Third Sector Health and Care Leaders Network

Monday 16 October 2023 3pm - 4:30pm

Via Zoom

Name	Organisation
Corrina Lawrence	Feel Good Factor
David Blythe	Academy
Becky Baldaro	Booth Leeds
Carl Harrison	LS TEN
Cedric Boston	Unity HA
David Smith	Cross Gates
Dom Charkin	Zest
Emma Holmes	LCLCS
Helen Beioley	Care Repair
Jeannette	Leeds Women’s Aid
Julia Preston	GIPSIL
Kathryn Ashworth	Solace
Kelly Hart	NHS Grad Scheme
Leah	Epilepsy Action
Lisa Mulherin	The Market Place
Lottie Roberts	Smart Works Leeds
L Norton	Epilepsy Action
Lucy Hancock	Leeds Mind
Rachel Kelly	Womens Health Matters
Rozie Razak	Care and Repair
Shannon Kennedy	DHSC
Shell Stanley	Leeds Health & Care
Simon Wood	Leeds United?
Tracey Simpson-Laing	Home Start
Wendy Bray	My Home Care
Ramesh Bains	Royal Voluntary Service
Tina Turnbull	People Matters
Tammy Boyce	UCL
Pip Goff, Jo Volpe, Mary Halsey, Karl Witty, Jenny Bull, Francesca Wood	Forum Central

Meeting Notes

Welcome and Introductions

Pip welcomed everyone to the meeting and reflected on the last meeting, highlighting the key points raised by Phil Wood:

affirmed the commitment of Leeds Teaching Hospitals Trust (LTHT) to address health inequalities and building trust and relationships at all levels between LTHT and partners
Working together on health agenda e.g using contact with LTHT as opportunity to address smoking and alcohol
Value of early diagnosis and community diagnostic centres alongside prevention and talked of the need to increase awareness and connections between LTHT staff and the Third Sector to increase the visibility of what the sector delivers in communities.

It was noted that Dr Magnus Harrison has been appointed as Chief Medical Officer, joining permanently this October to the role previously held by current Chief Executive, Professor Phil Wood. (New Chief Medical Officer appointed)

New Member Introductions

Pip welcomed seven new members to Forum Central, with further details available here: New Forum Central Member Bios - October 2023

Overview of Forum Central work (link to detailed update paper on Forum Central’s work from July - September)

Team Updates paper shared which details many areas of work. Pip highlighted workforce resources, which have been developed following requests from Forum Central members with the support of HR Network members:

Organisational Change/ Leadership and Management Resources

Forum Central Workforce Information

Career and Voluntary Opportunities in the Health and Care Third Sector within Leeds

State of the Sector 2022 Update and Cost Pressures Survey

Francesca presented overview of December 2022 data, with comparison to December 2020: The Third Sector in Leeds 2022_Infographic_Final_13.10.23.pdf

Slide deck and video commentary to follow for everyone to use. Report and infographic published through Third Sector Leeds, work done in conjunction with Voluntary Action Leeds.

Tina noted that many organisations will have last reported to the Charities Commission earlier at 31st March 2020.

October 2023 Cost Pressure Survey Results

Chronic lack of uplifts creating a growing number of unsustainable services: with some orgs using reserves to subsidise contracts and others losing staff to public sector
Statutory services cuts: suppressed demand resulting in demand from new users who cannot be safely/appropriately supported
Knock-on impact for health outcomes: negative impact on services providing safe/warm homes; food; transport; benefits advice; wraparound support for vulnerable people – this will inevitably translate to greater demand for preventable unplanned care utilisation and LCC crisis care
TSO Boards are being asked to take high level risks: e.g. use of reserves, lowering pay scales, service reduction - Boards are being asked to make decisions that they know will put business sustainability, staff levels and service user wellbeing at risk.

Note the Third Sector risks FC & reps are flagging across ICS, which cost pressure survey and TS meetings confirm:-

Risk 1: Increased demand and complexity

Harm to patients, especially those with the greatest Health Inequalities (HIs), as third sector is increasingly unable to support existing as well as rising demand amongst the most vulnerable groups and communities. Forum Central has previously reported on the rise in people referred to third sector organisations with complex needs including SMI who are not in receipt of NHS or LCC support services.

Risk 2: Risk to financial position

Where reduction in TS services results in increased use of costly Preventable Unplanned Care services, including crisis services and associated additional bed days, which will absorb resource for the two priority goals of the Healthy Leeds Plan (HLP)

Risk 3: Risk to current contracts and PHM/HLP approach and deliverability

Organisations unable to fulfil contracts and loss of third sector workforce and capacity tackling HIs and the HLP’s two priority goals, particularly addressing root cause associated with the presenting problem captured in the Leeds Data Model (i.e. just as Leeds data model analysis gets to the point where it can identify the population groups to prioritise, we lose the staff, services and organisations that would be best placed to be a critical part of the solution)

Pip - trying to help gather this information in a way that we can advocate on behalf of the sector and take this into the meetings we are in

Update - NHS Integrated Care P/ship Position

Pip reflected on the difficult NHS funding position.
Noted West Yorkshire was the first ICS to have stated publicly that its formal year-end forecast has deteriorated, although more are likely to follow. West Yorkshire is one of 18 ICBs classed as having no major concerns about their overall performance, according to NHSE’s oversight framework.
WY ICS forecasting 93.7m deficit.
Leeds ICB Worst case is £52.3m but likely scenario is £23.6m, after achieving £16m this year.

Likely to have a £30M savings needed next year which equates to 3% of spend - hence the backstop letters that many of you have received suggesting a reduction on all Leeds services of 3% across everything. Noted that we are advocating for a different approach for Third Sector.

All NHS DoFs and Chief Executives are meeting next week (Extra Ordinary Meeting) to continue discussions.
We are working with ICB to understand and speak to organisations affected.

Forum Central is also writing to Tim Ryley as Place Lead and Chair of PEG - keen to ensure we develop:

A Commissioning Framework for 3rd sector including:

Collaborative working between Third Sector and statutory providers

Inflationary uplift to 3rd sector contracts to reflect pay award equivalent to NHS and non-pay inflation equivalent to NHS (and subject to same efficiency saving as NHS)
Ceasing of review of Third Sector contracts purely based on timing

Fair and open scrutiny of all spend - NHS and Third Sector. This will – requiring more transparency/timely sharing of information.
Consideration of all investment / disinvestment decisions in the context of Marmot City, Staten Island and community based approaches and outcomes in addition to the medical model.
Transparency and engagement of the whole system in challenging conversations at a whole system level rather than at the level of individual contracts or populations – what do we stop doing to allow us to do the things that will really make a change?

Francesca noted that the Healthy Leeds Plan has now been published, and has two priority goals: to reduce preventable unplanned care utilisation across health settings, and to increase early identification and intervention (of both, risk factors and actual physical and mental illness), focussing on the 26% of the population in Leeds who live in the 10% most deprived areas nationally. Noted that cutting third sector will have a detrimental impact on those goals.

Update - Leeds City Council Position

Jo updated that there is a report going to Leeds City Council Executive Board on Wednesday: Agenda for Executive Board on Wednesday, 18th October, 2023, 1.00 pm

Strong recognition of the value of the work from Leeds City Council of the Third Sector.

Noted following key points on Leeds City Council Position:

Net budget for the general fund for 2023/24 was set at £573.4m.
Following the closure of the 2022/23 accounts, the Council’s general fund reserve stands at £33.2m.
The budget for 2023/24 requires delivery of £58.6m of savings and as at Month 5, it is anticipated that most of these budgeted savings will be delivered or mitigating actions found. However, a £12.0m shortfall has been identified primarily due to the significant pressures within Children’s social care.
Pay Inflation – The 2023/24 budget allows for £38.9m of pay inflation.

Actions to help offset that include:

Staff redundancies - a section 188 has been issued to the Union and there is a potential for 750 staff to be made redundant
Property release and disposal

Tina - know that the council have been supportive in retaining headline figure for third sector in current year but what is the outlook to continue that and are we sure we have the right channels in to get sight of this early. Also noted that in the NHS and Council, as pay awards are national, there is no equivalent protection, do we need to think about collective view point.

It was noted that Workforce was recently taken to Scrutiny Board.

Pip noted that the TS Strategic Commissioning meeting was cancelled this week but is following up on these conversations.

Leeds Volunteering Strategy

Volunteering Strategy launched last Thursday, alongside evaluation of Community Champions. Recognise importance of supporting and investing in Volunteering across the city and know that that there is a challenge as the State of the Sector showed the drop in number of volunteers.

Launching the Leeds volunteering strategy

Andrina Dawson at Voluntary Action Leeds is leading on this - Andrina.Dawson@val.org.uk

Staten Island Learning Reflections

Jo shared update and presentation: Staten Island Update

Noted that Team Leeds has a learning partnership with Staten Island Performing Provider System, recognising it is a different system but have taken some interesting approaches.

Pip noted strong connection with Marmot City conversations - a lot of these feel like things we know but difference is that making sure resources flow to make that work happen.

Tina noted that it is also interesting that the data held is so accessible to providers, down to named individuals, which brings us back round to information governance.

Jo noted that they do support TSOs with infrastructure and have confidentiality agreements in place.

Staten Island info in Healthy Leeds Plan p14: The Healthy Leeds Plan - 2023 - 2028

Corrina flagged that it is down to communication and to have computers talking to each other, don’t even have hospitals talking to each other. Need for investing and not a one year funding.

Upcoming Events / Meetings:

Joint Young Lives Leeds / Forum Central event - Kathryn Ingold FFPH, Chief Officer, Consultant in Public Health is joining to talk about the Annual Health Report “In our Shoes”

- Wednesday 15 November 9:30am - 12pm

Your Pension and the Menopause - A session for those with Defined Benefits or Public Sector pensions

Webinar on the potential impact of perimenopausal and menopausal symptoms on people’s ability to save for their pensions

- Wednesday 18 October 3pm

Trustees Empowering and Supporting Communities in Leeds Event – Come and join us (26/10/23 10-12.45, at Voluntary Action Leeds with light lunch provided).
As part of the build up to Trustees Week Trustees Week – Showcasing the work of charity trustees) which will celebrate the contribution of Trustees, we will be holding a meeting to bring together a range of trustees, from small charities, voluntary groups, particularly culturally diverse groups, in Leeds to encourage trustees to share their skills, experience and good practice with each other.

We will also be looking at how we can support you further as a trustee in the coming future, perhaps with a trustee network or workshops on specific issues. So please join us to share and learn more about developing yourself as a trustee, to benefit the people your organisation supports. Trustees Empowering and Supporting Communities in Leeds - Come and join us - Doing Good Leeds

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