Agenda and minutes

At this point in the meeting, Members are asked to declare:

·        any personal interests not included on the Register of Interests

·        any prejudicial interests or

·        any disclosable pecuniary interests

which they may have in respect of business on this agenda.

Members were asked to declare, at this point in the meeting, any personal interests not included on the Register of Interests, or any prejudicial or disclosable pecuniary interests they may have in respect of the business on the agenda.

Councillor Kallum Taylor declared a personal, non-prejudicial interest in agenda item 5 (Unity Health) as he is registered as a patient with Unity Health.

To approve and sign the revised minutes of the meeting held on 20 June 2018 and the minutes of the meeting held on 25 July 2018.

Members requested that the following change be made to minute 7 of the meeting held on the 20 June 2018.

a)    Amend line to read as follows:

-       “They expressed hope that the measures being put in place at Unity Health would enable them to turn the situation around”.

Resolved: That subject to the amendment to minute 7 (Unity Health), the minutes of the meeting of the Health Housing and Adult Social Care Policy and Scrutiny Committee held on 20 June 2018 be approved and signed by the Chair as a correct record.

Resolved: That the minutes of the last meeting of the Health, Housing and Adult Social Care Policy and Scrutiny Committee held on 25 July 2018 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. The deadline for registering is 5:00 pm on Monday, 10 September 2018.

Filming, Recording or Webcasting Meetings

Please note that, subject to available resources, this meeting will be filmed and webcast, or recorded, including any registered public speakers who have given their permission. This broadcast can be viewed at: http://www.york.gov.uk/webcasts.

Residents are welcome to photograph, film or record Councillors and Officers at all meetings open to the press and public. This includes the use of social media reporting, i.e. tweeting.  Anyone wishing to film, record or take photos at any public meeting should contact the Democracy Officer (whose contact details are at the foot of this agenda) in advance of the meeting.

The Council’s protocol on Webcasting, Filming & Recording of Meetings ensures that these practices are carried out in a manner both respectful to the conduct of the meeting and all those present.  It can be viewed at: http://www.york.gov.uk/download/downloads/id/11406/protocol_for_webcasting_filming_and_recording_of_council_meetings_20160809.pdf

There were two registrations to speak under the Council’s Public Participation Scheme, both speakers registered to speak about the Mental Health Support Line and more broadly, crisis support in York.

Jackie Harrison, a resident and service user, spoke about her positive experiences of the Mental Health Support Line and her concern at the proposed reduction of service hours. Ms Harrison explained her experiences of the alternative services and why they are not an adequate replacement for the Mental Health Support Line. It was explained to the committee that the Mental Health Support Line offers a unique and personalised service and whilst it’s hours are only being reduced, the loss of overnight support would be felt by service users.

Councillor Denise Craghill also spoke of her concern regarding the reduction in service hours of the Mental Health Support Line. Councillor Craghill reported that service users were not convinced that the alternative services suggested were capable of replacing the Mental Health Support Line and questioned the reasoning behind this proposed change. The Councillor also raised a question on sustainability of the overnight service when staff were being shared with Evelyn Crescent. The Councillor urged the Committee to investigate this issue in more depth, as any reduction in service hours for mental health and crisis support in York, must be considered carefully.

This report analyses the latest performance for 2018/19 and forecasts the financial outturn position by reference to the service plans and budgets for all of the services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.

Officers were in attendance to present the quarterly finance and performance report for Health, Housing and Adult Social Care. Members expressed their disappointment with the detail of performance indicators presented in the report. Members requested that more detail of individual performance indicators be shown in future reports. The committee requested that the Chair write to the Head of Democratic Services to request that this issue be looked at.

Following questions from Members, officers informed the committee that they would report back further on the following topics as officers present were unable to answer:

-       An update on support for the Disabled Workers Co-Operative

-       List of changes to the working arrangements of Health Checks

-       A list of steps being taken by the Council to affect numbers of adults drinking over 14 units of alcohol each week

-       Measures in place to improve DTOC figures

Members were pleased to see that the introduction of the 7 day discharge service was going well. Officers reported that cases are now being spread more evenly across the week and staff were reporting positive interaction with family members during weekend working hours.

Officers responded to questions from members regarding the re-commissioning of drug and alcohol support services and expressed confidence that the correct provider has been procured in what is a tight financial situation.

Members also discussed the freezing of employment at YorCraft, officers informed the committee that colleagues were reviewing how YorCraft supports people and how it could be developed to provide the best bespoke service for its users.

It was reported that there was a projected overspend for residential placements. Officers informed the committee that this was potentially due to a growth in the number of people with dementia or more complex cases but that the Quarter 2 report would give a better indication of the trends.

This report provides an update on actions undertaken by Unity Health to remedy the difficulties that patients are experiencing in contacting the practice.

There was one registration to speak on this item. Paula Tunbridge, Director of Campus Life and Wellbeing at the University of York spoke about the University’s concerns regarding any alternative service for students, should Unity Health not be allowed to register new patients. Ms Tunbridge explained that the bespoke student support offered by Unity Health was a crucial service, involving important pastoral and administrative factors to support breaks from study and student specific issues.

Dr Wilcox, a Partner at Unity Health, spoke about the changes that have been made to the communication and triage elements of their service since their last appearance at the committee.

-       The online triage system has ceased and the practice has moved to a phone based system.

-       More call-handlers have been employed and conversations have continued with BT to help resolve ongoing technical issues.

-       Drop in clinics organised on weekends

-       Redesigning of access model, now a doctor led point of contact with doctors and a pharmacist in the same room as the call-handlers, to help deal with issues quickly and identify more urgent cases easily.

Dr Wilcox informed the committee that the general feedback has been good and patients are reporting that it is now easier to access the service.

Dr Wilcox then informed the committee of the actions taken to rectify some of the larger concerns flagged by the CQC report:

-       Following the inspection on 23 May, where Unity Health were rated inadequate, the practice acted swiftly with help from the Clinical Commissioning Group, Local Medical Committee and the Royal College of General Practitioners.

-       More staff, including doctors and nurses have been employed

There has been open communication with the Care Quality Commission throughout this process and Unity health are confident of a more favourable follow up visit.

Members welcomed the effort that has been made by Unity Health to resolve some of the issues flagged up by the CQC report. There were still a number of outstanding concerns for members including:

-       The time that it would take to initiate ‘plan B’

-       Ongoing concerns with outstanding complaints

-       The pressure that the new student population would exert on the service and whether this would lead to the same issues re-occurring

Dr Wilcox informed the committee that all the plans were in place to receive the new intake of student patients as it always is and this year would be no different. It was also noted that all vacant call-handler positions had now been filled. It was also noted that only the two regulatory failures were being re-inspected in September and both Unity Health and the CCG were confident these had been rectified.

Dr Kevin Smith, from the Clinical Commissioning Group was also in attendance to discuss the support that he and his team had been giving to Unity Health and discuss with the committee the way in which the CCG currently monitor GP’s in the Vale of York.

Dr Wilcox finished by explaining to the committee the  ...  view the full minutes text for item 24.

To receive a report from Priory Medical Group on the progress of the Burnholme Health Centre.

Resolved: That this item be deferred as representatives from Priory Medical Group were unable to attend on this occasion.

This report provides an update on progress towards delivering the Older Persons’ Accommodation Programme, including Programme delivery, resource deployment and risk.

The Council Lead on the Older Persons’ Accommodation Programme was in attendance to present an update. It was reported that:

-       Issues with the Fordlands road site had been resolved and work has begun on the new care home.

-       Carlton Tavern would be removed from the list, but not before a discussion with the proposed developer

-       The proposed development of the Oaklands site continues to be an issue however there are plans that can be activated should the current option not be viable.

Councillors were informed that outstanding issues with the Burnholme site including landscaping and the cycle route were still being discussed and officers were confident that these issues would be resolved.

Councillors *were pleased to hear that expressed their desire for best practice, regarding co-production and information sharing with Councillors and residents, *was being to be shared with other departments in the Council.

The officer also reported on positive engagement with the York Central team on potential overlap with the Older Persons Accommodation Programme.

*As amended at the meeting on 16 October 2018

This report provides an overview of the Care Quality Commission (CQC) Local System Review Programme, highlighting the key findings and recommendations for York, the local improvement plan, and the current position on implementing the recommendations.

Following the recent review undertaken by the Care Quality Commission regarding the Local System Review, officers reported that CQC would be returning to use York as a case study for the journey of improvement, to better understand the enablers and barriers to the systems in place.

The Assistant Director of Joint Commissioning explained that she believed the review had come at a really good time as relationships had been improving amongst providers in York, however this would provide a welcome reminder of what still needs to be done.

Members also discussed the complex nature of joint funding. The officer explained some of the more common examples of joint funding such as the Better Care Fund, Improved Better Care Fund and discussed some of the more unique ways in which projects and programmes can be funded by multiple partners.

This report informs the Committee of the early work undertaken by the Task Group set up to examine commissioned substance misuse services in York and asks Members to agree the Task Group’s proposed aims and objectives.

The committee were informed that the task group established to review substance misuse services had now met on two occasions. The committee were asked to endorse the remit set by the task group.

Members expressed some concern that the remit of the task group may be too broad and that it was not clear what the task group would do with it’s findings.

Members agreed that the task group would be best to refine their remit as the review developed and as their subject knowledge increased.

Resolved: That the committee endorse the draft remit proposed by the Task Group to enable this scrutiny review to progress.

Members are asked to consider the Committee’s work plan for the current municipal year.

Members considered the committee’s work plan for the 2018-19 municipal year.

The following changes were made to the Work Plan:

-       A review of the Mental Health Support Line was added to the November meeting

-       An update report from Unity Health was added to the January meeting

-       The overview report on student health services, scheduled for November, has been moved to the January meeting

-       The update report from Priory Medical Group has been deferred until their funding arrangements have been agreed

Resolved: That the work plan be approved subject to the amendments above.