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From YouTube: Leeds City Council-Scrutiny Board (Adults, Health and Active Lifestyles Consultative Meeting 27/7/21
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A
A
As
such,
it
is
a
remote
consultative
meeting
of
the
children
and
family
scrutiny
board.
The
consultative
status
of
today's
meeting
means
that
some
of
the
usual
formalities
will
not
take
place
at
the
start
of
the
meeting,
and
while
it
also
means
that
the
board
will
not
be
in
a
position
to
take
any
formal
decisions,
today's
discussion
will
still
very
much
help
inform
the
work
of
the
scrutiny
board
and,
where
necessary,
any
proposed
actions
that
do
require
formal
ratification
will
be
referred
to
the
next
formal
public
meeting
of
the
scrutiny
board
for
approval.
A
B
D
Good
afternoon
john
beale,
I'm
chair
of
healthwatch,
leads
and
a
co-opted
member
of
this
board.
B
G
Good
afternoon
everybody
councillor
comet.
H
Heartbroke
wrathful
ward.
A
A
A
Thank
you
very
much
for
joining
us.
I
would
now
like
to
invite
the
officers
supporting
our
meeting
today
to
introduce
themselves
angela.
A
A
The
note
of
the
of
the
scrutiny's
con
wars
consultative
meeting,
which
was
held
on
the
15th
of
june
2021,
has
been
provided
for
your
information.
While
this
is
not
for
formal
approval,
members
will
have
this
opportunity
now
to
raise
any
matters
in
relation
to
the
note.
Do
we
have
anybody
with
any
comments
from
the
15th
of
june.
A
Okay,
thank
you.
We're
going
to
move
to
item
3
and
that's
the
health
bill.
Last
month,
the
board
expressed
an
interest
surrounding
the
anticipated
health
and
care
bill
of
2021
and
2020,
which
really
is
the
main
agenda
that
we
have
got
today
and
the
implications
of
this
for
health
and
social
care
in
west
yorkshire
and
leeds,
particularly
with
regards
to
the
development
of
the
new
local
integrated
care
system.
A
The
board
does
acknowledge
the
work
of
the
west
yorkshire,
joint
health
overview
and
scrutiny
committee
in
liaising
with
the
west,
yorkshire
and
harrogate
health
and
care
partnership
to
consider
the
implications
of
the
legislative
proposals
for
west
yorkshire,
including
a
focus
on
the
potential
future
role
of
scrutiny
as
part
of
the
new
ics
system.
The
joint
committee
met
very
recently
on
20th
july
to
consider
this
matter
further,
and
so
this
board
will
be
kept
updated
on
its
ongoing
work,
and
I
can
confirm
that
council,
latia
and
myself
were
at
that
meeting.
A
A
I
will
now
invite
all
the
participants
who
are
here
with
us
today
to
kindly
introduce
themselves.
I
will
start
with
counselor
banner.
K
Oh
hi,
everyone,
I'm
I'm
councillor,
fiona
benner,
I'm
the
executive
board,
member
for
adult
and
children's
social
care
early
years
and
health
partnerships
and
the
health
partnerships.
Part
of
that
is
that
I
chair
health
and
wellbeing
board
and
in
that
role,
I'm
the
elected
member
in
leeds
who
engages
with
the
regional
work
that's
happening
at
the
moment.
Thank
you.
L
G
Yeah
we
do
thanks
councillor
tony
chief
officer,
health
partnerships.
J
C
A
Thanks
for
joining
us,
I
believe
julian
hartley
will
be
joining
us,
but
then
we'll
be
will
be
joining
us
about
two
o'clock.
If
that's
correct
is
that
right,
angela,
excellent
okay,
like
I
did
say
earlier,
we've
got
kath
here
who
will
be
having
a
presentation,
but
just
before
kath
comes
in
I'd
just
like
to
ask
counselor
banner
or
counselor
eric.
Would
you
like
to
make
any
introductions,
or
would
you
like
me
to
go
straight
to
pat?
What
would
you
play.
K
I'm
happy
make
to
make
some
comments
to
start
with
yeah,
so
I
thought
I'd
make
some
introductory
comments.
Assuming
everyone's
read
the
paper,
so
I
wasn't
planning
to
talk
about
any
of
the
technical
detail,
but
I
thought
what
might
be
helpful
is
because
obviously,
my
roles
around
political
leadership,
so
I
thought
it
might
be
helpful
for
me
to
talk
about
the
role
of
elected
members
in
this
process
and
also
I
thought
I'd
touch
on
some
of
the
aspects
of
this
that
people
are
worried
about.
K
So
in
terms
of
concerns
that
have
been
raised
with
me.
So,
as
I
said
in
my
when
I
introduced
myself,
I
engage
with
these
structures
within
my
role.
So
within
the
councils
in
west
yorkshire,
the
leaders
of
the
council
and
the
chairs
of
the
health
and
wellbeing
board
are
the
people
that
are
engaged
with
the
meetings
around
the
this.
This
regional
way
of
working,
sometimes
that's
the
same
person,
so
the
leader
shares
the
health
and
wellbeing
board,
but
in
leeds
it's
myself
and
councillor
lewis,
and
we
have
a
partnership
board.
K
That's
referred
to
in
the
paper.
That's
chaired
by
councillor
tim,
swift,
who's,
the
leader
of
calderdale,
and
we
also
have
a
political
meeting.
That's
that's
just
the
count,
the
health,
wellbeing,
blood
chairs
and
leaders
from
the
authorities,
so
in
a
in
like
a
really
really
brief.
K
Nutshell
that
the
sort
of
the
main
change,
I
suppose
for
us
in
leads-
is
that
the
clinical
commissioning
group
will
cease
to
exist
and
its
functions
will
move
to
being
delivered
largely
by
the
integrated
care
system
and
within
that
there's
two
two
aspects
of
of
government:
there's
two
main
governance
boards.
So
there's
the
nhs
led
board
which
will
largely
carry
out
the
statutory
functions
of
the
ccg.
It
does
have
local
representation
on
it
as
outlined
in
the
act.
We
don't
know
who
that
will
be.
K
So,
for
example,
at
the
moment,
I
think
the
paper
refers
to
some
very
specific
forms
of
bariatric
surgery
that
we
do
regionally
because
that's
more
efficient
and
more
cost
effective.
K
But
for
all
of
us
who
are
engaged
with
this
process
and
for
those
of
us
who
are
operating
at
a
regional
level
within
this,
but
very
rooted
in
you
know
in
our
city,
or
you
know
our
authority
area.
It's
part
of
our
role
to
make
sure
that
that
commitment
to
place
remains
and
is
strong
throughout
this,
and
the
other
concerns
have
been
raised
with
me,
and
these
obviously
do
have.
A
political
edge
is
concerns
about
whether
aspects
of
the
act
represent
creeping
privatization
within
the
nhs
and
there's
two
aspects
of
that.
K
One
is
that
within
the
act,
there
is
the
option
for
private
sector
providers
to
be
on
the
partnership
boards.
Now
there
isn't
any
plan
for
that
to
happen
in
west
yorkshire,
certainly
at
the
moment,
but
the
legislation
does
allow
for
it
and
virgin
care
are
on
partnership
boards
in
some
part
of
the
country.
I
think
it's
the
south
south
somewhere
and
the
other
aspect
that
people
are
concerned
about
is
is
the
repeal
of
section
75
of
the
2012
health
and
social
care
act,
and
this
is
the
clause
which
it
it
basically
removes.
K
So
what
was
so?
What
the
clause
that
was
put
in
2012
was
that
the
nhs
couldn't
automatically
award
contracts,
whether
that's
to
itself
or
to
charities
or
to
other
providers.
There
had
to
be
a
process
of
competitive
tendering
and
nhs
campaigners
and
people
on
the
left
campaigned
against
that
vociferously
at
the
time
because
it
it
hugely
extended
the
role
of
competitive
tending
within
the
nhs.
K
E
K
Ironic
that
the
same
people
are
now
really
concerned
about
about
this
clause
being
removed
and
there'll
be
some
things
about
that.
They're
really
good.
So,
as
many
of
you
know,
I
used
to
be
the
chief
executive
lead
survivor,
their
crisis
service,
which
has
an
nhs
contract.
You
know
it's
paid
by
the
nhs
to
deliver
services,
crisis
services
that
keep
people
up,
psychiatric
birds
out
of
ama,
etc
and
competitive
tendril
is
really
threatening
to
an
organisation.
K
You
know
likely
to
spark
like
crisis
service,
because
your
contract
could
easily
be
lost
to
a
cheaper.
You
know
private
sector
organization
or
there's
a
lot
of
really
big
super
charities
that
are
very
inquisitive
and
snaffle
up
contracts
that
belong
to
little.
K
So
that's
those
are
the
kind
of
things
that
have
been
made
with
me
as
concerns,
but
again
the
role
of
people
like
myself,
who
are
democratically
you
know,
elected
members
in
this
process
is
to
you
know,
work
with
the
nhs.
You
know
to
certainly
hold
them
to
account,
but
also
that
that's
also
part
of
your
role
as
a
scrutiny
board-
and
I
know
council
marshall
katana,
said
this
in
her
opening
comments.
K
That
part
of
part
of
what
you
might
want
to
talk
about
as
a
scrutiny
board
is
where
you
will
sit
within
this,
where
you
will
position
yourself.
K
I
don't
know
enough
about
that
part
of
the
act
to
know
how
much
choice
you've
got
about
that
or
how
much
it's
prescribed,
what
your
role
will
be,
but
scrutiny
will
have
a
really
key
role
in
this
going
forward.
So
it's
really
good
that
you're
you've
got
this
on
your
agenda
today,
because
it's
really
important
that
you
understand
the
act.
You
understand
the
implications
of
it
and
therefore
in
a
position
to
be
able
to
scrutinize
it.
So
thank
you,
chair
I'll,
leave.
I'll
leave
my
comments.
There.
A
Thank
you
very
much.
Councillor
fenner
and
you've
recorded
a
lot
of
the
concerns
when
we
had
the
joint
just
meeting
last
week
as
well,
especially
when
it
comes
to
procurement
and
private
partners.
So
it
will
be
very
interesting
to
hear
from
others
today
and
what
our
guest
speakers
have
got
to
advise
us
on
that.
So
are
you
happy
for
counselor
aries?
Do
you
want
to
say
anything
or
do
you
want
me
to
go
straight
to
kath
and
then
come
back
to
you.
L
Just
just
some
brief
notes
from
my
perspective,
so
the
bill
provides
an
opportunity
for
leads
health
and
care
system
to
improve
health
and
reduce
health
inequalities
as
a
system
that
truly
promotes
the
health
and
well-being
of
local
communities,
as
well
as
treating
illness,
and
particularly
as
we
move
through
the
next
stage
of
the
impacts
that
kovid
has
had.
The
focus,
obviously
is
improving
health
and
well-being
is,
is
more
important
than
ever,
particularly
in
relation
to
the
underlying
public
health
challenges
that
we've
got
and
worked
towards
building
a
healthier
city.
L
I
guess
the
key
thing
that
I've
got
or
the
important
thing
that
I
think
is,
is
how
local
authorities
elected
members
can
have
an
actual
say
in
what
happens,
and
it's
not
just
the
nhs
talking
around
the
table
and
it's
important.
I
think
the
the
conversation
we
have
today
will
be
really
helpful
and,
as
councillor
bennett
has
has
said,
hopefully
as
a
board
as
a
scrutiny
board,
we
can
discuss
how
we
could
be
involved
in
the
process.
So
that's
that's.
L
A
Thank
you
very
much.
Councillor
arif
appreciate
that,
right
so
over
to
you
now,
kath
believe
you've
got
a
presentation
for
us.
Yes,.
M
M
G
M
Screw
this
is
when
I
got
my
own
level
in
sharing
screens
right.
Can
you
see
that?
Yes,
okay,
right?
Okay?
So
hopefully
this
presentation
usefully
summarizes
the
detail.
That's
in
the
report
and
it's
it's
a
combination
of
two
presentations
that
came
to
the
health
and
well-being
board
brought
to
board
event
recently
and
I'm
first
going
to
cover
explaining
what's
happening
at
a
west
yorkshire
level
and
then
I'll
go
on
to
talk
about
what
is
happening
in
leeds
and
hopefully
there's
some
structure
diagrams.
M
So
just
thinking
about
west
yorkshire
and
harrogate
health
partnership,
it's
been
around
since
about
2016,
when
we
were
all
required
to
produce
sustainability
and
transformational
plans,
which
then
turned
into
sustainability
and
transformation.
Partnerships,
and
out
of
that,
has
come
a
five-year
strategy
setting
out
priorities
for
health
and
care
at
the
west
yorkshire
level.
M
But
it
also
describes
how
it
envisages
the
partnership
working
at
that
neighborhood
place
and
system
level
to
nurture
and
support
the
integration
of
services
where
that
makes
sense.
There
is
very
much
a
long
tradition
of
working
work.
Working
locally
things
been
locally
led.
Sorry,
I'm
having
a
bit
of
a
croaky
moment
today
and
west
yorkshire
and
that
how
the
care
partnership
envisaged
its
role
is
to
support
those
subjectives
and
very
much
subscribes
to
the
concept
of
subsidiarity.
M
So
just
to
remind
you
what
is
in
the
west
yorkshire
plan,
so
it's
these
10
big
ambitions
and
you'll
notice.
It
goes
beyond
just
so
pure.
What
would
say
traditional
health
and
care
is
looking
around
the
diversity
of
leadership,
it's
responsive
to
climate
emergency,
as
well
as
having
a
role
in
strengthening
local
economic
growth.
M
So
it's
operating
model.
This
picture
shows
you
that
there
is
a
core
team
in
the
ics
which
is
in
the
middle
of
the
flower
or
the
propeller,
depending
which
way
your
brain
works.
This
particular
image
with
the
five
different
local
authority
areas
having
their
own
integrated
care,
partnership
and
the
green
circle.
I
don't
know
if
you
see
my
arrow
working
is:
represents
the
integrated
class
system
as
a
whole,
so
the
principles
of
this
is
around
subsidiarity.
M
But
looking
at
what
the
white
paper
says
for
ics's,
as
can
savannah
has
mentioned.
First
of
all,
there
will
be
a
partnership
that
partnership
will
have
a
responsibility
for
developing
a
plan
which
is
about
a
wider
system,
and
it
is
written
into
the
bill
that
local
authorities
will
have
a
seat
at
that
table
and
when
you
look
at
local
areas-
and
there
is
more
discretion.
So
what
the
bill
does
is
monday
and
minimum
make
up
off.
Who
should
be
on
those
boats?
But
there
is
discretion
to
add
other
partners
and
parties
to
it.
M
It
will
have
accountability
up
to
nhs
region
and
nationally
for
its
spending
performance
and
the
chief
executive
is
the
accountable
officer
for
that
nhs
money
allocated
to
the
nhs
body.
M
So
second
bullet
point
sets
out
the
minimum
of
who
might
be
on
the
board
and
again,
local
authorities
can
expect
to
seat
at
that
board
and
again,
it's
responsible
for,
as
well
as
the
the
population
plan.
But
also
things
like
a
capital
plan
for
the
nhs
providers
within
that
geography.
M
So
obviously
place
level
and
in
in
the
language
in
which
we
talk
about
so
place,
equals
local
authority
footprint,
so
place
level
arrangements
between
local
authorities,
nhs
and
other
partners.
We
have
discretion
as
to
how
we
want
to
organize
that
and
what
it's
legal
status
might
be
in
it
in
the
body
of
the
written
report.
M
It
summarizes,
I
think,
it's
five
different
ways
that
you
might
be
able
to
do
that,
but
the
role
of
the
statutory
ics
is
to
support
and
nurture
and
develop
how
we
integrate
locally
and
to
drive
up
improved
outcomes.
M
Obviously,
health
and
well-being
boards
still
stay
part
of
our
architecture
locally
and
we'll
still
have
responsibility
about
bringing
partners
together,
still
has
responsibility
for
the
requirement
to
produce
a
joint
strategic
needs
assessment
and
joint
health
and
well-being
strategy,
so
that
doesn't
go
and
the
tone
of
the
document
which
we
like
to
think
actually.
West
yorkshire
colleagues
had
quite
an
influencing
role
on
in
the
tone
of
it
is
very
collaborative,
and
that
is
seen
as
the
major
driver
for
improvement,
not
competition.
M
So,
as
councillor
venice
says,
I
think
competitive
tendering
in
the
past
has
been
seen
as
a
key
tool,
and
I
think
it
only
takes
you
so
far
and
the
interest
now
is
well.
What
can
we
do
through
collaboration,
including
a
duty
to
collaborate,
a
system
partners,
so
there's
lots
of
opportunities
there,
but
it's
something
that
needs
work.
Collaboration
doesn't
necessarily
result
in
improved
outcomes.
M
Just
because
you
get
on
with
your
partners-
and
I
think
that's
one
of
the
challenges
for
us
locally
is
to
make
sure
our
very
productive
partnership
results
in
improved
outcomes.
So
now
we
can
think
about
leads.
We've
got
a
really
clear
ambition,
which
is
the
green
writing.
That's
the
ambition
from
our
health
and
well-being
strategy,
and,
I
guess
we'd
say
actually
we
think
we've
been
operating
as
an
integrated
care
partnership
for
several
years.
M
We
we've
got
a
nationally
recognized
highly
effective
health
and
wellbeing
board
with
a
strategy
which
is
a
reference
point
across
partners
for
what
we
do
and
a
very
inclusive
membership
sitting,
underneath
that
is
an
officer
group
of
partnership.
Exec
and
we've
got
all
sorts
of
different
program
boards.
M
So
we
would
say
we
spent
a
long
time
developing
shared
values
and
principles
by
which
we
operate.
We
say
we
are
team
leads,
and
I
think
the
past
year
and
a
half
has
really
demonstrated
that
it
genuinely
is
team
leads,
we've
pulled
together
in
a
most
challenging
time.
I
would
sort
of
quote
the
vaccination
program.
M
A
really
brilliant
example
of
team
leads,
so
it's
not
just
a
concept,
it's
things
by
working
together
where
we
have
delivered
on
the
ground,
and
we
see
all
those
different
component
parts
of
our
our
health
and
well-being
strategy,
our
values,
our
principles,
our
commitment
to
having
better
conversations,
all
of
that
adds
up
to
a
tattoo
through
totality
of
our
integrated
care
partnership.
So
we
think
that's
a
strong
foundation
stone
upon
which
to
build
on
the
requirements
that
are
set
out
in
the
legislation.
M
It
sets
the
landscape
of
the
different
boards
and
partnerships
we
have
so
starting
in
the
top
right
hand,
column
we've
got
local
care
partnerships
which
we
see
as
a
pretty
much
our
foundation
stone
and
building
block
for
integrated
caring
leads.
We've
got
a
focus
on
health
inequalities,
which
has
really
played
a
very
strong
role
as
we've
tackled.
Some
of
the
inequalities
that's
come
about
as
a
result
of
the
pandemic.
M
We've
got
enabler
boards
which
it's
estate,
it's
your
id,
it's
your
workforce
and
they
support
and
underpin
the
work,
that's
happening
in
the
population
and
care
boards.
So,
for
example,
if
I
just
unpack
some
of
the
acronyms
we've
got
children
healthy
populations,
long-term
conditions,
learning
disabilities,
end-of-life
mental
health
plans
planned
care
cancer,
urgent
care
and
system
flow,
there's
all
multi-agency,
multi-disciplinary
boards
working
on
those
issues
and
they
all
feed
into
what
we
have
set
our
stall
out
to
say
if
we
are
successful.
M
This
is
how
the
world
will
shift,
and
we
call
this
the
left
shift
blueprint
and
the
detail
of
that
is
in
the
written
report
in
your
pack.
But
those
are
the
metrics
by
which
we
mark
our
own
homework
as
to
say,
are
we
making
the
impacts?
We
would
like
that's
feeds
into
the
partnership
executive
group
that
then
feeds
up
into
the
health
and
wellbeing
board
and
off
to
your
right.
M
But
by
being
a
joint
committee,
it
also
allows
us
to
add
other
pots
of
money.
Should
we
wish
to
to
come
under
the
governance
of
that
partnership.
So,
for
example,
we've
got
the
best
care
funds.
We've
got
pots
of
money
where
we
pull
together
to
pay
for
the
health
and
care
academy
and
our
own
health
partnership
team.
M
We
still
have
our
health
and
well-being
board,
but
then
you,
you
do
see
here
a
feed
up
into
the
west
yorkshire
committee
and
over
here
on
the
right.
We
still
have
a
provider
landscape
as
we
recognize
it.
So
if
we
look
at
the
wider
partnership,
you've
got
this.
On
the
left
hand,
side
you've
got
what
the
west
yorkshire
landscape
looks
like
and
you
can
see
in
yellow.
We
have
the
west
yorkshire
joint
overview
and
scrutiny
committee
and,
on
the
right
hand,
side,
which
is
the
leads
footprint.
M
We've
got
scrutiny
board,
but
otherwise
these
boards
very
much
mirror
each
other.
So
you
have
a
partnership
board
at
west
yorkshire
level.
We
have
our
partnership
board,
it's
the
health
and
well-being
board
at
leeds
level.
Then
you've
got
the
nhs
board
that
has
the
statutory
accountability
for
the
budget
and
then
leads
working
title
icp
board,
which
we
seek
to
take
a
default
budget
from
west
yorkshire.
M
So
I
hope
you
feel
there's
some
sort
of
yeah
some
symmetry
there.
So
thinking
about
the
leads
integrated
care
partnership,
so
we
will
have
countability
around
delivering
health
improvement
and
well-being
for
people.
At
least
our
ambition
is
to
have
high
quality
services
within
that
delegated
budget
and
to
ensure
that's
delivered
on
behalf
of
and
in
line
with
the
ambitions
of
the
west,
yorkshire,
ics
and
our
health
and
wellbeing
board
and
the
the
integrity
care
partnerships.
It's
got
to
provide
some
infrastructure.
M
We've
got
to
put
some
mechanisms
in
place
to
allow
risk
sharing,
how
we
use
resources,
how
we
provide
assurance
back
to
leeds,
but
also
up
to
west
yorkshire
and
above
and
there
is
a
an
integration
responsibility.
So
it's
continuing
that
development
that
we've
already
got
around
how
we're
delivering
together
integrated
care.
We
believe
it
that
it's
got
to
be
data
informed.
It's
got
to
be
personalized
and
have
a
strong
element
of
prevention.
M
So,
in
order
for
that
to
work
and
being
a
subcommittee,
it's
going
to
have
these
functions
that
are
set
out
in
the
the
bullet
points
and
they're
everything.
You
would
really
expect
from
a
sort
of
governing
body
really
so
around
finance
contracts,
digital
quality
and
performance
that
strategic
planning
looking
forward,
and
it
will
have
some
leads
roles
and
some
joint
appointments
across
into
the
ics.
M
So
our
next
steps,
as
we
said,
we're
still
talking
about
who
should
be
on
the
leads
board.
What
quite
its
configuration
would
look
like
how
we
need
to
engage
with
all
our
partners
around
that
our
ambition
is
to
have
a
shadow
board
in
place
by
october,
to
sort
of
give
it
a
go
with
a
sort
of
coming
into
statute
in
april.
M
So
working
that
through-
and
I
yeah-
I
think
it
mainly
some
tweaks,
so
we
might
get
it
right
first
time
and
to
an
a
agree,
an
investment
plan
in
line
with
our
allocation
and
what
we
set
out
as
the
sort
of
outcomes
we
want
to
see
and
to
support
some
of
that.
We're
going
to
have
to
think
again
about
where
does
the
partnership
execute
fit
in?
Are
all
our
current
boards
fit
for
purpose?
M
What
shall
we
call
it
because
they're
calling
it
an
icp
at
west
yorkshire
level?
So
do
we
need
to
call
it
something
different
at
a
lease
level
just
to
make
that
distinction
and
we're
doing
a
piece
of
work
at
the
moment
led
by
the
health
and
care
academy
which
we're
calling
hearts
and
minds?
M
Partly
that's
to
capture
all
the
positive
learning
from
the
past
18
months
of
working
together
over
covered
so
where
there
was
really
fantastic
examples
of
integrated
working.
Let's
capture
it,
let's
look
at
the
learning.
What
made
that
work?
Why
was
it
so
successful
what
happened
to
make
it
be
set
up
so
quickly,
so
we
can.
A
Okay,
I
think
we
have
chair
yes
right.
Okay,
can
we
angela,
are
you
able
to
take
us
back
to
the
full
screen,
please
without
the.
A
Okay,
can
we
yeah?
Can
we
try
to
see
if
we
can
get
cats
back,
because,
obviously
we're
going
to
go
into
comments
and
questions
now
and
obviously.
K
G
Yeah
thanks.
Thank
you
thanks.
Chad
capcath
was
just
going
to
close
with
the
point
that
what
we've
ultimately
got
on
this
is
very
much
an
evolutionary
response
and
the
culmination
of
a
huge
amount
of
work
from
up
from
a
huge
amount
of
people
in
leeds
and
that
we're
in
a
strong
position
as
a
city
to
move
forward
of
a
particularly
leads
focused
approach.
A
Okay,
thank
you
we'll
do
a
very
much
again
just
before.
Let's
see
if
cathy's
able
to
join
us,
if
not,
we
will
continue
with.
I
know
we've
got
a
very
good,
solid
team
here
today
that
will
be
able
to
answer
questions
I
believe
julian
has
joined
us.
O
A
A
P
A
Right
board
over
to
you
now
we
had
we
got
the
majority
of
pat's
presentation,
so
we're
now
open
for
discussions,
debates,
questions
comments
over
to
you.
D
First
of
all,
in
her
absence,
I'd
like
to
thank
kath
for
taking
us
through
that
introduction,
that's
been
a
very
comprehensive
look
at
the
situation
and
I
have
to
say
that
for
the
most
part
I
agree
with
her.
We've
been
doing
most
of
this
for
a
number
of
years
and
it's
just
being
built
on
in
in
the
legislation.
D
D
So
just
four
points
I'd
like
to
make
if
I
may
chair
the
first
is
of
timing.
In
my,
I
have
to
say
a
fairly
long
career
in
the
nhs
I've
been
through.
What
I'm
told
is
something
between
15
and
20
reorganizations
of
the
nhs
and
each
time,
and
I
have
to
say
that
that's
both
under
conservative
and
labor
governments.
So
it's
I'm
not
making
a
political
point
about
a
specific
party
reorganizing
the
nhs
each
one
has
promised
that
things
would
get
better,
but
each
one
has
also
been
costly.
D
It's
been
costly
both
in
terms
of
the
financial
costs
of
the
reorganization,
but
also
in
terms
of
the
effect
on
the
staff
staff
having
to
reapply
for
what,
essentially
their
own
jobs
and
the
disruption
to
the
working
relationships
which
have
been
built
and
need
to
be
rebuilt
in
the
new
structure
and
we're
we're
just
coming
out
of
a
pandemic.
D
D
Is
it
not
that
we
ought
to
be
putting
all
our
efforts
at
this
current
time
into
addressing
those
problems
in
the
nhs
and
social
care?
Has
its
problems
as
well
underpaid
staff,
working
vacancies
and
so
on.
So
is
it
the
right
time
to
be
doing
this?
D
Can
we
not
just
sure,
should
we
not
just
be
carrying
on
doing
what
in
leads
we're
doing
so
well
without
going
through
this
major
reorganization,
so,
secondly,
the
issue
of
integration,
as
cather
said,
we've
been
doing
integration,
we've
doing
been
doing
collaboration
between
the
nhs
and
social
services
for
a
number
of
years
now
leeds
has
a
good
track
record,
but
if
you
look
at
the
bill,
it's
not
the
health
and
care
bill.
D
It's
the
nhs
bill.
Where
is
social
care
in
this
bill
very
little?
It
seems
that
social
care
is
well.
I
was
going
to
say
taking
a
back
seat,
it's
not
even
in
the
back
seat
chair
it's
in
the
boot,
it's
hardly
there
and
we
really
need
we've
been
promised
a
reorganization
of
the
social
care
system,
we're
still
waiting
for
it.
D
The
prime
minister
has
talked
about
cross-party
discussions,
as
I
understand
it,
they
haven't
taken
place.
We
really
need
to
look
at
the
role
of
social
care
working
with
the
nhs.
D
D
D
Now
in
leeds,
we
have
a
a
five-year
contract
with
the
city
council.
We're
very
grateful
for
that.
The
funding
comes
from
the
city
council
or
via
the
city
council,
and
we
have
the
budget
set
for
a
five-year
period,
but
that
doesn't
go
up
that
that
is
going
to
be
the
same
in
real
in
actual
cash
terms
for
five
years.
In
other
words,
we
are
already
suffering
a
a
cut
each
year
in
real
terms
in
the
money
which
health
what
watch
is
receiving.
D
D
A
west,
yorkshire
and
harrogate
health
watch,
but
the
the
preferred
option
of
the
local
health
watch
across
west
yorkshire
is
that
each
of
the
health
watch
within
the
the
components
of
west
yorkshire
and
harrogate
are
funded
to
have
a
collaborative
role
relating
to
the
west,
yorkshire
and
harrogate
level,
and
we
believe
that
it's
very
important
that
that
funding
is
made
available.
D
D
A
patient
should
have
an
assessment
to
see
what
social
care
needs
that
patient
is
going
to
be
required.
The
proposal
on
the
bill
is
that
is
put
off
until
after
the
patient
has
been
discharged
and
wherever
they're
then
living
been
there
for
a
while
but
chair.
That
means
that
there's
a
possibility
that
if
no
assessment
is
carried
out
before
they
are
discharged,
then
they
may
not
have
the
right
support
at
the
point
of
discharge
as
they
go
into
their
own
home
or
to
a
care
home
or
whatever
it
might
be
chair.
D
It
needs
to
be
assessed
before
they
go,
so
they
go
out
into
the
community
with
the
right
support
and,
of
course,
continually
assess
the
whole
of
the
time
which
they
need
social
and
other
care.
So
my
concern
is
that
patients
may
lose
out
if
the
legislation
about
pre-discharge
assessment
is
is
altered.
Thank
you.
So
sorry
for
having
going
on
so
long
share.
A
N
Oh
thank
you
chair.
I
can
certainly
comment
from
a
director
of
public
health
perspective
and
the
the
other
others
of
john's
questions
which
other
colleagues
may
want
to
pick
up
on,
specifically
just
to
just
to
start
by
by
saying
that,
when
caf
presented
the
ten
key
ambitions
of
the
west
yorkshire
ics
strategy,
you'd
have
seen
in
there
that
they
are
incredibly
bold
ambitions
about
reducing
health
inequality,
increasing
healthy
life
expectancy,
reducing
suicide
rates,
etc.
N
It's
incredibly
positive
that
we've
got
such
bold
ambitions
for
both
leeds
and
west
yorkshire
in
our
integrated
care
system,
but
there's
absolutely
no
way.
We
know
we
can
achieve
those
just
by
having
a
narrow
response
from
the
the
the
nhs
on
its
own,
so
that
that
that
that
that
ask
john
around
you
know,
you
know
where
is
the
wider
system
and
and
the
wider
system
is
so
important
if
we're
going
to
go
anywhere
near
achieving
those
ambitions
is
certainly
supported
by
ourselves
as
directors
of
public
health.
N
N
We
have
to
have
improving
health
at
the
heart
of
the
new
bill,
rather
than
just
you
know,
a
reorganization
of
the
the
the
care
system,
the
health
and
care
system-
and
I
think
that's
something
that
you
know
we're
certainly
committed
to
locally,
and
you
know
we
we
we
need
to
keep
that
high
on
the
agenda
in
terms
of
looking
at
how
prevention,
improving
health
and
well-being
and
reducing
health
inequality
is
embedded
in
every
single
work
stream
across
west,
yorkshire
and
and
for
leads.
N
So
I
I
really
support
those
comments,
john,
and
it
reflects
the
the
director
of
public
health
kind
of
response.
N
The
another
comment
was
around
strong
relationships
with
elected
members
and
local
authorities,
and
there
is
something
really
important
and
council
avenue
touched
on
it
earlier
in
the
comments
around
the
really
close
collaboration
between
the
the
ambitions
and
programmes
of
this
new
system,
either
at
a
west,
yorkshire,
leagues
level
and
our
health
and
well-being
strategy
locally,
and
I
think
that
that
as
cath
set
that
out
that
that
seemed
to
be
important.
N
But
we
need
to
locally
ensure
that
those
really
strong
mechanisms
are
there
and
it
doesn't
kind
of
fall,
fall
off
the
edges,
as
it
were,
of
the
the
core
focus
of
the
the
integrated
care
partnership,
the
the
point
around
engaging
patients
and
communities,
I
think,
is
really
critical.
N
So
we
need
to
ensure
we
kind
of
maintain
that
principle
and
way
of
working,
but
but
very,
very
mindful
of
making
sure
that
we
work
with
all
of
the
assets
in
our
communities
and
use
those
assets,
including
patient
voice,
and
you
know
third
sector
organizations
real
trusted
community
assets
in
in
how
we
do
business
in
this
new
world,
and
I
think
that
locally,
we
know
we're
really
committed
to
to
making
sure
that
happens,
and
it
won't
happen
on
its
own.
N
I
think
that
the
last
thing
I
just
wanted
to
add
from
a
public
health
perspective
is
that
the
the
scope
of
the
the
work
of
the
ics,
the
responsibilities
of
the
ics,
is
continuing
to
develop.
So
last
thursday
we
had
a
letter
nationally
from
amanda
pritchard
from
nhse
deputy
chief
exec,
and
she
outlined
new
responsibilities
that
the
ics
will
take
on
from
next
year
and
they
include
a
whole
load
of
public
health
programs,
which
include
vaccinations.
N
Screening,
immunisation
and
others
which
so
far
have
been
taken,
have
been
the
responsibility
nationally
of
nhs
england.
So
we
are
starting
to
see
more
and
more
public
health
responsibilities
come
down
to
this
to
the
local
level,
which
is
a
real
opportunity
for
us.
But
we've
got
to
absolutely
see
that
as
the
core
business
of
of
of
both
the
leads
level
and
the
west
yorkshire,
the
work
we
do.
So
I
really
support
your
your
comments,
john,
and
it
really
echoes
what
we're
trying
to
do
locally
thanks
chair.
Thank
you
very
much.
A
Victoria,
are
you
still
commenting
on
dr
bill?
Is
that
right?
Oh
you've
got
a
question.
I've
seen
your
hands
up
is.
G
That
me
sorry,
sorry
for
a
second
but
yeah
just
to
answer
john's
point,
particularly
around
healthwatch
and
the
importance
of
healthwatch
and
patient
vice
I
mean
healthwatch
has
been
an
absolutely
key
part
of
the
of
the
system.
Unquestionably
over
the
last
few
years
in
leeds,
you
know
everything
from
the
the
work
around
mental
health,
which
was
really
groundbreaking
all
the
way
through
to
to
the
insight
on
vaccine
and
vaccine
inequalities,
and
the
survey
that's
been
done
regularly
over
the
last
few
months
and
obviously
john.
G
You
know
the
work
that
you've
been
doing
as
well
around
dentistry,
really,
and
I
think
one
of
the
key
points
that
that
you've
brought
through
a
number
of
these
reports
by
healthwatch,
which
is
why
integration
is
so
important.
It's
just
the
importance
of
of
seamless
services,
people
in
the
community.
They
don't
expect
us
to
be
overly
bureaucratized
and
to
have
highly
complex
referral
routes
and
pathways
and
systems.
They
expect
us
to
work
together
really
so,
to
my
mind,
you
know
there
are.
G
What
our
approaching
leads
is
to
take
the
leads
approach
which
is
rooted
in
a
a
very
integrated
patient-first
community-focused
model
and
to
build
on
that,
and
I
think
that's
one
of
the
things
that
that
we're
absolutely
trying
to
to
do
here
as
well
and
then
then,
finally,
because
I
know
cavson
now,
but
I
don't
think
she
she
had
the
social
care
question
that
that
you
asked,
but
the
issue
around
funding
and
workforce
there
is
is
absolutely
central.
G
There's
no
question:
you
know
we
saw
quite
a
lot
of
people
coming
into
social
care
in
the
early
part
of
the
pandemic,
but
there
are
now
challenges,
as
we
know,
due
to
the
wage
structure
and
competition
with
supermarkets
and
and
other
employers
as
they
you
know,
get
back
on
track
really.
So
the
point
is
a
valid
one
and
one
that's
hugely
important
to
us
and
one
that
we've
made
to
central
government.
A
Thank
you
very
much
tony
and
welcome
back
kath.
We
missed
you
for
a
few
minutes,
so
in
our
earlier
pre-made
we
were
talking
about
the
pros
and
cons
of
remote
meetings.
So
power
outage
is
one
of
the
cons
that
we
have
so
welcome.
Back
and
tony
did
finish
up
for
you.
So
that's
really
good
and
we're
just
into
comments
now
so
counselor
gibson
over
to
you.
F
Thank
you,
chair,
hello,
my
handle,
so
I
mean
just
as
you
get
your
head
around
one
nhs
three
organization
then
another
another
one
happens
is
dr
bayless
has
already
mentioned.
So
I'm
and
I'm
not
completely
okay
with
with
this
with
the
new,
the
new
reorganization,
but
I
just
so.
I
wanted
to
ask
a
question
around
funding
it
funding
agreement.
So
is
it
the
case
that
the
west
yorkshire,
icp
or
or
is
it?
Are
we
from
an
icp
or
an
ics?
F
I'm
sure
cathy
said
at
the
end,
though
that
was
we're
going
to
call
it
an
icp
for
west
yorkshire.
Is
it
the
case
that
the
the
department
of
health
and
social
care
agree
a
funding
agreement
with
with
the
I'll
call
it
the
west,
yorkshire
icp
for
argument's
sake
and
then
it's
down
to
the
icp
to
to
to
allocate
funding
to
the
individual
icps
based
on
the
local
authority
footprints?
F
So
in
this
case,
leeds
authority
and
and
it's
a
question
for
fiona-
actually
what's
that,
what's
the
political
implications
of
that-
you
know-
I'm
just
thinking
of
you
know
different
council
local
authorities,
sort
of
vying
for
a
pot
of
money
within
within
west
yorkshire
is.
Is
there
going
to
be
pro?
Is
there
problems
that
you
can
foresee
with
that
and
the
other
question
I
had
as
well.
F
What
we're
not
entirely
sure
what
options
there
are
and
opportunities
there
are
for
for
ourselves
as
a
scrutiny
board
to
to
be
involved
when
we,
when
we
know
more
about
that-
and
you
know
my
position-
would
be
that
we
should
be
in
as
involved
as
we
possibly
can
as
a
scrutiny
board.
But
what,
when
will
we
have
a
little
bit
more
guidance
on
on
exactly
what
opportunities
there
are
for
us
to
be
involved
in
this
new
structure?
K
I've
probably
answered
my
question
quite
quickly:
yeah,
obviously
that's
that's.
When
I
talked
about
the
things
people
are
worried
about.
Obviously,
when
you're
looking
at
operating
more
regionally,
that's
that's
one
of
the
first
things.
K
People
worry
about
is:
does
it
mean
resources
will
be
lost
from
their
area
to
a
more
regional
area
and
obviously
that's,
as
I
said,
there's
a
huge
commitment
to
things
being
delivered
in
place
and
that
not
happening,
but
it's
also
the
responsibility
of
people
that
were
involved
in
this
process
to
make
sure
that
that
continues
to
be
the
case
and
that
our
area
specifically
doesn't
lose
out
because
actually
leads
is,
I
believe,
the
biggest
area
in
in
the
country.
K
That
is
not
an
integrated
care
system
in
its
own
right,
so
we
could
have
just
been
our
own
integrated
care
system,
but
actually
see
benefits
to
working
in
this
collaborative
regional
way,
which
we
have
been
doing
for
many
years
before
it
became
you
know
a
requirement
in
the
way
that
it
is
now,
but
obviously,
and
in
some
ways
that
means
west
yorkshire
needs
us
more
than
we
need
them,
because
we
are,
you
know
the
most.
K
The
biggest
most
well-resourced
area,
but
so
obviously
all
of
us
who
are
working
at
this
regional
level
but
rooted
in
leads,
will
ensure
that
it
doesn't
mean
that
we
or
any
other
area
you
know
lose
out
as
a
result
of
this
way
of
working,
which
has
been
very
positive
and
collaborative
so
far.
Thank
you.
M
On
the
question
of
when
you
might
get
more
guidance,
I
don't
know
it's
the
short
answer:
if
it's
not
in
the
main
legislation,
then
we
can
expect
bits
and
bobs
to
come
out,
but
I
I
don't
have
no
idea
of
a
timeline.
Tony,
do
you.
I've
got
any
more
idea
than
me.
G
It's
been
quite,
it's
been
quite
piecemeal
to
be
honest,
but
you
know
as
we
get
it,
we
we
deal
with
it
and
we
lazy
fight.
Don't
we
basically.
A
Tony,
even
though
the
paper
says
legislation
by
20
april
2022,
so
obviously
will
things
come
back?
You
know,
would
this
come
back
to
ourselves
before
then
or.
G
H
H
I
think,
frankly,
a
lot
of
it
probably
won't
give
us
the
clarity
that
sometimes
we're
looking
for.
In
that
the
whole
the
legislation
is
designed
to
be
permissive
and
to
let
local
areas
develop
the
arrangements
that
suit
you
best
and
given
that,
given
that
the
bill
is
largely
based
around
the
way
that
we
have
successfully
worked
in
west
yorkshire
and
hurricane,
that
really
gives
us
in
many
ways
the
freedom
to
to
pick
the
to
to
develop
the
arrangements
that
work
best
for
us.
H
So
I
think,
as
we
said
in
the
presentation,
we
see
it
very
much
as
an
evolution
rather
than
a
revolution.
We're
not
like
some
systems
across
the
country
having
to
set
up
a
lot
of
stuff
from
scratch.
We're
not
having
to
do
that.
We've
got
a
partnership
board
in
place.
We've
got
effective
relationships
with
health
and
wellbeing.
Boys
we've
got
really
good
relationships
at
west,
yorkshire
and
harrogate
level,
with
scrutiny
and
at
local
level
with
scrutiny,
and
there's
no
real
need
to
change
that
because
it
works
for
us
at
the
moment.
H
So
there
is
a
load
of
guidance
coming
out.
Some
of
it
might
be
helpful,
but
frankly,
some
of
it,
I
don't
think,
will
be
as
specific
as
some
people
might
like.
A
Okay,
thank
you
very
much.
Counselor
gibson
is
that
an
old
hand
or.
F
Yeah
just
quickly
to
to
follow
up
then,
and
ask
just
wondering
if
we've
been
working
in
a
cross-party
way,
because
it
sounds
like
at
the
at
the
moment
there's
an
agreement
that
none
of
the
the
local
authority
or
icps
with
the
local
authority
footprint
are
going
to
lose
out,
but
that
you
know
there's
nothing
to
say
that
if
there's
a
change
of
political
leadership
or
anything
that
that
that
wouldn't
change
and
they
would
have
different
priorities.
F
A
I
Thank
you,
madam
chairman.
It's
the
the
plans
that
interest
me,
the
the
place
level
plans
and
okay.
This
is
west
yorkshire
and
harrogate,
and
it
strikes
me
that
the
plans
themselves
when
written,
would
need
to
be,
to
a
certain
extent,
sort
of
mutually
supported.
I
Have
we
got
any
thinking
on
those
lines
because
different
things
happen
in
different
parts
of
this
of
this
area
in
this
region
that
are
useful
to
others?
Needs
has
more
than
most,
admittedly,
but
if
you
see
the
drift
of
the
question,
are
we
are
we
going
to
is?
Is
there
any
oversight
of
the
writing
of
these
plans
to
make
sure
that
they
are
not
mutually
exclusive,
as
opposed
to
supportive,
bearing
in
mind
you
know
the
the
the
rather
big
differences
between
leeds
and
some
of
its
colleagues
within
west
yorkshire
and
hurricane.
M
M
In
the
same
way,
when
we
write
leads
plans,
we
always
look
at
make
reference
to
the
health
well-being
strategy.
I
would
envisage
that
when
we
write
local
plans
that
we
will
look
at
what
the
west
yorkshire
strategy
says
and
make
reference
to
it.
Where
that
makes
sense,
I
mean
some
of
the
targets.
We
would
definitely
need
some
aligned
action
around.
M
It
would
make
sense
to
do
so,
so
sarah
might
want
to
comment
on
how
mental
health
services
work
together
out
of
west
yorkshire
and
how
that
might
work
in
reality
to
deliver
against
some
of
those
mental
health
ambitions.
M
But
there
is
still,
I
would
say
plenty
of
discretion
to
write
plans
that
nonetheless
pick
on
and
focus
on
things
that
are
particular
to
leads.
A
E
Thank
you
chair
and
thanks
kath
for
that
really
comprehensive
report.
I've
been
in
many
meetings
about
the
integrated
care
systems
and
I
think
yours
wins
the
middle
for
the
clearest
one
so
far.
So
thank
you
for
that.
I'd
like
to
also
echo
dr
beale's
point
really
about
the
about
the
real
need
for
us
to
challenge
the
pre-discharge
assessment
plans
and
just
you
know,
emphasize
how
crucial
that
is.
E
But,
coming
on
to
my
my
other
point,
it's
just
digging
down
a
bit
into
the
report
and
looking
at
some
of
our
outcome
ambitions,
I
just
wonder
if
we
could
perhaps
rethink
some
of
the
wording
and
note
that
we've
got
reduced
weight
for
10
to
11
year
olds,
I'm
just
thinking
with
issues
around
you
know,
body,
image,
issues
and
self-esteem,
whether
we
should
be
talking
more
about
promoting
healthy
weight
or
improving
health
well-being
and
fitness
rather
than
focusing
on
reducing
weight.
Thank
you.
N
Yes,
I
I
I
I
agree
with
your
comments
and-
and
I
think
that,
in
a
way
it
the
example
you've
given
illustrates
how
we
need
to
make
sure
that
we're
joining
up
the
system
from
every
part
of
how
we
want
to
look
at
improving
public
health
and
improving
outcomes.
So
the
in
the
content
of
the
paper,
the
targets
that
are
in
there
are
from
the
the
plan
for
how
the
healthcare
system
is
going
to
work
around
inequalities.
N
So
what
was
called
as
cath
referred
to
the
left
shift
blueprint
for
the
the
health
system,
which
you
know
is
a
very
legitimate
set
of
of
priorities
and
and
and
and
and
program
areas
that
that
they've
committed
to
and
what
we
need
to
make
sure
we
do
as
a
city
and
as
a
system
is
link
that
up
to
what
we
as
a
council
with
our
public
health
function,
are
wanting
to
do
around
promoting
positive
health
in
children
and
young
people.
N
So
there
is,
I
think,
it's
sometimes
there's
some
different
kind
of
terminology
used,
depending
on
which
bit
of
the
system
you're
in,
but
I
think
it
really
illustrates
the
point
that
actually
you
know
if
we
join
that
up
as
a
as
a
city
and
a
health
and
well-being
board
and
and
what
actually
is
in
the
health,
health
and
well-being
strategy
is
much
broader
around
promoting
positive
health.
For
that
group,
it
kind
of
all
fits
together,
so
yeah.
N
I
think
it's
a
point
well
made,
and
it's
a
good
illustration
of
how
we
need
to
you
know,
make
sure
that
all
of
this
kind
of
works
for
all
of
us,
not
just
just
one
part
of
the
system
but
yeah.
Thank
you
for
the
comment
and
we'll
certainly
take
that
back.
B
Thank
you
just
just
a
few
points
to
make.
Firstly,
the
the
names
of
boards
and
and
language
we
used
I'm
confused.
Already,
I
see
p,
I
s
p
p
s
c:
can
we
just
name
boards
what
they
are
and
try
and
get
away
from
acronyms
so
have
a
shorter
name,
but
just
tell
us
what
it
is,
because
you
know
we're
hoping
to
engage,
lay
people
as
well
as
professionals-
and
you
know
we
just
can't
be
talking
like
this-
if
we're
actually
trying
to
engage
everybody
in
leads.
B
The
second
point
was
very
much
what
john
was
saying.
Dr
beal
about
you
know:
what
are
we
doing?
How
much
of
it
are
we
doing,
and
is
it
making
any
difference
at
all?
So
it's
it's
looking
at
what
success
would
look
like
and
setting
the
right
priorities,
because
sometimes
things
don't
go
in
a
straight
line.
You
know
taking
loose
point.
B
So
we've
talked
about
deprivation
and
funding
in
a
lot
of
the
systems.
You
get
an
amount
of
money
per
head
of
population,
but
you
also
get
a
waiting
on
that
as
well
for
deprivation,
and
we've
mentioned
that
the
health
outcomes
for
people
who
are
deprived
and
living
to
private
areas
is
much
worse.
So
are
we?
Is
that
going
to
play
any
part
in
the
funding
calculations
at
all?
B
B
And
finally,
it's
just
a
point
on
on
gps,
we've
mentioned
the
health
service
gps
at
the
front
door.
B
A
Thank
you
very
much
counselor
nelson
and
I
totally
agree
especially
when
it
comes
to
medical
jargon.
I
was
I
I'll
use
the
word
dragon,
because
if
you
don't
understand
what
that
means,
that
will
be
jargon
to
you
and
there
are
two
professions
that
use
a
lot
of
that:
the
medical
industry
and
the
legal
industry.
So
we
have
to
remember,
especially
if
we're
public
speaking,
that
we
keep
the
grammar
as
simple
as
possible
so
that
everyone
understands
what
it
means.
So,
please,
let's
all
take
note
of
that
and
who
will
be
responding
to
counselor
nelson.
A
C
Hi,
thank
you.
Sorry.
I
I
was
going
to
respond
to
councillor
gibson
as
well,
so
you,
but
I
couldn't
find
my
race
hand
function,
because
I
don't
use
them
very
often,
so
I
might
be
able
to
answer
both
questions
in
terms
of
funding.
I
was
going
to
pick
up
the
funding
and
deprivation
and,
what's
the
risk
to
us
as
a
system,
so
yes,
you're
correct
in
assuming
that
the
funding
will
now
go
directly
to
west
yorkshire
and
there
will
be
a
process
of
contra
giving
allocating
those
to
place.
C
We
have
been
given
reassurances
that
the
formula
that
is
currently
used-
and
I
think
it's
called
acura,
I'm
using
the
acronym,
because
I
don't
know
what
it
stands
for,
but
it's
some
kind
of
methodology
used
centrally
to
by
somebody
that
takes
account
of
some
a
level
of
deprivation,
not
not
a
huge
amount,
because
I
think,
as
core
cities
we've
always
been
dissatisfied
with
that
formula,
but
certainly
that
background
calculation.
That
would
have
told
us
what
our
ccg
allocations
would
have
been
had.
C
We
stayed
as
separate
statutory
bodies
that
will
still
continue,
so
there
will
be
a
nominal
figure
available
for
the
ics's
to
use
to
decide
how,
in
the
first
place,
our
fair
shares
would
be
at
place
level.
So
that
will
continue
in
terms
of
funding.
However,
what
it
does
also
give
us
an
opportunity
to
do
is
to
re
reinvest
those
or
pull
those
back
at
a
west
yorkshire
level
without
having
these
statutory
boundaries.
C
If
we
feel
there
are
things,
mental
health
could
be
one
example
where
things
that
we'd
like
to
do
as
a
as
a
system
rather
than
at
place
level,
assuming
that
it
suits
all
places
to
do
it.
That
way.
So
that's
that
bit
and
in
terms
of
gp's
front
door.
C
I
don't
know
if
other
people
know
more
than
me,
but
certainly-
and
I
don't
know
tony
you're
better
than
me
to
to
talk
about
that-
but
through
the
primary
care
networks,
which
is
asking
gps
to
improve
their
capability
of
in
terms
of
capacity
and
capability
to
engage
with
conversations
at
city
level,
we
have
nine
primary
care.
C
Networks
have
been
set
up
from
the
97
practices
we
have
and
we
are
giving
them
a
lot
of
support
in
the
centers,
giving
them
a
lot
of
support
to
to
free
up
their
leadership
to
be
part
at
the
table
and
part
of
these
conversations
so
that
they
feel
that
they
have
input
and
influence
into
the
system
as
well.
So
that's
what
I
was
going
to
add.
G
Yes,
I
can
come
in
on
the
back
of
that
and
I
think
fear
might
still
be
online,
who
might
be
able
to
come
in
on
some
of
the
gp
things
as
well.
One
of
the
things
that
we've
had
at
the
heart
of
the
leeds
approach
has
been
to
try
and
bring
gps
and
elected
members
in
particular
together
via
local
care
partnerships.
G
Primary
care
networks
also
are
part
of
that
conversation
and
what
that's
all
about
is
obviously
bringing
people
together
at
local
level
to
plan
local
services,
and
that
also
involves
obviously
social
care,
third
sector
and
community
organizations
as
well-
and
you
know
during
the
pandemic
that
those
systems
on
the
whole
have
worked
really
really
well
and
just
on
the
on
the
deprivation
point
as
well.
It's
absolutely
a
key
issue.
There's
no
question:
you
know
we
are
in
a
a
really
challenging
environment.
G
You
know,
and
everyone
that's
mentioned,
health
inequalities
is
absolutely
right
to
do
so.
You
know
if
you
look
at
the
latest
index
and
multiple
deprivation.
We
know
we
have
a
great
number
of
people
living
in
the
most
deprived,
decile,
the
most
deprived
areas
of
leeds-
and
we
might
we
know-
we've
got
more
children
and
young
people
living
in
those
areas
as
well,
so
as
well
as
integrating
the
health
system
and
doing
all
this
work.
We
also
know
that
you
know
the
things
that
create
good
health.
G
You
know
particularly
around
good
jobs,
decent
housing,
decent
environment,
air
quality,
green
space,
the
things
that
that
we've
got
to
focus
on
as
well.
So
I
think
a
lot
of
the
work-
that's
that's
been
alluded
to
here,
whether
it's
the
west
yorkshire
strategy
leads
health
and
well-being
board
the
health
and
well-being
strategy,
and
some
of
that,
some
of
the
other
work.
It's
about
putting
a
lot
of
that
stuff
into
practice
now
and
focusing
on
delivery
on
the
ground.
You
know
making
sure
we're
getting
more
jobs
for
people
in
in
local
areas.
G
Looks
at
the
big
institutions,
such
as
the
health
sector,
generating
small
business
and
and
other
things,
and
as
julian
you
know,
did
an
excellent
presentation
to
health
and
well
being
board
a
couple
of
weeks
ago,
telling
us
about
the
opportunity
to
employ
local
people
in
the
new
hospital
developments
and
to
do
some
really
proactive,
progressive
work
there
and
that
health
inequalities
work
is
going
to
be
a
main
feature
of
everything
that
we
do
from
september
onwards,
but
yeah.
A
B
Sorry,
it's
just
on
what
tony
said
to
end,
because
you
know
everything
is
said
is
right.
You
know
where
you
live.
The
amount
of
greenery
you've
got
around
you.
Everything
still
leads
to
where
we
are.
How
do
you
square
that
circle,
with
other
departments
around
better
housing,
the
private
rented
sector,
around
education,
around
jobs
where's
their
place
at
the
table,
to
actually
make
health
outcomes
better?
A
Thank
you,
victoria.
N
Sorry,
I
I
muted
myself
rather
than
unmuted
and
just
briefly,
to
endorse
counselor
dowson's
comments.
The
last
thing
we
want
this
to
be
is
a
focus
on
structure
and
reorganization
and
acronyms,
and
you
know
we're
certainly-
and
I'm
certainly
with
colleagues
working
really
hard
to
make
sure
that
this
is
about
the
focus
on
health
outcomes
rather
than
organizational
structure,
and
it's
really
really
helpful
to
have
this
conversation
today
with
with
yourselves.
N
That,
quite
rightly,
are
raising
that
point
around
how
we
hold
ourselves
to
account
on
on
that
real
focus
on
those
health
outcomes,
and
I
I
think
that
this
feels
like
it
should
be
central
to
our
future
com
conversations
to
say
you
know
how
how
have
the
new
arrangements
made
a
difference
and
how
are
they
continuing
to
make
a
difference,
but
I
I
certainly
welcome
your
comments,
counselor
doris
dowson,
and
it
is
something
that
we
want
to
be
absolutely
at
the
center
of
the
local
approach.
G
Yeah,
so
just
just
a
really
important
point
about
other
other
council
directors
that
was
made
as
well.
I
mean
we
have
made
a
huge
amount
of
progress
on
this
one
over
the
last
couple
of
years,
or
so
in
particular,
has
been
a
a
large
amount
of
work
with
city
development
looking
at
employment
and
skills,
I'm
looking
at
employment
for
particularly
for
people
with
with
mental
health
and
learning
disabilities
and
there's
around
50
organizations
signed
up
to
the
employment
and
health
programme
around
employability.
G
There's
the
anchor
institutions
program
which,
as
I've
mentioned
earlier,
is
all
about
using
the
power
of
the
big
city,
businesses
to
provide
employment
opportunities
for
people
with
particular
needs,
and
public
health
colleagues,
in
particular,
have
been
working
really
closely
with
communities
team
on
the
ground
around
understanding
what
works
in
communities.
So
it's
a
really
important
point,
and
you
know
there's
also
lots
and
lots
of
work
with
with
children's
services
as
well
around
adverse
childhood
experience
and
or
being
part
of
a
child
friendly
as
a
as
well.
G
And
it
is
this
approach
that
that
really
has
to
emphasize
work
on
the
on
the
social
determinants
of
health
and
our
new
health
and
wellbeing
strategy
will
have
a
real
focus
on
on
this
stuff
as
well.
Massive
priority
for
us.
P
Thanks
chair,
I
don't
know
if
we
really
need
a
response.
I
just
want
to
echo
everything
what
my
colleague
councillor
dawson
said,
and
what
I'm
going
back
on
is
2015-16.
P
When
we
talk
about
and
the
poorest
should
should
be
held
would
be
more
assist,
we
represent
a
very
deprived
area
where
there's
a
lot
of
illness
and
there's
different
areas.
Another
scene
where
the
power
is
health,
come
first,
where
anyone
better
I'm
still
seeing
obesity,
you
extra
you
name
it.
The
power
are
still
going
through
it,
and
this
project
is
similar
to
when
you
say,
the
poorest
recovery
quicker
and
the
police
outcome
first.
So,
when
we're
going
into
a
area,
we
need
a
third
sector.
P
How
are
we
going
to
sell
this
to
our
communities
when
this
says
you
promised
me
in
1516
that
my
health
would
be
assessed
first
and
I'll
be
improved
quicker?
And
if
tony
remember,
every
meeting
I
used
to
say,
how
can
you
improve
the
poorest
people
quicker
because
deprived
people
are
less
fortunate
with
funding
and
whatever,
and
this
is
exactly
similar,
the
same
thing
you're
going
to
bring
it
back
into
the
community
and
as
it
says,
when
you're
taking
something
from
individual,
we
have
to
give
something
back
obesity.
P
It's
not
everyone
can
pay
to
go
to
the
gym
the
doctor
used
to
prescribe
free
activities.
I
think
that
is
off
the
table
and
there's
so
much
things
we
need
to
put
in
place
for
the
deprived
area
to
help
them
to
maintain
their
health,
mental
health.
After
the
pandemic,
that's
going
to
be
a
absolutely
crisis
and
we
have
funding,
especially
for
that
young
people
and
not
just
young
people,
adults
as
well.
So
I
think
activities
are
very
good,
but
they
just
can't
afford
it.
A
Thank
you
very
much
councillor
taylor,
I'll
now
call
on
councillor
harrington.
Please.
I
Thank
you
chair,
it's
just
to
say
really
that
being
involved
with.
B
So
I'm
really
that's
my
only
worry
that,
because
there's
so
many
other
layers
that
are
there,
that
we
lose
that
impetus,
and
that's
that's
one
of
the
concerns
that
I
have,
and
it
will
also
mean
that
when
we're
looking
at
deprivation-
and
I
know
I
say
that-
is
it
this
every
meeting
and
will
continue
to
do
so-
it
isn't
only
the
inner
city
areas
that
have
levels
of
deprivation
outer
northeast
ottly.
Other
outer
areas
also
have
small
pockets,
but
again,
I'm
very
concerned
that
they
will
be
lost
in
all
this
other
reorganization
stuff.
A
B
Yes,
I
leave
the
local
care
partnerships
program
on
behalf
of
the
city,
and
I
know
norm
is
very
involved
in
in
the
in
the
work
of
one
of
the
local
care
partnerships
and
other
people
are,
and
absolutely
this
is
a
as
a
program
that
is
at
the
heart
of
our
work,
as
as
an
integrated
care
partnership,
an
integrated
way
of
working
for
leads
and
I'd
go
back
to
what
catherine
was
saying
at
the
beginning
in
her
presentation,
which
is
that
this
is
a
continuation
of
a
journey.
B
This
isn't
a
disruption
of
the
journey
and
the
local
care.
Partnerships
have
been
an
example
of
how
we
have
always
in
leeds
or
for
some
some
years
now
wanted
to
bring
people
together
and
wanted
to
ensure
that
people
could
work
more
closely
together
to
the
local
level.
So
we
are
very
committed
julian
kath
myself.
Sarah,
that
the
the
local
care
partnership
should
in
time
be
leading
and
making
more
and
more
decisions
and
they're
the
heart
of
our
way
of
working,
and
we
won't
go
anywhere
fast.
B
If
we,
if
we
don't
continue
to
support
them,
they
will
always
take
time
to
embed,
but
we're
absolutely
committed
to
them
can
absolutely
promise
you
that.
A
Thank
you
very
much
here.
Counselor.
L
Thank
you
chair.
I
just
want
to
follow
up
on
what
councillor
taylor
and
councillor
dalton
have
said.
You
know
like
like
them.
I
also
represent
any
city
initiative.
L
What
I
totally
take
on
council
harrington's
point
about
deprivation,
just
isn't
assigned
to
the
inner
city
areas,
but
we
also
know
that
there
was
a
certain
population
that
suffered
from
covered
far
more
than
other
other
populations
did,
and
I
think
going
back
to
what
castle
dawson
has
said
about
other
departments
having
to
play
a
role
in
in
in
sort
of
the
health
inequality
side
of
things
and
to
some
extent,
we've
we've
done
a
little
bit
of
that
cancer
dose
with
the
selective
licensing
that
we've
got
in
hair
hills,
because
I
know
that
some
of
our
young
children
are
living
in
really
poor
quality
housing
and
therefore
they're,
resulting
in
having
asthma.
L
But
if
we
can
tackle
the
housing
aspect
of
it,
then
we
can
deal
with
the
health
aspect
of
it.
I
think
more
of
that
work
needs
to
happen
and
obviously
I'm
quite
a
new
cabinet
member,
but
I
do
have
parks
in
my
remit
and
I
also
have
active
lifestyles
in
my
room
and
the
point
I'm
trying
to
make
with
the
directors
is.
L
We
need
to
have
the
thread
of
public
health
running
part
of
that,
because
if
you
want
to
be
healthy,
you
need
to
be
walking
and
then
you
need
to
be
walking
to
your
parts
and
the
parks
need
to
be
accessible.
You
know
it
all
very
much
links
and
I'm
and
that's
definitely
somebody
who
comes
from
hair
hills
sees
the
inequalities.
L
That's
a
point
that
I'm
politically
going
to
try
to
lead
on,
but
I
think
everybody
across
the
council
has
a
role
to
play
in
terms
of
tackling
the
deprivation,
because
public
health
runs
through
the
thread
runs
through
and
everything
that
we
do
really.
So
I
just
wanted
to
make
that
point.
Thank
you,
chair.
A
Thank
you
very
much
councillor
arif.
For
that
that's
helpful.
Can
I
call
on
julian
please
if
you've
got
any
comments
to
make.
I
do
know
you
from
your
presentation
last
week
you
can
just
shed
more
light
for
us.
Obviously
I
do
understand
that
lots
of
what's
going
on
with
this
bill,
we're
still
awaiting
further
confirmation
and
guidance
and
uncertainties
at
the
moment,
but
just
something
to
assure
us
of
where
we
are.
Thank
you.
O
Yeah,
thank
you
and,
and
thank
you
very
much
for
the
opportunity
to
come
along
to
this
session.
Just
first
of
all
to
restate
the
point
thea
was
making
about
the
support
we
all
have
for
the
partnerships
locally
and
how
all
as
we
as
as
local
leaders,
we
do
the
very
best
as
part
of
this
successive,
as
I
think
dr
bill
was
describing
reorganization
to
get
the
best
out
of
it.
O
We
can
for
our
communities,
citizens
and
people
so,
from
our
perspective,
we're
working
hard
in
leeds
teaching
hospitals
to
be
a
genuine
anchor
institution,
which
means
that
we
have
an
interest
not
just
in
what
happens
in
the
hospital
but
across
all
of
the
communities.
We
serve
we're
working
particularly
closely
with
the
health
and
care
academy
and
working
hard
on
creating
greater
employment
opportunities
for
people
that
live
in
immediate
areas.
O
Priority
neighborhoods
of
the
city,
for
example,
example
lincoln,
green,
which
is
adjacent
to
sir
james
and
indeed
in
many
of
the
areas
that
councillors
on
this
board
represent.
I
think
for
us.
A
big
part
of
this
is
obviously
the
opportunity
that
I've
spoken
about
before
at
the
health
and
wellbeing
board.
O
About
the
planned
investment
in
hospitals,
which
shouldn't
be
seen
just
as
an
investment
in
hospital
estate,
but
is
essentially
about
transforming
the
care
and
treatment
of
our
children
in
relation
to
the
children's
hospital
at
the
least
general
infirmary,
and
also
the
redevelopment
of
our
part
of
our
adult
services.
O
That
will
give
us
greater
facilities
and
access
to
things
like
critical
care
and
the
latest
advances
in
surgical
techniques,
which,
in
turn,
all
of
that
will
support
the
left
shift.
That
cath
spoke
about
because
the
more
we're
able
to
do
from
a
specialist
perspective
in
hospital,
where
we
can
treat
people
who
need
to
be
in
hospital
quickly
and
effectively
with
really
good
outcomes,
then
the
more
that
can
be
done
in
community
services
and
patients
that
don't
need
to
come
into
hospital
can
be
dealt
with
more
effectively.
O
And
ultimately,
the
plans
for
the
new
hospital
estate
see
in
overall
terms
a
smaller
hospital
rather
than
a
bigger
one,
which
should
mean
we
can
leverage
investment
in
community
and
primary
services
to
complement
the
pathways
that
patients
will
go
on
as
they
move
between
the
different
parts
of
the
system.
O
We've
got
some
big
challenges
at
the
moment,
not
least
because
we've
got
over
a
hundred
patients
with
covert
in
the
hospital.
You
might
think
from
some
of
the
media
reports,
obviously
with
six
days
of
reduction
in
infections
that
things
are
okay.
Well,
I
have
to
say
from
a
hospital's
perspective
and
I'm
sure
victoria
would
support
this.
O
We
still
need
to
be
cautious
and
vigilant
around
that,
and
we,
we
are
still
seeing
hospitalizations
as
a
consequence
of
covid,
so
we're
we're
reinforcing
the
importance
of
vaccination,
but
also
of
the
necessary
wise
and
cautious
measures
that
that
we've
all
been
taking
to
try
to
make
sure
that
we're
we're.
Not
seeing
those
hospitalizations
rise
and
patients
suffering
harm
as
a
consequence,
so
we've
got
a
lot
to
do.
O
But
what
I
would
also
say
chair
is
that
we
have
seen
a
big
increase
in
patients
seeking
urgent
care,
and
that
goes
across
the
whole
health
and
care
system,
in
primary
care,
in
community
services,
in
mental
health
and
particularly
in
hospitals,
where
our
emergency
departments
are
experiencing
the
highest
attendances.
We've
seen
so
clearly,
we've
got
to
work
hard
to
try
to
make
sure
that
this
integration
we've
been
talking
about
deals
with
some
of
those
pressures
and
challenges
as
well.
O
So
in
overall
terms,
I
think
we
we'd
support
the
the
idea
behind
the
integration
of
care.
I
think
there
is
a
lot
of
focus
on
the
governance
and
the,
as,
as
a
number
of
colleagues
have
pointed
out
already,
the
kind
of
the
the
acronyms
and
the
complexity
which
I
think
we
need
to
sort
of
kind
of
push
to
one
side
and
focus
what
on
what
matters
for
our
communities
and
our
patients
in
all
of
this,
and
for
me
that
is
about
how
we
join
things
up,
even
more
so
than
than
we.
O
A
Thank
you
very
much
julian
I'll.
Just
add
to,
I
believe
what
counselor
dowson
was
saying
in
terms
of
the
acronym.
Definitely
we
know
the
focus
and
what
we
would
like
to
do
in
terms
of
the
community
and
people,
but
obviously
it's
just
for
our
benefit
and
for
the
public
as
well,
who
are
who
are
listening
to
us
when
we're
making
presentations
and
when
we're
speaking
that
we
just
reduce
the
use
of
acronyms
and
just
make
it
as
simple
as
possible
so
that
everyone
can
understand.
So.
Thank
you
very
much
for
that.
B
Yeah
I
found
that
presentation
julian,
quite
interesting
in
so
much
as
it
sounded
to
me,
like
you
were
talking
about
utilizing
smaller
hospitals,
which
is
which
is
really
interesting.
If
that
is
the
case,
because
we
used
to
have
a
lot
of
smaller
hospitals
in
leeds
and
it's
a
bit
like
setting
up
the
ccgs
and
then
they're
going
to
go
and
changing
systems,
we
have
the
wolfdale
hospital
which,
to
be
quite
honest,
is
probably
underutilized.
B
We
have
seacroft,
I
mean
there's
tons
of
them
all
over
leeds
that
have
come
and
gone
and
hopefully
from
what
you've
said.
They're
gonna
come
back
again,
but
somebody
pointed
out
the
cost
of
actually
doing
all
this
chopping
and
changing
is
quite
extensive.
I
would
have
ma
I
would
have
thought,
but
the
other
one
is
is
around
utilizing
third
sector
organizations.
You've
just
told
us
about
the
strain
that
the
nhs
is
under
and
and
somebody
has
used
that
serious
health
care
system
over
locked
down.
B
I
can
tell
you
it
works
brilliantly,
but
I
could
see
on
the
faces
of
the
staff
the
stress
that
they're
actually
under
through
overwork,
which-
and
somebody
mentioned
using
third
sector
organizations
with
a
lot
of
the
prevention
we're
talking
about,
and
I
do
believe
we
need
to
have
an
emphasis
on
prevention,
so
we're
not
putting
such
so
such
great
strain
on
the
health.
The
hospital
services
you've
got
people
like
leeds
rhinos
foundation
and
these
united,
who
are
doing
things
about
mental
around
mental
health
and
sports.
You've
got
men's
weight
sessions.
B
You've
got
all
sorts
of
third
sector
organizations
that
are
very
rarely
referred
into
by
gps,
very
rarely
referred
into,
and
I
have
personal
experience
of
that.
So
I
can
quote
you
if
you
want
to
contact
me
later
about
how
this
lack
of
referral
of
people
into
a
system
that
they
would
accept
and
they
would
work
within
if
you're,
a
sporty
person
or
have
been
or
you
love
sport
being
referred
for.
B
Weight
maintenance
to
somebody
who
actually
is
has
a
focus
on
something
you're
interested
in
and
that
you
will
go
to
and
you
will
stick
at
because
it's
something
you
love
it's
much
better
than
saying:
oh,
go
and
look
at
it
on
a
computer,
so
I
think
we
need
to
get
that
pathway
right.
Prevention
is
key
and
I
just
think
we
need
to
think
a
little
greater
about
the
support
we
give
our
gps
to
actually
deliver
that
preventative
service
through
the
third
sector
organizations.
A
E
A
I
Yeah
right:
well,
I'm
a
relative
beginner
here
I
I
did
serve
on
the
original
health
committee.
I
I
won't
tell
you
how
many
years
ago,
but
the
the
health
service
has
reorganized
so
much.
I
I
am
an
absolute
beginner.
I
I've
been
listening
very
carefully
to
what
has
been
said,
but
it
does
strike
me
that
there's
no
money
forth
coming
for
this
and
I
I
think
that
local
authorities
will
probably
have
to
bear
the
brunt
again
and
be
blamed
for
any
failure
of
delivery,
not
because
they
don't
want
to,
but
because
they
haven't
got
their
funds
to
do
so.
I
I
I
This
wasn't
an
inevitable
situation,
but
a
structural
failing
and
they're
talking
about
more
money
so
that
the
charities
can
do
the
job,
and
I
I
may
have
missed
it,
but
I
don't
think
this
afternoon.
Any
mention
was
made
of
the
work
that
various
charities
do.
We
which
support
the
nhf
and
indeed
relieve
some
of
the
pressure
from
the
nhs.
N
Thank
you
chair.
It
was
really
just
a
short
point
to
to
pick
up
on
a
couple
of
things
julian
said,
and
also
councillor
dowson's
response
with
the
with
the
example
of
the
lead
rhinos
the
sector
work.
I
think
it
in
terms
of
brief.
The
brief
situation
julian's
described
around
really
understanding
the
pressures
even
now
on
the
hospital
around
covet.
N
You
know
all
of
the
learning,
as
a
system
that
we've
had
over
the
last
17
months
is
that
we
know
that
there
is
a
there
is
a
direct
relationship
between
how
we
work
with
communities
and
and
keep
people
well
or
in
the
example
of
covid,
keep
rates
down
and
then
and
then
the
the
direct
pressure
that
hits
the
health
system.
N
If
that's,
if
that,
doesn't
work
well
upstream
in
prevention,
and
I
think
that
all
of
our
learning,
through
covid
and
before
covid,
it
can
equally
be
applied
to
every
single
health
issue
that
that
we
know
hits
the
system,
whether
it's
alcohol,
smoking,
obesity
and
all
of
those
wider
impacts
on
health.
So
I
think
that
the
the
point
is
so
well
made
and
connected
to
councillor
dowson's
response
there
around.
You
know
real
commitment
to
investment
in
in
prevention
and
particular
work
to
keep
people
well
and-
and
actually
we
know
the
consequences.
N
If,
if
we
don't
do
that,
I
think
the
reality
which
which
actually
does
correspond
to
some
of
council
and
ash's
comments.
Just
now
is
that
the
mostly
the
the
commissioning
of
those
prevention,
third
sector
activities,
you
know,
come
as
part
of
the
local
authority's
public
health.
You
know
commissioning
program
and-
and
we
need
to
still
continue
to
make
the
case.
Why
why
it's
important
to
continue
our
commitment
to
to
to
invest
in
in
those?
N
Because
not
only
are
they
good
in
themselves,
but
they
they
do,
have
a
direct
impact
on
the
on
the
pressures
of
the
nhs.
So
I
think
that,
in
terms
of
the
the
new
system,
the
evolution
of
this
new
system
challenging
ourselves
to
to
understand
that
independence
even
more.
I
think
I
think
that
it.
It
really
summarizes
that.
N
Well,
so
I
just
wanted
to
to
reflect
those
comments
back
and
say:
that's
absolutely
what
we,
what
we
really
want
to
do
and-
and
we
would
welcome
scrutiny
boards
in
in
ask
you-
know,
asking
difficult
questions
around
how
that's
going,
because,
ultimately,
that
will
be
our
challenge.
So
thank.
A
K
K
K
I
used
to
work
in
leads
survival
crisis
service
that
has
an
nhs
contract,
so
it's
really
specifically
funded
by
the
nhs
to
keep
people
out
of
nhs
services,
so
they
deliver
out
of
hours
mental
health
crisis
services
to
keep
people
out
of
psychiatric
births,
a
a
police
contact,
other
statutory
services,
and
there
are
other
charities
in
leeds
that
have
nhs
contracts,
so
touchstone
community
links
mind
for
example,
and
they
do
a
huge
range
of
activity
that
supports
both
the
council
and
the
nhs's
work.
K
You
know
in
in
delivering
better
health
outcomes,
so
you've
got
charities
delivering
what's
called
social
prescribing
where
they
work
alongside
gps
and
support
gps
to
prescribe
social
well-being
type
activities
alongside
you
know,
medication
or
clinical
interventions.
Iact
is
is
a
specific
partnership
between
the
nhs
and
council
and
counselling
services
to
deliver
counselling
across
the
city.
This
other
counselling
provision
as
well.
That's
commissioned
you
know,
by
the
nhs
or
by
the
by
the
council.
K
As
I
was
saying
in
my
opening
comments
that
the
the
the
delivery
of
services
by
charities
is
one
aspect
that
will
be
better
for
not
having
to
go
through
a
competitive
tendering,
because
that's
incredibly
burdensome
for
you
know
particularly
smaller
community
based,
you
know,
often
really
grassroots
organizations
that
are
very
accessible
to
people
who
are
using
their
services
but
could
be
very
threatened
by
those
kind
of
those
processes.
K
Sometimes
also
you
you
with
reference
term,
and
I
haven't
read
the
article
I'm
only
going
from
the
headlines,
but
a
lot
of
charities
have
been
campaigning
and
lobbying
government
to
better
fund
social
care.
So
within
the
children's
world,
for
example,
the
big
charities
like
coram
nspcc
bernardos
have
done
a
lot
of
national
lobbying
about
how
desperately
children,
social
care
needs
to
be
better
funded.
K
So
they're,
quite
charities
quite
often
have
a
campaigning
element,
as
well
as
a
service
delivery
element
and
they've
certainly
been
using
their
platforms
during
the
pandemic
to
highlight
the
crisis
and
social
care
funding.
Thank
you,
chair.
M
I
just
wanted
to
highlight
that
with
the
nhs
plan
did
come
an
increase
in
investment
in
nhs
care
and
that
we
can
see
that
in
new
roles
in
primary
care,
so
primary
care
teams
have
been
able
to
expand
with
new
roles
like
being
able
to
invest
in
physiotherapy
or
expert
medicines,
management,
sometimes
ot,
and
also
there
is
investment
in
community
health
services
through
something
called
the
aging
well
programme,
which
I
think
at
the
moment
it's
about
three
million
pounds
and
we're
only
discussing
this
week.
M
M
So
already
there
is
investment
in
something
that's
called
a
virtual
world,
but
if
we
were
to
sort
of
unpack
that
as
a
sort
of
professional's
term,
I
would
just
describe
it
as
enhanced
care
in
the
community
so
to
give
parapathetic
support
to
those
really
really
vulnerable
people
who
would
otherwise
turn
up
at
st
james's,
possibly
be
a
hospital
admission.
M
A
Thank
you
very
much.
Kath
okay,
have
we
got
any
more
comments
or
questions
we're
coming
to
the
end
of
this
agenda
now
I
would
like
to
also
say
that
very
detailed
presentation
by
cath
is
also
available,
so
if
anyone
would
like
to
have
a
copy
of
the
presentation,
angela
is
more
than
happy
to
share
that
with
us.
So
thank
you
very
much
again
kath
for
that
presentation.
A
I
would
like
to
ask
yourself
and
counselor
winner,
if
you
can
just
should
suggest
you
know
roughly
a
time
frame
on
when
you
can
update
us
further.
I
know
there
are
lots
of
things
that
are
uncertain
regarding
the
bill,
but
obviously
we
would
like
at
some
point
to
know
to
have
updates
on
where
we
are
with
the
bill.
M
I
should
imagine
possibly
by
the
next
scrutiny
board.
We'd
have
an
idea
of
how
we
want
to
constitute
our
local
board
on
what
that
architecture
might
look
like
with
some
of
the
subcommittees,
so
as
a
minimum
we'll
be
able
to
come
back
with
that
if
they
do
publish
the
additional
guidance
as
promised
by
again
the
end
of
this
month,
then,
if,
if
there's
content
there,
we
will
come
back
with
some
updates
on
that
as
well.
So
I
can't
remember
the
next
scrutiny
bodies
actually,
maybe
september
all
right.
M
I'm
confident
we'll
have
some
more
stuff
to
report
back
to
scrutiny
board
by
them.
Excellent.
A
Thank
you
very
much,
so
huge,
thank
you
to
yourself
and
to
your
team
to
julian
all
of
you
for
attending.
As
always,
we
truly
appreciate
it.
I'd
also
like
to
add,
as
we're
also
a
scrutiny
board
for
active
lifestyle.
I
do
not
know
how
many
of
you
have
been
watching
the
olympics.
Normally
my
eyes
are
kind
of
brighter
than
they
are
today,
but
I
stay
up
till
about
2
30
in
the
morning
watching
olympics.
So
it's
been
great
to
see
what
the
yorkshire
lads
are
doing.
A
I
have
also
just
been
told
that
we've
gotten
the
very
first
ever
bronze
med
medal
in
women's
gymnastics
since
1928
our
women
not
doing
us
proud.
Yesterday
we
had
little
miss
taylor
for
the
triathlon.
Oh,
my
goodness,
did
you
see
her
on
that
bike?
He
was
something
else.
So
yes,
council
rfd
speak
about
active
lifestyle
and
keeping
healthy.
That
is
our
wealth,
so
wherever
you
find
two
minutes
in
the
day
encourage
somebody
to
keep
make
sure
they
watch
the
olympics.
A
I
know
with
the
time
difference
it's
crazy
timing,
but
honestly,
once
you
start
to
watch
it,
it's
just
amazing
elite
is
doing
so
well.
I
mean
look
at
these
lads
have
put
us
on
the
map.
Even
those
countries
have
never
heard
of
leeds
now
so
try
and
share
the
good
news
which,
with
whoever
you
can
share,
we
were
the
we
did
speak
earlier
and
counselor
hackbrook
did
say
that
if
it
was,
if
yorkshire
was
a
country,
we
would
have
been
number
you
know.
A
Actually
we
should
have
been
number
eight
according
to
the
statistics,
so
let's
keep
keeping
on
and
please
let's
chair
team
gb
in
what
term
they're
doing
so.
I
think
we
have
about
three
or
four
gold
medals.
Now
little
miss
taylor
yesterday
had
a
silver
in
the
triathlon.
We
had
little
legs
from
manchester
bless
her,
so
that
was
really
really
good.
So,
yes,
thank
you
for
that
and,
let's
keep
keeping
active.
I
will
now
call
on
angela
just
to
quick
chat
about
our
work
schedule
before
we
finish.
J
Thank
you
chair.
I
don't
know
how
I'm
going
to
follow
that,
but
there
you
go
we'll
move
on
to
the
way
he
said.
So.
This
report
relates
to
god's
forthcoming
workshop
joe.
So
last
month
the
members
discussed
possible
areas
of
work
for
god
to
undertake
this
year.
So
the
latest
version
that's
set
out
in
appendix
one
has
been
drafted
to
reflect
the
board's
discussion,
so
members
are
asked
to
consider
and
discuss
whether
they
would
like
to
make
any
suggested
changes
at
this
stage
as
it
currently
stands
within
the
schedule
itself.
J
There
are
two
work
items
for
september,
but
obviously
I'll
add
a
third
item
regarding
a
further
update
on
the
development
of
the
ics
given.
What's
just
been
great,
so
one
of
the
items
for
september
relates
to
improving
same-day
response
services
and,
as
I
mentioned
very
briefly,
the
last
item,
this
will
encapsulate
gp
services
as
well.
J
The
other
item
references
the
re-engagement
specialist
commission
services,
but
just
to
provide
further
clarity
in
terms
of
what
we
actually
mean
by
this
and
proposing
to
to
reword
it
to
talk
about
the
restart
and
prioritization
plans
for
the
delivery
of
nhs
health
check
program.
As
this
was
the
main
area
of
interest
to
members
last
month-
and
there
was
all
also
earlier
discussion
from
members
about
the
potential
status
of
this
board
meeting
in
september,
so
again
as
it
currently
stands,
it
is
proposed
that
this
meeting
be
held
as
a
remote
consultative
meeting.
A
A
From
all
of
us,
at
the
scrutiny
board
for
hell
adults
and
active
lifestyle,
thank
you
so
much
for
coming
as
always,
truly
truly
appreciated
and
good
luck
with
all
the
work
you're
doing
and
thank
you
don't
forget
to
watch
the
olympics.
It's
athletics
next
week.
That's
my
specialty!
So
I'm
looking
forward
to
that
one
take
care
and
have.