Thursday 15^th February 2024, 10:00 - 12:30

Severus Meeting Room; First Floor, West Offices

Chair: Ian Floyd

Present
Ian Floyd (Chair) (IF)	Chief Operating Officer		City of York Council (CYC)
Rebecca Field (RF)	Joint Chair of York Health and Care Collaborative		York Medical Group
Sarah Coltman- Lovell (SCL)	York Place Director	York Place, H&NY ICB
Cllr Jo Coles (JC)	Executive Member for Health, Wellbeing and Adult Social Care	CYC
Sian Balsom (SB)	Manager	Healthwatch, York
Alison Semmence (AS)	Chief Executive	York Centre for Voluntary Services (CVS)
Professor Karen Bryan (KB)	Vice Chancellor	York St John University (representing higher education)
Professor Mike Holmes (MH)	Chair	Nimbuscare
Martin Kelly (MK)	Corporate Director of Children and Young People	CYC
Peter Roderick (PR)	Director of Public Health	CYC
Cllr Claire Douglas (CDo)	Leader of City of York Council	CYC
Helen Day (on behalf of Brian Cranna and Zoe Campbell) (HD)	Director of Nursing (NYY&S)	TEWV
Melanie Liley (ML)		YSTHFT
Caroline Johnson (CJ)	Deputy Director of Nursing – York	York Place, H&NY ICB
Mark Bradley (MB)	Place Finance Director	York Place, H&NY ICB
In Attendance
Hannah Taylor (HT)	Team Administrator		York Place, H&NY ICB
Chris Davis (CDa)	Head of Mental Health Partnerships		York Place, H&NY ICB
Pete Thorpe (PT)	Executive Director of Strategy and Partnerships		H&NY ICB
Professor Lynne Gabriel (LG)	York Mental Health Partnership Co-Chair		York Mental Health Partnership
Tracy Wallis (TW)	Health and Wellbeing Partnerships Co-ordinator		CYC
Apologies
Brian Cranna	Director of Operations and Transformation, NYY&S	TEWV
Helena Ebbs	Place Clinical Director	York Place, H&NY ICB
Michael Melvin	Interim Director Adult Services	CYC
Michelle Carrington	Director of Nursing and Quality North Yorkshire and York	York Place, H&NY ICB
Emma Johnson	Chief Executive	St. Leonard's Hospice
Gail Brown	CEO	York Schools & Academies Board
Simon Morritt	Chief Executive	YSTHFT

Minutes – draft

1. Welcome and apologies for absence.

The Chair welcomed everyone to the meeting.

The minutes of the meeting held on 19.01.2024 were approved.

PT introduced himself as the Executive Director of Strategy and Partnerships for Humber and North Yorkshire Health and Care Partnership informing he was attending to understand the Place Partnership.

Matters Arising

SCL informed she has escalated the issues regarding the services out of date information on the NHS website to the ICB digital team.

SCL updated that the intentions for Place in 24/25 would be brought to the March meeting following the YHCP 'Time out together' and Humber and North Yorkshire Leaders forum. SCL informed that work has commenced on a 6+1 concordat between Places and the ICB. SCL confirmed that all of this work will be brought to the March Meeting.

Action

· SCL to send a draft of the 6+1 concordat to members of the committee and meet with any members who have any queries.

2. York Mental Health Partnership

Purpose and Priorities

LG gave a brief history of the York Mental Health Partnership which started around 2013. In 2018 the partnership changed as the city of York collaborated to follow a Trieste model which follows a community approach and helps connect people with opportunities that already exist. Continuing LG informed that the partnership's vision was of a whole life, whole person, whole system approach. LG shared the priorities of the Partnership being to continue the Connecting Our City project in which the aim is to embed community mental health projects into the city through a network co-produced of community Mental Health Hubs.

 LG informed of the pilot Mental Health Hub that ran at 30 Clarence Street, noting that it had been picked up by NHS England as an example of good partnership working.

There was discussion on:

· The Mental Health Hub Pilot that ran at 30 Clarence Street in 2022/2023 which provided an inclusive and welcoming portal for citizens. The Hub showed a positive impact of a York Model for community mental health transformation. The Hub had been picked up by NHS England as a good example of Partnership working.

· The Commitment across the Mental Health system partners to scale up the number of Hubs in York and open three permanent hubs in York the first being in April 2024 and the second and third being in October 2024 providing that they are set up correctly and all staffing and processes are in place so that things are not over promised.

· The location of the York Mental Health Hubs are being identified by the York Joint Delivery board and the Connecting Our City Programme project team

· Acknowledgment and learning around the impact of shared use environments

· Positive feedback on the Mental Health Hub pilot from everyone involved including people with lived experience

· 1 in 50 people in York have contacted TEWV's Crisis line in the last year which equivalates to 2% of the population which could get worse.

· The Mental Health Hub offering an open door, humane approach which needs to be reflected across all areas of contact of someone in Crisis.

· Mental Health being reflected across all areas and not currently connected to the other Hubs the city has to offer including the Family Hubs and the Frailty Hubs.

· Areas that may be missing or not actively involved including Children, Young People and Families and Police, primary care and early intervention and prevention

· Currently there being no Mental Health same day emergency care with people often going to A&E which often isn’t the right place, which may need a communication document for professionals and public on where is best to go.

· The need for Health inequalities and shared use to be considered when thinking of where the Hubs are located.

· Opportunities will be available for students within the Mental Health Hubs

· Public Health being linked in about managing the expectations of the Hubs.

The Committee supported the recommendations of:

i) The York Health and Care Partnership (YHCP) and Place Board enable the realignment of York Mental Health Partnership (YMHP) from the York Health and Wellbeing Board to the Place Board.

ii) The YHCP and Place Board work with the YMHP to develop agreed pathways, including financial alignment, for the ongoing development of the Connecting Our City programme.

iii) The YHCP and Place Board continue to support ongoing development of the York community mental health hub model.

Providing the oversight of the Mental Health Partnership at the Health and Wellbeing board

Action

· CJ and LG to connect about the connection of Mental Health Hubs.

3. Mental Health Hub Progress and Future Plans

CD updated that the Mental Health Hub model has been coproduced by clinicians, social work, local area coordination, voluntary sector and people with lived experience and carers aiming to provide easily access and deliver timely, flexible patient centred and strength based care and support in a welcoming environment with the Hub offering support for Adults with mental health needs. CD shared some of the key principles which are a warm welcome, the importance of relationships, inclusivity and accepting people without bias, trust, being flexible around people’s needs. Referring to the pilot Mental Health Hub at Clarence Street CD informed they had received positive feedback, the challenges that they faced have helped to develop the plan for the delivery of a more sustainable model across the city and the Pilot Hub was brought to a close to allow further recruitment and the implementation of learning by all organisations that are working together to deliver the model going forward,

Discussion ensued on:

· Aim for 3 hubs by 2025/26 with the first to open in April providing recruitment and processes are in place so the hubs are sustainable

· Importance of Staff wellbeing so they can provide the best possible care to citizens.

· Potential involvement of the public health team on the evaluation of the Mental Health Hubs

· Connecting and all areas following the same approach to help reduce concerns about the demand and resource that lead to frustration from being passed around the system

· Being transparent through a city-wide communication documents on the figures shared on the demand of the Crisis service

· Trieste model focussing on support to the individuals using the service.

· Cost of living crisis being a barrier for some people not being able to access the hubs face to face due to the cost of getting there

Action

PR to pick up a conversation with CD and IF about the Drug and Alcohol Service moving location and having a drug and alcohol liaison or worker in the Mental Health Hubs.

The board, supported the progress of the reopening of the hub and will receive further updates from the hub as it progresses.

4. MH ED as part of a broader social model

CD shared information on his visit with colleagues from a range of organisations to The Potting Shed and Harrison House which are ran by Navigo a Health and Social Care Community interest company that provides mental health services to the NHS across Northeast Lincolnshire. CD shared some background on the services informing their aim to deliver a range of mental health services that they would be happy for their own families to use. CD added that they are a strong part of the local community and they have strong partnerships with those in Northeast Lincolnshire.

CD shared some of the key areas they heard about at their visit including feedback that Navigo had received from people that have used their services, there is a whole system awareness and partnerships, the integration of Health, Social Care and Housing, there are no out of area patients, led by lived experience, personal  accountability for funding knowing it drives improvement, efficiency and quality  and the positive organisational culture-collaboration

Ending CD shared what it would mean if York were to run something similar including Leadership to drive and support change, vision to drive strategy, permission to design and develop collaboratively, Housing, Health, and social care pooled resources and budget and Integration –system working, and Asset based community development .

There was strong support from members of the Committee to develop a broader social model and incorporate this into the Hub.

Action

The Board to reflect infrastructure in York and aligning with the Estates Strategy in future plans.

5. Crisis Services Action Plan

HD informed in 2023 TEWV supported 3991 residents across York from their Crisis and Home based treatment team which operates 24 hours a day, 7 days a week to provide specialist assessments for adults who need urgent mental health care to try and prevent where possible admission to a mental health hospital. HD noted that although 99.69% of calls were answered within their 4 hour national target it is difficult to track those who may not hold or drop off the line. On evaluation of the 0800 crisis line which operates 24 hours a day, 7 days a week to provide a single point of contact where people can contact mental health services for urgent advice and access to services which works in conjunction with the crisis and home based treatment service, it showed that most people needed to be signposted to other services.

HD informed that the Force Control Team which provides advice and support to police officers to make the most appropriate decisions if they have a concern regarding someone's mental health and is Commissioned by North Yorkshire Police had 2928 contacts in 2023 in relation to Mental Health concerns. Concluding HD informed that they are monitoring the complaints they are receiving, using the intelligence from the Healthwatch report, and building on the Trieste model to develop the services.

Discussion ensued on:

· Communication concerns where people may feel they are in crisis but they are told following an assessment they are not and where they would turn to.

· Complex case holding within the Voluntary Care Sector due to being turned away from services and how to feed this into the next steps of the Crisis Services action plan

· The threshold and transition from children and young people to adults services and how these are managed.

· Data within the report being difficult to interpret on where we are compared to where we should be

Action

Partners who would like to observe and learn about the crisis team to contact HD

HD to gather data on the Mental Health Paramedics

HD and SB to look at cases of Complex case holding to see what they are able to offer

LG to meet the newly appointed Matron that is addressing the quality issues

HD to share data on where we are compared to where we should be for the Crisis Services action plan

BF to link with Dan Kimberling on linking in primary care with the action plan

Any Other Business

There was no Other Business