Health and Wellbeing Board

24 July 2024

 

Report of the York Health and Care Partnership

 

Summary

1.   This report provides an update to the Health and Wellbeing Board (HWBB) regarding the work of the York Health and Care Partnership (YHCP), progress to date and next steps.

2.   The report is for information and discussion and does not ask the Health and Wellbeing Board to respond to recommendations or make any decisions.

Background

3.   Partners across York Place continue to work closely together to integrate services for our population. The YHCP shares the vision of the York Joint Local Health and Wellbeing Strategy that in 2032, York will be healthier, and that health will be fairer.

4.   The YHCP has an Executive Committee (shadow) which is the forum through which senior Partnership leaders collaborate to oversee the delivery of the Partnership priorities. The Executive Committee meets monthly, and minutes from the last 3 meetings held in April, May and June are included as Annexes to this report.

Update on the work of the YHCP

York Health and Care Partnership Annual Report and Joint Forward Plan

5.   The Annual Report and Joint Forward Plan can be found at Annex A to this report. The annual report reflects on the work undertaken towards delivering YHCP priorities in 2023/24. The Joint Forward plan section of the report confirms that the priorities set by the YHCP in 2023/24 are long term, transformational ambitions, and therefore remain the same in 2024/25.  A workplan outlines the actions to be undertaken in partnership, for each priority in 2024/25. These support the ambitions and goals contained within York’s Joint Local Health and Wellbeing strategy and the Humber and North Yorkshire Health and Care Partnership Strategy.

6.   Integrated Care Systems are required to publish an update to their Joint Forward Plans for 2023 – 2028. YHCP’s contribution to Humber and North Yorkshire’s Plan is represented by this workplan, in the Annex A report. At the same time, Humber and North Yorkshire has undertaken a refresh of its strategy with stakeholders across the Integrated Care Partnership, including local authorities.

 

April 2024 Executive Committee Meeting (minutes at Annex B)

7.   The April meeting of the Executive Committee focused on integrated working in local communities. Often called locality or neighbourhood-based working, this refers to how multi-agency or multi-disciplinary teams organise themselves to work jointly around geographic communities. The following reports and presentations were received and discussed:

8.   Locality Model: a report was received which set out a process to define geographic areas that would ultimately lead to a locality model for health, care and community services. This piece of work aligns with the YHCP priorities to integrate our community offers and embed an integrated prevention and early intervention model.

9.   Integrated Neighbourhood Teams: YHCP received a presentation on developing integrated neighbourhood teams, which confirmed that these would be mapped onto the emerging Locality Model.

10.        On discussing both items YHCP members expressed support and highlighted a need for all agencies to have a shared vision and values which would require cultural and behavioural change; reducing complexity; user friendly language and producing a ‘roadmap’ to aid understanding of expectations.

11.Update to York Health and Care Partnership Place Development in 2024/25: The YHCP received, discussed and approved the final version of a framework developed by all six health and care partnerships in the area, called ‘Humber and North Yorkshire Strategic Framework: A Shared Framework for Excellence, Prevention and Sustainability at Place'.   Reference was also made to a local York Plan to respond to this, including:

·        Development of a narrative

·        Supporting our teams to act as ‘one team’ at every level of executive, managerial and professional level of leadership across our organisations, to find better ways of delivering services and addressing wider determinants of health.

·        Enabling our communities to shape, participate in and take ownership of their services.

·        Establishing how, by working differently, we can drive out avoidable costs and shift all our resources to support prevention, better care, and sustainability.

May 2024 Executive Committee Meeting (minutes at Annex C)

12.      The focus of the May meeting of the Executive Committee was prevention/children and young people. The following reports and presentations were received and discussed:

13.      Future Service Delivery Model and Estates Development: YHCP received a presentation highlighting themes from workshops bringing professionals together to co-design a new narrative which describes York’s future model for health, care and prevention in the context of integrated locality team-based working, and how buildings and infrastructure could be shaped to realise this. Key points highlighted in the discussion including the political perspectives in the context of a new Mayoral Combined Authority and City of York Council Local Development Plan for the built environment including housing and population growth; key worker and affordable housing; a workforce strategy in the context of culture change and the development of an out of hospital place based model of care; promoting York as a healthy city.

14.      Raise York: YHCP received a presentation entitled Raise York: Working Together with Children and Families to Improve Lives. Raise York is a network of people, places and online support. It supports children, young people and families from pregnancy to adulthood. For the next 3 years its priorities are:

·        Infant feeding

·        Perinatal mental health and parent/carer – infant relationships

·        Healthy weight in under 5s

·        Communication and language skills

·        Children and young people’s mental health

·        Cost of living

 

Its outcome ambitions are:

 

·        Increasing knowledge

·        Increased confidence

·        Increased resilience

·        Reduction in isolation

·        Increase in social networks

 

15.      The presentation also included information on lessons learned from pilot activity, the ‘toolbox’ to support delivery of the ambitions, the children’s workforce induction and the Solihull programme.

16.      Early Talk for York: YHCP received a presentation about Early Talk for York, a local area approach to improving speech and language communication outcomes for children aged 0 to 5. The presentation highlighted the benefits of joint working and having a consistent approach and narrative. Health and Wellbeing received similar information at their May 2024 meeting.

June 2024 Executive Committee Meeting (minutes at Annex D)

17.      The focus of the June meeting of the Executive Committee was driving social and economic development. The following reports and presentations were received and discussed:

18.      The future of the population: building our population health management approach across Humber and North Yorkshire: the focus of this presentation was in the context of the local ambition for everyone to live longer and healthier lives by narrowing the gap in healthy life expectancy between the highest and lowest levels in communities by 2030 and increasing healthy life expectancy by 5 years by 2035. Over the coming years we would expect to see a growth in the older population and more demand on health and social care services. There will be challenges around increasing capacity, improving productivity and efficiency and re-focusing on prevention.

19.      Preventative services in York – scoping assessment: this paper outlined some results of an initial scoping exercise around prevention services, supporting a range of prevention activities:

·        Behaviour change to reduce smoking, alcohol use, obesity, loneliness

·        Health champions in community

·        Local area resilience and social inclusion

·        Tackling determinants of health through social prescribing – loneliness, isolation, financial hardship

·        Prevention of disease/delay progression in general practice

·        GP list-based searches, optimising health whilst waiting for elective procedures, cardiovascular health

·        Clinical health coaching for patients at risk of high intensity emergency care use

20.      The ensuing discussion of the item highlighted the priority of the York Health and Care Partnership to embed an integrated prevention and early intervention model. YHCP agreed to look at ways of working together to maximise outcomes from available resources in the context of the challenges discussed as part of the population health item.

21.      Assurance report: this report set out progress against delivery of the 2024/25 Place priorities and NHS performance objectives. Areas of discussion with regards to NHS performance included:

·        Improvement in A&E waiting times and working towards achieving a minimum standard of 78% of patients waiting no more than four hours by the end of March 2025. However it was noted that long delays were experienced by some patients in May and June and plans were in development to address this to get performance back on track.

·        The Integrated Care Board is working towards ensuring that 85% patients who need an appointment get one within 14 days, by the end of March 2025.  York practices are already achieving this for their registered populations. 87.5% of patients were booked and seen within 14 days in April, with a total of 119,917 appointments delivered that month by York GPs.

·        Eradicating very long waiting times (those over 65 weeks) for planned hospital (elective) care by the end of year. The number of patients waiting a year or more is reducing and the total number of patients on the waiting list is also reducing. The planned improvement trajectory has been exceeded for these measures locally which is good news for local residents but there is still a long way to go to achieve 18 week referral to treatment standards.

·        Treating more patients within the 62-day cancer treatment standard (to 70%) and the 28 day faster diagnosis standard (to 77%) by March 2025. Plans are in place to achieve these standards by addressing delays in diagnostic pathways and improvement plans in place for Urology, Skin and Head and Neck, closely monitored by the Humber and North Yorkshire Cancer Alliance.

22.      Social care workforce priorities update: this update set out workforce priorities including recruitment and retention; care leavers; education and training; workforce data and key worker accommodation. Work continues across York to create new opportunities and to retain the existing social care workforce, but this is not without its challenges.

Work of the York Population Health Hub

23.      The York Population Health Hub continues to spearhead initiatives to improve population health outcomes in our city. One of the notable projects includes supporting York Medical Group Primary Care Network (PCN) in developing a practice-based Prevention Team. This team is poised to enhance preventative care within the community, focusing on reducing the incidence of chronic diseases through proactive health measures and patient education.

24.      In collaboration with York St John University, the Hub is also looking at facilitating placements for media studies students. This partnership aims to leverage the students' skills in creating impactful health promotional campaign materials. By engaging these creatives, the Hub hopes to produce engaging and effective content that promotes healthy living and disease prevention across various media platforms.

25.      Another effort by the Hub involves the development of advanced methods to analyse primary care data. A key focus is on constructing a comprehensive profile of childhood obesity using child growth percentiles, a resource previously unavailable to health professionals in this detailed format. This new tool will enable better identification, monitoring, and intervention for childhood obesity, supporting more tailored and effective health strategies.

26.      In June, the Hub successfully hosted a "Lunch & Learn" event, concentrating on Special Educational Needs (SEN). This event featured insightful presentations from colleagues at the City of York Council and local schools, fostering a deeper understanding and collaborative approach to addressing the needs of children with SEN. The event underscored the importance of community and inter-agency cooperation in creating inclusive educational environments.

27.      Through these initiatives, the York Population Health Hub continues to make significant strides in population health, driving innovation and collaboration to enhance the well-being of the York community.

 

York Mental Health Partnership

28.      The partnership hosted a spring workshop to recast its vision and aims, originally set out when the city's Connecting Our City programme was initiated. During the workshop, the York model for community mental health transformation was revisited and agreed, reflecting the Connecting Our City work and aspirations.  All partners contributed to the work.  In May, this work informed our Expression of Interest (EOI) for NHSE funding to set up a 24/7 community mental health centre in York.  Prepared by the partnership, the EOI was submitted as part of the ICB's regional submission and was supported by senior system leaders. We were pleased to be shortlisted and hosted an NHSE visit on 20th June, co-hosted between the Hub @ 30 Clarence Street and the York St John Communities Centre. We will be informed of the outcome after the forthcoming UK general election. 

29.      Key work supported by the partnership included the opening of York's first (post-prototype) Community Mental Health Hub at 30 Clarence Street.  The Hub manager and team, supported by the Connecting Our City project team and Joint Delivery Board (set up, by the partnership to support operational, management and leadership matters associated with the Hub), are to be applauded for their work.  The Hub is open on a phased basis (including hours of opening and the number of people supported) and the team are both supporting people who had previously accessed community services via 30 Clarence Street, and seeing individuals referred via the NHS Access team.  The transition to Hub 1 was enabled and informed through learning from the prototype phase.  In addition, the Connecting Our City project team have been supporting partners through contractual and organisational changes, alongside reinvigorating key programme pathways.  The Eating Disorders and Neurodiversity work pathways are developing well, and an Older Peoples workstream is underway, with plans to support older people within and exiting Foss Park hospital.  All work is underpinned by co-production and the VCSE are core to all York Mental Health Partnership/Connecting Our City work.

 

30.      Currently, the partnership is developing the work programme for 2025-2028, including the rollout of other mental health hubs and the scoping of a Community Interest (CIC) venture for community-based services in York.  Additionally, we are awaiting the outcome of the EOI.  Success will significantly influence the direction and pace of positive and constructive change to community mental health provision. 

31.      Additionally, the co-chairs of the mental health partnership have had an initial meeting with the Corporate Director for Children and Education at City of York Council to talk about children and young people’s mental health. There will be a further meeting in July where the co-chairs of the partnership will meet with the Corporate Director and his team to scope how the partnership can inform and support work with children, young people and families.

 

Contact Details

Authors:

 

Tracy Wallis, Health and Wellbeing Partnerships Co-ordinator, City of York Council

 

Chief Officer Responsible for the report:

Sarah Coltman-Lovell, NHS Place Director

Y
 
 

Report Approved

 

Date: 12 July 2024

 

 

ALL
 

Wards Affected

 

 

 

 

 

For further information please contact the author(s) of the report

 

Annexes

 

Annex A: Annual Report and Joint Forward Plan

Annex B: Minutes from the April 2024 meeting

Annex C: Minutes from the May 2024 meeting

Annex D: Minutes from the June 2024 meeting