Agenda and minutes

At this point in the meeting, Members and co-opted members are asked to declare any disclosable pecuniary interest, or other registerable interest, they might have in respect of business on this agenda, if they have not already done so in advance on the Register of Interests. The disclosure must include the nature of the interest.

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

[Please see attached sheet for further guidance for Members].

Board Members were invited to declare any personal, prejudicial

or disclosable pecuniary interests, other than their standing

interests, that they had in relation to the business on the

agenda. None were declared.

To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on 15 March 2023.

Resolved: That the minutes of the last meeting of the Health and Wellbeing Board held on 15 March 2023 be approved as an accurate record.

At this point in the meeting members of the public who have registered to speak can do so. Members of the public may speak on agenda items or on matters within the remit of the committee.

Please note that our registration deadlines have changed to 2 working days before the meeting. The deadline for registering at this meeting is at 5.00pm on Friday 21 July 2023.

 To register to speak please visit www.york.gov.uk/AttendCouncilMeetings to fill out an online registration form. If you have any questions about the registration form or the meeting please contact the Democracy Officer for the meeting whose details can be found at the foot of the agenda.

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Please note that, subject to available resources, this public meeting will be webcast including any registered public speakers who have given their permission. The public meeting can be viewed on demand at www.york.gov.uk/webcasts.

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It was reported that there had been 3 registrations to speak under the Council’s Public Participation Scheme.

[Assistant Director, Education & Skills arrived at 4:38pm]

Flick Williams spoke about mental health and Covid-19, asking members to consider Covid-19 as an ongoing issue, and not something in the past. She highlighted that public health was a shared public responsibility, and not just for individuals to care for themselves. She also mentioned how attitudes to Covid-19 precautions had dropped and that people should still be concerned at taking precautions for Covid.

Cat Ownes spoke on agenda item 6 – Healthwatch York Report: Breaking Point, A Recent History of Mental Health Crisis Care in York. Cat raised concerns with the absence of Autism and ADHD in the Joint Health and Wellbeing Strategy and stated that the Autism Strategy had been out-of-date since 2021. She highlighted that the report shows how difficult it was for people to access support. She also discussed misdiagnosis and how some people were diagnosed with mental health illness when they should receive support.

Hazel Kerrison also spoke on agenda item 6. Hazel stated there was a misunderstanding between mental health and neurodivergence, and there was a stigma around personality disorders. Many people received incorrect diagnoses and therefore received inadequate support that was not fitting with their situation. She explained people with personality disorders often face prejudice and discrimination when these disorders show on their records. She also discussed the lack of services available in York specifically targeted towards Autistic and ADHD individuals, and stated those that are available were hard to find.

This report provides an update to the Health and Wellbeing Board regarding the work of the York Health and Care Partnership, progress to date and next steps. The report also provides an update on the development of Humber and North Yorkshire ICB's Joint Forward Plan.

The Director of Nursing and Qualitypresented a report which provided an update to the Board regarding the work of the York Health and Care Partnership (YHCP). It was indicated that YHCP was transferring pathways of care and reducing inequalities, and it was discussed how the Council were on top of upcoming issues. She also told the board that the YHCP was the first in the Integrated Care Board (ICB) to have a population health hub.

In response to questions from members, the Director of Nursing and Quality confirmed that mental health was a priority for the YHCP, and that services were being improved all the time. She noted that a new A&E department which was opening at York hospital would provide more resources for those in crisis needing help with their mental health.

The Consultant in Public Health, City of York Council highlighted how health melas were being used to engage the public in mental health and public health discussions and help residents access health resources such as blood pressure monitoring. He noted that These were typically used more in communities where health inequalities were known to exist.

It was recorded that a School Attendance Reintegration worker would be appointed within the Learning Support Hub to work with the attendance team to understand trends on absence, and to work on helping get long-term absent children back into education.

Resolved:

i.                That the Joint Forward Plan be received and that the Board provided feedback on its approach that can support the ongoing development of the planning process for future iterations.

ii.               That the contents of the report and the progress made be noted.

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

This report is predominantly a discussion paper for Health and Wellbeing Board (HWBB) members to consider a variety of ideas to shape the Board going forward. The intention is to use the discussion to revise the HWBB Terms of Reference and present these at the September meeting of the Board for approval before they are submitted to Full Council for inclusion within the local authority’s constitution.

The Consultant in Public Health presented a report setting out the statutory functions of the Board as well as its status within the new NHS arrangements. It was stated that the changes involved in this report has been trialled at various other Health and Wellbeing Boards. The report shows that health inequalities predominantly come from education, home, and lifestyle conditions such as health and salary conditions for families, highlighting that the focus should not just be surrounding the NHS, but also other factors of Health and Wellbeing.

The Board discussed how agenda items and Board meetings should be organised and discussed The Consultant in Public Health’s suggestion of dividing the time into thirds for agenda management to give the Board an effective focus and not let time be wasted.

The Assistant Director, Education & Skills raised the issue of special educational needs and disability (SEND) within the Board and stated that reports are rarely formally presented to the HWBB from the Local Area Send Partnership. It was discussed that the Board should hold conversations with the YHCP to decide what issues and topics were brought to the Board, so that the overlap was limited, and workloads were not duplicated.

Questions were asked regarding the action tracker, and how issues that have been raised can be followed up to ensure progress was being made. The possibility of a Task & Finish Group being formed to investigate and follow up on actions, and report back to the Board was raised. The Consultant in Public Healthnoted that the Health and Wellbeing Strategy Action Plan was in place and was one of the documents that held the Board accountable. He noted that when Healthwatch brought a report with recommendations for partners, they would follow up on actions via email. It was suggested that the Terms of Reference (ToRs) could be updated to publicly assure that partners respond to recommendations.

It was then agreed that the ToRs would be looked at with the comments made by board members considered and brought back to the Board at the next meeting.

Resolved:

i.                That the themes highlighted within the report were discussed with specific reference to the summary set out in paragraph 39 of this report.

ii.               That any changes to the Board’s Terms of Reference be brought back to the September meeting of the HWBB for approval before being referred to Full Council for approval.

iii.             For the Monitoring Officer to ensure that the Council’s Constitution be updated to incorporate any revisions to the Terms of Reference once they have been agreed by the HWBB and Full Council.

Reason: In order to ensure that the Health and Wellbeing Board continues to undertake its statutory functions appropriately and effectively and continues to strengthen local partnership arrangements.

This report is for the attention and action of Board members, sharing a report from Healthwatch York which shares local experiences of seeking support for a mental health crisis in the city.

The Healthwatch York Manager presented a report which detailed the local experiences of residents in seeking support for a mental health crisis in the city. She also listed the organisations Healthwatch York regularly worked with, including the York Multiple Complex Needs Network.

In response to questions from the Board, the Managing Director (North Yorkshire, York and Selby) for Tees, Esk and Wear Valleys NHS Foundation Trust explained that:

·       The Crisis phoneline had recently been updated to replace the previous multiple phone numbers into one number which can then divert people to the relevant team. This had increased the number of calls received and had  also increased the pickup rate of calls to 60%.

·       Calls which were not answered but received a call back are not counted in these statistics.

·       Due to capacity people often had to call multiple times to get through. As face-face-face meetings were the priority due to resource issues.

·       COVID-19 had increased the number of calls received by the crisis line. Many organisations which were not deemed as crisis organisations have since turned into crisis organisations to assist with demand.

·       More people were being sent to A&E for mental health help than before and early-intervention could  reduce the strain upon both the Crisis Line and A&E.

The Chief Constable indicated how the Police often received crisis calls that should be dealt with via the crisis line, however when calls were received relating to risk to life, the Police were the right first point of contact. The Chief Constable highlighted a ‘Right Care Right Person’ approach.

It was suggested by the Consultant in Public Health and agreed by the board that this report will be revisited along with the revised ToRs.

Resolved:

i.                That the Healthwatch York’s report, Breaking Point: A recent history of mental health crisis care, be received.

ii.               That the Board Confirm how they wished to be informed on progress against the recommendations within the report.

Reason: To keep up to date with the work of Healthwatch York, be aware of what members of the public are telling us and identify the best route for the development of partnership improvement plans.

This report is for the attention and action of Board members, sharing a report from Healthwatch York which looks at the results of the second Healthwatch York survey exploring the health impacts of the rising cost of living.

A report was presented by the Healthwatch York Manager which analysed the results of the second Healthwatch York survey exploring the health impacts of the rising cost of living. It was outlined that the number of people using food banks had increased and more residents were struggling to eat healthily. She also highlighted that residents were not heating their homes due to increased energy costs.

Board members then echoed these the prevalence of these issues and then:

Resolved:

i.                That the Healthwatch York’s report, Health and the Cost of Living in York, be received.

ii.               That the Board requested responses to the recommendations from the bodies named within the report.

Reason: To keep up to date with the work of Healthwatch York, be aware of what members of the public are telling us and respond to the issues raised.

This report is for information only, sharing details about the activities of Healthwatch York in 2022/23 with the Health and Wellbeing Board.

Resolved:

i.                That the Healthwatch York’s Annual Report be received.

Reason: To keep up to date with the work of Healthwatch York.