Agenda and minutes

Introductions were carried out.

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. A list of general personal interests previously declared is attached.

Board Members were invited to declare any personal, prejudicial or disclosable pecuniary interests that they might have had in the business on the agenda, other than the standing interests which had been circulated with the agenda papers.

Councillor Douglas declared personal interests in the general theme of the meeting and in Agenda Item 6 (Annual Report 2015/16 of the Mental Health and Learning Disabilities Partnership Board to the Health and Wellbeing Board) as she was a member of the Mental Health and Learning Disabilities Partnership Board and also a Governor for Leeds and York Partnership NHS Foundation Trust.

No other interests were declared.

To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on 20 January 2016.

Resolved: That the minutes of the meeting of the Health and Wellbeing Board held on 20 January 2016 be signed and approved by the Board as a correct record.

In reference to the Action Grid, Board Members attention was drawn to the fact that the Alcohol Strategy for York would be brought to a future meeting of the Health and Wellbeing Board.

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 by Tuesday 8 March 2016 at 5.00 pm.

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 this meeting will 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: https://www.york.gov.uk/downloads/file/6453/protocol_for_webcasting_filming_and_recording_council_meetingspdf

It was reported that there had been no registrations to speak under the Council’s Public Participation Scheme.

This report asks the Board to confirm three new appointments to its membership.

The Board received a report which asked them to confirm three new appointments to its membership.

Resolved: That;

·        Sarah Armstrong, Chief Executive of York CVS be appointed to replace Kevin Curley former Chief Executive.

·        Jane Hustwit, Chair of the Board of Trustees be appointed as second substitute for Sarah Armstrong.

·        Marion Gibbon, Consultant in Public Health be appointed as substitute for Sharon Stoltz, Interim Director of Public Health, City of York Council.

Reason: In order to make these appointments to the Health and Wellbeing Board.

This report presents the Board with the Annual Report of the Mental Health and Learning Disabilities Partnership Board (MHLD PB).

The Board received the Annual Report 2015/16 of the Mental Health and Learning Disabilities Partnership Board to the Health and Wellbeing Board. The Chair of the Mental Health and Learning Disabilities Partnership Board (MHLDPB), Paul Howatson was in attendance to present the report.

Board Members were informed that membership wise the Board had welcomed a representative from York Hospital NHS Foundation Trust and City of York Council’s Assistant Director for Children and Families as a Board Members. The latter allowed for a link with the YorOK Board and children and young people’s emotional health and wellbeing. Membership was kept under review throughout the year.

In regards to work that had been carried out by the MHLDPB over the past year, they had established a Task and Finish group to look at housing for those with complex needs and this was due to report back in the summer. Other key focuses for the upcoming year would be work around various JSNA topics (students, learning disabilities and self harm); a Mental Health Strategy for York and input into the renewal of the Health and Wellbeing Strategy for York.

Board Members asked questions around the performance section of the report specifically;

·        Had the fall in the use of mental health care bed days experienced in the first quarter of 2015/16 brought York down to the national average?

·        Could further data be provided to Board Members on the spend per head on specialist mental health services and how much lower this was than the national average?

The Chair of MHLDPB agreed to take these questions away and report back to the Health and Wellbeing Board.

There were a number of comments around how performance was monitored by both the Health and Wellbeing Board and its sub structure and the Chair felt that this needed to be more robust. The Chairs of both HWBB and MHLDPB agreed to meet to discuss this further.

One Board Member asked why learning disabilities and mental health had been put together as they were distinct, and if there was service user involvement on the Board. Whilst service users themselves were not members of the Partnership Board they were represented through voluntary and community sector representatives who did sit on the Board. Additionally service users could attend any of the Partnership Board meetings to speak. The two learning disabilities focused meetings per annum were run as engagement sessions and well attended by service users.

It was reported that the sub boards that sit beneath the Health and Wellbeing Board would be reviewed as part of some forthcoming work with the Local Government Association (LGA).

Further questions from Board Members related to the support given to families who had to travel out of area to receive care, following the change in mental health provider.

It was reported that Tees, Esk and Wear Valleys NHS Foundation Trust did have a scheme for transport for admissions and they were planning on transport for discharges.

The Chair thanked Paul for his attendance.

Resolved:  That  ...  view the full minutes text for item 52.

This report provides an overview of the Together: York Pathways Project, which is a multi-agency collaboration that was established in April 2015 to identify and help address the issues associated with complex distress amongst York’s most vulnerable and service-intensive people.

Board Members received a report which provided them with an overview of the Together: York Pathways Project, which is a multi agency collaboration to identify and help address the issues associated with complex distress amongst York’s most vulnerable and service-intensive people.

Inspector Bill Scott from North Yorkshire Police and Samantha Durrant, Project Manager from York Pathways were in attendance to present the report and answer Board Members’ questions.

Inspector Scott informed the Board that people in distress did not just contact the Police, but contacted other services, such as the Ambulance Service, Acute Trust and the Council. Using the skills of pathway workers and with the consent of people, they worked to identify what issues the distressed people had to create resilience, social networks and alternatives to what was often chaotic behaviour.

Samantha Durrant informed the Board that the Pathways Team had many homeless people, or those presenting themselves as homeless approaching them for help. She added that they had commissioned a cost benefit analysis of the project and when this became available, that they would share this with the Board.

The Board were informed that there was also another project underway called ‘Making Every Adult Matter’ and they had worked to ensure that both projects completed rather than duplicated each other. In regards to the Together project, it was successful at winning a national award in November 2015.

The Chair thanked Inspector Scott and Samantha Durrant for their attendance.

Resolved:  That the Health and Wellbeing Board continue to endorse the work of the project and its innovative collaborative work to reduce distress, vulnerability and demand on emergency services in the city.

Reason:    To provide the Health and Wellbeing Board with a First Year Report.

This paper briefly outlines the main conclusions from a Conference held on 25 November 2015 at the National Science Learning Centre entitled “Everybody’s Business”. The Conference, which explored mental health issues for young people aged 0-25, was jointly commissioned by the Child and Adolescent Mental Health Services (CAMHS) Executive and the Higher York Board.

The Board received a feedback report from “Everybody’s Business” a conference which explored mental health issues for young people aged 0-25. The report was presented by the Associate Director and (Conference Chair), Paul Murphy of Higher York and Steve Wright, a consultant psychiatrist at Tees, Esk and Wear Valleys NHS Foundation Trust.

Paul Murphy introduced the report by sharing a few conclusions from the conference including;

·        Commissioners should not ignore York’s transient student population, some other cities gave them more prominence in their JSNA’s.

·        Transition continued to be an issue to address.

·        All of the feedback received requested a follow up event to the conference.

Steve Wright talked about the issue of transitions. He stated that transitions had been dealt with in a one dimensional manner by support services. There were at least four dimensions and could recur at various points in a young person’s life. The fourth dimension was geographical, in that more children had complex backgrounds and had often moved or were wanting to move somewhere new. An idea of a Young Minds Passport would help encompass these four dimensions.

Sharon Stoltz commented on the report and highlighted areas where work had been done to address issues raised (such as JSNA work around students); however there were some areas such as body image highlighted in the report and it wasn’t clear how these were being addressed when plans and strategies were being developed. She welcomed the report but questioned whether the workforce had adequate training around young people’s emotional health and wellbeing and whether there was a need to further develop training programmes to do more around this.

In response to a question from a Board Member about why there was a rising incidence of mental health issues, it was reported that there had been range of answers given at the Conference. It was a nationally recognised issue and there were a number of theories as to why it was happening. One was that social media had labelled things for children and young people.

The Chair thanked Paul Murphy and Steve Wright for their attendance.

Resolved: (i) That the report be noted.

(ii) That a further report be received on how feedback from the conference has been addressed.

Reason:  To inform the Board of the feedback of the Conference.

This report briefs the Board regarding Future in Mind and the NHS Vale of York Clinical Commissioning Group’s (CCG) Transformation Plan.

Board Members received a report which briefed them on Future in Mind and the NHS Vale of York Clinical Commissioning Group’s (CCG) Transformation Plan.

Victoria Pilkington from the NHS Partnership Commissioning Unit presented the report and was in attendance to answer Board Members’ questions.

The ambition behind the Future in Mind programme was to promote resilience, early intervention and prevention into healthy child mental health services.

The delivery mechanism was through the Local Transformation Plan, which was monitored by NHS England and local Health and Wellbeing Boards, to which is attach £1.3 million annually for 5 years to 2020 across North Yorkshire and York. Whilst funding for this year was agreed the planning process was still underway for next year; in addition to this the money was no longer ring fenced although NHS England had written to all CCGs to notify them of the funding made available for the delivery of the plans.

The Chair asked for clarification on whether the PCU would also work with local authorities in relation to this programme of work and was assured that this was the case. However, it was acknowledged that it was not solely about allocating monies to local authorities but about creating resilience across the wider health and social care system.

The Board had oversight of this and therefore needed to understand outcomes, key performance indicators and trends. The Chair therefore requested that these come back to the HWBB in regular progress reports.

Jon Stonehouse, Director of Children’s Services, Education and Skills welcomed the update report. He commented that the Health and Wellbeing Board had signed off the Transformation Plan which gave very clear details of the funding agreement and looked forward to receiving assurance that this would be allocated so work could continue around children and young people’s emotional health and wellbeing.

He hoped that the Health and Wellbeing Board would have clear governance of the Transformation Plan and suggested that this should be through the Child and Adolescent Mental Health Services Executive.

The Board felt that it was important that the monies continued to support schemes that addressed children and young people’s emotional health and wellbeing and did not want any schemes that had already started to stop; especially if they had been proven successful.

The importance of prevention and focusing on the first 1001 days from conception through early years was highlighted. Good maternity services, midwives, good ante and natal care and good maternal mental health were also highlighted.

Questions from Board Members included;

·        How would support be given to those who look for help at school, such as LGBT children and young people?

·        How could help be given to under fives who were not in touch with anyone but may need support?

It was suggested that the Board receive a report from the Child and Adolescent Mental Health Service Executive in regards to the Transformation Plan.

The Chair thanked Victoria for her attendance.

Resolved: (i) That the report be noted.

                 (ii) That the Board receive a report  ...  view the full minutes text for item 55.

This report updates the Health and Wellbeing Board on the Mental Health Facilities for York.

Martin Barkley, Chief Executive from Tees, Esk and Wear Valleys (TEWV)  NHS Foundation Trust gave an update on Mental Health Facilities in the city.  He informed the Board that besides building a new inpatient unit TEWV were very keen to get community mental health teams established in the city in fit for purpose accommodation.

In regards to some mental health estates currently being provided at York Hospital, Mike Proctor, Deputy Chief Executive of York Hospital, stated that he felt that the hospital, local authority and TEWV could collaborate more to understand what we have and how best to rationalise this.

The Chair requested that the Board be kept updated with progress. In addition, it was suggest that a report be received on what future rehabilitation and recovery services for working age adults will look like in early summer.

Resolved:  (i) That the current update around the mental health estate provision for York be noted.

                  (ii) That a further report be brought back to the Board on provision of a new mental health in-patient unit for York.

                 (iii) That a report on the rehabilitation and recovery services for working age adults be added to the Board’s Forward Plan.

Reason:   To keep the Board up to date on mental health services for York.

The aim of this report is to update the Health and Wellbeing Board (HWBB) on the progress with the Better Care Fund (BCF) in 2015/16 and the approach being taken for implementation of the Fund in 2016/17 and beyond.

The Board received a report which updated them on the progress with the Better Care Fund (BCF) in 2015/16 and the approach being taken for implementation of the Fund in 2016/17 and beyond.

Rachel Potts explained to the Board that whilst BCF monies had an impact elsewhere, emergency admissions had increased. The Chair requested that a report with what the money was spent on, alongside Performance Indicators be produced.

Martin Farran, the Director of Adult Social Care informed the Board that guidance on the BCF had changed since its inception. There had been progress in schemes but whether they could deliver the change across the whole of the health and social care system that was needed wasn’t clear; especially as the system as a whole in York was under significant pressure. He acknowledged that the BCF on its own was not the solution but wider system changes were needed.

He suggested that a further report come to the Board about what had been delivered in the past year and the learning from that so that this could be considered as part of the planning for the next year. This would also need to recognise the level of system change needed in the whole system given the financial pressures that were being faced.

He recommended that an emergency Board Meeting be arranged to discuss the BCF before its sign off in order to meet with national timeframes for submission.

Resolved: (i) That the update on Better Care Fund 15/16 be noted.

(ii) That the early approach to planning for Better Care Fund 16/17 be noted and agreed.

(iii) That an additional meeting of the Health and Wellbeing Board be arranged to discuss and sign off the Better Care Fund.1

Reason:  To keep the HWBB up to date in relation to the Better Care Fund.

The Chief Operating Officer from the Vale of York Clinical Commissioning Group will give a verbal update on sustainability and transformation plans.

Rachel Potts, Chief Operating Officer, Vale of York Clinical Commissioning Group (CCG) gave Board Members a verbal update on Sustainability and Transformation Plans (STP).

She informed the Board that over the last few weeks, the footprint of the Plan which would have encompassed the city had now increased. There were now six CCGs involved in the STP; North East Lincolnshire, Vale of York, North Lincolnshire, Scarborough and Ryedale, East Yorkshire and Hull. Plans were in motion to set up a workshop and also to focus cancer services across a bigger footprint that the Vale of York CCG.

Transformation plans needed to be developed at a local level but on the greater footprint for things such as specialist services.

Partners agencies were seeking to have a transformation approach for the Vale of York area and had recently established an Integration and Transformation Board (ITB). This had already had its initial meeting and a further meeting scheduled for 16 March. The ITB had an independent Chair who had experience in both local government and the NHS.

The reporting line for the ITB would be into the Health and Wellbeing Board and report on their work would be brought to a future meeting.

Resolved: That the update be noted.

Reason:    So that the Board are kept up to date on Sustainability and Transformation Plans.

To consider the Board’s Forward Plan. [To be tabled at the meeting]

Board Members were asked to consider the Board’s Forward Plan.

Sharon Stoltz suggested that the performance and monitoring be brought forward from the July meeting to May.

Resolved: That the Forward Plan be approved with the following amendments;

·        An emergency additional meeting to discuss and sign off the Better Care Fund.

·        A report on how feedback from the ‘Everybody’s Business’ conference has been addressed.

·        A report from the Child and Adolescent Mental Health Service (CAMHS) Executive on their plan in regards to the Transformation Plan.

·        That a further report be brought back to the Board on progress on a new mental health inpatient unit for York.

·        That a report on rehabilitation and recovery services for working age adults be added to the Board’s forward plan.

·        A report from the Integration and Transformation Board.

·        A further report on the development of Sustainability and Transformation Plans.

Reason:   To ensure that the Board has a planned programme of work in place.