Agenda and draft minutes

To receive and note apologies for absence.

The board received apologies from the Corporate of Childrens and Education, City of York Council; there was no substitute.

The board received apologies from the Area Manager Director of Community Risk and Resilience, North Yorkshire Fire and Rescue Service, who was substituted by the Head of Early Intervention and Prevention.

The board received apologies from the Chief Superintendent, North Yorkshire Police; there was no substitute.

The board received apologies from the Chief Executive, York and Scarborough Teaching Hospitals NHS Foundation Trust, who was substituted by the Director of Communications.

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 Wednesday, 19 November 2025.

Resolved:   To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on Wednesday, 19 November 2025.

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 Monday, 17 January 2026.

 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.

Webcasting of Public Meetings

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.

It was reported that there had been two registrations to speak under the Council’s Public Participation Scheme; one speaker sent apologies due to sickness. 

Flick Williams spoke on item 7, questioning the decision-making process. She said it appeared unclear whether there would be any further public consultation on this matter and if the decision was being made here, she questioned the lack of a human rights and equalities impact assessment to accompany it.

She voiced concerns that adding fluoride to the water supply amounted to “universal dosing” of a medication, which would impact residents’ health and human rights, removing the element of individual choice. She also queried the possibility of an ensuing price rise for water bills.

This presentation by members of the York Health and Care Collaborative (a sub group of the York Health and Care Partnership) outlines the working approach and delivery mechanism for neighbourhood working in York and the all age approach to neighbourhood health, care and other local service integration, prevention and early intervention.

The Health and Wellbeing Board is likely to have a clear leadership role in developing Neighbourhood Health Plans going forward, as has already been announced in the Fit for the Future – 10 Year Health Plan for England, July 2025 and the work already undertaken by YHCC will help inform interim strategic planning that is expected of HWBB going forward.

HWBB members will be asked to note the progress made by YHCC in partnership and consider the board’s future responsibilities in light of available guidance expected imminently from Government.

The Director of Public Health introduced the item, noting that it was the board’s duty to publish a Neighbourhood Health Plan, and this would hopefully allow acute hospitals to work much more at a neighbourhood level, with external services more deeply integrated and embedded with the NHS, which he said was a timely alignment for York. He suggested that the board’s role in this process should be to steer the agenda and outlined how the model fitted in with York’s wards and

The item was then presented by The Director of Housing and Communities and the Director of Urgent Care, Nimbuscare.

The Director of Housing and Communities summarised how health services would fit into this model, advising that the local authority had planned for services to work within communities via an early intervention and prevention approach, to work with people as early and locally as possible. She noted that in York there were various existing models of integrated working to build upon, such as Local Area Coordinators, SEND hubs, Frailty hubs, Family hubs, and Mental Health hubs.

She advised that Neighbourhood Partnership Boards had been organised across the city, and work was being undertaken with the voluntary care sector to better respond to local issues. She detailed how the Integrated Neighbourhood Team would support the population on an individual level as well as through more complex cases identified by data. A consistent approach to working with the INT had been agreed between York Health and Care Collaborative and the council’s Executive.

The Director of Urgent Care went on to discuss Population Health Management. She advised that this involved using data to identify residents who needed multi-agency support, and working together to provide better support than the current single agency system was able to. She talked the board through a case study on how multi-agency social prescribing and trusted relationships looked in real terms.

The Director of Public Health advised that national guidelines concerning how Health and Wellbeing Boards needed to form their Neighbourhood Plan had not yet been received but were anticipated in the coming weeks. He stated that initial guidance suggested that boards would be required to offer leadership, and he hoped that partners would be able to further discuss this at the Local Government Association workshop being convened in March and at the subsequent meeting of the HWBB.

The Chair noted that York was in a strong position with this plan and the board simply needed to determine how deeply involved it wished to be with the neighbourhood plan.

Board members asked how “Caroline’s story” - the case study in the presentation – tied in to the Neighbourhood Model and what about York’s model had led to a different outcome in this case.

The Director of Urgent Care responded that the case study highlighted the need for different organisations to come together through a multiagency approach, working around the needs of an individual. She stressed that this was fundamentally different from partners looking after patients without interaction  ...  view the full minutes text for item 34.

This report is a verbal update from the York Health and Care Partnership, delivered to the board by the York Place Director, Humber and North Yorkshire ICB. The Board is asked to note the update.

A verbal update on the York Health and Care Partnership was delivered by the York Place Director; she apologised for the absence of a written report, explaining this was due to ongoing changes around the Integrated Care Board, including aspects of the Neighbourhood Health Policy, and she wanted to wait for more information on the ICB’s plans and the national policy direction on the Neighbourhood Health work so that the York Health and Care Partnership could establish its position before reporting to the Health and Wellbeing Board.

She stated that the Neighbourhood Health strategy was a core policy to the board’s 10-year-plan, and that York had been identified as being in the best position to scale neighbourhood working around the city. She assured partners that this was something which the NHS took seriously and stressed the importance of scaling change, noting they needed to focus initially on prevention and early intervention in order to ultimately be a better partner for Neighbourhood Health, and that the strategy was more holistic than just NHS partners.

She noted four upcoming pieces of guidance that were anticipated, impacting the board’s statutory duty to the Neighbourhood Health Plan:

1.    Work around the model neighbourhood, in the form of a document discussing success factors, key ingredients and so on.

2.    Guidance on new contract forms; not simply a vision or a plan, this would involve new models for single and multi-neighbourhood provider contracts with different forms to what had been used before and would incentivise providers  to deliver this model, making improvements to cash flow and work flow.

3.    The Better Care Fund, as already discussed by the Director of Public Health.

4.    Guidance on better use of physical assets; within the City of York 50+ buildings were owned or rented between General Practice, York Hospital Trust and TEWV, not to mention the many civic and council assets. To work in a way that supports people going forward it would help to have some ability to share use of these premises.

On the ICB policy direction she explained the demand for ICB’s to make a 50% reduction to their running cost by April 2026. The ICB needed to ensure its statutory functions continued to be delivered and this left relatively fewer resources for commissioning, but this remained a key focus.

She indicated that going forward, commissioning would have to focus on assessing population needs and developing the long-term population health strategy for system procurement contracting, getting contracts and incentives in place and then evaluating impact of services.

She outlined that the HWBB would still be able to engage with the ICB as a strategic commissioner, in the development of a long-term population health strategy and the evaluation of its implementation. She added that this came back again to the Neighbourhood Health model.

She discussed anticipated running cost and commissioning reductions, noting that approximately 150 redundancies were expected over the next few months. The outcome of the ICB's consultation was expected on 10 February, at which point  ...  view the full minutes text for item 35.

This report brings together key reference sources and summarises relevant evidence on water fluoridation. The aim is to provide a well-informed evidence base to support the development of consultation responses and strategic decision-making.

Health and Wellbeing Board members are asked to support the principle of fluoridating the water supply in York, in support of the improvement of oral health within the city. The ultimate decision and costs of doing so rest with the Secretary of State, not with the Board.

The report was presented by the Director of Public Health, who explained that this was very detailed due to the tooth decay situation in York worsening over recent decades. He explained that this was against a backdrop of tooth decay being the leading cause of children 6-9 going into hospital, with 22,000 UK hospital admittances every year necessitating an extraction under general anaesthetic. He noted that this was a topic that had been debated and discussed for 90 years, and the debate over fluoridation was therefore not new.

Addressing the comments of the speaker during Public Participation, he offered to correspond or meet with the speaker to further discuss this. For the purposes of the meeting, he suggested that many of the speaker’s arguments had been extensively debated in the past but sought to reassure over two of her key points.

He confirmed that the addition of fluoride to the water system was supported by all four Chief Medical Officers in the United Kingdom; the Chief Dental Officer of the United Kingdom, the British Dental Association, the Royal College of Paediatrics and Child Health and the British Society of Paediatric Dentistry, and there was thereby significant weight of professional opinion behind this. The science of its effectiveness in reducing dental cases and hospital admissions was established.

He stated that adding fluoride to water reached everyone, passing on beneficial properties, noting that this was effective in narrowing the gap in dental health between affluent and poor communities, as it was generally poor and deprived children who ended up in hospital with this issue, but in areas which are have fluoride in the water that was far less the case. He advised that there were already 6 million people in the UK who had fluoridation in their water (either through natural means or via adding fluoride to the ater as was proposed for York). He noted that the paper cited studies suggesting this could have both an adverse but particularly a beneficial effect on children’s dental health.

He stressed that fluoride was not considered a medicine as the speaker had suggested, rather it was a part of the water system. He noted that drinking water was treated with additives to make it safe, removing impurities from it, such as bacteria and viruses. Adding fluoride was part of this water treatment process and did not constitute adding a medicine and people were already receiving it and other treatments in their water without specific consent.

He proposed that while this report was specifically calling on the board “in principle” to support in the addition of fluoride to the water for York, the board should additionally ask the Council Leader, Cllr Claire Douglas, to write to the Secretary of State, to reinforce that this is the conversation our local clinicians, elected members, senior officers, those in the voluntary and community sector have assented to. He suggested partners could put their names to a letter and statement, as this was something the government was proactively seeking  ...  view the full minutes text for item 36.

This report sets out a new approach to supporting people achieving and maintaining a healthy weight in York, led by the public health team at city of York Council but with implications for the whole system of health and beyond in the city. It gives an overview of services to support children, families, and adults, with a particular focus on the shift to a compassionate approach to weight.

The focus of this report is on the framing of, and approach to, healthy weight support in the city, rather than on the wider issues behind weight, diet and exercise – for instance poverty, housing, the ‘obesogenic environment’, our food systems. These things are the focus of Goal 5 in the Joint Health and Wellbeing Strategy 2022-32, and are reported on regularly to the board.

The board are asked to note and endorse the approach set out within this report and are encouraged to promote the ethos of a compassionate approach to healthy weight, and the services available within their own departments/organisations.        

The Head of Public Health presented the item, noting that there was increasing recognition that obesity was a chronic repeating condition. He discussed how the council was providing services around support to healthy weight within the city at each stage of life, the stigmatising effect of the wording on letters that had previously been sent out to residents and the impact of weight loss drugs. He summarised that the next step for the HWBB was for all partners to agree to approve and promote the compassionate approach to weight loss across all organisations, and where possible look to embed trauma-informed practice, weight stigma reduction, a focus on holistic health rather than just weight outcomes and have a real consideration of those commercial influences on food and activity choices.

The Managing Director, TEWV welcomed the change in approach. She acknowledged that in cases where people had severe and enduring mental illness there was a direct link between obesity and any measure that was more engaging and less stigmatising. She noted that TEWV had recently been involved in research and took a particular approach for mental health, so they already had some foundational work on this in place.

The Chair asked whether evidence supported the improved long-term outcomes from a greater focus on health gains and becoming healthy, rather than solely a weight loss programme. The Head of Public Health said this was supported by evidence, stating that when interventions focused solely on weight, they missed so much else in terms of the holistic view of health and someone could be of healthy weight and chronically unhealthy or vice versa. He stressed that embedding these basic principles around physical activity and nutrition was key and being able to communicate the benefits to families, individuals, groups and organisations would result in better outcomes all across the city.

He noted that there were different sections of the community which experienced greater challenges than others achieving and maintaining a healthy weight, so the services listed in the report would need to be proportionate and directed to where the need was greatest.

Board members asked how Public Health was engaging with other parts of council (such as active transport or weaning children). The Head of Public Health answered that they were working closely with colleagues, noting that last year the city hosted the National Active Travel Conference and public health had worked with that team to look at how active travel could be embedded. Public Health were also working on the active schools programme, which linked in closely around looking at how walking and cycling into school was promoted.

The board identified a potential gap between breast feeding and healthy eating vouchers where parents of young children may be less supported than other age groups, and specifically discussed children who were weaning.

The Head of Public Health responded that he was working closely with colleagues across Children's Services concerning the Raise York Partnership (supporting parents, carers, children, young people and anyone who works with these groups)  ...  view the full minutes text for item 37.

This report includes an Annual Report discussing the work of members of the City of York Safeguarding Adults Board to carry out and deliver the objectives of the strategic plan during 2024/25.

It also includes the City of York Safeguarding Adults Board strategic plan for 2025-28.

The item was presented by the Independent Chair of the Safeguarding Adult Board. The Assistant Director of Adults and Integration assisted her with questions from board members.

The Independent Chair noted that the purpose of her presentation was not to invite a decision from board members, but to update them on the work of the Safeguarding Adults Board in the year 2024/25 and its strategy for 2025-28.

She explained that in York the Chief Operating Officer had delegated responsibilities to the Corporate Director of Adult Social Care and Integration as well as the Executive Member for Health, Wellbeing, and Adult Social Care at City of York Council, who were the key points of professional and political accountability. She added that agencies and providers also had responsibilities to promote well-being and provide advice, regardless of whether a statutory adult safeguarding duty applied, or whether the local authority had identified an action for itself following a safeguarding inquiry. She stressed that CYSAB endorsed the collaborative, preventative, neighbourhood approach being advocated in other items on the agenda.

She discussed the three core duties of the CYSAB:

1.    To develop and publish a strategic plan setting out how CYSAB would meet its objectives, and how member and partner agencies would contribute.

2.    To publish an annual report which detailed how effective its work had been.

3. To commission Safeguarding Adults Reviews (SARs) for any cases which met the SAR criteria.

She noted that the voice of the lived experience of adults was important to the board and they had strengthened and focused in on this in the past year. It was not merely an issue of data, rather the board was working to let the voice of those adults influence its work as a partnership.

She stated that work on the three year strategy 2022-25 had been concluded in the past year, embedding guidance for professionals and staff working around safeguarding. Partnership working had been strengthened, and more emphasis had been placed on organisations that represented people in the City of York. Self-Neglect Practice Guidance had been published, because it was felt from studying SARs that this was an area that required systemic improvement. Other improvements included publishing guidance to encourage frontline staff to have better professional curiosity, to assist in responding to situations, and to establish an escalation protocol.

She noted that statistics showed concerns increasing year on year by at least 10%, this year was no exception, and she did not anticipate this changing in the future. She stressed that this didn’t mean more people were being abused within the City of York, rather it was an indication of greater awareness about how to raise a concern, and people understanding their roles and responsibilities in relation to that.

She noted that in addition to strong partnership working within the authority, CYSAB had this year strengthened its relationship with North Yorkshire, working collaboratively with colleagues there, which had been mutually beneficial, particularly as many partners had a shared footprint and collaboration saved a  ...  view the full minutes text for item 38.

This report is for the attention and action of Board members, sharing two reports from Healthwatch York.

These share feedback received about mental health services, and people’s thoughts on future delivery of mental health support in the city.

The report was presented by the Manager of Healthwatch York; she noted that it exemplified the way that Healthwatch York could convey residents’ experiences of health and social care, and utilise their reported experiences to identify areas for further exploration.

In this case the report concerned mental health support offered, and the expanded support of mental health through primary care. She thanked Rachael Maskell MP for working with Healthwatch on the report and responding to residents’ concerns, indicating that while there were no specific recommendations in this report, it reflected the recommendations in Healthwatch’s previous report, which she believed were still valid. She welcomed the commitment made to discuss these reports at the next Mental Health Partnership and expressed her hope the partnership could support the work being done there to continue the transformation of local mental health services.

The Managing Director, Yorkshire, York and Selby – Tees, Esk and Wear Valleys NHS Foundation Trust admitted that the content of this report was difficult to hear and that TEWV were sorry for the negative experiences of its services that had been raised. She advised that Alison Smith, the new Chief Executive, had been in York responding to these concerns, TEWV had spoken to Rachael Maskell to address residents’ complaints, and improvements were planned with the Trust’s Voluntary, Community and Social Enterprise partners. She emphasised the focus around York’s Mental Health hubs and stated that TEWV would be working with Healthwatch to retain the voice of lived experience.

The Corporate Director, Adults and Integration commented on the work still to be done, noting that there were currently two Mental Health Hubs with ambitions and funding for a third, and this was a positive foundation to build upon, working with partners to offer an integrated model of Mental Health in York.

The York Place Director stated that the team around the person had potential to make a key difference here; moving away from a referral-based to a relation-based model. She suggested that NHS services were not always helped to move to new models; somehow expecting providers to continue with traditional models while working in new ways. She agreed that the Mental Health hubs needed to be established as a central part of this new model and was optimistic that the Neighbourhood Health Policy would facilitate this, suggesting that partners including the ICB could do more to support bringing this new model together.

It was then

Resolved:   To receive Healthwatch York’s reports, “Mental Health in York: A Progress Review”, and “Mental Health: What good should look like”.

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

This paper is designed to summarise key issues and progress which has happened in between meetings of the Health and Wellbeing Board, giving Board members a concise update on a broad range of relevant topics which would otherwise entail separate papers.

The report was presented by the Chair of the Health and Wellbeing Board, who broadly took the report as read, although members wished to discuss Annex A; specifically to express concern about the loss of 100 hours pharmacy provision and pharmacy services on Saturday afternoons and Sundays for Westfield Ward.

The Chair agreed that this was particularly unfortunate, and with the removal of out of hours provision, people who work, people with small children and others would have difficulty obtaining pharmacy services.

The Director of Public Health stated that the board had done what it could, and this was precisely why the Pharmaceutical Needs Assessment had been written. Although the PNA could not directly compel the opening of a pharmacy, it did lay the groundwork to encourage a business to open, giving favourable treatment to any application that was proposed for this area. Should any contractor wish to open a pharmacy here, the statement demonstrated a need, and the contractor’s application was therefore likely to be approved.

The York Place Director noted that the ICB’s pharmacy service, together with the Director of Public Health had fully investigated this issue to ensure that everything possible was being done. She acknowledged this was a rules-based system which was prescriptive in terms of what can and can't be done and when, but the HWBB had done everything it possibly could to advance this situation.

The Director of Public Health concluded by noting that following a similar need arising in Clifton, a contractor had now come forward and been appointed in that area. He was unable to give the board an exact date when that pharmacy would open, but on the basis of this example he wanted to reassure them that the process did work.

It was then

Resolved:   That the Health and Wellbeing Board noted the report.

Reason:     So that the Board were kept up to date on: Board business, local updates, national updates, and actions on recommendations from recent Healthwatch reports.