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City of York Council |
Committee Minutes |
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Meeting |
Health and Wellbeing Board |
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Date |
16 March 2022 |
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Present |
Councillors Runciman (Chair), Cuthbertson, Looker,
Dr Nigel Wells (Vice Chair) – Chair, NHS Vale of York Clinical Commissioning Group
Alison Semmence – Chief Executive, York CVS
Stephanie Porter – Director for Primary Care, NHS Vale of York Clinical Commissioning Group
Jamaila Hussain – Director of Prevention, Commissioning and Education
Peter Roderick – Joint Consultant in Public Health, City of York Council and NHS Vale of York Clinical Commissioning Group (substitute for Sharon Stoltz)
Janet Wright – Chair, Healthwatch York (substitute for Siân Balsom)
Mabs Hussain – Deputy Chief Constable, North Yorkshire Police (substitute for Lisa Winward)
Bridget Lentall – Head of Service, NHS Vale of York Clinical Commissioning Group (substitute for Naomi Lonergan)
Lucy Brown – Head of Communications – York and Scarborough Teaching Hospitals NHS Foundation Trust (substitute for Simon Morritt)
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Apologies |
Councillor Craghill
Sharon Stoltz – Director of Public Health, City of York Council
Siân Balsom – Chief Executive, Healthwatch York
Simon Morritt – Chief Executive, York Teaching Hospitals NHS Foundation Trust
Lisa Winward – Chief Constable, North Yorkshire Police
Dr Emma Broughton – Chair of the York Health and Care Collaborative & a PCN Clinical Director
Naomi Lonergan, Director of Operations, North Yorkshire & York – Tees, Esk and Wear Valleys NHS Foundation Trust
Mike Padgham – Chair, Independent Care Group
Shaun Jones – Deputy Locality Director, NHS England and Improvement |
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79. 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.
80. Minutes
Resolved:
i. That the minutes of the last meeting of the Health and Wellbeing Board held on 19 January 2022 be approved as an accurate record.
81. Public Participation
It was reported that there were members of the public registered to speak under the Council’s Public Participation Scheme.
82. Presentation on the Day: Better Care Fund Update
The Director of Prevention & Commissioning gave a presentation to provide the Board with an update on the Better Care Fund (BCF).
Key points raised during the presentation included:
· Better care funding had been agreed for 2021/22 and 2022/23.
· The York plan had been signed off and agreed by NHS England with activity targets.
· An outline of changes in BCF performance metrics was given, together with an update on performance around unplanned hospitalisation for chronic ambulatory care sensitive conditions, length of stay and discharges.
· BCF funds had remained the same at ~£20 million.
· Key findings from VENN included that there was a focus on discharges from hospital and crisis teams and Local Area co-ordinators were working well together to support people in remaining at home for longer.
· There were concerns that the no wrong door approach may support more people accessing statutory services unnecessarily.
· The short and long term next steps for the BCF were outlined, which included effective discharge pathways, strength based assessments, an effective brokerage system and a workforce strategy.
Comments and questions from Board members included:
· It was clarified that ‘ambulatory’ care referred to conditions that did not require people to be transported to hospital via emergency vehicle.
· Officers stated that consultation and co-production would feature prominently in the next steps of the BCF.
· Admittance to hospital could often be prevented if ambulatory care conditions were treated earlier.
· VENN compared York’s BCF system to others and were positive about its response during the Covid-19 pandemic with respect to the acute sector.
Resolved:
i. That the contents of the update be noted.
Reason: To inform Board members on the BCF.
83. Healthwatch York Report: Dentistry in York: Gaps in Provision
Board members considered a report from Healthwatch York, which examined people’s experiences of dentistry in the city. The Chair of Healthwatch York and Healthwatch York Research Officer were in attendance to present the report and respond to questions.
Key points raised during the presentation of the report included:
· This report was Healthwatch’s third on dentistry in York and focused on the impact of lack of provision.
· The report included statistics and quotes from local residents on their experience of dentistry provision in York, and detailed that there had been 25 percentage pointed reduction in the number of York residents saying they had a dentist between the 2019 and 2021 polls.
· 71% of York’s residents who didn’t have a dentist said it was because there were no practices taking on NHS patients and 52% of respondents reported having more problems associated with dental pain or poor oral health.
Comments and questions from Board members included:
· Concerns were raised around ensuring children and children in care in York had access to dentistry, and the Executive Member for Children and Young People indicated he would write to the Minister of State for Children and Families.
Resolved:
i. That the contents of the report be noted.
ii. That the 4 areas for action identified on pages 57-58 of the report be noted.
Reason: To update Board members on the provision of dentistry in York.
84. Healthwatch York Report: Dementia Support
This report aimed to help shape the dementia strategy in York, sharing Healthwatch York’s work looking at the experiences of people caring for those living with dementia in the city. The Chair of Healthwatch York and the Healthwatch York Research Officer were in attendance to present the report and respond to questions.
Key points raised during the presentation of the report included:
· Waiting for a diagnosis of dementia was a key issue.
· Carers were the key respondents and evidence base for the report due to difficulties in accessing dementia patients during the Covid-19 pandemic.
· Carers requested reduced waiting times for diagnosis and improved communication and support following diagnosis, as well as a new service which included an allocated person to seek support from in the long term and a key physical place/centre in York to provide social and physical support for people.
Comments and questions from Board members included:
· It was noted that the issues raised in the report were the same as ones raised in previous years, and members suggested creating a partnership across a range of services including the voluntary sector to support dementia services.
· Evidence in the report seemed to show the speed of diagnosis very varied and somewhat random, ranging from weeks to years.
· There was a lack of knowledge in the community on what signs to look for to identify early onset dementia.
Resolved:
i. That the contents of the report be noted.
ii. That the key aspirations for improving dementia support in York be noted.
Reason: To inform Board members on dementia support in York.
85. Annual Update from the HWBB's Mental Health Partnership
This report presented the Health and Wellbeing Board with an update on the work the partnership has undertaken since last reporting to the board in January 2021. The Independent Chair of the Mental Health Partnership was in attendance to present the report and respond to questions.
Key points raised during the presentation of the report included:
· There had been significant progress in recent years, though there were still areas of concern, including dementia.
· There was a desire within the city to recognise the skilled attributes within the Voluntary, Community and Social Enterprise (VCSE) sector.
· Major health partners had reported that some children had consistent issues in accessing diagnosis.
· There been considerable amounts of work done on eating disorders, however York had the highest number of people with severe eating disorders in accommodation in the Integrated Care System Area.
Comments and questions from Board members included:
· The City of York Dementia Strategy was due to be presented to Health Scrutiny and the HWBB in May 2022 and implemented by July 2022, including an action plan to bring in additional dementia services.
· CYC went to market for mental health housing, but did not receive any tenders, and were now looking at whether the Council’s housing team can provide properties and a care provider to be engaged in order to prevent a gap in service provision.
Resolved:
i. That the contents of the report be noted.
ii. That the Board indicates its continuing support for the Mental Health Partnership and its chosen direction of travel.
Reason: To ensure Board members remain informed on the Mental Health Partnership.
86. Update on the Integrated Care System
This report updated Board members on the national reforms to the NHS, health and care, and developments locally to plan for the changes which were due to come into force in July 2022. The Joint Consultant in Public Health, City of York Council and NHS Vale of York Clinical Commissioning Group was in attendance to present the report and respond questions.
Key points raised during the presentation of the report included:
· Clinical commissioning groups were to be abolished on 1 July 2022 and replaced with regional integrated care systems (ICS).
· As part of the transition, a number of appointments at board level of the ICS had been made and the place-based partnership was to be a key committee of the new system to ensure as many decisions as possible are made locally.
· The place-based partnership was due to have responsibility for areas such as quality and safety of care, in the financing of healthcare and population health elements in order to maximise health gain.
· Place-based partnership governance arrangements had not yet been established.
· Health and Wellbeing Board chairs will be invited to sit on the Integrated Care Partnership and will have an active role in setting the ICS Strategy.
Resolved:
i. That the developments, including the proposed structure and arrangements for the NHS and care within our region from next financial year be noted.
ii. That the minutes of the November 2021 York Health and Care Alliance meeting be noted.
Reason; To ensure members remain informed of developments in the establishment of the Integrated Care System.
87. Report of the Chair of the York Health and Care Collaborative
The Health and Wellbeing Board considered a report on the work of the York Health and Care Collaborative. The Joint Consultant in Public Health, City of York Council and NHS Vale of York Clinical Commissioning Group was in attendance to present the report and respond to questions.
Key points raised during the presentation of the report included:
· The Collaborative was an operational group consisting of many senior managers running out of hospital services in York including community services, primary care, and the voluntary sector.
· The Collaborative’s priorities were focused on prevention of health issues by discussing support around smoking, drugs, alcohol and substance abuse and obesity.
· Ageing well was also a priority, with work done around the 2 hour urgent care standard and supporting and identifying those in need of support for frailty.
Comments and questions from Board members included:
· Obesity in younger children of reception age was a significant concern.
· City of York Council was a signatory to the Healthy Weight Declaration, however it was recognised that there was a need to improve the quality of school meals.
· It was recognised that healthy food including fresh fruit and vegetables was often more expensive than more unhealthy processed foods.
· The Holiday Activities and Food Programme was discussed, which supported less advantaged children in accessing food and enriching activities during school holidays.
Resolved:
i. That the contents of the report of the Chair of the York Health and Care Collaborative be noted.
Reason: To ensure that Board member remain updated on the work of the York Health and Care Collaborative.
88. Presentation: The Poverty Truth Commission
The Chief Executive of York CVS gave a presentation to board members on the Poverty Truth Commission.
Key points raised during the presentation of the report included:
· The Poverty Truth Commission sought bring together those who have experienced poverty (community commissioners) and those who have power to make change within the city (civic commissioners) in order to work to alleviate issues of poverty in York.
· York was overall a wealthy city, however there significant issues such as a 13 year difference in life expectancy from the least to most deprived parts of the city, a higher than average number of part time, insecure and low paid jobs than average and 1/3 of residents in rented or social accommodation.
· The ratio of rent to earnings in York was comparable to London.
· The Poverty Truth Commission sought to humanise decision making and create positive relationships between those with power and those the decisions affect.
· Money had been raised for one year, and more was being sought for a second year.
· Two co-ordinators had been recruited and began work on 1 March 2022.
Comments and questions from Board members included:
· Members commented that poverty was the root cause of almost all health issues including eating habits, housing, dentistry and care costs.
· The cost of living was set to increase dramatically in 2022, making the importance of the Commission greater.
· A similar approach had been taken in Leeds, and had led to greater credibility of decisions made around poverty due to the input of community commissioners.
· It was recognised that the Commission would not eradicate poverty in the city, however it sought to alleviate the issue by improving decision making and building trust.
Resolved:
i. That the contents of the presentation be noted.
Reason: To update members on the work of the Commission.
89. Presentation on the Day: Update on the Current Situation re: Covid-19
The Joint Consultant in Public Health gave a presentation on the current situation in relation to Covid-19 including recovery plans. This item was in presentation format to ensure that the most up to date information could be presented to the Health and Wellbeing Board.
Key points raised during the presentation of the report included:
· Cases of Covid-19 were increasing and nearing 600 cases per 100,000. York had the highest case rate in the Yorkshire and Humber region, however the increase was broadly in line with national trends.
· Vaccinations were reducing the effect of increasing Covid-19 infection rates.
· Case rates were highest in the 35-39, 30-34, 40-44 and 45-59 age ranges respectively.
· 18.4% of cases were of the BA.2 Omicron sub-lineage strain which was a variant under investigation, but thought to have a higher transmissibility rate the BA.1 Omicron.
· As of 15/03/2022 there were 156 people with Covid-19 in a general/acute hospital bed in York and 2 in the Intensive Treatment Unit. Many other these may be in hospital with Covid but not necessarily in hospital for that reason.
· Free Covid testing funded by the Government was due to end at the end of March.
Comments and questions from Board members included:
· A fourth vaccine dose for over 75s and a first dose for children 5-11 were due to become available in April.
· Anyone who had not yet taken up the offer of a vaccine were still welcome to book a slot.
· There were acute pressures for availability of beds in York hospitals due to infection control measures.
Resolved:
i. That the content of the presentation be noted.
Reason: To ensure that Board members remain updated on the current situation regarding Covid-19 in York.
90. Urgent Business
The Chair mentioned that both the Health and Wellbeing Board and the York Health and Care Alliance were to distribute a Cultural Values Survey to Board members in the first week of May.
The Chair thanked the Vice-Chair, Dr Nigel Wells for his work on the Health and Wellbeing Board due to his post being scheduled to be abolished before the next meeting of the Board.
Cllr C Runicman, Chair
[The meeting started at 16:30 and finished at 18:31].