Health and Wellbeing Board	20^th March 2024
Report of the York Health and Care Partnership

Summary

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

2. The report is for information and discussion and does not ask the Health and Wellbeing Board to respond to recommendations or make any decisions.

Background

3. Partners across York Place continue to work closely together to commission and deliver integrated services for our population. The YHCP shares the vision of the York Health and Wellbeing Strategy that in 2032, York will be healthier, and that health will be fairer.

4. The YHCP has an Executive Committee (shadow) which is the forum through which senior Partnership leaders collaborate to oversee the delivery of the Partnership priorities. The Executive Committee meets monthly, and minutes from the last two meetings held in January and February 2024 are included at Annexes A and B to this report.

5. This report provides an update to the York Health and Wellbeing Board on the YHCP's progress since the last report provided in January 2024.

Update on the work of the YHCP

January 2024 Executive Committee Meeting

6. In January the Place Board discussed progress towards the Partnership's six priorities, as outlined below:

7. Strengthening York's Integrated Community offer: Work towards this ambition continues with the establishment of the York Frailty Crisis Hub. This is a new service for Winter 2023/24 and is a fully integrated collaborative team from four different providers working together at Acomb Garth Community Centre. The aim is to support and keep people that are vulnerable and frail safe in their homes whenever possible, whilst respecting people's wishes. An important part of this model is the Extra Discharge Support Service provided by three voluntary sector organisations which support patients when they are discharged from hospital. The Frailty Advice and Guidance line was also launched in November 2023. The line provides additional support to clinicians working with vulnerable and frail people with the hope that with this additional support, these individuals can continue to be cared for at home.  

8. Implement an urgent and emergency care offer:  Joint work with Nimbuscare has strengthened over the winter period to provide additional support to our population. This includes the establishment of Primary care hubs at New Earswick, the York Urgent Treatment Centre and Scarborough Urgent Treatment Centre, all running 8am-6pm Monday to Friday. The North Yorkshire Clinical assessment service has also been established, which has a GP co-located in a Yorkshire Ambulance Service centre to provide remote clinical triage and assessment for York residents. These schemes provide additional and flexible capacity into the system and early indications suggest they have provided additional support to our population, and reduced pressures the York health and care system over the first period of winter. All partners expect to realise the ambition and benefits of an integrated urgent care service ahead of winter 2024/25.

9. Further develop primary and secondary shared care models: York Place has a well-established Primary/Secondary Care Interface Group that meets monthly, with senior clinical representation from York and Vale Practices, and York & Scarborough Hospitals. The group has dedicated GP resource, which is leading practical, clinical pathway transformation projects in partnership with Hospital colleagues. Examples of pathway development projects to date include neurology, gynaecology, and dermatology. Work is in progress across the ICB to explore how our different Primary/Secondary shared care models can be further developed, and potentially scaled across the ICB, to deliver more clinically effective pathways and better patient experience.

10. Develop a partnership based, inclusive model for children, young people and families: The CYP Quality lead working with key partners to establish priorities based on data and intelligence from key stakeholders, including consideration of CYP with Speech, Language and Communication Needs, CYP with Special Educational Needs and Disabilities, who are looked after or care leavers and those who are a Child in Need, or on a Child protection plan.

11. Integrated prevention and early intervention model: work continues to scope what an integrated prevention and early intervention model should look like for York Place, including a comprehensive review of the prevention workforce across the York system, and the development of an expert steering group to inform future models of care. The aim is to develop a model that is evidence-based and tailored to the meet the specific needs of York's population. Delivery of the 2023/24 Health Inequalities projects continues to progress well, including improving care to many of York's Core20PLUS5 populations such as sex workers, asylum seekers and refugees.

12. Drive social and economic development: partnership work on workforce has strengthened over 2023/24, with a comprehensive work plan in place including future recruitment events for health and social care, the care leavers support programme, and plans to increase placement providers across health and care roles.

13. At the January meeting the Place Board also discussed the development of Family Hubs which are a key integration priority for the Partnership. The Board agreed with the vision and ambition of the Family Hubs model and emphasised the need to build trust with our communities so that access, outcomes, and experience can be improved for children, young people, and their families. Further work will continue in Partnership to develop a health inequalities project to be embedded into the Family Hubs model in collaboration with the Integrated Care Board and CYC Public Health.

14. The Partnership also discussed the development of Integrated Neighbourhood teams, which are a national initiative, to support teams and services to work in a much more integrated way across the system. A further update on this work will be provided at the May Place Board and subsequently to the Health and Wellbeing Board.

February 2024 Executive Committee Meeting

15. The focus of the YHCP Executive Committee meeting was mental health. Professor Lynne Gabriel, one of the co-chairs of the Yok Mental Health Partnership was in attendance to present and contribute to the discussions. There were four substantive items on the agenda, all with a focus on mental health. These were as follows:

16. Realignment of the York Mental Health Partnership (YHCP) From the York Health and Wellbeing Board to the York Health and Care Partnership: The York Mental Health Partnership is a longstanding partnership that has existed for and developed over the past 10 years or so. Its current key focus is developing a community based; research informed approach influenced by Trieste in Italy. This approach has shown that connecting people with opportunities already existing across mental health provision helps to maintain and improve health and wellbeing. The Partnership’s high-level vision is of a Whole Life, Whole Person, Whole System approach and a city where citizens can:

· All feel valued by our community, connected to it, and can help shape it

· Are enabled to help ourselves and others, build on our strengths and can access support with confidence

· Are proud to have a mental health service that is built around our lives, listens to us, is flexible and responds to all our needs

17. An early project for the Partnership connected system leaders; brought together key representation from across the mental health network, including NHS, local authority, VCSE and lived experience representatives (co-production). This ultimately became the Connecting our City Project. With the aid of Community Mental Health Transformation Funding the Connecting our City project has been able to develop a community mental health hub model leading to a recent city centre mental health hub pilot/prototype.

18. The Partnership has to date been operating as a sub-group of the Health and Wellbeing Board. Realigning the York Mental Health Partnership to the YHCP will bring reciprocal benefits and would actively align the ambitions of Connecting our City project with the vision of the YHCP.

19. For the Partnership to move into its next phase of development it is crucial that all partners within the health and social care system are supportive of the partnership’s aims and priority areas of work. It is also important that, going forward, the Mental Health Partnership has strong and robust governance arrangements through a Joint Delivery Group, a Memorandum of Understanding across system partners and the YHCP to enable the development and continuation of community mental health hubs as well as the further development of the Partnership itself.

20. As part of this realignment the Partnership is committed to supporting the YHCP to transform mental health services in the city; delivering against the mental health priorities in the Joint Health and Wellbeing Strategy 2022-2032; reviewing the Partnership’s structure and purpose; exploring how the Partnership can better be an all-age collaborative and creating a workplan that reflects priority areas for the partners across the health and social care system.

21. Mental Health Hub Progress and Future Plans: The Hub model has been co-designed by a group of practitioners from both health and social care, commissioners, voluntary sector and individuals with lived experience and carers. It provides a step forward in terms of transforming local mental health support and services. It aims to be accessible, deliver timely, flexible, person centred and strength-based care and support within a welcoming environment. The hub model prioritises prevention and acting early to support people with their mental health and wellbeing being along with their social needs. It draws on assets and resources of people and their communities. It is for adults with a mental health need and will be staffed by a multidisciplinary team that draws together resources and expertise from across the voluntary and statutory sectors.

22. A prototype mental health hub was delivered alongside other services at Clarence Street in 2023. Whilst the prototype hub faced several challenges evaluation of and learning from these has helped the development of a plan for the delivery of a sustainable mental health hub model that can be rolled out across the city over the next 12 to 18 months.

23. There is a commitment across system partners to open permanent hubs in the city with the aim to open the first in April 2024.

24. Broadening our Mental Health Offer Alongside Social Determinants of Health: Multi-Agency Visit to NAVIGO (Grimsby) in January 2024: In January 2024 a small group of staff from across the health and social care system in York visited NAVIGO, a health and social care community interest company that provides mental health services across Northeast Lincolnshire. The basis of NAVIGO’s work is to deliver services that they would be happy for their own family to use. They offer a range of mental health services including acute and community facilities as well as specialist support. They also run an income generating business that provides training, education and employment opportunities.

25. The visit enabled our local staff to learn about a successful model of health, social care and housing integration, whole system awareness, approaches and partnerships and organisational culture collaboration.

26. Update on Mental Health Urgent and Emergency Care Provision: The importance of being able to access mental health care and support at a time of crisis is essential to support the safety and wellbeing of people in their communities. Urgent and emergency mental health support is provided by many organisations across York and a person in crisis may present or seek support from any of those organisations.

27. YHCP received information on the current state of mental health urgent and emergency care provision including acute hospital liaison teams, crisis and home-based treatment teams, 0800 crisis line, learning from people’s experience of service and co-creating future developments, Right Person Right Care, Force Control Room Team, urgent and emergency mental health care pathway governance and community mental health hubs.

28. Progress to improve these services is being made but there is still considerable work to be done to deliver transformed services for those experiencing mental health crisis.

29. Reflections and Key Messages from the February YHCP Meeting:

· It was evident that the proposal to align the Mental Health Partnership (MHP) with the Place Board was positively received.  This is a welcome move and brings completion of the NHS mental health transformation process firmly into the heart of the integrated care system.  

· The Community Mental Health Hub model represents a positive and creative portal for accessible community care and entry into a range of citizen wellbeing resources.  The premise of early intervention and prevention underpins the Hub model. 

· Ultimately, the Hub’s interdisciplinary early intervention and prevention approach could be a cost-effective means of delivering mental health support. 

· There was support to create an opportunity to consider the development of a broader social model based on the learning from the NAVIGO visit.

· There is a real commitment to system working to progress community transformation with the long-term aim of reducing the need for crisis services or admission to hospital. Tees, Esk & Wear Valleys NHS Foundation Trust (TEWV) colleagues are committed to continue driving this collective vision whether it be strategic planning, operational updates or engagement service visits and focus groups to enable shared understanding of services.

· As a system we need to do more work on how we talk about health and care in terms of parity of esteem and working across commissioning and sector boundaries, both health and social, to deliver the best care every day in every service – creating a ‘social movement’ will help drive strategy and policy.

Contact Details

Authors: Anna Basilico, Head of Population Health and Partnerships, Humber, and North Yorkshire ICB (York Place) Tracy Wallis, Health and Wellbeing Partnerships Co-ordinator, City of York Council	Chief Officer Responsible for the report: Sarah Coltman-Lovell, NHS Place Director √ Report Approved Date: 08.03.2024 Ian Floyd, Chief Operating Officer CYC and York Place Lead √ Report Approved
ALL Wards Affected	Date: 08.03.2024
For further information please contact the author(s) of the report

Annexes

Annex A: YHCP minutes January 2024

Annex B: YHCP minutes February 2024