Report of the Executive Member for Health and Adult Social Care to Full Council – 21 October 2021.

During the recent COVID 19 pandemic, both sides of my portfolio have been incredibly busy and although the majority of restrictions have eased, it remains a challenging period for both Public Health and Adult Social Care.

Both the city’s Public Health team and all the various branches of the NHS have worked to capacity and very often beyond, to keep our residents safe and ensure they receive the help and support that they need. This has included setting up testing sites and more recently vaccination sites, undertaking community outreach work, as well as advising our schools and businesses as national legislation and guidance evolved.

I have been involved all through the pandemic in the ever-changing situation for universities and colleges. Meeting weekly at first, the University and College subgroup of the Outbreak Management Advisory Board, has interpreted Government guidance and ensured consistency of approach across the city. It is good to be able to report that there have been no outbreaks in teaching areas in the institutions and the numbers of students that have now been vaccinated are very high.  Students are only too willing to be vaccinated, so that relatives and friends are safe and life can return to normal as much as possible.

The Public Health team has been involved in tracing the contacts of those notified to them by Public Health England that have tested positive, making every effort to reach them as quickly as possible.

Due to ongoing issues with the national system, in March 2021 York’s Public Health team launched a local contact tracing service, undertaking the contact tracing of all contacts of positive cases. This saw more than 90% of contacts reached within 24 hours since the launch of the scheme, which played a key role in containing outbreaks and reducing the spread of infection in York.

Changes in the NHS Test & Trace system are now seeing local teams no longer able to undertake contact tracing in York and positive cases are no longer referred to the local team until after 4 hours. This is creating unwelcome delays in the follow up of positive cases and presents a risk locally of residents not being able to access the right level of local support soon enough. The Leader of the Council has written to the Secretary of State on behalf of the Outbreak Management Board to raise this issue.

The success of the local contact tracing programme has been a testament to the excellent work of the Public Health team. They have also made particular efforts to reach those groups that were reluctant to be vaccinated and those in areas where vaccine take up was low. Their hard work has contributed to low levels of infection in the city, although I must emphasize that the virus is still around and I’d urge everyone to remember hands, face, space and in particular, getting plenty of fresh air and exercise when they can. The importance of remembering both physical and mental health has also been highlighted by CYC’s PH Health Trainers Team to encourage people to get out and about.

In Adult Social Care, pressures due to the continuing rise in demand during the pandemic have been significant. Our hospital team based at York District Hospital has worked hard to ensure that as many beds are available as possible for those who have COVID-19 infections and other serious conditions. They also ensured that those who could be discharged, were discharged with the appropriate support. This put extra pressure on services in the community and on residential and nursing care, where issues with staffing became an issue as more staff contracted COVID-19 or were self-isolating. This also happened in the hospital and in primary care settings. I cannot speak too highly of the efforts made by every team in every setting, both in the hospital and in our communities and surgeries, to keep the services going, sometimes in new and different ways, despite all the pressures they were under.

There has been greater use of technology during the pandemic and this is an area I would like to see developed further in the coming months. I have attended several web based LGA training sessions for HWBB chairs, and some webinars, including one by Sir Michael Marmot. However, the use of technology extends well beyond training and has plenty of useful applications in the fields of health and adult social care.  I expect this to develop in the next year.

During the pandemic, I have chaired meetings of the Health and Well-being Board where many issues of strategy and service delivery have been considered. I have also attended meetings of the Adult Safeguarding Board and the Mental Health Partnership where the effect of the pandemic soon became very apparent, especially on lonely and isolated people. We are still seeing a rise in mental health referrals and this administration committed an additional £100k in the last budget to help alleviate some of that pressure.

In the light of a surge in demand for mental health support from residents of all ages and backgrounds, the city’s leaders have come together to set in place an action plan that would ensure a joined up and coordinated response to the growing mental health challenge.

York’s mental health summit was held on the 26th March involving the NHS, universities, police, MPs, council and charities – with a focus on emotional health education in schools and extra support for businesses to help their staff and suicide prevention services.

Recent research presented at the meeting suggests that almost 20% of the population will need either new or additional mental health support as a direct consequence of the Covid-19 crisis.

The short-term actions agreed by the city’s leaders ranged from the introduction of special school recovery curriculum, additional support of suicide prevention programmes and proactive work with local businesses to the rolling out of Northern Quarter Project across the city and other measures.

In order to monitor this work, I have attended meetings of the Northern Quarter Partnership, which involves a number of partners working together to improve the mental health and well-being for residents in the city.

I have also discussed the increasing incidence of mental health issues with the Chair of the Tyne, Esk and Wear Mental Health Trust, as the trust are experiencing similar pressures on their services. I was pleased to be able to visit the newly opened Foss Park Hospital, an innovative, cutting-edge establishment that provides the highest quality of care for our local communities.

The Outbreak Management Board has met regularly and as its Vice Chair, I have attended all meetings. The strength of the partnerships that have developed across the city and beyond is well demonstrated at the OMAB meetings and has been a characteristic of the work across Health and Adult Social Care throughout the pandemic. The co-operation of all our partners is greatly appreciated.

As the Clinical Commissioning Group enters into its last six months of existence, the Integrated Care System is developing in its place. Not all the necessary government guidance is yet available but I have been briefed as the ICS plans emerge and it has been discussed at meetings of the HWBB.

I particularly enjoyed my visit to the extended Marjorie Waite Court which now offers a very congenial independent living environment where residents can go in and out as they please and eat in the very modern cafe which offers excellent meals at reasonable prices. In the area of residential care, Haxby Hall has also been transferred to Yorkare who will invest in the improving and extending the building and so increase the number of beds available.

Budget discussions have taken much of my time throughout, as is the same with all members of the Executive. As a low funded authority, increasing pressures on our services make for difficult discussions about issues that must be resolved before the budget is set in February. It is planned to bring budget papers to Executive Member Decision Sessions in December. Unfortunately, recent government announcements about funding for adult social care have not brought clarity or relief to the ASC funding situation. We have contacted the Secretary of State to express our concerns, and also have raised the same issue in a submission to the Government’s Spending Review.

I have been involved in discussions about the restructuring in ASC and have been on the appointment panel for several key posts. I would like to put on record my thanks to all officers in the directorate who have kept delivering services during the changes and unprecedented challenges that the past 18 months have brought - they have done a great job. I must also thank our corporate Director, Amanda Hatton, for all the work she has done during her time with us and wish her well in her new post in Edinburgh.

Finally, I cannot finish before putting on record my very grateful thanks all our partners in the voluntary and community sector who have played such a significant role during the pandemic. Their work throughout the city has helped and supported many residents who otherwise would have been in great difficulties. The CVS has played an important role throughout and they, as well as other organisations, tell us that even one supportive phone call a week can make a difference to the life of a lonely person.

As we come out of lockdown and as the effects of the pandemic subside, I hope that all the cafes, clubs, societies and other informal gatherings, often supported by ward committee funds, will start up again and be able to give people the friendship and help that they need. Our Local Area Co-ordinators and Social Prescribers also deserve thanks for all they have done in our communities.

This last year and even longer than that have been the most difficult time and it is to everyone’s credit that we have all pulled together, got through it and emerged even stronger than we were before.

Cllr Carol Runciman.

October 2021.