Agenda and minutes

At this point in the meeting, Members are asked to declare:

·        any personal interests not included on the Register of Interests

·        any prejudicial interests or

·        any disclosable pecuniary interests

which they may have in respect of business on this agenda.

At this point in the meeting, Members were asked to declare any personal, prejudicial or disclosable pecuniary interests, other than their standing interests that they might have had in the business on the agenda. No interests were declared.

To approve and sign the minutes of the meeting held on 19 July 2016.

Resolved: That the minutes of the meeting of the Health and Adult Social Care Policy and Scrutiny Committee held on 19 July 2016 be approved and then signed by the Chair as a correct record.

At this point in the meeting, members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. The deadline for registering is 5:00pm on Tuesday 27 September 2016.

Filming, Recording or Webcasting Meetings

Please note this meeting may be filmed and webcast and that includes any registered public speakers, who have given their permission.  This broadcast can be viewed at: http://www.york.gov.uk/webcasts.

Residents are welcome to photograph, film or record Councillors and Officers at all meetings open to the press and public. This includes the use of social media reporting, i.e. tweeting.  Anyone wishing to film, record or take photos at any public meeting should contact the Democracy Officer (whose contact details are at the foot of this agenda) in advance of the meeting.

The Council’s protocol on Webcasting, Filming & Recording of Meetings ensures that these practices are carried out in a manner both respectful to the conduct of the meeting and all those present.  It can be viewed at: http://www.york.gov.uk/download/downloads/id/11406/protocol_for_webcasting_filming_and_recording_of_council_meetings_20160809.pdf

It was reported that there had been three speakers registered to speak at the meeting under the Council’s Public Participation Scheme and that one Member of Council had also registered to speak.

Councillor Warters spoke about access to GP services and felt that it should be considered as a scrutiny review topic. He felt that Members should request that the proposed surgery on the former Burnholme School site stay open for 7 days a week.

In response, it was acknowledged that Healthwatch York had recently completed a piece of work into Access to GP services. There was also a National GP Surgery Access Survey which gave waiting times information on a practice by practice basis.

Two speakers had registered to speak on Agenda Item 6 (Report on Change of Services at Archways Intermediate Care Unit).

Sheena Foxwell, who was previously the former clinical lead at Archways, remarked that although she agreed with some points made by the briefing paper on deconditioning effects on the elderly that this only referred to those who were in an acute medical setting rather than a rehabilitative one. She also commented that Archways had been receiving a number of patients who were failed discharges from the hospital.

Dr Mick Phythian was of the opinion that the closure of Archways was a cost cutting measure and he questioned how the Expanded Community Response Team would be staffed.

Amanda Griffith spoke regarding Agenda Item 8 (Bootham Park Hospital Draft Final Report). Her concerns regarding mental health services in the city following the closure of Bootham Park Hospital were primarily that former patients felt unsafe and there was a risk to life. She added that she felt that the current policy of Tees, Esk and Wear Valleys NHS Foundation Trust of working with the Police to carry out safety checks on service users was inappropriate. She felt that the Trust did not listen to service users.

This report provides the Health and Adult Social Care Policy and Scrutiny Committee with an update from the Chair of the Health and Wellbeing Board. The Chair will be in attendance at the meeting to present the report.

Members considered an update report from the Chair of the Health and Wellbeing Board (HWBB), Councillor Runciman, who was in attendance to answer Members’ questions.

Members were informed that the Draft Joint Health and Wellbeing Strategy would be launched at the Health and Wellbeing Board in March. In response to comments raised by the public speakers, the Chair confirmed that she had been unaware of any public consultation that had taken place regarding future proposals for Archways Intermediate Care Unit and was also surprised at its closure.

Questions from Members related to York’s voice in the Sustainable Transformation Plan (STP), the current situation at Peppermill Court and mental health services in York.

The HWBB Chair felt that Local Authorities and people needed to be more involved in the STP. It was highlighted that a meeting of all the Local Authorities in the STP footprint would be held on 7 October, and that guidance on public consultation had recently been released.

The deadline for an outline STP plan to be submitted to NHS England was 21 October. It was noted that the newly appointed lead officer for the STP, would be invited to the Health and Wellbeing Board and Members would also consider the outline plan. The Chair suggested that the STP lead officer attend a future meeting of the Health and Adult Social Care Policy and Scrutiny Committee.

The Chair of the Health and Wellbeing Board informed Members that the current facilities offered at Peppermill Court, although interim, were light and airy and offered a peaceful courtyard. She also informed them that the consultation documents on the new mental health hospital for York were now available and it was noted that the three preferred sites were;

·        Bootham Park site

·        Clifton Hospital site

·        Bio Rad site in Haxby Road

All Members and the public were urged to respond to the consultation.

The Chair thanked Councillor Runciman for her attendance.

Resolved: That the report be received and noted.

Reason:   To keep Members up to date with the work of the Health and Wellbeing Board.

This report analyses the latest performance for 2016/17 and forecasts the financial outturn position by reference to the service plans and budgets for all of the services falling under the responsibility of the Director of Adult Social Care and the Director of Public Health.

Members received a report which analysed the latest performance for 2016/17 and forecasted the financial outturn position by reference to the service plans and budgets for all of the services falling under the responsibility of the Director of Adult Social Care and the Director of Public Health.

Regarding Direct Payments, Members were informed that as not all money was spent by customers, the formula was to be reviewed. Officers felt that Direct Payments were a successful method of supporting care for some customers (for example those with learning disabilities), but the Council had not been successful in transferring money from place to place and therefore there had been overspends.

In response to Members’ questions it was reported that;

·        In occupational therapy there would be less emphasis on care management.

·        There had been an overspend in the Public Health budget for example; costs around accommodation and IT - the scanning of records. The costs could also increase due to the transfer of staff from Public Health England into the Council.

·        Officers would review low employment rates for those with learning disabilities and would work with the economic development department to ensure that recognised companies in York took on employees who had a learning disability. However, ensuring employers took on those with a long term mental health condition would be more of a challenge.

·        Officers would include data of those in York who remained substance free after 12 months, within the new substance misuse service tender.

Resolved: That the report be received and noted.

Reason:    To update the Committee on the latest financial and performance position for 2016/17.

Members will  receive a verbal update on the change of services at Archways Intermediate Care Unit.

Members received a briefing paper on the change of services at Archways Intermediate Care Unit. A paper from Healthwatch York on Closure of Archways: Changes to Intermediate Care Services in York was circulated to Members and published online with the agenda following the meeting.

The Deputy Chief Executive and the Director of Out of Hospital Care from York Teaching Hospital NHS Foundation Trust and Interim Deputy Chief Clinical Officer, from NHS Vale of York Clinical Commissioning Group (CCG) were in attendance to present the paper and answer Members questions.

Members were informed that the decision to close the unit was made as it was felt it was best to support existing patients in their own homes. The decision had been taken by the Provider Alliance Board and a consensus had been reached. The Provider Alliance Board’s membership includes representatives from City of York Council, North Yorkshire County Council, Tees, Esk and Wear Valleys NHS Foundation Trust and the Voluntary Sector.

The Deputy Chief Executive underlined how he felt rehabilitation services were better delivered in a patients home, and accepted that the hospital had not carried out consultation in the best way. They were also happy to accept the recommendations proposed by Healthwatch York in their briefing paper.

Questions from Members related to;

·        The number of care visits and assessments

·        Whether there would be a gradual lead in for closure and transfer of patients out of Archways

·        What steps had been taken to ensure mistakes were not repeated?

·        Could any patients be sent to units in Selby and Malton

·        What were there cost pressures in community care?

It was reported that;

·        Patients would be assessed on an individual basis, but on average a person could expect four visits a day.

·        There would be a gradual closure of beds.

·        The steps taken were to admit that the hospital should have involved all stakeholders in consultation, and to have a less paternalistic attitude.

·        The hospital had seen the closure as a small service change, and had made the case on the evidence that they had.

·        There may be a rare circumstance when a patient may be moved to Selby or Malton, but this would be at the discretion of the GP.

·        The funds from the sale of Archways would release £1.5m, the CCG would use their share to fund community services.

The Chair requested an update on the change to the services in the spring.

Resolved: (i) That the briefing paper be received and noted.

                                      (ii) That the feedback and recommendations from the Healthwatch York: Closure of Archways: Changes to intermediate care services in York be received and noted.

                (iii) That an update on service changes be received by the Committee in spring.     

Reason:       So that Members are kept aware of the service changes involved.

Members will receive a verbal update on the financial recovery and improvement plan that the NHS Vale of York Clinical Commissioning Group (CCG) are developing.

Members received an update report on the financial recovery and improvement plan that NHS Vale of York Clinical Commissioning Group (CCG) had in development.

The Chief Financial Officer and the Interim Deputy Chief Clinical Officer from NHS Vale of York Clinical Commissioning Group was in attendance to update Members and answer questions. She informed them that the financial recovery plan could not be shared with the Committee due to legal direction from NHS England. It was reported that the plan would be publicly available before the end of October. It would however, then need to be assured by NHS England.

The Chair thanked the Chief Financial Officer for their attendance and suggested that NHS England be invited to attend a future meeting along with the CCG. [Amended at Health and Adult Social Care Policy and Scrutiny Committee meeting on Tuesday 18 October 2016]

Resolved: That the report be received and noted.

Reason:   So that Members are updated on the status of the financial recovery and improvement plan of the NHS Vale of York Clinical Commissioning Group.

This report provides the Health & Adult Social Care Policy & Scrutiny Committee with all the information gathered around the closure of Bootham Park Hospital and actions taken to date to restore mental health services in York.

The Committee received a report which provided them with all the information gathered around the closure of Bootham Park Hospital and actions taken to date to restore mental health services in York.

Councillors Cannon and Cuthbertson, who had been members of the Bootham Park Hospital Scrutiny Task Group were in attendance for this item.

Members highlighted their disappointment at the Secretary of State for Health’s decision to not conduct an inquiry into the hospital’s closure. It was felt a copy of the final report should be sent to the Secretary of State, the Director General of the Care Quality Commission and the Head of the NHS. It was felt that the most significant recommendation from the scrutiny review was to have one person nominated as the lead body responsible for mental health services in the city.   

Questions were asked about the responsibilities of all organisations involved and it was felt that the recommendation wording of the memorandum of understanding should be amended. It was agreed to circulate via email to encourage further discussion before finalisation.

The Chair on behalf of the Committee thanked John Ransford, the Independent Expert Adviser who had advised the Committee throughout the scrutiny review. He also thanked the scrutiny officer and Director of Adult Social Care for all their hard work.

Resolved: (i) That the report be received and noted.

               (ii) That the draft recommendations as set out in paragraphs 70-72 of this report be endorsed and the review signed off as being completed subject to the revision of paragraph 70 iii.

             (iii)  That the wording of paragraph 70 iii be circulated amongst Members of the Committee for further examination ahead of being endorsed and signed off.

              (iv) That the report and its final recommendations be referred to the Executive and the Health & Wellbeing Board for consideration and endorsement, prior to forwarding to NHS England for consideration.

              (v) That copies of the report be sent to the Secretary of State for Health, the Director General of the Care Quality Commission and the Head of the NHS.

              (vi) That copies of the report be sent to the organisations mentioned in Paragraphs 70-72, namely NHS England, NHS Vale of York Clinical Commissioning Group, Care Quality Commission, Tees, Esk and Wear Valleys NHS Foundation Trust.

              (vii) That the organisations mentioned within the recommendations respond to the Committee within three months.

                     Reason: To conclude work on the review.     

Members are asked to consider the Committee’s work plan for the municipal year.

Consideration was given to the Committee’s work plan for the municipal year 2016/17.

It was suggested that the Annual Report of the Yorkshire Ambulance Trust be deferred from the October meeting to allow for the Trust to receive the results of their Care Quality Commission inspection results. It was agreed that reports relating to the merger of Beech Grove and Front Street, Acomb, GP practices, the re-procurement of community equipment and wheelchair services and winter pressures monies could be circulated to members by email and taken off the work plan.

Further discussion took place around scrutiny of Public Health Grant Spending. Members were informed that the Council had to submit a return to the Government on how the Grant was being spent, and how they were spending it on Public Health priorities. Discussions were also underway about the establishment of a Public Health Council.

It was suggested that the STP and the NHS Vale of York Clinical Commissioning Group Turnaround and Recovery Plan should be considered at November’s meeting and discussion took place on what further implications this raised.

Members decided that they wished to receive finance and monitoring reports via email, the Scrutiny Officer responded that he would check to see whether this was possible.

Resolved: That the work plan be received and noted with the following amendments;

·        The removal of the following items from the work plan;

Update Report on Winter Pressure Monies (now to be received by email)

Update Report on roll out of the re-procurement of North Yorkshire Community Equipment and Wheelchair Services (previously circulated to Members)

Report on the merger of Beech Grove and Front Street, Acomb GP Practices (to be received by email)

·        The Annual Report of the Chief Executive of Yorkshire Ambulance Trust be deferred to be considered at a later date.

·        An update report on service provision for short term rehabilitative care following closure of Archways Intermediate Care Unit.

·        That an item on the STP and the NHS Vale of York Clinical Commissioning Group Turnaround and Recovery Plan be considered at November’s meeting. An invitation be sent to the lead Officer responsible for the Sustainable Transformation Plan (STP) to attend this meeting along with a representative from NHS England.

Resolved: To ensure that the Committee has a planned programme of work in place.