Minutes of the meeting of the York Health and Care Alliance Board held on 29 November 2021 conducted via Microsoft Teams
Present
Cllr Keith Aspden (Chair) Leader City of York Council
Ian Floyd Chief Operating Officer, City of York Council
Professor Mike Holmes Chair, Nimbuscare York
Professor Charlie Jeffery Vice Chancellor and President, University of York
Phil Mettam Accountable Officer, Vale of York CCG
Simon Morritt Chief Executive, York and Scarborough Hospital NHS Foundation Trust
Alison Semmence Chief Executive, York CVS
In Attendance
Michelle Carrington Executive Director for Quality & Nursing Vale of York CCG /
Director of Nursing & Quality Lead, HCV ICS
Abby Combes Head of Legal and Governance, Vale of York CCG
David Hambleton DH Leadership Alliance, NECS Associate
Frances Harrison Legal, City of York Council
Jamaila Hussain Director of Prevention, Commissioning and Education, City of York Council
Peter Roderick Consultant in Public Health, City of York Council /
Vale of York CCG
Catherine Scott York CVS
Tracy Wallis Health and Wellbeing Partnerships Co-ordinator, City of
York Council
Jo Baxter Executive Assistant, Vale of York CCG
AGENDA
The agenda was discussed in the following order.
1. Welcome and apologies for absence
The chair welcomed everyone to the meeting and gave special mention to Ian Floyd, Chief Operating Officer, City of York Council (CYC) who had now joined the Board to replace the departing Corporate Director of People.
Apologies were noted from Sharon Stoltz and Brent Kilmurray.
The minutes of the meeting on 27 September 2021 were approved by the Board.
The one item on matters arising remained as the Section 75 Agreement training previously suggested for Board members; this would be deferred to Quarter 4 and synchronised with future governance requirements of the Board as they developed.
Phil referred back to the Alliance Time Out in October where a small number of Board members and Alliance Leadership Team (ALT) members had met and agreed the development of a Prospectus. The ambition of the group was to have a draft Prospectus ready for early in 2022 which could describe the future healthcare offer.
Since then, Phil advised that work had taken place and the Prospectus was firming up with 3 chapters; these were:
· Chapter 1 – a provider led outline of recovery from the pandemic
· Chapter 2 – a ten year forward view
· Chapter 3 – the governance and leadership to be proposed to enable York to take forward the delegated functions and responsibility required to deliver on the above.
In respect of Chapter 2 to describe the vision, arrangements were now coming together for two workshops in January/February to involve and engage local communities in the shaping of the narrative; partners would be asked to help organise and run these workshops.
The Board:
- Welcomed the progress on the Prospectus.
3. Cultural Values Proposal
In introducing Catherine, David alluded to a presentation from Catherine given at the Time Out session in October on the York Cultural Values programme supporting the Multiple Complex Needs Network and surrounding activity. The positive impact the work had had on participants in understanding people's perspectives and developing shared purpose had been emphasised with support given to exploring a cultural values process for the Board and ALT.
Catherine had now joined to elaborate on how a cultural values process for the Alliance could work with suggested timeframes and indicative costings. Additionally, Catherine highlighted consideration of undertaking the programme jointly with the Health and Wellbeing Board (H&WBB).
David gave appreciation to Catherine for the work so far and sought ratification from the wider Board members to proceed as proposed, including the suggestion on the joint H&WBB proposal.
Board members remained supportive and agreed the joint programme with the H&WBB was a sensible suggestion; David would therefore pull together the next stage on behalf of the Board including the establishment of a steering group.
The Board:
- Supported in principle the joint Cultural Values proposition with the H&WBB
- Noted that nominees for the steering group would be gathered by David
- Noted that a future discussion on costs would be required
4. Update on Alliance area of focus: Diabetes and Healthy Weight
Peter introduced the paper to update the Board on one of its three areas of focus during 21/22, working together to increase the number of people with a healthy weight and to improve outcomes for those with diabetes in York. He highlighted some of the success stories outlined in the paper and the many programmes of work already underway across the system.
Peter referred back to the collaboration on diabetes and healthy weight being chosen as an area of focus by the Alliance, identified as a population health need which crossed multiple sectors and partners around the table. The progress shown in the paper validated the benefit in working together in this way and he welcomed a discussion on how the work on diabetes and healthy weight in York could evolve into the future.
Mike led a discussion and reiterated the thoughts of Peter referring to current system pressures and the need to work together and identify the challenges. There would be opportunities to build on current knowledge, using a population health based approach, empowering people and understanding the finances and resources available could also create opportunities. A radical shift in diabetes was needed which would need strong leadership with learnings taken from other systems. The importance of dedicated resource and time to progress this work including coproduction was emphasised.
The Board acknowledged the need for change and supported the direction of travel; further work would now take place outside of the meeting and be brought back to a future meeting.
The Board:
- Supported the suggested strategy on diabetes and healthy weight and requested that updates be brought back to future meetings.
CJ left the meeting
5. Latest news from the Alliance Leadership Team
The ALT had met twice since the last Board meeting and David provided a brief update from the discussions; he spoke about the meetings being an opportunity to check in with ALT members on how people and the system were feeling, which at the moment was challenging and pressured in all areas with people feeling very stretched. Members had acknowledged the need to discuss the behaviours in the system that were both enabling encouraging collaboration and those that were not, referring back to the behaviours in the peak of the pandemic which had seen everyone really ‘pulling together’.
David advised that some debate still remained around the purpose of the ALT versus the York Health and Care Collaborative; the role of ALT had been discussed as the engine room for the Alliance Board, connecting the board to the front line, providing challenge and leading the behaviour change required. A further discussion was suggested about the future of the two groups to confirm their separate purposes.
To help with the understanding of the role of each group alongside the Board, Phil suggested this was articulated in slide form and circulated to members ahead of the next meeting.
The Board:
- Noted the update from the ALT
- Noted that the roles of the ALT and YHCC would be concluded
CS left the meeting
6. Outline of Functional Responsibilities to be carried out in Place
Prior to introducing this item, the Chair highlighted the concerns from Local Authorities, including CYC, around the importance of Place on the proposed Constitution for the Integrated Care System, in particular the desire for each Place Director to have a place on the Integrated Care Board.
Phil referred to the ICS governance which continued to emerge and the HR framework which was still awaited. In the absence of the HR framework, Phil advised that the CCG had been considering the functions that might take place in Place, whilst remaining sensitive to the circumstances. Michelle would shortly be presenting the work so far which had already been shared with CYC colleagues and he gave further assurance to Board members of their involvement as the work progressed.
Michelle presented the slides which described the CCG functions and aimed to raise an initial awareness of opportunities; these also included early comments from CYC. She sought the ambition of the Board on maximising and prioritising the opportunities for Place.
Ian welcomed the aspiration for Place, it was important not to get hampered with the governance and continue working together for the citizens of York. The North Yorkshire and York Partnership between Place and the ICS on the Constitution remained the biggest concern and would need to be clarified; CYC had already formally fed back their concerns.
Jamaila agreed there were many opportunities to deliver in Place but the decision making proposed for Place did not align.
Michelle referred to the unease regarding the North Yorkshire and York Partnership; whilst the slides, which were similar to other Places, demonstrated fewer opportunities within the Partnership, there would be areas where some business might be better in that space and a substantive post for a Programme Manager was now in train who once appointed would help establish all of this.
The conversation moved on to how the interaction between Place and the Partnership would take place and the Board agreed the Director for the North Yorkshire and York Partnership would be invited to a future meeting or a proposed Alliance Time Out in January.
Simon also highlighted that the Collaboratives were missing from slides and reiterated the national expectation that collaboratives would have responsibilities like Places.
In bringing the conversation to a close, Phil summarised the discussion and suggested the following actions:
· To use the date for the next Board meeting on 24 January as a Time Out to take stock and review the earlier discussion.
· To invite the Humber, Coast and Vale ICS designate Chair and Chief Executive, and the North Yorkshire & York Partnership Director to the proposed time out via letter summarising the earlier concerns and highlighting the progress of York Place so far.
· Establish an 'Alliancing brand' sub-group to create impetus around awareness and marketing of the work to date, and the plans for the next phase. Communications and Media Leads from partners would be invited to take this work forward.
The Board:
- Sought clarity to differentiate the roles of York Place and the North Yorkshire and York Partnership
- Welcomed the work so far on the functions in Place
- Supported a letter to the ICS designate Chair and Chief Executive as proposed
7. Time Out Proposal January 2022
The Board agreed the meeting in January 2022 would be utilised for an Alliance Time Out; a decision on whether this could be a face to face meeting would be made in early January.
8. Any Other Business
Board members agreed to stand down the next meeting on Friday 17 December due to a number of apologies .
The Chair closed the meeting.