Agenda and minutes

At this point Members are asked to declare any personal or prejudicial interests they may have in the business on this agenda. A list of general personal interests previously declared are attached.

Members were invited to declare at this point in the meeting any personal or prejudicial interests they might have in the business on the agenda.

The following interests were declared further to the standing personal, non-prejudicial interests declared at previous meetings and circulated with the agenda.

Cllrs Fraser and Wiseman declared a personal non-prejudicial interest in relation to Agenda item 4 (Healthy City Board – Progress Update) as members of the York Healthy City Board.

Cllr Morley declared a personal non-prejudicial interest in relation to Agenda item 5 (Dementia Review – Final Draft Report) as he had the power of attorney for a resident who used the befriending service offered by Age Concern.

To approve and sign the minutes of the meeting held on 6 October 2008.

RESOLVED:             That the minutes of the last meeting of the Committee held on 6 October 2008 be approved and signed by the Chair as a correct record.

At this point in the meeting members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. Anyone who wishes to register or requires further information is requested to contact the Democracy Officer on the contact details listed at the foot of this agenda. The deadline for registering is Friday 31 October 2008 at 5.00pm.

It was reported that there had been two registrations to speak at the meeting, under the Council’s Public Participation Scheme.

The first was from Jack Archer on behalf of the Older People’s Assembly who congratulated Members and Officers on their well written and researched final draft report on the Dementia Review. He stated that some disturbing evidence had been heard and that comments of relatives and carers had differed from that of Hospital staff but he hoped that the Committee would follow through their recommendations and request a progress report in six months time. He asked that the request for an update report be included as an additional recommendation in the final report.

The second was from Di Keal on behalf of the Alzheimer’s Society who also welcomed the report and the work undertaken by the Committee to gain evidence for their report. She questioned Members as to what follow up mechanism would be put in place to ensure that their recommendations were acted upon and scrutinised.  She reiterated that with dementia sufferers there was still a need to focus on the individual and that she was pleased to see that the report gave weight to the personal need and circumstances of the individual and that however inconvenient it was to the smooth running of the ward it recommended that carers should be fully involved in patients’ care. She pointed out that carers often did not have an understanding of the running of the hospital and that a leaflet outlining the roles and responsibilities of staff would be useful to encourage joint working. She thanked the Committee and all the partners for their involvement in the review. 

This report provides an update on current Healthy City Board priorities in light of the newly launched Sustainable Community Strategy (SCS) and Local Area Agreement (LAA).

Members are asked to note the contents of the report and to consider how they SCS and LAA priorities may influence their work.

Consideration was given to the joint report of the Associate Director of Public Health, the NYYPCT, the City of York Council and the Chair of the Healthy City Board, which provided an update on current Healthy City Board priorities in light of the newly launched Sustainable Community Strategy (SCS) and Local Area Agreement (LAA).

It was reported that the Without Walls Executive Delivery Board, who oversaw performance monitoring and management of the SCS and LAS, focused on the following three types of measures:

• ‘State of the City’ indicators
• LAA2 indicators  and
• Key actions and milestones

As the Healthy City Board met on a quarterly basis it was reported that most of the activity to deliver the priorities took place outside of the formal meetings, led by the appropriate partners.

Rachel Johns, as Chair of the Healthy City Board presented the report and explained the targets and strategic aims and programme from September 2008 to July 2009. She pointed out that information was not yet available in relation to LAA Indicator 139 (People over 65 who say that they receive the information, assistance and support needed to exercise choice and control to live independently) as this was a yearly indicator and that this information would be available early next year. In relation to NI112 (under 18 conception rate) she confirmed that overall rates had declined but that there was still some improvement to be made. She confirmed target for Indicator NI156 (obesity among primary school age children) had been a challenging target to achieve and she reported that an implementation group for York was due to oversee partnership work to reverse the rising trend of obesity during which regular updates would be made.

Members and Officers requested clarification of the terms “key high level longitudinal measures” referred to in the first bullet point in paragraph 7, and the initials ‘AAACM ratio” in the table in paragraph 9 of the report.

RESOLVED:   (i)         That the contents of the report be noted.

(ii)That further update reports be provided for the Health Scrutiny Committee in relation to any targets, which vary significantly from that which had been set. ^1.

REASON:                  In order to remain up to date on the health and well-being of the citizens of York.

To consider the final draft report from the Dementia Review.

Members considered the final draft report on the Dementia Review whose aim had been to look at the experience of older people with mental health problems (and their families/carers) who accessed general health services for secondary care in order to identify where improvements may be required. The report set out six draft recommendations for consideration.

The Chair reported that the Committee had also considered the addition of a seventh recommendation concerning the befriending service. The Head of the Neighbourhood Pride Unit gave members further details of these services and confirmed that Age Concern had now written to all wards to inform them they would not be seeking funding from 2009/10 onwards from ward budgets.

A representative of Age Concern, confirmed that although this service had not been found to work through the Ward Committee’s, befriending services would continue through Age Concern and the Alzheimer’s Society.

Consideration was also given to the following documents circulated at the meeting:

• ‘This is Me’ leaflet prepared by the Alzheimer’s Society which included information on individual patients;
• Details of the befriending services supported by the Ward Committee process and the Ward Committee Local Improvement Schemes process;
• Sections from the NHS ‘Essence of Care’ document which detailed patient focused benchmarks for clinical governance. It was reported that this document formed part of healthcare training, which was then cascaded down to all staff.

Members and partners made the following comments;

·        The experiences of patients were often different to those commented on by staff and that there may be a need to revise the preamble to paragraph 6 of the report to reflect this.

·        A member of the Hospital Trust confirmed that they welcomed the opportunity to take part in the review and that they now wished to take the Committee’s recommendations forward in partnership with the Local Authority and the PCT.

·        Concern was expressed that funding was not to continue for community outreach workers through  Ward Committees.

Following further discussion the Chair thanked all the individuals and partners who had attended meetings and participated in the review for their support.

RESOLVED:    (i) That the final draft report including the following recommendations as amended be agreed: ^1.

1.That the York Hospital Trust, in liaison with other appropriate service providers* be urged to develop and implement the Psychiatric Liaison Service (Annex A). The development of this programme to be a benchmark for training and support for staff working with dementia patients who access secondary care.

*The Yorkshire Ambulance Service is to be included amongst the service providers, whilst acknowledging the unique nature of their role.

REASON:To enable the development of the Psychiatric Liaison Service to progress.

2.That all service providers be urged to review their arrangements for staff training in relation to recognising and working with those with an underlying condition of dementia. Any such review should include:

oPromoting the use of Link nurses and investigating the possibility of nominating Link clinicians within defined staffing groups.

oInvestigation of the large gaps in training.

o  ...  view the full minutes text for item 28.