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 is attached.

Members were invited to declare at this point in the meeting any personal, prejudicial or disclosable pecuniary interests, other than those listed on the standing declarations attached to the agenda, that they might have had.

Councillor Doughty declared his standing personal interest that his partner worked for York and District Mind.

Councillor Hodgson declared his standing personal interest that he had previously worked at York Hospital. He also declared a further personal interest in the remit of the Committee as a member of UNISON.

Councillor Jeffries also declared a personal interest in the general remit of the Committee as the Co-Chair of York Independent Living Network.

Councillor Riches declared personal interests in the general remit of the Committee as the Council appointee on the governing body of York Hospital and a member of UNITE.

Councillor Richardson also declared personal interests in the general remit of the Committee as a frequent user of York Ambulance Service and as a member of Haxby Medical Centre. He also declared that his niece worked as a staff district nurse for NHS North Yorkshire and York. He requested that these interests be added as standing interests.

No other interests were declared.

To approve and sign the minutes of the meeting held on 26 June 2012.

RESOLVED:       That the minutes of the meeting of the Health Overview and Scrutiny Committee held on 26 June 2012 be approved and signed by the Chair as a correct record subject to the following amendment;

·        Minute Item 3 (Public Participation) “Both the Health and Wellbeing Board and Health Watch would be integral in sharing information about this process”.

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 Friday 20 July 2012 at 5:00 pm.

It was reported that there had been three registrations to speak under the Council’s Public Participation Scheme.

David Smith from York District Mind spoke regarding Agenda Item 7 (Presentation on the Health and Wellbeing Strategy) about the proposed membership and structure of the York Health and Wellbeing Board. He expressed concerns on the process used for establishing the Health and Wellbeing Board’s strategy groups, and felt that voluntary sector groups in mental health had not been consulted properly.

Jackie Chapman from York LINks spoke about the introduction of a passport for those with neurological conditions. She informed the Committee of how the passport would be kept within the patient’s medical notes, and it could be transferred to travel with the patient wherever they were treated. A copy of the passport was circulated at the meeting and was attached to the agenda post-meeting.

John Yates from York Older People’s Assembly spoke regarding Agenda Item 9 (Work Plan 2012-13 and Briefing Notes on Scrutiny Topics Proposed at the Scrutiny Work Planning Event).

In relation to Community Mental Health Services in Care of Adolescents (particularly boys) he stated that although the briefing note referenced harm to and from young people, it did not mention self harm. He added that some young people with mental health problems had a tendency to self harm, and felt that this should be explored particularly given York’s large student population. Finally he sought clarification on whether those who self harmed were referred to Mental Health Services from the Hospital and Ambulance Service.

He also spoke about the Access to Talking Therapies briefing note and felt that the significance of good mental health to wellbeing was often underestimated or not understood by the general public. He urged the Committee to investigate this topic further.

The Cabinet Member for Health, Housing and Adult Social Services will be in attendance at the meeting to present an annual report.

 The Cabinet Member for Health, Housing & Adult Social Services, attended the meeting and presented her annual report to the Committee.

Questions from Members to the Cabinet Member focused on the following issues;

·        The Council’s Day Services for those with Learning Disabilities, in particular the move towards personal budgets and representation on the Project Board which would review the Council’s day services.

·        The new criteria and approaches to funding community care services through Fair Access to Care Services (FACS) framework.

·        Living accommodation for York residents with Learning Disabilities.

In relation to Learning Disability representation on the Project Board for the review of Council’s Day Services, it was reported that although the Board’s membership included Care Managers, that service users did not sit on the Board but that there was an option to have this in the future. The Chair asked for the Cabinet Member to supply further information on service user representation on the Project Board to Members of the Committee.

Discussion on the funding of FACS took place, and Members asked if an appeals process would be put in place for those whose needs had been assessed at a lower level than before. Some Members pointed out that recently a large number of residents had been assessed wrongly and that serious concerns and confusion over the new system had been expressed by those who used the funding to pay for their care needs.

The Cabinet Member admitted that an administrative error had taken place which had led to the production of incorrect assessment letters. However, the Cabinet Member stated that lower levels of funding for social care services meant that there was not enough money to maintain funding for all of those residents who had previously been eligible for support.

In relation to accommodation for those with Learning Disabilities the Cabinet Member reported that 48% of residents with Learning Disabilities in York were not living within families but were either living in Council Housing or Social Housing schemes. Members asked for figures on how many of these people had made that choice personally, or whether it was determined by their carers.

The Cabinet Member informed the Committee about how she felt that social care services in the city should move towards a more preventative model, to ensure that residents within the system did not have to be reliant on care.

The Chair of the Committee thanked the Cabinet Member for her attendance at the meeting.

This report updates Members on the progression from LINks (Local Involvement Networks) to Local HealthWatch by April 2013.

Members received a report which updated them on the progression from LINks (Local Involvement Networks) to Local HealthWatch by April 2013.

Members asked Officers questions about the following;

·        Lay representation in the procurement process

·        The cost of the ‘signposting’ element of PCT Patient Advice and Liaison Services (PALS) teams

·        Government guidance in relation to the structure of Local Health Watch

It was reported that a Job Description had been produced in order to recruit a lay member to be involved in the HealthWatch procurement process. In relation to costs of the signposting element of PALS, Members were told that a very small percentage of the current PALS budget was used for this function.

It was underlined that funding for HealthWatch would not be ringfenced, and that officers felt that government guidance in relation to the day to day running of HealthWatch would not be highly prescriptive.

RESOLVED:       That the report be noted.

REASON:           To oversee the transition from LINks to HealthWatch is identified as a priority in the Health Overview and Scrutiny Work Plan.

This report analyses the outturn performance for 2011/12 and the financial outturn position by reference to the service plan and budgets for all of the relevant services falling under the responsibility of the Director of Adults, Children & Education.

Members received a report which analysed the outturn performance for 2011/12 and the financial outturn position by reference to the service plan and budgets for all of the relevant services falling under the responsibility of the Director of Adults, Children & Education.

In relation to the report, Members raised the following concerns;

·        That unobtainable targets should not be placed on timeliness of social care assessments.

·        That users of Mental Health Services who were receiving Self Directed Support were not being included in the performance analysis figures.

Officers informed Members that the method of social care assessments had been changed, in that longer assessments were being conducted, as it was felt that a snapshot of a person’s needs could not be obtained over a week.

In response to a question from a member of the public, they added that they recognised that issues of non availability of Mental Health Services had arisen, but that they were not aware of instances where there had not been sufficient funding for it.

RESOLVED:       That the report be noted.

REASON:           To update the Committee on the latest financial and performance position for 2011/12.

The Director of Communities and Neighbourhoods will be in attendance at the meeting to give a presentation on the Health and Wellbeing Strategy.

Members received a presentation from the Director of Communities and Neighbourhoods about the Health and Wellbeing Strategy.

The Committee were informed about a number of updates to the presentation including;

·        That a new Director of Public Health had been appointed, Paul Edmondson-Jones, who would join the Council in August.

·        That an officer had been seconded into a team to look at cases that had arisen from the Marmot Review.

·        That the Association for Public Service Excellence (APSE) had commissioned the Council to conduct a study into how to get people involved in Public Health.

It was hoped that the APSE work would look at issues of health inequalities in the city, and would help to facilitate debate on issues of Public Health across York.

Members underlined that it was crucial to have relevant people involved on the Shadow Health and Wellbeing Board, rather than identifying which groups should be represented.

Some Members questioned why some groups had not been consulted in getting involved on the Board. It was commented that half of those involved in the Shadow Health and Wellbeing Board at their last meeting in July were from the Council. Officers admitted that a greater balance needed to be made, and felt that a representative from Local HealthWatch should be involved in the Board.

A comment that sub groups of the Shadow Health and Wellbeing Board should be properly resourced, was made. This would mean the sub groups would have be able to have their own terms of reference and secretariat, which would ensure that their views and work was examined by the Board.

Members were informed that it was hoped that the Draft Health and Wellbeing Strategy would be completed by November, and then signed off in December. It was noted that community consultation on the strategy would take place in September.

For reference, a copy of the presentation was attached to the agenda post-meeting.

RESOLVED:       That the report be noted.

REASON:           To update the Health Overview and Scrutiny Committee on developments in the production of York’s Health and Wellbeing Strategy.

The Chair will give a verbal update on recent developments in relation to Children’s Cardiac Surgery, including the emergency motion to Council on 12 July 2012. On the 4^th July 2012 the Joint Committee of Primary Care Trusts (JCPCT) met in London to make a decision on which centres would provide Children’s Cardiac surgery in the future.

In addition to this the Committee are asked to agree to the continuing appointment of the Chair (with Vice-Chair acting as substitute) to the Joint Health Overview and Scrutiny Committee considering this matter. This Committee is supported by Leeds City Council and contains a representative from all Local Authorities across the Yorkshire and Humber region.

The Chair gave a verbal update to the Committee on recent developments that had taken place in relation to children’s cardiac surgery and informed the Committee of the decision of the Joint Committee of Primary Care Trusts (JCPCT) in relation to which centres would continue to provide cardiac surgery in the future.

It was reported that the decision of the JCPCT was to close a centre in Leeds, and to move children’s cardiac surgery provision to a centre in Newcastle.

It was also reported that the Joint Health Overview and Scrutiny Committee, which was composed of representatives from all Local Authorities across the Yorkshire and Humber area, would examine the decision and the implications of this. The Chair informed the Committee that the Joint Health OSC was due to meet to discuss the implications of the decisions. She informed Members that she would keep Members up to date with progress.

Members were asked to agree to the continuing appointment of the Chair (with the Vice Chair acting as substitute) to the Joint Health Overview and Scrutiny Committee.

The Scrutiny Officer informed the Committee that she would bring a written progress report on the work of the Joint Health Overview and Scrutiny Committee to the October  meeting, this would also include information on a forthcoming consultation on adult cardiology services and the likely continuation of the Joint Committee to respond to this.

RESOLVED:       (i)      That the verbal update be noted.

(ii)      That the continuing appointment of the Chair (with Vice-Chair acting as Substitute)  to the Regional Joint Health Overview and Scrutiny Committee be agreed.

(iii)     That a future report on the work of the Joint Health Overview and Scrutiny Committee regarding Children’s Cardiac Surgery be brought to the October meeting of this Committee (to also include information on a national consultation about adult cardiology services).

REASON:                     In order to keep the Committee informed of circumstances and current issues surrounding the provision of children’s cardiac surgery.    

Members are asked to consider the Committee’s updated work plan for the municipal year 2012/13. As part of this agenda item they are also asked to consider a number of briefing notes in relation to proposed scrutiny topics and to make a decision as to which, if any, of these topics they would like to progress to review during this municipal year. Officers and key health partners will be in attendance at the meeting to answer any questions that Members might have.

Members considered a report which outlined the Committee’s work plan for 2012-13 and a set of briefing notes on scrutiny topics that were proposed at the Scrutiny Work Planning Event which was held on 2 May 2012.

Proposed briefing notes were considered which looked at the following areas;

·        Personalisation

·        Community Mental Health Services in Care of Adolescents (particularly boys)

·        Access to talking therapies

·        Mental Health Day Services for Older People

In relation to the Briefing Note on Personalisation, Some Members felt that a review needed to be conducted because they felt that the process for accessing Council services was too prescriptive, and that the process needed to reflect the experiences of service users.

Members decided that work on a review should be undertaken by a Task Group made up of Councillors Jeffries, Cuthbertson and a nominee from the Conservative group. It was suggested that due to a full work plan, that scoping work to identify a focus for the review could take place later this year with the actual review commencing early in 2013 (or earlier if the ongoing End of Life Care Review has been completed).

Regarding the topic on Community Mental Health Services in Care of Adolescents, some Members felt that a review should focus on the issue of self harm. It was agreed that some initial scoping work should take place to establish the best focus for a fairly short scrutiny review that would be likely to commence in the New Year. The Scrutiny Officer agreed to e-mail the Committee for volunteers to sit on a Task Group to undertake both the scoping work and the review.

In response to the Briefing Note on Access to Talking Therapies, Members questioned whether service users and service user groups would be involved in future work on reducing waiting times. A representative from Leeds and York Partnership NHS Foundation Trust confirmed that service user groups would be involved in future work, as their expertise would be welcomed.

A representative from York Mental Health Forum stated that as funding for Improving Access to Psychological Therapy Services (IAPT) still remained low and demand continued to be high, that an  item on IAPT be added to the Committee’s work plan. Members agreed that a regular report be presented on issues around IAPT, but suggested that it be scheduled in at a later date due to the heavy workload for the Committee. Members decided not to progress this topic to review but agreed to exercise their overview role and have regular update reports in relation to this.

A representative from Age UK spoke regarding the proposed topic on Mental Health Day Services for Older People. She felt that it was crucial for the topic to be examined by the Committee due to continuing cuts and an increased demand for the services offered by them. She also felt that the topic was particularly relevant for future generations. On consideration of this topic Members decided not to progress it to review at the moment due to  ...  view the full minutes text for item 18.