Agenda and minutes

At this point in the meeting, Board 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.

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 11 July 2018.

Resolved: That the minutes from the meeting of the Health and Wellbeing Board held on 11 July 2018 be approved and signed by the Chair as a correct record.

It is at this point in the meeting that members of the public who have registered their wish to speak can do so. The deadline for registering is at 5.00 pm on Tuesday 16 October 2018.

To register please contact the Democracy Officer for the meeting, on the details at the foot of this agenda.

Filming, Recording or Webcasting Meetings

Please note that, subject to available resources, this meeting will be filmed and webcast, or recorded, including 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 no registrations to speak at the meeting under the Council’s Public Participation Scheme.

This report asks the board to confirm new appointments to its membership and to its list of substitutes.

A report was presented to the board, asking for the confirmation of new appointments to its membership, including some new substitute members.

Resolved:  That the Health and Wellbeing Board endorse the appointments as set out in the report.

Reason:     In order to ensure that the Health and Wellbeing Board has the full complement of members as set out in its Terms of Reference

This report presents the Health and Wellbeing Board with an update on the work and activities undertaken by the Mental Health Partnership to date.

Tim Madgwick, the Chair of the Mental Health Partnership, introduced the report and stated that from early discussion three priority areas had initially been identified. These were:

-      Self harm (and in particular, admissions to A&E for self harm)

-      Housing and supported accommodation

-      Long term prevention

It was also noted that communication between partners and patients would be key in working towards these priorities. He also gave special mention to the excellent work being done on suicide prevention within the Public Health Team and in particular the recent conference that they had organised.

Members of the board discussed Mental Health Crisis Support Services. It was noted that operational issues would continue to be looked at but that the service must be more resilient and sustainable and that this should be reflected in any further resources allocated to services.

Members of the board welcomed the preventative approach and the concordat and discussed the trends and data presented in the report and what this meant for mental health in York. The chair of the partnership highlighted that whilst we have data, the challenge was now to understand what this meant for mental health in York. Officers also highlighted that it was now important to understand what these preventative pathways would look like and what resources needed to be committed. It was noted that system wide co-operation would be key in establishing any community focussed preventative services.

Members discussed IAPT (Improving Access to Psychological Therapies) and the potential challenges around workforce in this area. It was also noted by the Chair of the Clinical Commissioning Group that GP referral behaviour in this area had changed due to the demands on the service and that this would need to be challenged when looking at the service.

Cllr Runciman, the Chair of the board, highlighted that members of the Health and Wellbeing Board were being asked to sign up to the Prevention Concordat for Better Mental Health.

Resolved:  That completion of the necessary documentation for sign up to the prevention concordat for better mental health be delegated to the Chair of the Health and Wellbeing Board and the Director of Public Health; and

That a commitment be made by members of the board as both leaders within their own organisations and as leaders across the York health and social care system, to do what is required to transform the mental health of people living in York. Board members were asked to take this back to their individual organisations for action.

Reason: To give the Health and Wellbeing Board oversight of the work of the new Mental Health Partnership.

This report looks at the priorities that have been established by the All Age Autism Strategy 2017-2021 and presents to the Board the challenges and progress seen to date.

Officers introduced the update to the All Autism Strategy and highlighted two key issues that are of primary focus:

-      Promoting and understanding autism; and

-      Improving information for those who are awaiting assessment

Members asked about the literature that is currently available for schools regarding assessments and diagnosis and on what support is available for families whose children may not be diagnosed. Officers informed the Board that work is currently ongoing with CAMHS (Children and Adolescent Mental Health Services) in order to develop literature for schools. It was also noted that there is support available for families with children who are not diagnosed, however this is mostly in the form of signposting to other local services and support based within schools. Officers highlighted that this is a gap in provision but is a difficult area to resolve due to the individual nature of support required by families in this situation.

There was discussion regarding the thresholds used for diagnosis and whether these were correct. Officers informed the board that this is something that is being looked at and should the data continue to imply that the diagnosis is low, further work would be done to interrogate the current thresholds and the screening processes.

Officers also mentioned the need to not lose sight of the aim to build a community approach to tackling issues such as autism and the support that the community can give to families and adults who are diagnosed.

The board also discussed the employment of adults with autism. Officers agreed that this is a key area and currently employment rates are very low. It was noted that there has been work carried out on supported internships and work continues with United Response to improve the levels of employment.

The Chair asked officers to distribute information amongst board members regarding autism awareness training.

Resolved:  The Health and Wellbeing Board endorse the All Age Autism Strategy action plan to maintain the progress to meeting need and proactively promoting an autism inclusive city; and

Health and Wellbeing Board members promote autism awareness training to all agency frontline staff within their organisations.

Reason: To keep Health and Wellbeing Board up to date in relation to delivery against the All Age Autism Strategy

This report presents the Board with the draft Local Transformation Plan for 2018/19 and requests authorisation to submit the plan to NHS England on 26 October 2018.

Officers informed the board that this was the annual refresh of the Local Transformation Plan (Future in Mind). Officers highlighted some of the successes from this year, including the positive feedback from children and staff with regards to the School Wellbeing Service and the improvements to capacity and training within schools on this issue. Officers then outlined the aims for the upcoming year.

The board asked for clarification on the funding allocated to services for the coming year. Officers informed the board of the following commitments:

-      £120k recurrent funding in Limetrees (CCG)

-      £50k recurrent funding into the autism pathway (TEWV)

-      £90k non-recurrent funding into Autism Assessments (CCG)

Officers responded to questioning on the targets for this area and stated that significantly higher staffing levels and further resources would be needed in order to bring waiting times in line with NICE (National Institute for Clinical Excellence) guidelines, however the current funding would allow for significantly more assessments and an improvement to waiting times.

The board discussed the concern of mental wellbeing in schools and the Interim Corporate Director for Children’s Services highlighted the following points:

-      That schools were building capacity and understanding in this area

-      Changes to assessment within schools’ curriculum were having an affect on anxiety levels and brought a new challenge

-      That social media was influencing the need for new styles of pastoral care

-      That zero tolerance behaviour policies were causing issues with exclusion and mental health generally.

It was confirmed that the plan covered the whole of NHS Vale of York CCG’s footprint and that the CCG were accountable to NHS England for the plan on behalf of all organisations represented at the Health and Wellbeing Board.

Resolved:  That the Health and Wellbeing Board have commented on the draft Local Transformation Plan and authorise the Chair to endorse the final draft prior to submission to NHS England on 26 October 2018.

Reason:     In order that the Health and Wellbeing Board are sighted on the development of the Local Transformation Plan prior to submission to NHS England.

This report presents to the Board the work of Healthwatch York in assessing the experiences of the LGBT+ community with regard to Health and Social Care Services in York. The report has recommendations that the Health and Wellbeing Board are asked to consider and respond to.

The Chair noted that this report was to be taken back to board members’ individual organisations and responses sent to the Healthwatch York within 20 days.

The Manager of Healthwatch York outlined the report and highlighted under questioning that the most significant recommendation was to encourage sector wide training and education.

It was also noted that the Health and Wellbeing Partnerships Co-ordinator would circulate the details of the LGBT Forum’s Training programme to the Board.

Resolved:  That the report and recommendations be further considered within the individual organisations represented at the Health and Wellbeing Board

That individual organisations respond to Healthwatch York within 20 working days from the date of the board meeting, acknowledging receipt of the report and detailing any actions that they intend to take.

That the report be referred to the Joint Commissioning Group for consideration of any implications for joint commissioning.

Reason:     To keep members of the board up to date regarding the work of Healthwatch York.

This report presents an update on the Better Care Fund for the 2017-19 period. The Health and Wellbeing Board are asked to note this report.

The Assistant Director for Joint Commissioning (CYC and NHS Vale of York CCG) was in attendance to present an update on the Better Care Fund (BCF).

The board were informed that a notice has been received from the Department of Public Health of additional funding available through the Improved Better Care Fund to assist with Delayed Transfer of Care (DTOC).

Officers informed the board co-production events for the BCF have been very effective in bringing together services and organisations to discuss and inform the use of BCF allocation. It was also noted that the Care Quality Commission (CQC) have created automated data profiles which was a positive step and an important tool for organisations.

Members of the board noted the significant improvement in patient’s length of stay and highlighted issues funding the winter plan. It was also noted that there are staffing issues in both primary and secondary care and that we are currently seeing unprecedented troubles in recruiting to General Practice.

Members also commented on the importance of planning for next winter and using the BCF to help fund preventative measures and services to keep people out of hospital where possible.

Resolved:  That the Health and Wellbeing Board noted and commented on this report.

Reason:     To keep the Health and Wellbeing Board updated in relation to the BCF

This report provides an update to the Health and Wellbeing Board on the progress of the York Health and Care Place Based Improvement Partnership (PBIP).

The Interim Chief Executive of York Teaching Hospital NHS Foundation Trust, gave an update on the Place Based Improvement Partnership (PBIP), informing the board of the reasons for creating PBIP and a brief overview of the report.

It was noted that Cllr Cannon had written to the Chief Executive of CYC asking for the papers of the PBIP to be made available publicly.

Resolved:  That this report has been noted.

Reason:     To keep the Health and Wellbeing Board up to date with the work of the Place Based Improvement Partnership.

This report provides the board with an update on the work that has been undertaken by the Health and Wellbeing Board (HWBB) Steering Group. The board are asked to note the update and ratify the steering group’s decision to establish an ageing well partnership.

The Director of Public Health presented the update from the Health and Wellbeing Board Steering Group.

It was noted that there had been a proposal to create an Ageing Well Partnership for York and the board was asked to ratify the creation of this partnership.

Resolved:  That the Health and Wellbeing Board noted this update and agreed to ratify the HWBB Steering Group’s decision to establish an Ageing Well Partnership.

Reason:     To update the board in relation to the work of the HWBB Steering Group.

This report provides information to the Health and Wellbeing Board on the work of the Safeguarding Adults Board over the course of 2018.

The Chair informed the Board that the current Chair of the Safeguarding Adults Board would be stepping down due to ill health.

It was noted that the Board would like to thank Kevin McAleese for all of his hard work and wish him well.

It was also noted that the recruitment for a new Chair of this board was well under way and a candidate was expected to be appointed by the end of the month.

Resolved:  That the Health and Wellbeing Board has noted the Safeguarding Adult’s Board Annual Report.

Reason:     To keep the board apprised of the work of the Safeguarding Adult’s Board.

This report presents the Annual Report of the Independent Chair of City of York Safeguarding Children Board 2017/18.

The Chair informed the board that the Children’s Safeguarding Board was moving to a more centralised system and the creation of a Children’s Safeguarding Partnership. It was noted that the Terms of Reference were currently being finalised for this new way of working.

Resolved: That the Health and Wellbeing Board received the Annual Report of the Independent Chair of the Children’s Safeguarding Board.

Reason: Communication between boards and an understanding of each board’s key messages and priorities enhances collaborative work and optimum outcomes.

The Director of Public Health for the City of York would like to present her annual report and accompanying video to the Health and Wellbeing Board. The report can be found in the agenda papers and the link to the accompanying video can be found online or alternatively can be found here: https://www.youtube.com/watch?v=zxrntPM2DiA&feature=youtu.be

The Chair highlighted to the Board that the Director of Public Health’s annual report was in the form of a video that was included in the agenda details.

This briefing note informs the Health and Wellbeing Board of the forthcoming follow up review by the Care Quality Commission which is scheduled for mid-November.

The Chair Highlighted that this was acknowledgement of the positive news that the CQC would be returning to carry out a follow up review of York’s joint working arrangements and relationships and was scheduled for November.