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City of York Council |
Committee Minutes |
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Meeting |
Children, Education and Communities Policy and Scrutiny Committee and Health and Adult Social Care Policy and Scrutiny Committee - Commissioned Joint Committee |
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Date |
9 November 2022 |
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Present |
Councillors Baker, Cullwick, Daubeney, Doughty (Chair), Heaton, Hollyer, Hook, Looker (substitute for Cllr Fitzpatrick), Orrell, Webb and Wells |
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Apologies
In Attendance |
Councillors Barnes, Fitzpatrick and Vassie
Councillor Waller, Executive Member for Children, Young People and Education Jamaila Hussain, Corporate Director of Adult Social Care and Integration Abby Hands, Head of Transformation Fiona Phillips, Assistant Director of Public Health Tracy Logan, School Nurse Gillian Chalk, Health Visitor |
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1. Election of Chair (5:30pm)
Resolved: That Cllr Doughty be elected as Chair of the meeting.
2. Declarations of Interest (5:31pm)
At this point in the meeting, Members were asked to declare any disclosable pecuniary interests or other registerable interests that they might have in respect of business on this agenda, if they had not already done so in advance on the Register of Interests. None were declared.
3. Minutes (5:31pm)
Resolved: That the minutes of the meeting of the Committee held on 28 February 2022 be approved as a correct record and then signed by the Chair.
4. Public Participation (5:32pm)
It was reported that there had been no registrations to speak at the meeting under the Council’s Public Participation Scheme.
5. A refreshed all-age Autism Strategy for the City (5:32pm)
Members considered a report that outlined the current strategic position in York around improving the support available to autistic people and their families and carers.
The Corporate Director of Adult Social Care and Integration and the Head of Transformation provided an overview, noting that to build upon the work already completed locally under the 2017-2021 All-age Autism Strategy, and to address the nationally identified challenges for autistic people, a refreshed co-produced 2021-2026 All-age Autism Strategy for York was required.
It was noted that the government had renewed its commitment to autistic people and had published a refreshed 2021-2026 National Strategy for Autistic Children, Young People and Adults. The Strategy outlined six areas for change:
a. Improving understanding and acceptance of autism within society.
b. Improving autistic children and young people’s access to education and supporting positive transitions into adulthood.
c. Supporting more autistic people into employment.
d. Tackling health and care inequalities for autistic people.
e. Building the right support in the community and supporting people in inpatient care.
f. Improving support within the criminal and youth justice systems.
Officers confirmed that to refresh York’s All-age Autism Strategy there was a firm requirement for a schedule of co-production to ensure that the many and varied voices of citizens were heard. This would require different methods of engagement, including expertise from people with lived experience. The schedule also had to account for the work required to collaborate with key service providers in the city, ensuring that the work aligned with other strategic priorities within Health, Social Care and Education.
In answer to questions raised by Members, it was noted that:
· Waiting times for an autism assessment could be high in the city, with the average child or young person waiting more than the mandated 13 weeks. Whilst waiting, pre-diagnosis support was available and post diagnostic support was also accessible to children and young people who had not been diagnosed with autism but showed some characteristics.
· Gender bias would be considered in the consultation to reduce misdiagnoses across genders.
· The consultation would draw feedback from parents and carers to ensure that several respite opportunities would be made available.
· The consultation and refreshed strategy would strive to improve the understanding and acceptance of autism in society and support employment opportunities for autistic young people.
· An Autism Strategy Board would be established to oversee the new strategy.
· The consultation would include in-depth conversations with key stakeholders, including with schools and General Practitioners.
During the discussion, officers noted that the complexity of autism could be enhanced within future reports, and they agreed to provide Members with:
· A breakdown of the current levels of children and young people diagnosed with autism.
· The services available to support adults.
Members recognised the need for exhaustive consultation with key stakeholders and they thanked officers for their continued work to support the growing needs for autistic people within our city.
Resolved: That the proposed refresh, and the schedule of consultation with key stakeholders outlined, be supported.
Reason: That having a co-produced all-age autism strategy for the city would ensure that the council were meeting the growing needs for autistic people in our population and were compliant with their statutory responsibilities.
6. Healthy Child Service (6:04pm)
Members considered a report that provided an overview of York’s Healthy Child Service.
The Assistant Director of Public Health highlighted how the Healthy Child Service set out a universal offer to support prevention and early identification of need, and a targeted offer to ensure the right support was provided by the right people/service.
She also noted that:
· The Healthy Child Programme set out the universal offer, which consisted of five mandated contacts:
§ Antenatal contact from 28 weeks pregnant
§ New birth visit 10-14 days
§ 6-8 week review
§ 1 year review
§ 2 year review
· Health Visitors and School Nurses were key partners in multi-agency safeguarding arrangements.
· The service received its first full Care Quality Commission (CQC) inspection in September 2021 and was rated ‘good’ overall, with two areas identified as ‘required improvements’.
· Progress following the inspection had been good and the CQC visited the service again in June 2022. The CQC were satisfied with the improvements that had been implemented.
· In house training programmes had led to an increase in School Nurse capacity, however, retention and recruitment of experienced Health Visitors had been challenging. The pay gap and differences in terms and conditions compared with NHS Health Visitors and School Nurses could be a contributing factor.
· The performance data showed that York compared favourable against other areas and successful recruitment and retention was key to achieving the transformation required in the 5-19 years offer and in the ongoing delivery of an effective 0-19 years offer.
The Health Visitor and School Nurse provided an overview of their work, highlighting case studies, feedback received, and the challenges faced when providing the following services:
· Infant feeding support
· Child health and development clinics
· Targeted support for speech, language and communication, parenting, sleep, diet, toileting and perinatal mental health
· Targeted Healthy Families parenting programme (HENRY), in partnership with the Health Trainer service
· National Childhood measurement programme (NCMP) (reception and year 6)
· Hearing and vision screening (reception aged children)
· Bowel and bladder tier one 5-19 years
· Targeted support for emotional wellbeing, sexual health, healthy lifestyles support 5-19 years
· 0-19 years Review Health Assessments for children in care
During discussion and in answer to questions raised, it was noted that:
· New birth visits helped build a relationship and enabled conversations to take place in a supported environment, allowing Health Visitors to make an holistic assessment.
· The School Nurse team was split between staff nurses and public health specialist nurses. Two staff nurses had completed their master’s degree to become public health nurses and one Health Visitor had successfully completed a conversion course to dual school nurse qualification.
· Retention and recruitment would continue to be a significant priority. Consideration would be given to career progression options and conversations with HR were also underway.
· A specialist SystmOne Business Intelligence Officer had been employed to monitor outcomes against the full offer and there would be a focus on the red rated performance indicators.
· The Healthy Start scheme provided eligible parents with a prepaid card to buy fruit, vegetables and milk. Following a drive to increase the uptake, 75% of eligible families now claimed the voucher, and the aspiration was to reach all eligible families in York.
Members noted the capacity issues and they commended the Health Visitor and School Nurse for delivering an essential service, and they thanked them for highlighting real life experiences.
Resolved: That the report be noted.
Reason: To keep Members updated on the Healthy Child Service.
Cllr Doughty, Chair
[The meeting started at 5.30pm and finished at 6.51pm].