Health and Wellbeing Board

22 January 2025

 

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 integrate services for our population. The YHCP shares the vision of the York Joint Local 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. Since 2022, the YHCP has been an Executive Committee of the ICB, drawing on membership across Integrated Care Board (ICB) senior officers, City of York Council senior officers, York and Scarborough NHS Teaching Hospital, Tees, Esk and Wear Valley NHS Mental Health Trust, primary care, York Centre for Voluntary Services, Healthwatch York, the university and education sectors, and City of York Council elected members.

5.   The Executive Committee meets monthly, and minutes from the September 2024 meeting are included at Annex A to this report.

Update on the work of the YHCP

September 2024 Executive Committee Meeting (minutes at Annex A)

6.   The September meeting of the Executive Committee focused on the following four items:

Ø Feedback to the ICB on the Design for the Future Blueprint Proposition: The NHS Place Director for York confirmed she had shared the feedback from YHCP on the Design of the Future Blueprint Proposition with colleagues in the ICB. The Design for the Future Blueprint Proposition sets out the potential future design of services intended to meet the challenge of the next two decades. It has been developed to set a strategic direction that supports the Humber and North Yorkshire Health and Care Strategy and to provide the basis for conversations, gather views, opinions, comments and perspectives and to support the co-production of proposals to deliver the design for the future. A summary of the YHCP’s feedback along with an outline of the proposition was presented as part of the NHS Place Director’s report to the HWBB in September 2024. Additionally, the Executive Director of Communications, Marketing and Media Relations attended the November meeting of the HWBB to present a report regarding the engagement approach (public and patient) delivered by Humber and North Yorkshire NHS Integrated Care Board (ICB).

Ø Community Frailty Services: in November 2023 YHCP started a pilot scheme with the aim to shift how care for those living with frailty would be delivered. The York Frailty Crisis Response Hub is a model that supports York's intermediate care offer. The hub brings together a range of services that had previously been working in isolation into a shared physical workspace, co-locating teams and embedding a multi-disciplinary approach. The pilot has boosted the amount of capacity available to support frail people in crisis in the community, enabled partnership working and supported the wider system pressures. The model emulates the Jean Bishop core offer in that the service operates at a tier above the level of core primary and community services and raises the bar of what can be achieved at the tier below acute services, enabling the re-direction of demand away from the Emergency Department (ED) and into a community environment. YHCP supported the next phase of this work to develop a fully integrated community frailty service for the population of York. In its first full year, the service is predicted to support 4700 cases of crisis, avoid 1800 attendances, avoid 900 hospital admissions, and 33,000 work hours per year (based on the assumption that hub working saves 7 hours of staffing time in 25% of crisis cases).

Ø  York Joint Committee Establishment (Section 75 Agreement between Humber and North Yorkshire ICB and City of York Council): In April 2024 the YHCP Executive Committee approved the intention to fully explore the option of forming a joint committee from April 2025. A Joint Commissioning Forum was duly established to oversee the work and report back to the Executive Committee in September 2024.  The creation of a Joint Committee is intended to improve the quality of health and care for residents in the city. As an enabling mechanism, it will not directly change services overnight, but the partnership working, joint planning and joint funding arrangements it allows between the council and health will lead to greater integration between health and care services. YHCP approved a decision in principle to develop and establish a Section 75 Partnership Agreement starting from 1st April 2025. In furtherance of this work, the ICB Board and the City of York Council Executive Committee both received a report in November 2024 setting out a proposal to form a Joint Committee (Section 75 agreement) between Humber and North Yorkshire Integrated Care Board and City of York Council. This proposal was approved by both organisations and work is now underway to set up the Joint Committee by 1st April 2025.

Ø  System Assurance Report: this report provided some progress updates against Place priorities as follows:

Strengthening York’s integrated community offer:

Ø  Mental Health Hub – following the establishment of the first City of York hub in May 2024, non-recurrent funding (2 years) has been awarded by NHS England to develop a second hub in the city which will operate 24 hours a day.

Ø  A health and social care bridging service supporting discharge from hospital has been in place since 4th June 2024, supporting around 70 discharges per month, and reducing the amount of time that patients spend in an acute hospital bed once medically fit for discharge by allowing the assessment of their ongoing needs to take place in their home environment.

Implementing an integrated urgent and emergency care offer

Ø  Intense focus on urgent and emergency care recovery with three immediate recovery actions put in place over July, August and September 2024 in readiness for the busy winter months. The three main areas are plans which return ambulances to the road more quickly; let the Emergency Department (ED) be ED and leadership at every tier

Further develop primary and secondary shared care models

Ø The Primary/Secondary Care Interface Group is now also acting as a forum for discussion and resolution of issues that present through General Practice Collective Action. Collective action is GPs taking action that may stop or reduce certain work. It is not the same as industrial action and staff are still working and seeing patients.

Develop a partnership based, inclusive model for children, young people (CYP) and families

Ø  Developing resources to support CYP with sensory processing differences and difficulties. These locally coproduced resources will enhance the universal offer and support those around CYP to provide targeted support. This work is being led by York and Scarborough Hospital CYP Occupational Therapy (OT) team and supported by ICB. The resources and changes to the delivery of the York and Scarborough Hospital CYP OT Service launches end of January 2025

Ø  There is significant concern around NHS speech and language waiting list times. An options paper is being shared with YSTHFT senior board members September 2025. Significant service development has taken place, but referrals continue to increase.

Ø  Partnership for Inclusion of Neurodiversity in Schools (PINS), neurodiversity in schools project (NHSE) and ADHD foundation project (commissioned by CYC) are now underway across chosen settings in York.

Embed an integrated prevention and early intervention model

Ø  Meeting held with providers of prevention services following scoping exercise carried out for integrated prevention model. Priority areas identified and actions to be developed.

Ø  York took part in the national ‘Know Your Numbers’ week campaign with an event at York Designer Outlet featuring our health kiosks and community pharmacy to target diagnosis and treatment of hypertension.

Drive social and economic development

Ø  Development of a future service model and associated infrastructure is progressing well, with workshops held in September and October with a wide range of system partners to review and feedback.

October 2024 Executive Time Out Session

7.The focus of the October ‘time-out’ session was Radical Place Leadership. Radical Place Leadership creates an enabling environment to work in a person-centred approach with a genuinely shared vision and priorities, empowerment and engagement, enabling anchor institutions, community decision making and action, and release of tangible financial savings. The YHCP has agreed to use the model as a basis for developing relationship-based practice across York’s health, care, voluntary sector practitioners to create a better working environment and experience of joined up care for residents.

November 2024 Executive Committee Meeting (The minutes for this meeting have not yet been approved and will be included as part of the next update to HWBB in March 2025)

8.The November meeting of the Executive Committee focused on the following three items:

i.          Place Priority #2: integrated urgent care update and planning considerations:

ii.          York Bereavement Alliance: Progress of York Bereavement Alliance work has been steady and productive over the first year of its delivery. Gaps in provision have been identified, relationships with stakeholders deepened and a universal York place desire to improve citizens bereavement support is encouraging to note.

iii.          YHCP Partner Finance and Efficiency Overviews/VCSE State of the Sector Report: A summary of the financial challenges, efficiencies and system opportunities for each of the health and care organisations represented on the committee was presented. The committee also received a report on the recent VCSE state of the sector survey, designed to capture how York's VCSE sector is doing, to identify challenges and opportunities, and to evidence where more support is needed. This work will inform our joint commissioning approaches and decision making as we make our preparations for establish the Joint Committee from April 2025.

December 2024 Executive Committee Workshop

iv.          The focus of this workshop was for partners to take some time to discuss how joint committees can take decisions; in contrast to committees where member organisations represent their own interests and take decisions in that context. The discussion covered a number of areas such as membership of the joint committee; budgetary concerns; governance structures; transparency; and a framework setting out how the organisations represented around the table might best work together.

Work of the York Population Health Hub

9.The York Population Health Hub (PHH) serves as a vital collaborative platform uniting diverse stakeholders from health and the local authority to enhance population health management in York. The PHH includes members from the Integrated Care Board's York place, Business Intelligence Team, General Practice, Secondary Care, the Community & Voluntary Sector, and City of York Council's Public Health and Business Intelligence Teams. This multi-organisation approach facilitates the development and implementation of population health strategies that address the unique needs of York’s residents.

The PHH actively produces resources and initiatives to promote population health management, such as a quarterly newsletter that provides updates and highlights opportunities for engagement. The latest issue promoted the Winter Directory of Services, designed for professionals to use to signpost to support available for York residents. The Winter Directory of Service for the public is available on the Live Well York Website and on the ICB’s website and is included as Annex B to this report. The Directory of Service for Health Professionals is at Annex C to this report.

 

10.    Additionally, the team organise and hold quarterly Lunch & Learn events. Delivered virtually, recorded, and published online, the events offer the opportunity to hear from subject matter experts. The latest session focussed on Hypertension Case Finding and included a talk by representatives from community pharmacy. The upcoming session (January 30th) will focus on Staying Well during the Winter.

11.    These collaborative efforts extend to the compilation of significant reports, including Joint Strategic Needs Assessments and the forthcoming Impacts of Poverty report. Over the coming months the hub will be contributing essential data to support the development of York's Integrated Neighbourhood Teams (INTs). The PHH remains open to new members, fostering a culture of shared learning and innovation in population health.

York Mental Health Partnership

12.    Key highlights from the Mental Health Partnership include:

Ø Work on the development of the existing Mental Health Hub at Clarence Street continues.

Ø A further 24/7 Neighbourhood Mental Health Centre at Acomb Garth continues to be developed supported by NHSE funding. A manager for the centre has been recruited.

Ø A recruitment event was held in Acomb in December and there was a great deal of interest in a variety of roles at the 24/7 centre. Formal recruitment will be taking place in the first quarter of 2025

Ø The Mental Health Partnership are developing a strategy on a page and accompanying narrative. Work on this is progressing well. Once this is complete this will be shared widely.

Ø Work is ongoing to establish a Children and Young People’s Mental Health Group and an initial meeting has been held to discuss how this might happen. Further meetings to progress will take place soon.

 

Contact Details

Authors:

 

Compiled by Tracy Wallis, Health and Wellbeing Partnerships Co-ordinator, City of York Council

 

Chief Officer Responsible for the report:

Sarah Coltman-Lovell, NHS Place Director

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Report Approved

 

Date: 10th January 2025

 

ALL
 

Wards Affected

 

 

 

 

 

For further information please contact the author(s) of the report

 

Annexes

Annex A – Minutes of the September 2024 Meeting of the York Health and Care Partnership

Annex B – Directory of Services for the Public over Winter

Annex C – Directory of Services for Health Professionals