Health and Wellbeing Board

16 November 2022

Report of the York Health and Care Partnership

Simon Bell, Interim Place Director, York Health and Care Partnership

Jamaila Hussain, Corporate Director of Adult services and Integration (DASS), City of York Council

1. Summary

This report provides an update to the Health and Wellbeing Board (HWBB) regarding the work of the York Health and Care Partnership (previously the York Health and Care Alliance), progress to date and next steps.

2. Introduction

Partners across York continue to work closely together to commission and deliver services for our population. The York Health and Care Partnership (YHCP) has a shared vision and aspires to raise our population health outcomes to become the healthiest city in Northern England. With a focus in our Health and Wellbeing Strategy being on population health, we are theming our work using a life course approach of Starting Well, Living Well, Aging and Dying Well.

The YHCP has an executive committee (shadow) which is the forum through which senior Partnership leaders meet and collaborate to oversee the delivery of the Partnership priorities, working in accordance with the Partnership's values and principles to achieve the aims and shared purpose across the City of York. Minutes from the September and October meeting are available in Annexes A and B.

This report provides an update to the York Health and Wellbeing Board on YHCP's progress since the last report provided in July 2022.

3. National and Local Context

As outlined in the July 2022 report, the Health and Care Act came into law during April 2022. From July 1 2022, this has enabled the dissolution of CCG’s and the implementation of an Integrated Care Board (ICB). The Humber and Yorkshire ICB has been established alongside 6 place executive committees (shadow). The new Health and Care Act (2022) places a duty and responsibilities on the ICB to perform the following functions:

· Commissioning Hospital and other Health Services

· Commissioning Primary Care Services

· Transfer schemes in connection with the transfer of Primary Care Functions

· Commissioning Arrangements

· General Functions

· Expansion of financial duties of integrated care boards and their partners.

The Health and Care Act (2022) focusses on statutory agencies working closely together supporting the commissioning and delivery of services across populations and place.

Following the update provided in July 2022, the following national guidance has been published:

· The Department of Health and Social Care has issued statutory guidance to support Integrated Care Partnerships to produce integrated care strategies, and guidance on Adult Social Care principles for Integrated Care Partnerships.

· NHS England has published formal statutory guidance for integrated care boards, NHS trusts and foundation trusts on the new collaborative working arrangements that are possible between NHS organisations and local Government following commencement of the Health and Care Act 2022.

· NHS England has also published the next steps for increasing capacity and operational resilience in urgent and emergency care ahead of winter.

The YHCP continues to work closely with HNY ICB in this dynamic environment to implement guidance and support the health and care system ahead of winter.

HNY ICB have developed a 'Transitional Operating Arrangement' between the ICB and each Placed Based Partnership. The Transitional Operating Arrangement is a statement about the arrangements and the ways of operating in the York Health and Care Partnership as further work is undertaken to understand delegation arrangements at system and place-based level. To align with other Place Based Partnerships in the HNY ICB, the York Placed Based Partnership took the decision to be named the York Health and Care Partnership, signalling a change from the previous title of 'Alliance'.

4. Update on the work of the Alliance and Current position

The Partnership have recently published a Health and Care Prospectus (see Annex C) which describes the new way of working for Integrated Care Systems and Place Based Partnerships, the changes the Partnership is currently putting in place, and what our population has told us they would like to see in future years. The Prospectus was coproduced through the York Big Question engagement exercises, academic input, strategic enquiry, and a coproduction workshop. The document describes the strengths and challenges we have in York and the opportunities we have as a Place Based Partnership to focus on integration, early intervention and reducing health inequalities.

The Partnership has set priorities based on immediate pressures in the health and care system in York, as well as the longer-term needs of our population with a focus on reducing health inequalities:

· Overarching goal: Delivery of the York Health and Wellbeing Strategy

· Priority area 1: Quality of services: quality, safety, experience of care

· Priority area 2: Population health: health generation, prevention, early intervention

· Priority area 3: Access to services: general practice, dentistry, planned care

· Priority area 4: Resilient community care: preventing admissions, in-and-out-of hospital care, effective discharge

· Priority area 5: Urgent and emergency care: capacity, resilience, responsiveness

These priorities are underpinned by a series of enablers including finance, workforce, communication and engagement and the York Population Health Hub[1]. The priorities:

· cover the whole health and care system, including mental health and social care, and cover a pathway from health through low-level care needs to more complex care.

· are sector based but broad enough to cover the YHCP's key responsibilities around immediate pressures whilst also delivering integration and service transformation and reducing health inequalities.

· align well with what people told the YHCP they wanted to see through the Health and Care Prospectus.

· will enable the YHCP Executive Committee to have oversight of operational and financial performance across Place, reflecting the key role of this place committee in the delivery of ICB functions locally.

York's strategic intent slide (see Annex D) summarises the YHCPs intentions under our framework for a health generating city of Grow, Act, Care and Connect.

Currently, the governance structure for the YHCP consists of the Partnership Executive Committee and the City of York Health and Wellbeing Board. The YHCP has an executive committee (shadow) which is the forum through which senior Partnership leaders meet and collaborate to oversee the delivery of the Partnership priorities, working in accordance with the Partnership's values and principles to achieve the aims and shared purpose across the City of York.

Figure 2 below outlines the interim governance structure.

Figure 2: YHCP interim governance structure

The Executive Committee provides reports on its work to the Humber and North Yorkshire ICB and to the City of York Council Health and Wellbeing Board through this report. It is intended by the Partners that as these arrangements develop, the Executive Committee will review how it works with existing partnership engagement forums and the City of York Council Health and Wellbeing Board. The YHCP has recently agreed it's Terms of Reference which will also be subject to review as arrangements develop.

The York Population Health Hub continues to enable the collection of a wealth of data, which provides a clearer picture of the health of the population of York and the inequalities people face across the borough. This clearly shows that there is still work to do if we are to achieve equality of health across the city.

5. Implications

· Legal

The Health and Care Act (2022) is now in place, over the next 12 months the place board will further explore governance process as these will continually change as the ICB and place board develops.

6. Next steps

The YHCP continues to develop and mature partnership arrangements in preparation for future delegation arrangements.

Recommendations

The Health and Well Being Board is asked:

To note the content of the report and progress made
To support dissemination of the York Health and Care Prospectus across partners.

Reason: To keep the board updated about the developments at Place.

Contact Details

Author:	Chief Officer Responsible for the report:
Simon Bell Interim Place Director, York Health and Care Partnership Humber and North Yorkshire ICB simonbell@nhs.net Jamaila Hussain Corporate Director of Adult services and Integration (DASS) City of York Council jamaila.hussain@york.gov.uk	Simon Bell Interim Place Director, York Health and Care Partnership Humber and North Yorkshire ICB
	Report Approved	ü	Date	3/11/2022



Wards Affected: List wards affected or tick box to indicate all.					All	ü

For further information please contact the author of the report

Background Papers:

- Annex A: York Health and Care Partnership meeting minutes September 2022

- Annex B: York Health and Care Partnership meeting minutes October 2022

- Annex C: York Health and Care Prospectus

- Annex D: York's Strategic Intent Slide

[1] The York Population Health Hub was established in 2021 to bring together colleagues from health, public health, and business intelligence to enable, analyse and undertake public health management approaches.