Thursday 11 July 2024, 10:00 - 12:30

Severus Meeting Room; First Floor, West Offices

Chair: Ian Floyd

Present
Ian Floyd (Chair) (IF)	Chief Operating Officer	City of York Council (CYC)
Sian Balsom (SB)	Manager	Healthwatch, York
Zoe Campbell (ZC) on Teams	Managing Director North Yorkshire and York	Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV)
Sarah Coltman- Lovell (SCL) on Teams	York Place Director	Humber and North Yorkshire Integrated Care Board (H&NY ICB)
Brian Cranna (BC) on Teams	Director of Operations and Transformation, North Yorkshire and York	TEWV
Cllr Claire Douglas (CD)	Leader of City of York Council	CYC
Dr Rebecca Field (BF)	Joint Chair of York Health and Care Collaborative	York Medical Group
Professor Mike Holmes (MH) on Teams - part	Chair	Nimbuscare
Melanie Liley (ML)	Chief Allied Health Professional	York and Scarborough Teaching Hospitals NHS Foundation Trust (YSTHFT)
Peter Roderick (PR)	Director of Public Health	CYC
Alison Semmence (AS)	Chief Executive	York Centre for Voluntary Services (CVS)
Cllr Lucy Steels-Walshaw (LSW)	Executive Member for Health, Wellbeing and Adult Social Care	CYC
In Attendance
Natalie Caphane (NC)	Assistant Director of System Planning and Improvement	York Place, H&NY ICB
Professor Lynne Gabriel (LG)	Co-Chair	York Mental Health Partnership
Caroline Johnson (CJ) on Teams	Place Deputy Nurse Director	York Place, H&NY ICB
Michele Saidman (MS)	Executive Business Support Officer	York Place, H&NY ICB
Tracy Wallis (TW)	Health and Wellbeing Partnerships Co-ordinator	CYC
Dr Stephen Wright	Co-Chair	York Mental Health Partnership
Apologies
Mark Bradley (MB)	Place Finance Director, North Yorkshire and York	H&NY ICB
Gail Brown (GB)	Chief Executive	Ebor Academy Trust
Professor Karen Bryan (KB)	Vice Chancellor	York St John University
Michelle Carrington (MC)	Place Director for Quality and Nursing, North Yorkshire and York	H&NY ICB
Dr Helena Ebbs (HE)	Clinical Place Director, North Yorkshire and York	H&NY ICB
Emma Johnson (EJ)	Chief Executive	St. Leonards Hospice
Martin Kelly (MK)	Corporate Director of Children and Education	City of York Council
Simon Morritt (SM)	Chief Executive	YSTFT
Sara Storey (SS)	Director Adult Social Care and Integration	CYC

1. Welcome, apologies for absence and minutes

The Chair welcomed everyone to the meeting. Apologies were as noted above.

There were no declarations of interest in the business of the meeting.

The minutes of the meeting held on 20 June 2024 were approved subject to amendment on page 3 item 2 The future health of the population – building our population health management approach across Humber and North Yorkshire where the action to read:

'PR to lead on development of an improvement programme for

York’s preventative services for presentation at a future meeting'

Discussion ensued in the context of maximising available resources through working together, including the perspectives of the York Health and Care Collaborative and the development of Integrated Neighbourhood Teams with recognition of prevention in terms of primary, secondary and tertiary services. SCL referred to discussion at the previous meeting about arranging dedicated time and proposed an informal session to gain an understanding of the remit of each organisation with expert input to support a "time out". PR additionally noted that he would circulate a slide pack with explanations of various definitions around prevention (circulated 16 July).

Action

SCL to lead on development of a "time out" proposal.

Matters arising

Formation of a Joint Committee: IF advised that, subsequent to the meeting he and SCL had attended with the ICB on partnership working, further discussion in the context of lessons learned was being planned. The work of Professor Donna Hall was also noted in this regard.

2. Mental Health Hub Update

BC presented the report that described the partnership working to embed a multi-agency model of open access, community based mental health support through the Connecting our City Project. The first Mental Health Hub, based at 30 Clarence Street, had opened on 23 May 2024, with planning under way for two more later in the year in Acomb and Burnholme/Tang Hall for which potential venues were being scoped.

BC detailed: the phased opening and initial referrals approach; the multi-disciplinary team; the location and whole team approach; systems and governance; coproduction and appointment of Ben Hutchinson as Coproduction Champion; integration and the system change needed to support the model long term; the commissioning and finance perspectives; and future hub developments. He commended the partnership working across agencies that had been key to the success of the hub model to date and noted that the phased approach to access would continue.

Detailed discussion commending the progress achieved included:

· Emphasis of the hub being a crisis prevention offer but with links to crisis services as required and the principle of ensuring appropriate support for both mental health and physical health needs.

· The Mental Health Hub as a blueprint for integration for aspects of health and wellbeing.

· The context of maximising existing resources across the partner organisations, realignment of services and progress towards sustainability.

· Relationships with primary care.

· The commitment of the voluntary sector.

· The need for clear communication about the hub offer as the phased opening and availability of clinical and specialist interventions progress.

· Concerns about management of capacity and demand with emphasis on the need for transparency.

· Noting that details were being finalised for an event later in the year celebrating the opening of the hub.

· Potential opportunities for support from City of York Council in relation to communications and venues.

SB noted that Healthwatch had already received positive feedback from a user of the hub who had been seen immediately and received appropriate support.

York Health and Care Partnership Executive Committee:

i) Noted the content of the report.

ii) Noted the need to secure venues for future hubs and for support to achieve this.

iii) Noted the need to prioritise future commissioning arrangements of this model.

iv) Noted the requirement for additional funding to support hub expansion.

3. Update on York Health and Care Partnership Place Development in 2024/25

BC and MH left the meeting during this item

In introducing this item NC referred to discussion at previous meetings, the York Health and Care Partnership strategic intentions for 2024/25 and set of seven actions (a. to g. below) for their delivery to progress collaboration and integration at Place, and the outline of the next steps in the report.

a. Develop a shared narrative of what we are doing and why.

b. Behave as one leadership team and help our workforce do the same, at every level.

c. Create the bandwidth in our organisations to engage in dialogue that finds better ways of delivering services across physical and mental health, social care and wider determinants of health.

d. Enable our communities to shape, participate in, and take ownership of their services.

e. Conduct quality impact assessments of proposed changes to adopt a consistent approach, hold ourselves to account and promote continuous learning.

f. Establish a joint commissioning forum (without formal delegated powers in 2024/25) to oversee preparations for a Joint Committee and co-opt expertise from ICB/LA as required.

g. Establish how, by working differently, we can drive out avoidable costs, and shift allocation to support prevention, better care, and sustainability. Start with open communication on how each partner is reducing waste and optimising costs. This is an example of practice from North East Lincolnshire and will support YHCP to create a financially healthier system in readiness for transfer of responsibilities and decision-making.

PR explained that the Joint Commissioning Forum had been meeting monthly since January 2024 as a first step towards potential joint commissioning initially in early intervention and prevention with a view to becoming a vehicle for formally pooling available resources. Proposed services for inclusion, currently being identified, would require approval through the ICB and Local Authority governance structures and would then be presented to the York Health and Care Partnership. A number of joint posts were also being considered.

NC referred to the report appendix which described a methodology tested with St Leonard's Hospice to progress understanding across the partnership on the approach of each partner to reducing waste and optimising costs. It was proposed to replicate this approach across partners to allow compilation of a partnership view including system opportunities and a series of proposed actions. This would also support the intention to align system resources to integrated services by building on the opportunities identified, and to consider how as a partnership the existing resource can begin to be utilised to prioritise prevention and early intervention, highlighted at the June meeting as a priority. Reconfirmation of each organisation's commitment to share information to progress this was sought.

Discussion, mainly relating to the significant challenging financial position across the system, included:

· The need to manage expectations of joint commissioning and integration focusing on improving quality outcomes.

· The respective savings plans of each organisation, including a request for an update on the NHS position.

· The context of transparency and sharing of financial and resource challenges as key to improving services and outcomes through joint decisions on investment.

· Adoption of a co-production approach, including the voice of the patient, to maximise utilisation of health and care resources and avoid duplication through alignment to joint principles.

York Health and Care Partnership Executive Committee:

i) Noted the updates on progress against the place actions.

ii) Agreed that the approach and format of the partner financial briefing in appendix 1 of the report be replicated across partner organisations to inform a picture across the partnership.

iii) Reconfirmed organisational commitment to sharing this information with a view to producing a similar overview for each organisation by the end of August.

Action

An update on the NHS financial position to be presented.

4. York Place, Primary Secondary Care Interface Update

This item was deferred.

5. Perinatal Mental Health and Parent-carer/infant Relationships

This item was deferred.

6. Any Other Business

IF advised that it appeared the August meeting would be quorate but prior confirmation of attendance would be sought.

SB advised that the Healthwatch Annual Report 2023/24 had been published, available at:

Healthwatch-York-Annual-Report-2023-24.pdf (healthwatchyork.co.uk)

Item for Information

The Bereavement Alliance report was noted as received.

Next Meeting: Thursday 8 August 2024