Joint Scrutiny
Customer & Corporate Services Scrutiny Management Committee (CSMC) / Health & Adult Social Care Policy & Scrutiny Committee

13 July 2022

Report of the Assistant Director Policy and Strategy

The 10 year strategies: A focus on the draft 10 year Health and Wellbeing priorities

Summary

1. The Government has published the Levelling Up White Paper and is currently taking the Regeneration and Levelling Up Bill through Parliament. The White Paper includes 12 missions that set levelling up targets for 2030 and sets an expectation that the devolution deal for York and North Yorkshire will progress, leading to the establishment of a Mayoral Combined Authority.

2. In addition, health and care reforms set out how Integrated Care Systems, and partnerships at place-level, will better support local areas plan and commission health and care services to improve the wellbeing of local residents.

3. In response, the council is developing a 10 year strategy comprised of interdependent strategies and informed by existing or emerging policies.

4. By following a sustainable development approach to set out the strategy for the decade ahead, the council is developing three interdependent 10 year strategies (Economy, Climate Change and Health and Wellbeing), with subsequent strategies informed by the priorities set by these 10 year strategies.

5. Joint Scrutiny committees, chaired by the Customer & Corporate Services Scrutiny Management Committee (CSMC) Chair, will consider the interdependencies, shared principles, priorities and focus of each of the draft 10 year strategies in turn.

6. The Joint CSMC/ Health & Adult Social Care Policy & Scrutiny Committee will consider the draft Climate Change Strategy and Economic Strategy through the lens of the draft Health and Wellbeing strategic priorities.

7. Feedback from the joint scrutiny committees will be used to help inform the draft strategies, with a subsequent joint scrutiny meeting in September reviewing recommendations proposed in response to this feedback.

8. In addition, the feedback gathered through these joint scrutiny committees together with the 10 year strategy resident consultation which takes place throughout the summer, is the start of the budget consultation process and will provide early sight of aspects of York residents are concerned about.

Recommendations

9. Joint Scrutiny Committee are asked to:

(i) Review the draft strategies attached as annex.

(ii)Review the shared principles describing how the council will work with the city to deliver the draft strategies and consider how this consistent approach will support the city over the decade ahead.

(iii) Consider how the health and wellbeing of residents over the decade ahead might (positively or negatively) influence a thriving greener economy driven by good business and/or our ambition to be net zero by 2030.

Reasons: The council is developing a 10 year strategy comprised of interdependent strategies and informed by existing or emerging policies. By following a sustainable development approach to set out the strategy for the decade ahead, the council is developing three interdependent 10 year strategies (Economy, Climate Change and Health and Wellbeing), with subsequent strategies informed by the priorities set by these 10 year strategies.

To consider the interdependencies, shared principles, priorities and focus of each of the draft 10 year strategies in turn. This will inform the development of the strategies with a particular emphasis on the relationship between each strategy to mitigate the risk of inadvertently missing opportunities or introducing issues that would prevent realisation of the ambitions.

National Policy Context

Levelling Up

10. The Government has published the Levelling Up White Paper and is currently taking the Regeneration and Levelling Up Bill through Parliament.

11. The [i]White Paper includes 12 missions that set levelling up targets for 2030. These missions are designed to provide consistency and clarity over levelling up policy and will act as a catalyst for action and innovation across private and civil society sectors (including local authorities). Delivering on them will require close collaborative work with devolved administrations.

12. The Government is establishing a statutory duty to publish an annual report analysing progress against these missions, together with a new Levelling Up Advisory Council. With several levelling up missions similar or aligning to the current set of Council Plan priorities there is likely to be cross over between the two. However, it is anticipated that reporting on the Levelling Up missions will sit separately because the Council Plan addresses a broader set of priorities including climate, social care, operational management and outcomes for residents which are specific to the York population and environment. (see Annex A).

13. The Levelling Up White Paper sets an expectation that the devolution deal for York and North Yorkshire will progress, leading to the establishment of a Mayoral Combined Authority. The negotiating process is underway. It will set out an initial programme of work, however, with devolution expected to be set for at least 30 years, there will be more opportunity to influence the mayor’s priorities in the years ahead.

14. The Mayoral Combined Authority will be uniquely placed to influence the cycle of Spending Reviews, potentially unlocking more investment for the city and region.

15. A spending review (sometimes called a comprehensive spending review or CSR(year)) is a Treasury process that sets firm expenditure limits, and through public service agreements (often called PSAs) defines key improvements the public can expect.

16. The City of York Council has not been in a position to directly influence Spending Reviews before with investment either through a Local Government Association negotiated settlement or through bidding for Department-specific grants.

Integrated Health and Care

17. The Government has legislated within the Health and Care Act 2022[ii]. to establish Integrated Care Systems whilst at the same time abolishing Clinical Commissioning Groups (CCGs). The Act also allows the health and care system to create local place-based committees to plan care where appropriate.

18. In York, this place-based committee is known as the York Alliance and is comprised of partners including the council, health and care and community partners. The York Alliance is developing a prospectus that will set out commissioning of services to improve the health and wellbeing of residents will be undertaken in York Place. By understanding the health and wellbeing opportunities presented through the 10 year strategies will help ensure the York Alliance partnership is able to work across the city on the areas that will make the biggest difference.

Climate Change policy

19. The Climate and Ecological Emergency Bill is a private member’s Bill currently in its 2^nd reading. It seeks to ensure the Government fulfils its Paris Agreement to limit global temperatures to increase no more than 1.5C, conserve the natural world by protecting and restoring ecosystems and establishes a citizen’s assembly to recommend measures for inclusion in a climate nature strategy.

20. In tandem the Environment Act 2021 is in its 2^nd reading and sets out targets, plans and policies to improve the natural environment and protect air quality, waste and resource efficiently and nature and biodiversity.

21. In the meantime, like many councils, City of York Council declared a climate emergency in 2019 and has since then initiated a series of actions and developed a draft Climate Change Strategy in response.

Local Policy Context

22. The local policy context has informed the development of the draft 10 year strategies.

The Council Plan The Council Plan – City of York Council

23. The Council Plan, Making History Building Communities 2019-2023 articulates the priorities for the administration and sets out the actions the council will take to achieve these.

24. For the first time, the council plan priorities were mapped to the UN Sustainable Development Goals to reflect the ambition to make York an exemplar sustainable city. The UN Sustainable goals act as an internationally recognised blueprint to achieve a better more sustainable future for all and are, to some extent, synonymous with national Levelling Up policy and supported by the draft 10 year strategies.

25. The Council Plan is refreshed/renewed every four years following the local elections (taking place 2023, 2027 and 2032).

The Local Plan The Local Plan – City of York Council

26. The Local Plan is a city wide plan which articulates the development space that is available, and its uses. It is a plan which helps with development control in York, it sets out the opportunities and policies for building and development (such as new homes or businesses) and describes what is or is not permitted.

27. The emerging City of York (CYC) Local Plan sets out a strategy for the future development of homes, employment, education and community and other infrastructure of York to 2032/33 and provides capacity to meet development needs to 2037/38. It recognises that in response to extensive resident consultation which informed the Local Plan, there is a requirement for the Planning Authority to preserve York’s unique setting, heritage and character. It is being developed in accordance with the National Planning Policy Framework (2012) and currently entering its 3rd phase of examination which will explore the spatial distribution of individual sites, greenbelt boundaries and the soundness of site specific policies. Phase 4 will then explore individual development policies such as transport.

Local Transport Plan Local Transport Plan 2011-2031 – City of York Council

28. York’s existing Local Transport Plan covers the period from 2011 to 2031 and sets out how the city will configure its transport to (a) meet York’s wider objectives (b) efficiently manage the city’s extensive transport asset base of roads, park and ride sites, footways, streetlights, highway drains etc.

29. We are developing a new Local Transport Plan to new government guidance to be released later this year. This guidance will ask local transport authorities to set out the transport policies and measures that will contribute to the city’s economic prosperity, whilst meeting challenging national and local targets for reducing emissions.

30. It is recognised that once the 10 year strategies have been finalised, as a key enabler, a Local Transport Strategy will be produced to inform the Local Transport Plan (which will be a statutory document, prepared to statutory guidance which has not yet been received). The Local Transport Strategy will set out the key policy framework for the Local Transport Plan, but will not include the policies for asset management likely to be required for the Local Transport Plan.

31. The emerging Local Transport Strategy is drawing on the consultation and engagement activities that have informed the development of the other 10 year strategies.

32. In the meantime, Government guidance is expected to prescribe requirements for the development of updated Local Transport Plans. This will include which body in new Mayoral Combined Authorities will be responsible for LTP preparation.

33. To demonstrate the interdependencies between the policy context and the 10 year strategies and to support Scrutiny discussions. A summary and map of interdependent goals, is included in Annex A.

Articulating York’s ambitions

34. To prepare for the Mayoral Combined Authority and support the development of the York Alliance prospectus, it is important that York articulates its economic, climate change and health and wellbeing ambitions, understands the strengths the city can build on and is mindful of both challenges and opportunities.

35. By knowing what we want, we will be better placed to negotiate increased investment or commission better services in the longer term.

36. By following a sustainable development approach to set out the strategy for the decade ahead, the council is developing three interdependent 10 year strategies (Economy, Climate Change and Health and Wellbeing), with subsequent strategies informed by the priorities set by these strategies.

37. These 10 year strategies have not been developed in isolation but set against the national and local policy context.

The 10 year strategies

38. The council is following a sustainable approach to developing the city’s ambitions for the decade ahead. The goal of sustainability is to, “create and maintain conditions, under which humans and nature can exist in productive harmony, that permit fulfilling the social, economic, and other requirements of present and future generations.” or put simply - ‘Enough, for all, forever’ – a concept first developed by Charles Hopkins ERIC - EJ868704 - Enough, for All, Forever: The Quest for a More Sustainable Future, Education Canada, 2009.

39. This means that sustainable approaches need to consider the interdependencies between actions that might affect the environment, society, and the economy. To this end, the council is developing three strategies to inform city-wide direction over the next decade. These strategies cover health and wellbeing, economic growth and climate change – each strategy is equal to the other two. No strategy has primacy.

40. The Economic Strategy (Annex B) and the Climate Change Strategy (Annex C) have been drafted and are ready for final consultation. The Health and Wellbeing Strategy is being developed through the partnership of the Health and Wellbeing Board with the Health and Wellbeing Strategy priorities (Annex D) shared as part of the joint scrutiny committee’s discussions and for resident consultation. Annex D includes an overview of the Joint Strategic Needs Assessment (JSNA) which sets out the health and wellbeing of York residents.

41. A city-wide engagement process has informed development of the draft 10 year strategies which has included an attitudinal survey, focus groups with communities with protected characteristics, and round table discussions.

42. The 10 year strategies will articulate the overarching ambition, objectives and, where appropriate, targets required to deliver these ambitions. The strategies set the direction for the city for the decade ahead and as a result, need to last the test of time.

43. The council will work closely with partners to develop supporting strategies, policies and plans that describe the actions required to meet the ambitions set by these three strategies.

44. Working with city leaders, the council is establishing those priorities city leaders would like to focus on and how, by mobilising the city around a small number of priorities, we will be able to better respond to the national policy context and deliver greater impact. The draft of the city leader priorities (known as the 10 Year Plan) will be shared at September’s pre-decision joint Scrutiny committee.

Resident consultation

45. We have invited residents, businesses and stakeholders to review the draft 10 year strategies and tell us what they think (link to Our Big Conversation Strategy Consultation). Residents can also visit libraries at York Explore, Clifton Explore and Tang Hall Explore to read the strategies and fill out the survey.

46. The three joint scrutiny committee round table discussions taking place throughout July 2022 are part of the resident consultation with the feedback collated for review at September’s joint pre-decision Scrutiny Committee.

47. On 4 and 5 July, “Climate Corner” drop-in sessions at York Explore will provide residents with the opportunity to discuss the Climate Change Strategy in more detail, with roundtables taking place with the business community to explore themes in the Economic Strategy.

48. In September 2022, a pre-decision Scrutiny Committee will consider the feedback from these consultation and engagement activities together with the feedback from the three joint scrutiny committees. The Health and Wellbeing Board will consider the feedback as they finalise the Health and Wellbeing Strategy.

49. In the autumn 2022, the Health and Wellbeing Board will be invited to approve the 10 year Health and Wellbeing Strategy and the City of York Council’s Executive will be invited to approve the final 10 year Climate Change and Economic Strategies.

50. In addition, the feedback gathered through these joint scrutiny committees together with the 10 year strategy resident consultation which takes place throughout the summer, is the start of the budget consultation process and will provide early sight of aspects of York residents are concerned about.

The Health and Wellbeing Priorities

51. There is a statutory requirement for every local authority to have a Health and Wellbeing Board, and for that Board to produce a Health and Wellbeing Strategy.

52. The Board in York is made up of many partners, from NHS bodies to the council and third sector representatives, and so although the Health and Wellbeing Strategy (currently being written to cover 2022-2032) is one of the city’s 10 year strategies, it is developed through a slightly different process, led between the partners within the health and care system rather than by the council.

53. The Health and Wellbeing Strategic priorities will inform the development of the strategy itself and are based on extensive consultation with the health and care sector. They set out how York can be a healthier fairer city and what would need to be in place to support this.

54. Good health and wellbeing are the key driver behind a more inclusive economy and for taking climate action now to protect our environment for future generations.

55. By looking at the health and wellbeing strategic priorities through the lens of the economy and climate change, we will identify whether they have captured the key aspects of what it means for all our residents to live healthier, happier lives in the city.

56. Although many in York enjoy good health and wellbeing, there are pockets of significant deprivation and associated ill health, as well as a number of health and wellbeing challenges the city has faced over the last decade which have been exacerbated by the COVID-19 pandemic.

57. We know that good health is never evenly distributed, and in York the 2010s were what Professor Michael Marmot described as a ‘lost decade’, in which life expectancy improvement stalled, and in the more deprived deciles of the population life expectancy declined for the first time in generations.

58. We know that for York, our overall health outcomes can be seen as positive compared to local neighbours, but when compared nationally are often average; for example York ranks 89th out of 150 Local Authority’s (LA) on female life expectancy at birth and 77th on under 75s mortality from preventable causes.

59. There are also several areas of longstanding concern for the city's health, highlighted in the city’s Joint Strategic Needs Assessment, where we don't do as well as our affluence would indicate, including:

(i) Drug related death

(ii) Alcohol consumption and hospital admissions

(iii) Suicide and self harm

(iv) Population anxiety scores

(v) Children and young people’s mental health

(vi) Diagnosis gaps in dementia, blood pressure and diabetes

Joint Scrutiny Committees

60. Joint Scrutiny committees, chaired by the CSMC Scrutiny Chair, are invited to consider the interdependencies, principles, priorities and focus of each of the draft 10 year strategies in turn.

61. The Joint CSMC/ Health & Adult Social Care Policy & Scrutiny Committee are invited to consider the draft Economic Strategy and Climate Change Strategy through the lens of the draft health and wellbeing strategic priorities.

62. To aid discussions, Joint CSMC/Health and Wellbeing Scrutiny are invited to reflect on the below:

(i) Are the delivery principles detailed in the Climate Change and Economic 10 year strategies likely to help focus on meeting health and wellbeing strategic priorities or could they become a barrier to implementation?

(ii)How could a healthier, fairer city support the strategic priorities set by the economic strategy – specifically to be a greener thriving economy driven by good business?

(iii) How could being a healthier, fairer city influence the pace and ambition set by the Climate Change Strategy?

(iv) Are there any risks that the strategic priorities set by the health and wellbeing strategy would have a negative impact on economic growth or the climate actions required to reach net zero?

63. Feedback from the joint scrutiny committees will be used to help inform the draft Economic and Climate Change strategies, with a subsequent joint scrutiny meeting in September reviewing actions proposed following this feedback.

64. This feedback will also be provided to the Health and Wellbeing Board to help inform how they then finalise the Health and Wellbeing Strategy.

Council Plan

65. The council plan is at the heart of the strategies which responds to the priorities well paid Jobs and an inclusive economy and a cleaner and greener city and Good health and wellbeing.

66. Implications

· Financial Funding the resident consultation is already covered by the Our Big Conversation budget. The 10 year strategies are not funded – it is the action plans that are derived from the strategies that will respond to the available funding, with the ambitions set by the 10 year strategies informing future investment bids.

· Human Resources (HR) (none

· Equalities an Equalities Impact Assessment has been completed for the Strategy Consultation to encourage representative participation

· Legal There is no legal requirement to consult on the strategies. Any issues requiring legal support will be addressed as and when they arise.

· Crime and Disorder none

· Information Technology (IT) none

· Property none

· Other Communications and engagement remains a core element of the development of the strategies.

Risk Management

67. Under-representation: To mitigate the risk that different voices have not felt able to contribute to the engagement/consultation activities, community groups have been approached to take part and focus groups have been held with individuals with protected characteristics. To help the consultation be more accessible, the online survey is also available in libraries, together with the strategies, with face to face activities themed around the strategies. The focus group report will be published with the feedback at September’s pre-Executive Joint Scrutiny Committee.

68. Feedback influencing the final versions: the different opportunities for residents, businesses and Executive members to feedback about the strategies will help refine the strategies. A table will be developed collating feedback and the recommended response which will be presented to September’s pre-Executive Joint Scrutiny Committee.