
about.
We
had
a
health
and
well-being
board
meeting
a
couple
of
weeks
ago,
where
we
took
the
outline
approach
to
them
for
their
feedback
on
developing
the
new
health
and
well-being
strategy,
and
they
did
endorse
our
approach,
but
had
some
specific
feedback
to
give
us
I.
Think
one
of
the
really
key
messages
was
so
what
so?
Well,
we've
got
this
new
study.
H
What
does
that
mean?
For
you
know,
people
who
live
and
work
in
Leeds,
and
they
also
were
really
clear
that
we
need
to
have
some
clarity
and
some
realism
about
which
priorities
are
important
and
what
we
can
actually
achieve,
recognizing
that
it
takes
generations
to
make
some
of
the
shifts
we
want
to
make.
So
at
the
moment,
as
you
know,
we've
got
20-year
Gap
in
life
expectancy
between
our
more
affluent
and
our
more
deprived
areas,
and
it
is
not
realistic
to
think
we
will
change
that.
H
You
know
in
a
couple
of
years
that
is
really
really
long-term
work
and
so
the
importance
of
recognizing
the
progress
that's
already
been
made,
looking
at
what
the
priorities
are
and
what
we
feel
we
can
deliver.
You
know
in
the
in
the
time
frame
of
this
strategy,
and
they
also
felt
we
needed
to
be
really
clear
about
where
the
health
and
wellbeing
strategy
aligns
with
other
strategies.
So,
for
example,
we
had
housing
as
an
agenda
item
a
few
months
ago,
because
that's
so
Central
to
People's,
Health
and
well-being,
there's
also
housing
strategy
for
leads.
H
So
it's
really
important.
We
look
at
how
the
strategies
dovetail,
how
they're
measured
together,
how
they
work
together,
effectively
not
duplicating
work,
etc.
Okay,
so
and
then
our
plans
coming
back
to
health
and
wellbeing
board
in
December,
so
that's
how
their
involvement
will
continue
and
I'll
hand
over
to
councilor
Arif
tools
to
make
some
comments.
Thank
you.
I
Thank
you
Fiona.
So,
from
my
perspective,
just
some
Reflections
within
my
own
portfolio
of
Public
Health
and
active
lifestyle.
So
our
leads
team
leads
approach,
has
been
a
key
to
navigating
the
challenges
of
the
pandemic
and
delivering
the
effective
vaccination
program
across
the
city
and
the
physical
activity.
I
Ambition
and
public
health,
Rule
and
health
protection
prevention
and
early
intervention
will
continue
to
be
crucial
in
improving
Health
outcomes
and
whilst
progress
against
tackling
Health
inequalities
has
been
impacted
by
the
pandemic,
it's
still
important
to
reflect
on
the
successes
which
have
been
made
indifference
and
in
a
difference
that
will
be
important
to
build
on,
for
example,
the
pre-pandemic
reduction
in
in
child
abuse
that
we
had,
particularly
in
our
deprived
neighborhoods
and
the
Leeds
neighborhood
networks,
promoting
Community
participation,
social
connection
and
healthy
aging.
I
We
had
the
Lincoln
Green
employment
and
skills
project
and,
of
course,
in
my
ward
and
in
Beeston,
we've
got
the
selective
licensing
which
is
raising
the
standard,
private
and
rented
housing
in
Beeston
and
and
here
Hill,
so
just
some
some
of
the
sort
of
key
things
that
I
wanted
to
pick
out
there.
At
this
point
I'll
hand
over
to
Tony.
M
Thank
you,
and,
and
thanks
for
that
introduction
and
it's
great
to
be
here.
I
wish
I
took
the
previous
health
and
wellbeing
strategy
through
scrutiny
on
a
couple
of
occasions
and
in
fact
around
this
table.
There's
a
lot
of
people
that,
in
over
various
years,
have
had
seats
on
on
the
health
and
well-being
box.
So
there's
a
lot
of
knowledge
in
this
room
on
all
sides,
I
think,
which
is
always
always
great
to
see
and
I.
M
M
M
For
example,
kickstarting
a
lot
of
the
the
anchors
work
with
the
hospital
and
the
Lincoln
Green
program
that
councilor
Reef
has
just
mentioned,
agree
in
a
a
really
radical
and
Community
focused
mental
health
strategy,
which
is
really
beginning
to
to
pay
some
dividends,
I
think
for
certain
Community
groups
and
obviously
having
that
focus
on
on
all
the
wider
determinants
of
of
health
and
and
the
challenge
of
improving
the
health
of
the
the
poor
is
the
fastest.
But
likewise
there
has
been
I
think
it
it.
M
It's
sometimes
difficult
to
to
see
the
progress
when
we've
got
all
the
challenges
around
cost
of
living.
The
budget
issues
that
have
been
mentioned,
but
it's
fair
to
say
over
the
last
period
as
well.
There
has
been
no
successes
that
I've
just
mentioned,
but
also
around
things
like
the
reduction
in
smoking,
the
reduction
in
childhood
obesity
that
was
seen
pretty
pandemic
and
actually
the
development
of
a
number
of
new
and
interesting
pilot
programs,
one
of
which
I'll
mention
in
in
a
bit.
M
So
as
I
say,
it's
been
very
much
a
an
evolution.
The
the
key
Pages
perhaps
are
page
24
and
25,
which
outlines
how
the
12
existing
priorities
have
changed.
M
So
I'm
just
going
to
take
a
a
couple
of
quick
minutes
just
to
just
to
go
through
some
of
the
key
ones
there,
and-
and-
and
some
of
this
has
very
much
come
out
of
the
the
big
Leach
chat
that
many
of
you
will
be
familiar
with,
and
one
of
the
key
findings
from
that
big
lead
to
chat
is:
is
the
concept
of
of
being
friendly
and
ever
being
friendly
to
each
other
in
communities,
whether
that's
child,
friendly
or
age
friendly
or
indeed,
the
support
that
people
might
get
with
challenges
at
work
is
really
really
key.
M
So
the
first
priority
is,
is
around
promoting
that
friendliness
in
in
Leeds
and
and
that
builds
on
some
of
the
work
that
social
care
have
done
about,
ensuring
that
social
Care
Service
users
have
got
at
least
three
people
that
can
call
on
in
any
crisis.
So
we're
looking
to
to
roll
that
concept
out,
obviously,
a
bit
further
and
and
city-wide
as
well.
M
We've
already
heard
about
we're
getting
more
people
more
active,
more
often
than
that
remains
a
huge
priority
and
linked
into
that
is,
is
the
need,
I
think
to
improve
some
of
those
transport
links
that
have
been
begun
to
be
discussed
at
a
previous
health
and
well-being
board.
M
The
mentally
healthy
leads
thing
absolutely
is
a
a
theme
that
runs
through
the
the
entire
strategy,
we're
also
in
the
process
of
reviewing
at
the
moment,
the
mental
health
strategy
and
and
just
quickly,
there's
been
some
some
challenges
in
that
area,
obviously,
in
the
pandemic
and
before
particularly
around
Children's
Mental
Health,
but
over
the
last
period
we
have
reviewed
early
intervention
services
for
people
with
anxiety
and
depression.
M
In
particular,
we've
opened
Redcat
view,
obviously
in
in
Leeds,
for
as
a
children's
residential
project,
and
we've
got
the
excellent
Synergy
work,
which
looks
to
improve
outcomes
for
black
and
minority
groups
within
the
mental
health
system,
and
particularly
the
the
acute
system.
So
the
Firefall
in
the
The
People's
category
there
is,
is
the
importance
of
supporting
people
who
care
for
a
relative,
neighbor
or
friend.
That's
a
new
priority
and
and
reflecting
on
all
the
work
in
in
the
pandemic,
particularly
around
the
community
hubs.
M
We
felt
that
that
was
really
important
to
be
reflected
in
this
in
this
strategy,
so
we've
also
got
four
priorities
in
in
in
the
draft
play
section.
Obviously
these
are
all
at
the
moment
open
for
for
discussion.
These
are
just
things
that
we're
Landing
for
engagement.
M
As
you
know,
we
feel
the
fifth
one
is
about
reflecting
the
the
absolute
importance
of
the
diversity
of
the
Leeds
Community,
but
connecting
those
communities
to
each
other
and
within
communities
as
well,
particularly
around
some
of
that
work
on
intergenerational
factors
that
we
know
is
increasingly
important
as
we
get
a
significant
growth
in
the
population
of
children
and
young
people,
but
also,
at
the
other
end,
the
the
challenges
that
we've
rehearsed
in
this
Bob
before
about
the
Aging
population
and
the
number
of
people
with
long-term
conditions.
M
The
sixth
one
covers
a
lot
of
the
work
that
that
we've
done
around
Community
safety
around
Health
protection,
but
ultimately,
how
we
promote
health
and
well-being
across
leads,
as
well
and
I.
Think,
as
we
know
how
people
feel
and
and
interact
in
the
neighborhood
is
a
real
indicator
of
good
health.
If
you
feel
unsafe
on
the
ground,
it
leads
to.
You
know,
stresses
and
strains
that
can
lead
to.
M
You
know
earlier
access
to
things
like
residential
or
or
domiciliary
care,
so
improving
the
work
that
we
do
with
our
colleagues
in
the
in
the
safer
communities
world
and
the
community
section
more
more
generally
is
really
important,
and
then
the
one
that
I
think
we
all
agree
is
is
something
that
we
need
an
additional
focus
on.
So
we've
set
up
I.
M
Think
probably
a
lot
of
people
around
the
table
will
know
a
breakthrough
project
to
look
at
how
we
improve
housing
and
health
and
and
and
how
we
really
look
to
improve
sort
of
a
lot
of
the
the
offer
that
we've
got.
M
Perhaps
things
around
that
the
private
sector
accommodation
we've
got
selective
licensing
it's
councilor
Reef
mentioned:
we've
also
had
a
couple
of
pilot
projects
around
mental
health,
for
people
who
live
in
tower
blocks
that
we're
looking,
maybe
to
to
reinstate
and
to
try
and
get
funding
to
to
scale
that
up
a
little
bit
as
well.
But,
ultimately,
we
know
housing
is
a
real
indicator
of
good
health,
so
that'll
be
one
the
board
focuses
on
over
the
foreseeable
future.
The
eighth
one
is
around
around
integration.
M
So
the
idea
with
this
strategy
is
that
it
sits
really
closely
with
the
healthy
leads
plan
that
we've
just
heard
about,
and
our
colleagues
in
the
NHS
are
obviously
doing
a
huge
amount
of
work
on
population
Health,
on
managing
long-term
conditions
and
on
integrating
the
the
acute
sector
into
into
all
the
work
that
that
we
do
as
well,
so
that'll
be
a
huge
priority
for
for
Tim,
Rebecca
and
and
all
our
colleagues
and
then
finally,
the
productivity
ones
again.
These
are
these
are
really
really
important
and
I
think
it's.
M
It
is
important
to
acknowledge
the
real
challenge
that
we've
got
around
employment
and
around
cost
of
living
and
around
some
of
the
inequality
indicators,
but
one
of
the
things
that
that
we
think
we
can
do-
and
at
the
moment
we
probably
don't
do
as
well
as
we
could-
is
to
improve
outcomes
for
people
with
mental
health
learning
disabilities
and
physical
health
problems,
but
also
as
a
result
of
a
couple
of
the
papers
that
have
come
out
last
week
of
the
office
for
National
statistics.
M
We
know
that
nationally
about
half
a
million
over
50
is
after
kobit
have
left
the
workforce.
So
we
know
if
we're
going
to
get
those
people
back
into
work,
and
we
know
some
of
the
challenges
we've
got
of
recruitment
in
in
all
sectors.
M
At
the
moment,
we
need
to
keep
our
people
healthy,
but
we
also
need
to
make
sure
that
we
we
target
employment,
support
far
more
effectively
on
on
some
of
those
groups,
and
it
is
a
challenge
but
I
think
the
learning
from
the
pandemic,
which
we've
we've
heard
about
is
it
probably
gives
us
a
few
a
few
lessons
so
on
on
the
learning
disability
agenda
in
particular,
we
took
some
quite
Brave
decisions
to
promote
the
vaccine
and
open
up
the
vaccine
to
all
people
with
learning
disabilities
at
an
early
stage,
and
that
yielded
some
huge
dividends,
saved
lives
and
I.
M
Think
that
that
type
of
focus
is
something
I
think
we
can
do
with
employment
and
employment
support.
So
we're
talking
to
colleagues
of
City
development
and
the
department
for
work
and
pensions
about
how
we
up
our
game
in
that
area
as
well
and
then
the
final
three
equally
important
and
linked
into
inclusive
growth
is,
is
how
we
develop
skills
in
the
in
the
workforce,
both
in
the
health
sector
and
and
more
generally
huge
issues
to
keep
our
people
healthy
and
and
to
keep
the
workforce
in
good
shape.
M
The
11th
one
is
something
against
scrutiny.
Board
has
taken
papers
before
about
how
we
work
with
the
universities,
about
health
Innovation
and
some
of
the
work
of
the
Leeds
academic,
Health
Partnership,
which
we're
bringing
in
to
this
conversation
as
well
and
I.
Think
importantly,
one
of
the
the
lessons
that
we've
probably
got
in
this
area,
if
you
look
at
particularly
London,
but
also
to
some
degree,
Manchester
they've
had
a
number
of
pilot
projects
that
look
to
develop
small
and
medium
Enterprises
social
Enterprises
in
some
of
our
more
challenging
areas.
M
And
there
are
lessons
about
how
we
might
do
that
and
really
sort
of
bring
through
the
talent
that
we've
got
across
the
city
in
those
areas
and
then,
finally,
and
and
the
idea
of
the
the
strategy
was
to
bookend
friendly
at
the
start
and
and
fairer
at
the
end,
which
came
out
of
a
lot
of
community
engagement
and
that's
around
the
the
work
on
which
I
guess
is
the
golden
thread
running
through
that?
M
The
first
presentation
this
one
unimpact,
the
one
we
got
to
follow
as
well
is-
is
how
do
we
get
to
to
a
fairer
leads
for
all
and
I
think
that's
the
ultimate,
Challenge
and
and
I'll
probably
leave
it
there.
This
is
obviously
the
first
conversation
we've
got
in
scrutiny
and
and
liked
him
and
Rebecca.
We
will
be
coming
back
at
a
later
date,
I
think,
probably
in
December
and
February
as
well.
Thank
you,
chair.
A
Thank
you
very
much.
Tony
yeah
you're
due
to
come
back,
I
believe
it's
in
March,
so
you're
down
on
the
schedule,
and
just
just
let
you
know
that
every
month,
I
do
catch
up
with
Tony
on
updates
and
I.
Tell
you
even
whilst
I
was
on
holiday
himself
and
Steve
did
inspire
me.
I
had
to
zoom
in
from
abroad
to
joining
this
update,
so
I
do
know
how
much
work
they
do
on
this
and
it's
lovely
to
see
these
priorities
like
we
said
previously,
we
just
need
this
to
be.
A
You
know
we
need
outcomes
now
they
are
great.
The
strategy
looks
really
really
promising
and
yeah.
We
look
forward
to
hearing
from
yourself
with
him
in
terms
of
the
key
highlights
of
this
this
strategy.
Thank
you.
N
Thanks
chat,
I
think.
The
only
thing
I
want
to
kind
of
add
to
what's
already
been
said
is
I.
Want
you
to
make
the
point
that
links
to
the
previous
comments
in
the
last
item
around
the
equality,
diversity
and
inclusion
lens
to
this
as
well,
particularly
in
the
look
and
feel
of
the
document,
but
making
it
accessible
and
making
sure
it
reflects
the
diversity.
N
The
rich
diversity
of
our
communities
across
the
city
and
and
one
of
the
things
I
think
is
really
important,
which
councilman
has
really
pushed
as
well
and
promoted
on
the
health
and
wellbeing
board
is
the
allyship
program
which
links
our
health
and
well-being
board
members
with
community
of
Interest
Network
third
sector
colleagues
as
well,
so
we're
having
that
constant
conversation.
We
don't
just
wait
for
board
meetings
to
happen.
Actually,
that's
that
constant
conversation
with
third
sector
colleagues
and
third
sector
leaders
to
understand
the
priorities
of
marginalized
communities
as
well.
N
So
I
just
thought:
I'd
highlight
those,
probably
because
it
you
know
it
really
links
well
and
I.
Think
the
other
thing
is,
and
it
links
to
the
last
item
that
again
is
around
the
West
Yorkshire
partnership
strategy.
So
when
we
presented
it
to
the
health
and
wellbeing
board.
A
F
This
this
one
kind
of
links
to
the
last
agenda
item
as
well.
In
a
way,
it's
a
question
about
how
the
links
work
with
people
being
discharged
from
hospital
and
the
social
care
aspects
are
involved
in
that
and
support
for
them,
because
councilor
Anderson
and
myself
have
been
made
aware
of
of
a
lady
who's.
F
She
was
provided,
we
think,
with
a
an
operation
in
a
private
Hospital
on
behalf
of
the
NHS
and
was
then
discharged
from
that
hospital
very
early
and
shoved
back
into
her
own
home,
but
without
any
care
procedures
being
put
in
place
for
that
and
any
treatment.
So
it's
the
bit
about.
How
do
we
stop
her?
F
Because
the
health,
the
active
lifestyle
bit,
is
about
how
do
we
stop
her
and
then
back
up
in
hospital
again,
because
she
hasn't
had
the
care
that
she
needs,
but
also
what
are
the
links
between
a
private
Hospital
doing
an
operation
on
behalf
of
the
NHS?
How
do
they
actually
link
that
to
the
discharge
process
so
that
the
social
care
is
linked
into
that?
So
it's
it's
a
question
that
it
has
been
raised
two
or
three
times,
but
there
has
been
a
very
recent
case,
which
is,
is
quite
unsettling
involving
a
90
year
old
lady.
M
Can
take
that
one?
Thank
you.
Yeah
there's
been
a
huge
amount
of
work
on
Hospital
discharge,
but
inevitably
there's
probably
a
lot
more
to
do
and
I
think
in
individual
case,
like
that
probably
needs
to
be
taken
back
so
I'll
have
a
conversation
with
with
katha's
director
and
Council
Harrington
I'll
I'll
either
give
you
a
call
I'll
ask
tough
to
do
so,
but
I
do
think
more.
M
More
generally,
some
of
the
Pathways
in
and
out
from
my
time
in
the
NHS
a
number
of
years
ago,
in
and
out
of
private
sector
have
always
been
been
quite
a
challenge,
because
systems
are
traditionally
always
talk
together.
I
think
we've
seen
some
of
the
challenges
as
I'm
sure
Dr
Bill's-
probably
going
to
jump
in
on
this
one
about
how
this
works
with
with
Dentistry
as
well.
M
J
Yeah
thank
you,
chair
and
just
to
just
to
add
thanks
to
councilor
Harrington.
For
that
and
it's
not
the
first
time
we
we're
hearing
these
stories.
Is
it
I
think
there
are
some
patterns
here?
We
need
to
be
mindful
of
and
I
think
going
back
to
the
last
conversation
with
with
Tim,
though
there
is
something
very
real
about
looking
at
all
of
the
pressure
that
the
NHS
is
under
and
the
solutions
that
are
found
to
manage
that
and
really
thinking
about.
J
J
How?
How
do
we
ensure
that
that
that
you
know
we
maintain
the
quality
and
all
of
that
patient
experience
stuff?
J
As
we
see
some
of
some
of
some
of
this
happening
more
and
more
often
so,
I
think
there's
a
role
for
all
of
us
to
play
in
sort
of
keeping
a
a
watching
brief
on
some
of
that
and
supporting
our
NHS
colleagues
in
in
listening
to
the
feedback
and
making
sure
that
that's
built
into
some
of
the
solutions
so
yeah
thanks
for
raising
it
and
I
think
that's
part
of
our
jobs
going
forward.
Thank
you.
Thank.
C
A
quick
question:
Tim
I
drew
for
an
application,
no,
they
just
said,
for
instance,
and
it's
under
the
NHS
and
the
NHS
referred
me
to
a
private
hospital
to
do
it,
but
it's
still
NHS.
Are
you
telling
me
there's
no
communication
between
both
parties?
Because
if
I
went
on
the
behalf
of
the
NHS
and
they
are
going
to
discharge
me
a
while
I'm
there
shouldn't
they
not
be
communicating
both
sides
to
know
this
patient
is
going
home
is
happening,
my
ward
a
few
weeks
ago
as
well.
Should
they?
Where
is
the
communication?
M
Foreign
obviously
can't
answer
specific
cases,
but
one
thing
that
the
NHS
has
always
done
is
is
utilized
capacity
in
the
private
sector.
At
times
of,
obviously,
of
you
know
when,
when
times
are
busy,
and
particularly
Primary
Care,
inevitably
will
use
that
capacity
in
private
sector
in
Leeds,
so
yeah.
It's
just
making
sure
that
those
pathways
are
in
place
and
are
working
effectively.
Isn't
it
and
making
sure
that
a
clinician
in
the
hospital
communicates
appropriately
with
a
clinician
in
in
Primary
Care?
M
It
can
be
harder
in
different
systems.
Inevitably,
although
at
times
obviously
it
can
be,
it
can
be
difficult
in
in
any
system
when
you've
got
complex
clinical
pathways.
C
Nursing
is
my
background
and
that's
what
I
used
to
be
in
the
hospital,
so
I
think
the
communication
just
gone
out,
because
in
my
days
back
in
early
2000s,
when
I
was
there,
it
was
Bupa
days
then,
and
if
we
were
for
someone
to
Boop,
there's
always
communication
between
us
and
Bupa
would
not
discharge
this
individual
until
we
at
the
other
end,
get
all
the
works
in
place.
So
are
you
saying
it's
stopped?
There's
no
community
of
this
page
and
that's
it.
No.
M
No
I'm
not
saying
that
and
I
think
oh
yeah,
yeah
yeah,
so
yeah
yeah,
yeah,
yeah,
yeah
I
think
it
can
come
communicationally
on
your
system
can
can
be
challenging
at
time
and
there
are
things
like
the
friends
and
families
test,
but
obviously
everyone
does,
after
you
know
an
intervention.
It's
important
to
use
that
and
to
feed
back
to.
You
know
to
the
many
people
that
are
responsible
for
for
care,
ultimately,
and
obviously
in
the
acute
sector
that
there's
Pals
as
well
as
a
service
that
that
people
can
use.
M
C
M
And
yeah
absolutely
completely
agree.
You
know
the
winter
is
a
really
critical
time
for
for
everyone,
isn't
it
and
no
one
needs
a
an
intervention
that
that
is
perceived
to
be.
You
know
not
something
that
that
helps
them
and
if
people
are
being
discharged
too
early,
obviously
it's
something
that
the
office
is
here
or
or
NHS.
Colleagues
can
can
help
and
support
with.
There's
no
question
we'll
do
our
best.
A
Thank
you
Tony.
So
definitely
that
will
be
something
that
we
would
get
need
some
update
on
when
you
could,
when
we
come
back
in
March
of
2023,
but
in
the
meantime
you
did
promise
to
get
back
to
councilor
Harrington
on
that
yeah.
So
it'll
be
really
nice
to
know.
What's
going
on
there,
it's
Dr,
Bill
and
then
counselor
hatbrick.
D
Thanks
Jack
I'd
like
to
pursue
what
councilor
Harrington
started
on
looking
at
at
the
right
level
of
care,
but
I
want
to
move
towards
unpaid
carers.
One
of
the
things
that
Council
levena
has
introduced
for
members
of
health
and
wellbeing
board
is
that
we
all
have
an
ally
from
the
third
sector.
It
so
happens
that
my
Ally
is
Kara's
leads
and
I'm.
D
I
have
to
say
it
goes
back
to
David
Cameron's,
the
big
Society,
a
good
idea
which
which
never
really
flourished,
never
really
took
off,
but
I
believe
that
we're
going
to
have
to
rely
more
and
more
in
the
economic
crisis
on
unpaid
carers,
and
it's
very
important
that
we
care
for
the
carers
Because
unless
they
are
cared
for
unless
they're
supported,
unless
they're,
given
breaks
and
and
so
on,
then
the
person
they're
caring
for
is
going
to
suffer
so
I.
Think
we've
got
to
look
very
carefully
at
how
we
best
care
for
carers.
A
Absolutely
Dr,
Bill
I
couldn't
agree
more
and
from
a
cultural
point
of
view.
I
do
know
my
culture
and
so
many
other
cultures
where
our
elderly
people
we
do
not
take
them
into
nursing
homes,
a
residential
homes,
so
we
care
for
them
in
our
own
homes.
So
you
can
see
why
that
priority
is
really
really
important,
because,
no
matter
how
much
you
care
and
love,
you
would
need
a
break
and
any
support
for
sometimes
the
person
who's
actually
given
the
care
is
so
so.
A
What's
the
word
in
English,
tired,
exhausted
and
would
need
a
break,
so
any
form
of
support
I
really
really
welcome
this
priority
in
terms
of
encouraging
people
and
obviously,
as
we're
getting
into
more
difficult
times,
it
will
be
more
needed
than
ever
so
I
had.
Is
it
cancer
heartbroke
and
then
did
I
have
I
had
a
hand
there
Council
venner
and
then
back
to
you
customer
Anderson.
Thank
you.
L
I
certainly
know
in
my
community
and
around
I
see
more
of
that
being
done.
I
wish
less
of
it
was
needed,
but
it
is,
and
it
fulfills
a
vital
role
and
should
be
recognized
as
such.
L
L
It
needs
to
be
honest
around
actually
we're
either
commissioning
to
get
their
private
sector
to
do
some
of
some
degree
of
follow-up
or
we're
very
clear
that
isn't
there
and
therefore
have
decisions
to
make
within
the
NHS
and
within
our
clinical
provision.
What
we
do
to
fill
that
up
and
factor
that
into
the
total
life
cycle
cost.
H
Thank
you.
I
wanted
to
follow
up
Dr
beale's
point
about
about
carers.
H
I
meet
regularly
with
the
chief
executive
careers
leads
and
casters
as
well
Cather
off
separately
to
me,
and
it
feels
really
important
that
we
do
that,
so
that
we,
both
of
us
as
kind
of
see
near
leaders
within
the
system,
get
really
direct
like
first-hand
feedback
from
her
about
what
it's
like
for
carers
on
the
ground,
and
it's
really
helpful
because
she'll
give
us
that
that
very
front
line
Grassroots
experience,
and
we
are
really
aware
that
carers
are
being
asked
to
do
more.
H
Assessments
have
done
really
promptly
that
people
have
access
to
respite
if
they
need
it,
and
we
have
a
career
strategy
for
leads
which
has
a
title
of
Clarence
at
the
heart
of
everything
we
do,
which
is
very
much.
What
kind
of
caress
leads
and
Karis
wanted
to
be
our
approach
and,
of
course,
we
have
a
lot
of
young
carers
and
leads
as
well.
H
We
have
a
lot
of
children
who
are
carers,
who
are
also
supported
by
specific
services,
but
I
just
wanted
to
give
Assurance
to
the
board,
really
that
both
Kath
and
I
am
really
aware
of
the
pressure
on
carers
and
that's
why
we've
set
up
this
very
direct.
Regular
contact
with
carers
lead
so
that
we
can
hear
firsthand
how
it
is
for
people
and
try
and
ameliorate
the
pressure
that
people
are
under.
Thank
you.
A
Thank
you,
that's
very
comforting
to
know
councilor
Bennett.
Thank
you,
councilor
Anderson
thank.
F
We
had
a
subcommittee
meeting
this
morning
of
the
health
subgroup
of
our
outer
Northwest
Community
Committee,
and
we
heard
from
Tim
a
forgotten
his
surname,
who
might
have
been
yeah
specializes
in
dementia,
within
adult
social
care
here,
and
he
was
telling
us,
and
even
in
our
area
there
are
12
of
the
people
with
dementia
and
I
really
are
living
with
severe
dementia
and
of
those
50
are
still
living
at
home,
which
is
in
one
way
it's
great
because
they're
not
in
a
nursing,
home
and
they're
being
cared
for
by
a
spouse
or
a
partner,
and
but
they
must
be
under
so
much
pressure
and
I
know.
F
During
the
pandemic,
we've
got
at
least
three
friends
who
were
looking
after
their
husbands
or
wives,
with
severe
dementia
during
the
pandemic
and
I
just
cannot
fathom
how
they
how
they'd
got
through
it
really
but
I
think
you
know
they
do
an
absolutely
wonderful
job.
You
know,
unpaid
care
is
fantastic
and
I
always
refer.
People
to
carers
leads
just
for
support
and
to
see
what's
what
is
available
for
them,
because
a
lot
of
the
time
people
don't
actually
know.
F
H
Here,
I
just
wanted
to
come
back
on
that
really
specific
point
about
people
not
knowing.
What's
out
there
I
think
this
board
might
remember
when
we
brought
the
the
monitoring
from
the
adult
social
care
outcome
framework
they
ask
of
measures.
H
A
couple
of
months
ago,
we
noted
that
just
satisfaction
levels
had
gone
down
for
both
people
in
the
receipt
of
service
and
carers,
and
at
the
time
we
didn't
have
data
for
either
for
other
authorities
to
just
compare
whether
this
was
a
national
issue,
because
actually
it
was
looking
back
over
the
last
year
and
I,
don't
I,
don't
think
anyone's
satisfaction
with
their
life
over
the
last
year
would
have
gone
up
really
given
what
we
were
living
through.
But
we
were
really.
H
We
did
really
know,
really
focus
on
the
current
aspects
of
that
and
I
think
and
whether
people
know
what
support
is
out
there
and
custard
actually
take
an
action
away
about
committing
to
making
sure
that
we
write
out
characters
and
remind
them.
What
is
there
because
I
think
when
you're,
when
you're
very
immersed
and
caring
it,
you
need
that
information
given
to
you
really
directly
and
easily
and
excessively
because
it's
hard
to
look
for
it
yourself.
So
we
have.
We
have
absolutely
picked
up
a
specific
action
from
the
ask
of
monitoring.
Thank
you.
L
I
think
that
actually
signposting
people
to
the
fact
you
are
a
carer,
because
I
again
I've
experienced
that
you
know
in
my
own
my
own
kind
of
family
situation,
where
whether
it
be
they're
being
registered
at
the
GP
as
a
carer
or
actually
thinking
of
themselves
as
as
a
carer,
rather
than
just
doing
what
any
family
member
would
do.
You
know
there
is
because
often
it's
not
a
step
change.
Often
it's
a
gradation,
especially
with
things
like
dementia,
where
some
subject
just
creeps
up
on
you
and
I.
L
Actually,
you
are
now
doing
this,
and
here
are
some
resources
that,
as
this
progresses
and
you
go
on
this
journey
with
your
loved
one,
you
couldn't
you
know,
gain
access
to
an
increasing
and
appropriate
level
to
to
the
resources
that
are
out
there
and
it's
it's
difficult
from
a
sign
posting
point
of
view,
because
it's
not
it's
not
it's
not
binary,
it's
not
a
switch
where
something
goes
from,
not
being
a
carer
into
a
carer.
Often
it's
a
slope.
H
The
point
I
wanted
to
make
an
in
response
to
you
was
actually,
as
I
mentioned
at
this
point
earlier
term,
in
response
to
something
you
said,
but
I
was
referring
to
the
point
about
people
aren't
necessarily
identifying
as
carers
I
spoke
at
an
event
earlier
this
year,
that
was
about
dementia
in
Bain
communities.
H
Most
people
there
were
specifically
from
from
black
minority
groups
and
that
the
point
you
made
earlier
to
come
across
really
clearly
about
people
want
to
care
for
their
relatives
at
home
and
for
them
not
to
go
into
Care
Homes.
So
the
absolute
importance
of
making
sure
carers
have
support,
but
there
was
also
a
theme
about
people
not
identifying
as
carers.
So
you
know
well,
it's
my
mom.
It's
my
partner
I'm,
just
not
having
not
not
necessarily
recognizing
that
label
of
care.
H
It's
just
what
you
do
if
you've
got
a
partner
or
a
family
member
who
needs
care
so
I
think
that
makes
it
that
is
an
I
mean
it
was
identified
in
the
event
that
that's
an
additional
potential
barrier
to
people
getting
support
if
they
don't
identify
as
occur
and
that's
more
prominent
in
some
groups.
Thank
you.
A
Thank
you
very
much,
Wasim
Tony
is
there
anything
you
would
like
to
add
to
this
before
we
move
on
to
the
next
agenda
and.
M
Just
just
to
say,
thanks
for
all
the
comments,
we'll
absolutely
take
them
on
board
and
I
think
just
just
quickly
on
on
the
carers
issue,
one
that
carers
was
not
in
the
previous
strategy,
it's
something
that
that
is
entirely
new
and
that
absolutely
reflects
the
need
for
visibility
and
the
importance
of
of
the
agenda.
So
when
we
do
the
communications
and
engagement
over
the
next
few
months,
obviously
that's
something
we.
M
We
will
have
a
an
absolute
focus
on
which
will
be
encouraging
people
to
understand
whether
they
are
a
carer
and
and
the
role
that
carers
play
as
well.
I
mean
I.
Think
probably
everyone
in
the
room
is
probably
caring
for
for
someone
either
younger
or
or
older,
so
yeah.
Absolutely
it's
something
that
needs
that
that
prominence,
but
also
in
in
the
communications
around
the
strategy
as
well.
A
Thank
you
very
much,
so
we
will
continue
to
have
a
watching
brief
on
that
and
I'm
obviously
you're
coming
back
to
ourselves
in
March
of
2023.
So
you
would
be
really
good
to
just
to
have
an
update
on
the
refreshed
health
and
well-being
strategy
prior
to
our
meeting
in
March
of
2023.
So
thank
you
very
much
again.
A
I
think
you're
still
gonna
be
there
for
the
next
agenda,
maybe
just
Wasim
or
similar
free
to
stay.
If
you
would
like
to
but
well
yeah
that's
fine,
Tony,
I
I
know
you're
you're
down
for
the
next
agenda.
Okay,
so
then
number
nine,
you
will
be
Mammoth
City
progress
update.
We
all
know
that
this
is
the
mammoth
City
and
proposal
was
something
this
board
really
welcomed
them
and
personally,
very
proud
of
it
and
where
we
are
so
far,
so
it
will
be
very.
A
It
will
be
brilliant
to
hear
from
yourselves
and
what
you
have
been
doing
so
far
and
all
the
existing
commitments
across
all
Partners
to
reduce
Health
inequalities
and
improve
the
health
of
the
poorest,
the
fastest
I.
Don't
know.
Councilor
Taylor
says
she
doesn't
like
that
word
of
the
poorest
and
the
fastest,
but
yeah
there
you
go
it's
down
there,
so
we
would
need
an
upgrade
and
sorry
update
in
terms
of
the
progress
for
this
work
and
obviously
we
would
also
love
to
know
your
next
steps.
A
O
It's
all
right!
Thank
you
very
much
chair
and
great
to
be
here.
So
it's
Tim,
Fielding
I'm,
deputy
director
of
Public
Health,
so
I
started
relatively
recently
with
the
council
back
in
July,
so
yeah
pleasure
to
be.
I
Yes,
chair,
that's
me
so
yeah,
please
bring
this
Marmot
City
pronounce
report
back
to
the
board,
particularly
on
the
back
of
the
conversations
councilor
tilling
vote
on
about
health
inequalities.
So
lots
of
progress
has
been
made
since
January,
including
recruitment
to
some
K
public
posts
that
will
contribute
to
the
Man
City
work,
including
our
deputy
director
of
Public
Health
Team,
and
also
the
head
of
Public
Health.
I
We've
been
developing
the
approach
based
on
the
feedback
from
scrup
and
other
key
forums,
including
identifying
the
best
art
and
housing
as
two
of
the
key
priorities
for
leads.
We've
been
ensuring
understanding,
support
and
buying
across
the
system.
We
know
from
the
other
Marmot
cities
that
strategic
commitments,
Partnerships
and
relationships
relationships
are
key
to
the
success.
I
We've
been
working
with
the
leads
for
the
three
best
city:
ambition
pillars
to
embed
Marmot
City,
the
Monmouth
approach
in
the
refreshed
strategies
currently
being
drafted,
and
also
embedding
the
principles
and
approaches
in
wide
in
a
wide
range
of
work.
That's
that
the
officers
will
will
talk
about.
I
It's
also
important
to
appreciate
that
it's
still
very
early
days
and
we
we
have
not
yet
formally
agreed
or
launched
the
approach
with
the
national
Marmot
team,
Council
of
NS
senior
officers
and
I
are
meeting
with
the
Marmot
team
at
the
beginning
of
November
to
discuss,
confirm
the
approach
and
time
scales.
It's
also
important
to
recognize
that
becoming
a
mum
at
city
is
not
it's
not
going
to
to
lead
to
lots
of
completely
new
projects
and
interventions.
I
Unfortunately,
there's
no
additional
Marmot
funding
stream
and
everybody
around
this
table
will
be
aware
of
the
financial
challenges
that
the
city
faces.
But
what
we
will
do
is
help
us
go
further
and
faster.
Improving
the
health
and
of
the
poorest
and
the
fastest
is
is
detailed
in
in
section
19,
and
some
of
the
work
that
will
be
that
we'll
be
doing
is
building
on
the
approach
that
we've
taken
in
lead
so
far
and
quality.
So
we're
going
to
amplify
work
already
already
happening
and
going
faster
and
quicker.
I
We're
going
to
use
by
using
the
evidence
to
identify
gaps
and
opportunities
influencing
resource
allocation
where
appropriate
and
working
with
colleagues
across
the
council.
Ensuring
that
equality
inequalities
is
everybody's
business,
while
wanting
to
push
on
the
work
and
make
a
difference
fairly
quickly.
It's
also
important
that
we
do
it
in
the
right
way
and
we
don't
rush
anything
that
we
ensure
that
the
approach
taken
is
absolutely
right
for
leads,
which
is
being
done
currently.
O
Thank
you
serif
and
thanks
Jay
I'll,
assume
people
have
read
the
report
and
hopefully
can
see
some
of
that
progress
we
made
and
some
which
has
been
covered
there
through
through
Council
RF
and
all
of
this
work
over
this
last
year
in
developing
the
Marmot
City,
work
has
led
to
a
significant
impact
already
across
a
range
of
areas
in
terms
of
really
informing
and
shaping
a
range
of
work.
O
So,
even
though
the
the
formal
stage,
if
you
like
of
the
Marmot
City
work,
hasn't
yet
commenced
and
will
follow
on
from
that
more
formal
agreement
with
the
Institutes
of
Health
Equity,
and
we
we
anticipate
that
that
would
starting
kick
in
early
next
year.
It
is
still
had
a
significant
bearing
on
shaping
across
a
wide
range
of
the
work
following
on
from
this
last
year.
So
some
of
the
particular
areas
I
wanted
to
highlight
were
areas
like
housing.
O
Some
of
these
really
key
building
blocks
of
of
our
health
and
our
own
health
and
communities,
so
Public
Health,
housing
and
health
Partnerships
colleagues
have
been
working
really
closely
across
colleagues
across
the
council,
linked
to
some
of
the
work
that
Tony's
already
mentioned.
For
example,
through
the
Breakthrough
project
really
ensuring
that
the
there
was
a
marmot
approach
taken
right.
The
way
through
that
work
through
the
Breakthrough
project,
get
aligned
with
that
best
city
ambition.
O
So
some
of
the
early
sort
of
examples
that
have
come
from
that
we're
doing
a
piece
of
work
at
the
moment
evaluating
ourselves
and
self-assessing
ourselves
right
across
all
of
the
the
range
of
moment,
recommendations
that
have
come
out
from
existing
Marmot
reports,
including
some
specifically
on
housing.
That's
going
to
give
us
a
really
valuable
Baseline
and
showing
really
key
light
early.
Even
before
we
started
the
formal
work
and
Tony's
already
mentioned
some
of
the
other
areas
like
the
selective
licensing
and
the
continuing
roll
out
of
that
work.
O
Looking
at
some
of
the
the
further
extension
potentially
of
the
rise
High
work
and
some
of
the
wider
partnership
work
that
we're
doing
and
again
absolutely
ensuring
that
we
do
that
in
a
really
dovetail
way
through
the
Marmot
approach
with
those
existing
areas
to
ensure
that
they
absolutely
do
add
as
much
value
as
possible
to
right
the
way
across
the
population.
As
Council
virus
already
said,
the
Marmot
approach
isn't
going
to
be
something
that
is
completely
new
and
sits
entirely
separate
from
existing
work.
O
It's
one
of
the
key
principles
that's
highlighted
in
the
report
is
about
that
strategic
alignment.
It
will
be
about
working
in
really
close
alignment
with
those
existing
structures
with
those
existing
colleagues
with
those
existing
strategies,
particularly
those
big
three
of
the
the
best
city
ambition
and
also
the
healthy
leads
plan
to
make
sure
we
are
as
effective
as
possible
in
relation
to
the
health
inequalities
within
them.
Another
key
areas
around
cost
of
living,
obviously
very
acute.
O
The
time
frames,
as
the
report
highlights,
are
that
we'll
be
working
across
them,
the
short
medium
and
longer
term,
which
is
critical
when
we're
looking
at
some
of
these
Health
inequalities,
but
actually
we
we
do
need
to
be
really
clear
about
those
very
short-term
pressures
that
people
are
facing
right
now,
and
so
obviously,
ourselves
working
really
closely
with
with
other
colleagues
around
those
immediate
cost
of
living
issues.
We're
also
working
really
closely
thinking
a
bit
further
ahead
around
the
inclusive
growth
and
employment
issues,
as
well
so
building
again
on
some
of
the
work.
O
That's
already
been
referred
to
working
really
closely.
Some
of
the
examples
there
are
pieces
of
work,
for
example,
that
we're
in
the
process
of
planning,
jointly
with
health,
Partnerships
team
and
inclusive
growth.
Colleagues
around
really
understanding
and
researching
what
is
underneath,
the
the
current
trends
and
current
economic
inactivity
that
we're
seeing.
So
why
is
it
that
we
see
that
the
trends?
O
We
know
that
the
the
new
trends,
if
you
like
in
economic
inactivity,
which
are
driving
some
of
those
inequalities
really
getting
under
the
skin
and
understanding
those
in
our
communities
in
Leeds?
Also
building
on
some
of
the
work
that
we've
got
funded,
currently
three-year
funding
with
Health
Foundation
working
building
on
the
work?
O
That's
been
done
with
anchor
institutions,
but
taking
that
into
the
private
sector,
around
business
anchors
and
really
trying
to
strengthen
the
role
of
the
business
sector,
private
sector
and
links
with
public
sector
anchor
institutions
and
the
community
as
well,
and
then,
finally,
just
to
mention
the
best
start
area.
So
the
best
starts
another
area
that's
been
highlighted
is
one
of
the
key
priorities.
We
do
have
a
Best
Start
Plan
with
an
action
plan
that
goes
with
that
and
there's
going
to
be
workers
identified
in
the
report.
O
That
will
really
be
one
of
the
key
areas
that
we
take
forward,
but
again
really
to
try
and
assure
the
committee
that
actually
significant
work
is
already
being
done
in
anticipation
of
that
piece
of
work.
Preparing
the
health
needs
assessments
undertaking
the
evaluation
of
what
the
impact
of
the
current
plan's
been,
but
also
really
shaping
existing
work
with
that
Marmot
approach
about
recognizing
all
those
principles
at
the
moment
approaching
the
work
that's
happening,
for
example
around
childhood
vaccinations
and
also
the
sort
of
recovery
from
covert
in
relation
to
children.
O
So
really
just
happy
to
take
any
questions.
Anthony
and
very,
very
happy.
I
would
expect
to
be
get
the
opportunity
to
come
back,
hopefully
early
next
year,
once
we've
got
that
Clarity
and
the
sort
of
formal
time
scales
and
processes
with
the
Institute
to
give
that
next
update
about
where
we
are
and
how
we're
taking
that
forward
for
them.
Thank.
A
You
sure
thank
you
very
much.
Tim
now
over
to
board
members
councilor
Gibson.
B
Thank
you,
chair,
I
was
really
excited
actually
when,
when
I
first
heard
about
this
project,
I
think
it's
wonderful
and
it
was
great
when
he
came
to
full
Council,
so
I'm
really
glad
to
see
that
it's
progressing
I'm
disappointed
to
hear
that
there's
no
money
specifically
allocated
to
it,
but
I
mean
you
know
in
the
times
that
we're
in
in
the
12
years
of
cuts
and
things
are
set
to
go
to
worse.
I.
Suppose
that's
not
surprising,
but
my
first
question
relates
to
to
funding
directly.
B
Is
there
an
acknowledgment
from
central
government
about
the
benefits
of
this
approach
and,
and
is
there
any
support
from
central
government
and
including
money
for
taking
this
sort
of
approach?
Or
is
it
very
much
just
you
know
as
a
local,
Authority
and
and
maybe
regionally,
we've
just
decided
that
it's
something
that
we
want
to
move
forward
forward
with.
J
Yes,
please
so
yeah
I
mean,
as
we
all
know,
there
is
no
money,
new
money
for
anything
at
the
moment,
so
I
think
it
feels
it
feels
absolutely
the
right
thing
to
do,
but
we
have
to
be
kind
of
extra,
bold
and
creative
about
how
we're
going
to
create
the
resources
to
do
it.
So
the
fact
that
we've
been
able
to
carve
out
some
you
know
part
of
Tim's
role
and
then
create
some.
J
Some
other
parts
of
roles
within
the
public
health
department
and
with
other
partners
means
that
we've
just
we've
just
been
really
creative
and
a
potentially
challenged
ourselves
to
stop
doing
stuff
that
isn't
as
important
as
this.
So
there
is
no
new
money,
there
is
no
kind
of
regional
pot
or
National
Pot
we
can
tap
into
for
this,
but
we've
we've
taken
the
decision
locally
to
to
to
make
that
happen
and
I
think
the
answer
to
the
central
support
is
it
is
is
no
this.
This
is
a.
J
I
Yeah
thanks
for
that
Victoria,
so
20,
question
communication
to
the
government's
priority.
Actually
I
think
it
was
only
last
week,
the
three
of
us
councilor
Vena
Council,
the
leader
of
the
council,
James
Lewis.
We
brought
to
the
state
of
Secretary
of
State
for
Health
and
Social,
because
there's
actually
reports
that
they're
not
going
to
publish
the
white
paper
on
health
inequality,
which
is
you
know,
it's
it's
ridiculous
to
be
to
be
quite
Frank
and
actually
shows
the
commitment
in
terms
of
funding.
I
Actually
public
health
and
leads
I,
don't
know
if
you're
aware
we
get
compared
to
the
rest
of
the
core
cities,
one
of
the
lowest
grant
funding
I,
believe
we
get
59
pound
per
head,
I
think
Manchester
Compares
at
108
pounds.
So
that
tells
you
the
level
of
money
that
we
have
got,
but
I
think
Leeds
does
recognize
that
it's
this
work
is
really
important.
We
recognize
that
the
pandemic
did
highlight
Health
inequalities
and
there
were
certain
areas
where
you
know.
Health
inequalities
certainly
were
a
greater
counselor.
I
The
chair
give
a
really
sober
statistic
earlier
and
other
server
statistic
is
that
women
in
Leeds
dock
have
the
lowest
life
expectancy
in
the
whole
of
the
country.
I
So
I
think
it's
those
sort
of
Statistics
where
we
as
Leaders
of
for
the
council,
have
got
to
think
about
what
what
can
we
do
and
how
can
we
commit
to
this
work
because
it's
really
really
important,
but
we've
got
to
sort
of
do
it
in
the
constraints
that
we're
up
against
councilor
Gibson
and
we're
trying
to
and
we've
got
Tim
in
place
and
we've
got
that
coming
and
carving
that
out,
but
I
think
we've
got
to
amplify
some
of
the
work
that
we're
talking
about
and
I
think
we've
got
to
be.
I
Creative
and
housing
is
definitely
something
that
is
is
really
important.
Just
to
give
you
an
example,
when
we
talk
about
why
the
determinants
of
Health
I
was
out
with
some
colleagues
from
selective
Licensing
in
hair
Hills
literally
last
week,
and
we
knocked
on
the
door
and
you
know,
she's
got
four
children
and
one
of
the
children
is
suffering
from
I.
Imagine
caseworkwise,
we
all
get.
I
This
is
breathing
difficulties
and
because
they
had
damp
in
the
house,
but
we
were
able
to
go
as
officers
and
we're
going
to
have
conversations
with
that
landlord
about
the
quality
of
that
housing.
I
So
I
think
those
are
the
sort
of
things
that
we
need
to
look
at
in
and
The
Wider
determinants
of
health,
and
that's
why
this
work
is
so
important
and
and
then
I'm
really
really
happy
that
the
council
is,
you
know,
pushing
forward
with
this
work,
but
it's
not
going
to
be
easy
and
we
just
have
to
be
really
clear,
creative
and
amplify
some
of
the
really
good
work.
That's
happening.
A
Thank
you
very
much
Victoria
and
councilor
Harry
for
that
obviously
breaks
my
heart
to
know
that
for
such
a
brilliant
proposal
as
this
which
all
of
us
and
this
on
this
board,
you
know
welcomed
and
looking
forward
to
to
seeing
seeing
it
happen,
and
we
know
that
for
some
certain
things
to
be
successful,
you
need
good
funding.
So
obviously
Victoria
you
did
say,
there's
no
new
money.
Is
there
any
old
money.
J
Well,
I
mean
that's
the
approach
we're
having
to
take
to
sort
of
recycle
and
re-prioritize
the
the
the
resources
we
already
have.
So,
for
example,
you
know
all
of
our
all
of
our
Public
Health
teams
are
re-looking
at
the
work
programs,
with
the
Marmot
focus
and
saying.
Actually,
how
do
we
bring
this
to
all
of
the
work
we
do,
rather
than
it
being
like?
Tim
was
saying,
rather
than
being
a
separate
project.
This
is
something
about
challenging
everybody
in
their
day-to-day
work,
so
yeah
we're
having
to
work
within
those
circumstances.
Chair.
A
Okay,
so
Tim,
then
counselor
hatbrick
and
counselor
Gibson.
O
O
One
is
it's
about
trying
to
to
raise
the
bar
further
on
the
effectiveness
of
the
things
that
we
do
collectively,
particularly
as
a
council,
but
also
as
a
system
and
a
city
and
a
group
of
Partners,
and
so
that's
about
getting
even
greater
banging
for
a
book
of
the
existing
money
that
that
we
do
get,
and
so
the
the
approach
hopefully
we'll
do
that.
O
The
second
thing
is
about
being
able
to
to
operate
more
efficiently
across
a
wider
range
and
drawing
and
attract
resource
resourcing
kind
and
be
able
to
be
in
a
better
place
position,
because
actually
we
have
that
even
stronger
narrative
lead
has
a
really
strong
narrative
about
addressing
inequalities.
But
this
is
about
going
even
further
and
raising
the
bar
for
that
that
will
mean
we
can
draw
and
we
can
make
better
use
of
collective
resources
more
efficiently.
O
O
That
was
written
in
a
point
of
adverse
economic
climate
and
it
was
written
coming
off
the
back
of
the
2008
economic
challenges,
and
it
was
really
highlighting
that
actually
that
just
really
strengthened
the
need
for
taking
that
approach
for
addressing
those
inequalities
at
that
point
and
seizing
that
opportunity,
even
in
those
constrained
financial
times
and
I,
guess
that
just
feels
like
it
really
resonates
now
in
terms
of
where
we
are
as
well.
Thank
you.
L
Hello
Gibson
was
itching
to
come
and
follow
me,
but
I'll
make
a
quick
Point.
I
was
just
picking
up,
I
mean
the
old
money
new
money
discussion
I
mean.
Let's
pick
up
on
something
councilor
Iris
said
around
the
level
of
the
disparity
between
funding
per
capita
between
Manchester
and
Leeds
I'm
slightly
taken
it
back
quickly.
To
be
honest,
is,
is
this?
Is
there
something?
Is
there
some
simple
explanation
or
is
there
and
more
importantly,
is
there
anything
that
we
as
a
city
can
do
to
bridge
that
Gap.
F
J
Yes,
so
the
simple
explanation
is
that
when
Public
Health
came
over
to
local
authorities
in
2013,
we
brought
with
us
the
budget
that
was
that
was
in
place
for
public
health
for
each
local
Authority
area,
so
previously
to
2013
Public
Health
as
part
of
the
NHS
were
commissioned
by
what
was
then
the
version
of
the
ccg.
That
was
a
health
authority
or
a
PCT
or
whatever
it
was
then
so
it
was
a.
It
was
a
health
commissioning
decision
about
about
how
much
to
invest
in
public
health
in
every
single
place.
J
So
we
we
had
a.
We
had
a
view
on
that
in
Leeds,
and
that
was
the
that
the
position
we
we
brought
with
us
to
the
council
since
then,
there's
been
some
kind
of
benchmarking
done
nationally
with
this
is
what
area
should
be
funded
per
head
of
population?
Can
you
please
try
and
get
up
to
that?
J
So
we
know
where
in
Leeds
were
about
12
to
40
Millions
below
the
level
really
of
The
Benchmark,
not
the
level
of
the
best
but
the
level
of
The
Benchmark,
and
we
you
know
that,
because
of
since
2013
cuts
that
have
had
to
be
made
every
year
that
we've
we've
never
managed
to
to
to
improve
that
position
for,
but
it
it's
so
it's
it's
based
on
the
decisions
of
our
health
commissioning.
J
Colleagues,
previously
now
often
areas
that
have
very
large
teaching,
Hospital
trusts
have
have
relatively
lower
Public
Health
budgets,
because
you
it's
only
what
you
know.
So
there
is
an
impact
of
there's
only
so
much
money
and
there
has
to
be
decisions
made
about
how
to
spend
that
across
the
Health
Care
system,
and
we
were
part
of
that
Healthcare
System.
J
So
it's
very
much
a
legacy
of
those
decisions
that
were
made
in
Leeds
by
NHS
decision
makers
of
the
day
that
we
now
have
got
to
make
the
best
of
that
and
and
continue
what
I
will
say
on
a
more
positive
basis
is
that
on
top
of
the
59
pounds
per
head,
because
of
that
relatively
low
position,
we
do
have
proportionally
quite
a
lot
of
additional
funding.
That
comes
in
now
from
Tim,
who
has
just
been
sitting
there
and
almost
to
try
and
compensate
for
the
low
starting
point.
J
So
we've
got
quite
a
lot
of
additional
bits
of
money,
but
again
that's
not
recurrent
long-term
Grant.
It's
it's
often
short-term
money,
for
particular
things,
so
not
to
say
NHS.
Colleagues
aren't
very
helpful
because
obviously
this
is
all
before
Tim's
day,
but
it
really
is
trying
to
redress
that
balance.
And
no,
you
know,
but
there's
not
an
obvious
place
to
get
that
funding
from.
M
Yeah
and
just
to
Echo
that
point,
we've
been
quite
successful
in
in
bidding
for
that
sort
of
full
pneumonia,
as
it's
known
so
a
lot
of
the
work
around
the
employment
advice
in
primary
care
that
I
mentioned,
which
we,
which
we're
hoping
to
to
scale
up
basically
was
funded
from
some
money
from
I,
can
never
remember
it's
the
department
that
is
now
called
leveling
up.
Basically,
so
we've
got
some
short-term
money
there,
which
is
quite
successful.
M
We've
also
got
some
money
from
the
health
Foundation
for
a
project
called
good
jobs,
better
health,
fair
Futures,
which
funds
a
lot
of
the
working
and
around
Community
anchors
and
I
think
is
probably
quite
well
known.
We've
well
two
weeks
ago
submitted
a
bid
to
department
for
work
and
pensions
for
around
two
million
pounds,
and
the
intention
is
to
to
scale
up
that
work
in
GP
surgeries
around
targeting
people
with
learning,
disability
and
mental
health
into
work.
M
And
if
we
get
that
two
million,
the
idea
is
that
we
can
support
a
thousand
people
into
work
over
a
two-year
period,
so
we're
doing
our
best
to
bring
in
other
resources
that
can
really
build
to
the
mom
at
work
and
the
wider
work
on
health
and
well-being
and
and
ultimately,
we've
been
relatively
successful.
But
we
suspect
that
probably
will
be
a
way
forward
in
terms
of
accessing
the
sort
of
maybe
non-traditional
resource
that
we've
not
always
applied
for.
In
the
past.
A
Thank
you
now,
I'll
need
to
say
something
but
counselor
Gibson.
B
Follow-Up
question
with
my
first
question,
chair,
I,
think.
The
reason
that
Marmot
City
stuff
is
so
good
is
because
it's
it's
sort
of
it's
packaged,
really.
Well,
isn't
it
it's
easy
to
understand
it's
easy
to
get
your
head
around.
So
from
a
comms
perspective,
it's
fantastic
and
I've
noticed.
You
know
when
I'm
talking
to
my
constituents
about
it.
You
know
it's
easy
to
win
the
hearts
and
minds
and
get
people
to
buy
into
it.
So
yeah
it.
Of
course
everything
requires
money,
but
it's
not.
B
Having
said
all
that
about
comms,
it
seems
to
me
that
you
know
that
it
is
because
it
is
easy
to
win
the
hearts
and
minds
of
and
get
people
to
buy
into
things
if
there
was
an
area
of
leads
say
that
was
built
in
five
thousand
houses
and
football
pitches
and
and
a
new
shopping
center
and
a
new
retail
Park,
and
things
like
that.
That
would
be
a
good,
a
good
area
to
sort
of
try
and
bring
people
in
to
sort
of
pilot.
This
I
don't
know
what
your
thoughts
are.
A
Don't
you
love
counselor
Gibson's
dream
who's
answering.
Thank
you.
O
Okay,
okay,
I
yeah
I
can
say
we
haven't
met
I
I,
believe
you'll,
be
referring
to
developments
happening
in
East,
Leeds
I.
Think,
it's
fair
to
say:
yeah
I
mean
I,
think
you
know
I'm
a
big
fan,
I
suppose
two
different
one
of
one
of
which
is
the
the
moment
approaching.
Health
inequalities,
it's
at
the
core
of
what
we
do
with
that
sense
of
the
the
widely
determines
the
social
impact
of
where
we
live,
influencing
our
obviously
our
our
health
outcomes
and
really
shining
a
light
on
that
social
gradient.
O
That
happens
right
the
way
across
not
just
in
the
most
deprived
versus
the
least
deprived,
but
actually
all
the
way
through
community
and
the
importance
of
the
fact
of
how
we
address
that
and
the
the
continuing
impact
through
people's
lives.
So
I'm
really
Keen
with
that,
and
also
around
spatial
planning
and
the
impact
that
that
can
have
again
in
terms
of
building
those
really
valuable
building
blocks
and
the
impact
that
that
can
have
so
I
think
I
completely.
You
know,
agree
and
welcome.
O
I
am
involved
in
some
Regional
work
around
spatial
Planning
and
Building
of
healthy
places.
How
we
can
bring
those
two
and
align
them?
There's
some
fantastic
work
happening
through
colleagues
in
public
health,
working
with
planning,
colleagues
around
influencing
the
planning
system,
introducing
health
impact
assessments
and
influencing
planners
at
the
earlier
stages,
so
really
Keen.
To
look
at
the
opportunities
that
we
can
bring
those
principles
of
Marmot
into
to
influencing
the
thinking
across
the
board
that
that,
for
me,
is
the
sort
of
vision
of
of
how
it
should
go
seeping
in
across
everything.
B
A
It's
all
right:
okay,
councilor,
Taylor
and
then
council
is
it
Berg
was
it
you
did.
You
want
to
say
something
after
counselor
Taylor.
C
It's
been
robbed
from
us
and
you're
working
with
what
you
have
and
thank
you
for
that,
but
my
colleague
mentioned
planning,
which
I
was
going
to
mention
you
I'm,
chair
of
the
planning,
but
you
need
to
work
more
closely
with
planning
where
we
put
in
this
fast
food
shop,
and
you
have
studied
at
the
right
place
in
schools,
because
kids,
educate
parents
and
leads
of
different
languages,
and
some
parents
don't
understand
what
the
kids
will
help
to
improve.
C
So,
yes,
I
do
welcome
it
and
I'm
really
pleased
for
it
and
I
was
impressed
with
councilor
Arif
says:
you've
been
to
houses.
This
is
where
you
go
to
the
deprived
area,
and
this
is
what
I
want
to
see.
At
least
you
take
it
to
them,
but
you
can't
make
them
do
it.
So
thank
you
for
that.
Counselor,
Arif
and
I'd
like
to
spread
it
out
across
the
city
just
to
pop
in
every
sort
of
thing.
Thank
you.
G
Thank
you.
I,
too,
welcome.
Mommy
I
think
it's
a
fantastic
policy
approach.
Two
questions
really
one
I
spent
some
time
reading
the
Manchester
Midway
review,
which
throws
up
some
quite
interesting
insights.
Doesn't
it
into
progress
mode
so,
based
on
that,
the
one
thing
that's
I
nearly
said
missing
but
I
mean
not
present.
Obviously,
is
the
measurement
and
evaluation
tools
and
that
we
would
use
to
look
at
progress
made.
G
Distance
traveled
is
probably
a
better
thing
to
say
and-
and
that
was
one
of
the
things
that
was
really
prevalent
in
the
Manchester
report
and
I'm,
saying
Manchester,
because
they've
been
at
it
quite
a
while.
Aren't
they
so
they've
kind
of
learned
some
lessons
from
it
and
the
other
thing
for
me
is
and,
like
you
said,
it
overlaps
it's
kind
of
a
holistic
approach
to
the
policies.
So
foreign
two
things,
one
measurement
and
evaluation,
which
I
think
is
key
to
next
steps.
G
Isn't
it
so
it
will
continue
to
become
embedded
and
how
do
you
earn
to
embed
all
the
six
principles
of
the
mammoth
city
which
are
huge,
huge
principles
either
and
particularly
where
we
have
limited
control,
Beyond,
The,
Authority,
very
limited
control,
Beyond
The
Authority
could
have
influence,
but
no
control.
How
do
you
envisage
and
begging
them
across
the
city
outside
the
Realms
of
the
local
authorities?
I
think
that's
important.
Thank
you.
O
Yeah,
thank
you.
I
mean
two
fantastic
questions.
I'll
take
them.
You
ask
measurement
hugely
important.
You
know
one
of
the
things
that
really
highlighted
in
the
report.
One
of
the
real
values
that
can
come
from
this
is
about
that
that
that
really
clear-sighted
view
of
what
is
happening
in
relation
to
inequalities
both
across
the
city,
but
also
in
relation
to
specific
strategies
and
decisions.
O
For
me,
the
real
sort
of
ethos
of
of
the
Marmot
City
work
is
is
having
that
impact
on
inequalities
and
impacts
across
that
social
gradient
at
the
heart
of
every
decision
that
we
make
and
understanding
and
knowing
what?
What
impact
that
is
having
across
that
that
bridge
that
population
and
in
order
to
do
that,
you
have
to
have
a
really
clear
view
on
the
data
and
you
have
to
understand
what
impact
that's
making.
So
the
the
monitoring
and
the
measuring
will
be
absolutely
Central
to
that.
O
So
there's
a
couple
of
sort
of
early
things.
One
of
the
things
is
about,
firstly,
starting
with
that
principle
of
strategic
alignment
and
not
trying
to
jump
in
by
inventing
whole
new
structures
and
bureaucracies
where
things
are
already
happening.
So
there's
a
number
of
mechanisms
already,
either
in
train
or
in
development
that
we're
already
working
with
and
trying
to
look
at
alliances.
Some
of
them
come
here.
There's
a
public
health
performance
reporting
that
comes
twice
a
year.
O
O
O
Well
imagine,
working
really
closely
with
colleagues
like
Tony,
like
Sam,
Foye
and
others
in
the
policy
teams
who
work
on
developing
those
and
in
our
Public
Health
intelligence
team
to
again
to
look
at
how
we
can
work
closely,
align
and
and
ensure
their
fit
for
purpose
around
the
moment
agenda
and
then
two
others
I'll
just
mention
one
is
again
working
with
those
same
colleagues
on
the
development
of
the
dashboard
and
the
the
performance
framework
around
the
best
city
ambition
to
to
again
to,
as
far
as
possible,
ensure
that
that
serves
this
purpose
and
the
other
is
the
work.
O
That's
been
done
and
I
think
is
predominantly
coming
through
the
inclusive
growth
area
around
the
social
Progress
Index,
which
has
huge
potential
I
think
in
this
area
and
is
an
area
we've
already
started.
Looking
at
and
seeing
how
we
we
can
combine
so
there's
some
of
the
the
strands
that
we're
looking
at
already.
O
But
it's
going
to
be
one
of
the
areas,
we're
also
really
Keen
to
learn
what
other
areas
have
done
and
pick
up
with
the
Institute
of
Health
Equity
when
we
talk
to
them
but
yeah
and
applying
that
to
individual
decisions
and
projects
that
we're
taking
forward
as
well
to
be
able
to
really
have
that
that
rigor
and
discipline.
O
The
second
point
about
the
six
principles
and
taking
it
out
wider.
So
this
this
is
where
we
have
to
to
get
some
balance
of
measure
about
biting
off
manageable
bits
and
getting
carried
away
with
trying
to
do
the
whole
thing
and
trying
to
get
the
appropriate
balance
between
the
two.
Obviously,
the
full
scale
of
the
Marmot
approach
is
fast.
O
It
covers
all
of
those
conditions
in
which
we,
you
know
live,
grow
up,
work
around
the
city
and
right
across
the
the
people's
lives,
as
is
reflected
by
the
original
six
and
now
the
eight
principles
of
the
approach,
so
I
think
we
do
need
to
have
the
appropriate
level
of
ambition
about
the
fact
we
are
working
across
all
of
those
and
the
fact
that
this
isn't
just
this
isn't
a
council
initiative
instead
of
a
city,
initiative
and
program
we
take.
O
But
we
do
need
to
balance
that
by
actually
recognizing
that,
if
we
try
and
do
too
much
too
soon
too
fast,
we'll
potentially
not
not
achieve
what
we
want
so,
hence
having
you
know,
the
value
of
those
priority
areas
already
been
identified,
the
the
best
out
in
the
housing,
namely
so
one
of
my
roles,
I
see
it
is
going
to
be
trying
to
balance
out
and
we'll
pick
that
up.
O
I
think,
in
the
conversations
with
the
ihe
in
formalizing,
what
that
that
whole
approach
looks
like
about
how
we
do
get
that
balance
over
the
the
program
about
working
across
the
breadth
working
across
the
sectors,
but
also
being
focused
on
enough
within
the
resources.
We've
got
that
we
can
actually
make
real
gains
and
strides
forward
so
hopefully
I'll
be
able
to
come
back
with
I've,
got
some
early
thoughts
around
that,
but
hopefully
come
back
with
a
much
clearer
view
on
that
when
we
come
back
and
give
the
next
update.
That's.
Okay,
thank.
J
So
Tim
said
it
almost
all
there
and
I
agree
on
the
on
the
question
about
how
do
we
know
if
we're
making
a
difference?
I
think
that
one
of
the
reasons
why
we
did
this
is
because
we
were
tracking
all
of
the
indicators
in
the
six
months
report
we
bring
here
and,
and
they
weren't
going
in
the
right
direction.
We
all
know
that
they
were
either
stalling
or
going
in
the
wrong
direction.
So
I
don't
think
it's
that
we
need
to
set
up
a
load
of
different
processes
to
measure
how
it's
going.
J
We
need
to
look
at
the
stuff.
We
we
look
at
anyway
and
actually
you
know
see
if
that's
make
us
see
if
it's
making
a
difference,
so
I
I
think
that's
the
general
approach
on
that
councilor
Burke.
J
I
think
that
your
second
comment
is
really
interesting
and
kind
of
goes
to
the
goes
to
the
heart
of
this,
because
I
think
what
we've
decided
to
do
as
a
city
and
it's
interesting
with
councilor
Gibson's
comments
as
well.
Is
this.
You
know
if
you
look
at
the
eight
key
principles
that
they
are
so
big
and
bold
and
Broad
and
you're
right.
You
know
some
of
this.
We
don't
we,
you
know
in
terms
of
principle,
seven
seven
tackle
discrimination
rate,
racism
and
their
outcomes.
J
We
don't
control
all
of
that,
but
but
we
absolutely
are
committed
to
doing
everything
we
can
across
all
eight.
So
the
the
there
was
this
thing
about,
as
we
came
through
the
pandemic
after
10
years
of
seeing
inequality
stall
and
actually
seen
in
Health
outcomes
and
inequalities
take
a
huge
hit
from
the
pandemic.
Knowing
that
we
had
to
be
incredibly
bold
because
we
couldn't
carry
all
of
the
great
things
we
were
doing,
we
needed
to
continue
to
do,
but
it
still
wasn't
enough.
J
We
they
were
still
moving
in
the
wrong
direction,
so
this
is
massively
ambitious.
It
we've
got
to
be
really
Brave
and
Bold.
Haven't
we
and
we
we
won't
achieve.
You
know
all
the
all
of
this
at
once
as
Tim
said,
but
but
but
I
guess
that
what
mama
gives
us
is
that
hope,
like
the
hope
that
actually
there
are
there
are.
This
is
a
solvable
problem.
There
are
things
that
we
know
we
can
do.
That
is
just
that
Collective
kind
of
will
to
want
to
do
it.
J
So
I
think
that
it's
so
heartening
to
hear
people's
comments
today,
but
I
think
we're
going
to
need
all
of
us
to
be
ambassadors
for
all
of
this
and
and
I.
Think
that
being
here
in
the
council
is
absolutely
the
place
where
you
get
you
get
all
of
this
stuff,
but
But
continuing
that
message
around.
Actually,
the
building
blocks
of
good
health
at
80
are
all
down
to
these
eight
things
and
actually
we're
we.
We
actually
can
influence
and
shape,
probably
more
in
that
more
if
we
think
than
that.
J
A
O
Yeah,
so
I'm
just
sorry
bear
with
me
yeah,
so
there
isn't.
As
far
as
I'm
aware,
that's
happened
as
yet.
The
engagement
I
think
is
largely
been
done,
as
it
says
in
in
point
24
in
terms
of
Representative
bodies.
So
in
some
of
the
well
most
of
this
precedes
me
coming
in
so
others
might
want
to
come
in,
but
I
think
there's
been
a
wide
amount
of
consultation,
engagement
and
discussion.
O
That's
been
done
through
a
wide
range
of
of
boards
and
and
forums,
including
this
one,
but
also
health
and
well-being,
board
and
other
representative
boards
that
have
obviously
included
a
wide
range
of
of
Representatives,
which
I
think
and
others
might
want
to
comment,
probably
felt
appropriate,
given
the
nature
of
the
the
decisions
taken
at
the
time.
But
I
think,
as
this
goes
on.
O
One
of
the
things
that
is
also
included
in
there
is
about
that
principle
of
needing
to
ensure
that
there's
a
real
focus
on
this
on
the
people
at
the
heart
of
it
has
already
been
mentioned
several
times
this
afternoon,
and
that
this
doesn't
become
as
an
approach
detached
from
the
the
people
at
the
heart
of
it.
And
that
we
are
working
with
and
and
doing
with,
and
not
too
so
really
thinking
about
how
we
do
that
I,
don't
think
we
know
quite
yet
until
the
approach
is,
is
fully
shaped.
O
What
and
how
that
looks
like
so
I
think
one
of
the
things
we've
just
tried
to
do
at
the
minute
is
really
highlight
that
as
a
as
a
key
principle
and
a
key
value
at
the
heart
of
the
way.
We
want
this
approach
to
evolve,
to
make
sure
that
we've
got
it
down
as
a
marker
as
it
as
it
evolves
that
we
need
to
do
that.
But
I
don't
know
if
anyone
else
wants.
A
No,
that's
fine
I,
like
the
word
yet
so.
For
me,
one
of
my
attraction
to
the
proposal
was
it
was
very
people-centered
and
people
focused,
so
it
will
just
be
good
to
know
that
you
know
the
consultation
at
some
point
is
in
the
picture.
Thank
you.
Councilor
Aaron,
Chef.
I
I
may
come
in
with
the
idea
also
is
to
get
involved,
the
health
Champions
across
the
city,
and
so
this
is
going
to
go
to
the
health
Champions
meeting,
but
also
our
community
committees
for
their
feedback
as
well.
I
think
that'll
be
really
important,
so
it's
sort
of
still
early
days
work
in
progress,
but
yeah
really
valid
point
that
you
made
there.
Thank.
A
B
Yes,
thank
you
chair.
This
is
the
latest
version
of
the
boards
work
schedule
for
the
current
Municipal
year,
also
attached
his
appendix
to
the
latest
executive
board
minutes
from
September,
as
well
as
the
West
geometry,
joint
health
overview
and
security
committee
minutes.
Draft
minutes
and
I
think
important
points
to
note,
some
of
which
have
been
discussed
in
the
pre-meeting.
B
Is
the
now
scheduled
new
meeting
on
the
8th
of
November,
which
at
two
o'clock,
which
constitutes
the
board's
next
meeting,
so
that
is
to
consider
dentistry
and
issues
that
the
board
have
discovered
previously
sorry
discussed
previously,
then,
in
the
on
the
22nd
of
November
meeting,
which
is
the
one.
B
After
that,
there
is
a
new
item
on
the
the
work
program
which
relates
to
Winter
planning
and
then
resilience
within
the
Health
and
Care
system
in
Leeds,
which
I
think
came
from
a
discussion
at
the
September
meeting
of
the
board
budgetary
work,
as
as
some
of
you
will
know,
takes
place
annually.
B
There
has
been
a
slight
adjustment
to
that
following
discussion
with
Finance
colleagues,
so
of
the
working
group
will
now
be
in
December
as
opposed
to
November,
and
that
reflects
the
time
scales
for
the
proposals
coming
through
from
from
colleagues
in
finance
and
the
exact
date
on
that
is
as
yet
to
be
determined,
but
I
will
obviously
our
Angel.
B
My
colleague
will
keep
you
informed
us
as
soon
as
as
possible
and
then
lastly,
I
think
there
are
a
couple
of
items
from
today's
meeting
that
perhaps
need
to
be
worked
into
the
work
program
with
you
chair
when
the
opportunity
arises,
items
eight
and
nine
in
particular,
I
think
we'll
be
returning
this
year.
Thank
you
very
much.
A
Thank
you
very
much
Rob
and
just
to
say
a
huge
thank
you
to
each
and
every
one
of
you
board
members
executive
members
officers,
our
lead
students.
Are
they
still
here?
Oh
well
done,
I
hope
we've
been
able
to
be
helpful
in
your
public
policy
module
and
hopefully
we
get
to
see
you
again.
So
thank
you
very
much
for
coming,
because
your
lecturer
is
still
here.
Oh
you're,
there
right.
Thank
you
very
much.
Can
you
look
after
them
for
us,
please
yeah
excellent.