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City of York Council |
Committee Minutes |
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Meeting |
Health and Wellbeing Board |
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Date |
6 January 2021 |
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Present |
Councillors Runciman (Chair), Craghill, Orrell, Perrett.
Dr Nigel Wells (Vice Chair) Chair, NHS Vale of York Clinical Commissioning Group (CCG)
Sharon Stoltz Director of Public Health, City of York
Amanda Hatton Corporate Director of People, City of York Council
Lisa Winward Chief Constable, North Yorkshire Police
Alison Semmence Chief Executive, York CVS
Sian Balsom Manager, Healthwatch York
David Kerr Right Care Right Place Programme & Delivery Lead (NYY) as substitute for Naomi Lonergan Director of Operations, North Yorkshire & York - Tees, Esk & Wear Valleys NHS Foundation Trust
Simon Morritt Chief Executive, York Teaching Hospital NHS Foundation Trust
Beverley Proctor Chief Executive, Independent Care Group as substitute for Mike Padgham Chair, Independent Care Group
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Apologies: Dr Emma Broughton, Chair of the York Health and Care Collaborative & a PCN Clinical Director Shaun Jones, Deputy Locality Director, NHS England and Improvement Mike Padgham, Chair, Independent Care Group and Naomi Lonergan Director of Operations, North Yorkshire & York - Tees, Esk & Wear Valleys NHS Foundation Trust Stephanie Porter, Acting Director for Primary Care and Population Health for NHS Vale of York Clinical Commissioning Group |
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20. Declarations of Interest
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.
21. Minutes
Resolved: That the minutes of the Health and Wellbeing Board held on 28 October 2020 be approved and then signed by the Chair at a later date.
22. Public Participation
It was reported that there had been one registration to speak at the meeting under the Council’s Public Participation Scheme.
Mr Burkeman, Chair of the York Dementia Collaborative, (formerly YDAA) questioned the progress City of York Council had made in developing a dementia strategy for York. He stated that he would welcome an update on the timelines and questioned when a consultation draft would be produced.
When invited by the Chair to comment, the Independent Chair of the Mental Health Partnership confirmed that work on the dementia strategy was being led by the Ageing Well Partnership and he agreed that it was vitally important the strategy was put out for consultation.
The Director of Public Health stated that the strategy was being developed but had been halted due to the current pandemic and she noted the importance of York being a dementia friendly city.
It was agreed that the revised timescales would be sourced and be included in the minutes.
Following the meeting, contact was made with both NHS and Council staff, where it was confirmed the progress on the development of a dementia strategy for York had been hampered by the current pandemic. There was a commitment across the system to progress the development of the strategy and restart conversations about this. Reports detailing progress would be prepared and presented to both the Ageing Well Partnership and the Mental Health Partnership at their next meetings in February and March respectively.
An update on progress would then be presented to the Health and Wellbeing Board as part of the Ageing Well Partnership’s report to them in May 2021.
23. Review of Terms of Reference for York's Health and Wellbeing Board
The Board considered the revised Terms of Reference for York’s Health and Wellbeing Board (HWBB) and noted the revisions made which included the insertion of a paragraph under ‘membership,’ which explained how members were appointed and listed the various posts and organisations.
It was noted that only one elected member opposition representative was currently appointed to the Board and not two as stated in the TOR. Following discussion, the Board were keen to continue to have representation that reflected the current political balance of the Council and they requested the TOR corresponded with the current elected member membership, Executive Member for Health and Adult Social Care, Executive Member for Children, Young People and Education, a Green party representative and a Labour party representative.
Resolved:
(i) That the Terms of Reference be agreed subject to the Chair and Health and Wellbeing Partnerships Co-ordinator updating the elected member membership.
(ii) That the updated Terms of Reference be referred to Full Council for approval.
(iii) That the Councils Constitution be updated to incorporate the revised Terms of Reference.
Reason: In order to ensure that the Health and Wellbeing Board continued to undertake its statutory functions appropriately and effectively.
24. Report of the Independent Chair of the York Health and Wellbeing Board's Mental Health Partnership
The Board received a report that gave an update on the work the Mental Health Partnership had undertaken since last reporting to the Board in September 2019.
The Independent Chair was in attendance to provide the update and he informed the Board of the progress made by the Multiple Complex Needs network, which was also supported by various partner organisations including York CVS.
The Board noted that despite the current pressures on the health and social care system the Northern Quarter Project (NQP) and the bid for Community Mental Health Transformation Funding was still progressing. The Independent Chair expressed his thanks to colleagues and partner organisations who had engaged in and continued to support the work being undertaken.
He recognised that the demand on services would be significantly increased this year across all age groups and major change would be required to ensure that all agencies and partners worked together on all sectors to meet the challenges and pressures moving forward. The Independent Chair expressed his gratitude to all agencies and partners for supporting the city during the pandemic and for ensuring essential services continued.
The Board noted the key changes to the Partnership’s Terms of Reference and in answer to their questions it was noted that:
· The Multiple Complex Needs network could be invited to attend a future Health and Wellbeing Board meeting.
· The Terms of Reference could include membership from service users/groups and could include a strengthened primary care representation.
· The Northern Quarter Project would eventually be expanded across the whole city, to enable the service to be spread around users.
The Board thanked the Chair for his update.
Resolved:
(i) That the Terms of Reference be approved.
(ii) That the ongoing work being undertaken on the Northern Quarter Project and the application for Community Mental Health Transformation Funding be supported.
Reason: To give the Health and Wellbeing Board oversight of the work of the Mental Health Partnership and assurance in relation to strategy delivery.
25. Building a Health System in York based on Population Health Need
The Board received a report and presentation that summarised the work being carried out across organisations in York to better understand our population, and to use the data and intelligence to plan and build a health system in York based on population health need.
The Acting Consultant in Public Health was in attendance to provide an update and he shared information on the key aspects of work, together with some key recent insight into the health of the public in York.
The Board noted that the key context work included:
• the impact of Covid-19 on the health and wellbeing of people in York;
• the NHS Long Term Plan;
• the NHS England document ‘Integrating Care: Next steps to building strong and effective integrated care systems across England.
The Acting Consultant explained how Population Health Management (PHM) aimed to improve population health by data driven planning and delivery of care to achieve maximum impact. He gave examples of PHM, explaining how it applied to health and social care data and would help better understand the health of York’s population.
Discussions took place regarding how this method could translate into targeted services, how the data could be used to understand and support inequalities across the city, particularly within areas of need and how additional Covid related inequalities could be identified and tackled.
The Boards questions were answered and it was noted that sharing local intelligence and data from across the Council and partner organisations would enable this process to progress and help improve the physical and mental health outcomes and wellbeing of people, whilst reducing health inequalities within and across a defined population.
The Board agreed that a separate workshop would be beneficial to focus on the co-production approach and the integrated care documents.
Resolved:
(i) That the approach from partners in York, to base future changes within the health and care system on linked data and intelligence on population health need, be endorsed.
Reason: The Board have a key oversight and leadership role in health and care services in the city and should shape the future development of these services.
(ii) That the ‘population health management’ approach be noted in particular the areas of need and inequality faced by the York population.
Reason: The Board have a key remit to tackle inequalities, and this was a chance for them to comment on how this work can be optimised to achieve this goal.
26. Update on Covid-19
The Director of Public Health gave an update on the latest data regarding Covid-19 in York up to 3 January 2021.
The key points arising from the presentation included:
· The provisional rate of new Covid cases per 100,000 of population for the period 28.12.20 to 3.1.21 in York was 559.8.
· The latest official “validated” rate of new Covid cases per 100,000 of population for the period 25.12.20 to 31.12.20 was 464.8. The national and regional averages at this date were 546.9 and 264.6 respectively.
· As at 5.1.21 there were 13 care homes in the City of York Council (CYC) area with confirmed Covid-19 infection (at least 1 case of either a staff member or resident).
· The latest ‘outbreak’ (2+ cases) in a residential care setting in York was reported by Public Health England on 5.1.21 (2 homes)
· In the 7 days up to 3.1.21 there were 104 children of primary and secondary school age who tested positive (across 40 different schools).
· In response to a community outbreak, Bishopthorpe, Woodthorpe and Acomb Park had mobile testing units in place.
· Between 22.10.20 and 25.12.20, 396 ‘actionable’ positive Covid-19 CYC cases had been referred to the local contact tracing service. 390 of the referrals (98.5%) had been actioned and 6 were still ‘in progress.
· There have been 39 Covid-19 deaths of CYC residents reported by ONS in the last 11 weeks (Weeks 41 to 51).
· Testing sites were expanded and the University of York would also be opening for lateral flow testing.
· The roll out of the vaccination programme had begun and would be accelerating over the coming weeks as the vaccine becomes more readily available.
The Director confirmed that care home staff were receiving weekly Covid tests and the care home residents were receiving monthly tests. She thanked all of the staff who worked in the care home sector for their incredible support throughout the pandemic and she also thanked York St John University and the University of York for making their sites available for testing.
The Chair then invited Board Members to provide a Covid update within their work areas and the following key points were raised:
· As of 6 January 2021 there were 81 people with Covid in York hospital and the hospital trust were considering ways to expand Covid capacity. The Chief Executive of York Teaching Hospital NHS Foundation Trust hoped the impact of the lockdown would show in the next 7 to 10 days but that they expected the numbers to rise before then. He confirmed that staff and staff of sister partners were starting to receive the vaccine and he welcomed the continued support from schools for key worker children to attend.
· The vaccination programme was being rolled out from two approved sites in York, Haxby Health Centre and Askham Bar and that the longer term plan was to allocate more sites around the city.
· The care home sector continued to work closely with key partners to ensure vaccines were offered to care home staff and residents.
· The definition of a key worker had been widened meaning some schools were at capacity but staff were committed to ensuring places were provided for key worker and vulnerable children. The Director of People commended schools for managing this process and she confirmed there was a real commitment to work collaboratively.
· Children’s services remained fully open and children in need were being supported. The Corporate Director of People thanked staff for their continued support throughout the pandemic.
· Referrals into mental health services had started to escalate and staff were working to maximise the capacity of the frontline.
· The social subscribing team and the Covid monitoring hubs had seen a large increase in referrals and York CVS were also working on finding volunteers to support the vaccination process.
· A full Policing service would continue and the latest regulations and key messages would be shared within communities.
In answer to the Boards questions it was noted that best practice across both vaccination sites would be observed to enable residents to receive a more coherent experience.
The Chair then expressed the Boards gratitude to all organisations and partners across the city for their continued partnership working, support and determination to keep the city safe during the pandemic.
Resolved: That the update be noted.
Reason: To ensure the Board were aware of the current situation in York relating to Covid-19.
27. Better Care Fund Update
The Board considered a report that provided a brief update on the arrangements for the Better Care Fund (BCF) 2022-21 and 2021-22.
The Assistant Director of Joint Commissioning gave an update and confirmed the Better Care Fund Plan 2021-21 was developed in a collaborative process with partners and that the government had published a formal statement on 3 December confirming that the BCF would continue into 2021-22 financial year.
The Board noted that the plan would not need to be submitted formally as in previous years but that the financial assumptions for a roll forward into 2021-22 were being reviewed to ensure BCF was delivering the greatest impact on outcomes possible.
The Chair welcomed the continued support through to 2022 and in answer to the Boards questions it was noted that information on the schemes the BCF supported was outlined in the BCF annual report to the Health and Wellbeing Board, which can be accessed here: https://democracy.york.gov.uk/ieListDocuments.aspx?CId=763&MId=12403&Ver=4
Resolved:
(i) That the York Better Care Fund update be noted.
Reason: The Health and Wellbeing Board was the accountable body for the Better Care Fund.
(ii) That the responsibility for signing off the Better Care Fund Plan 2020-21 be delegated to the Chair and Vice Chair, supported by the Council Corporate Director of People and the Clinical Commissioning Group (CCG) Accountable Officer.
Reason: The government has now confirmed that the plan will not need to be submitted formally as in previous years. The plan commitments were recorded within the NHSE excel template. This can be obtained from the report author on request but is not in an accessible format for publication. A financial summary was attached at Annex 1 of the report.
(iii) That the intention to review the financial allocations for BCF 2021-22 to ensure maximum impact on outcomes for the system be noted.
Reason: It was important for the sustainability and stability of the whole system that the funding commitment was reviewed regularly to be assured of value for money and impact on outcomes. The Chair and Vice Chair, have approved this approach, supported by the Council Corporate Director of People and the CCG Accountable Officer.
28. Healthwatch York Report - Listening to BAME people about Health and Social Care Services in York
The Board considered a report that highlighted Black, Asian and Minority Ethnic (BAME) people’s experiences of health and social care services in York.
The Manager of Healthwatch York confirmed the initial report was completed at a time consultation was challenging due to the pandemic but that these first steps would lead to stronger partnership working to support BAME residents and the barriers they face collectively.
The Chair thanked Healthwatch York for starting this process and she welcomed an update at a future Health and Wellbeing Board meeting. She requested the Board consider how their organisations could help extend this conversation and support this initiative.
Resolved: That the report be noted and any feedback be communicated to the Health and Wellbeing Partnerships Co-ordinator or Healthwatch York.
Reason: To keep the Board up to date regarding the work of Healthwatch York, and the recommendations made to member organisations.
Cllr Runciman, Chair
[The meeting started at 4.00pm and finished at 6.16pm].