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.

At this point in the meeting, Members were invited to declare any personal, prejudicial or disclosable pecuniary interests that they might have had in the business on the agenda.

Councillor Gunnell declared a personal interest in the remit of the committee as her sister worked for City of York Council as a carer.

To approve and sign the minutes of the meeting held on 28 May 2014.

Resolved:  That the minutes of the Health Overview and Scrutiny Committee held on 28 May 2014 be signed and approved by the Chair as a correct record.

In relation to Minute Item 6 (Men’s Health Scrutiny Topic), Councillor Watson spoke to Members about the confusion that existed around access and responses to requests for Men’s Health checks, particularly prostate cancer checks, and how it was crucial that all men should be encouraged to go for health checks.

The Chief Clinical Officer of the Vale of York Clinical Commissioning Group (CCG) explained that recent research had shown that prostate screening had caused damage to the patient. He underlined that if men had symptoms of prostate cancer then a visit to the doctors was recommended. However, doctors would not recommend blood tests to men without symptoms.

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 Tuesday 1 July 2014 at 5:00 pm.

Filming, Recording or Webcasting Meetings

Please note this meeting may be filmed and webcast and that includes 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/downloads/download/3130/protocol_for_webcasting_filming_and_recording_of_council_meetings

It was reported that there had one registration to speak under the Council’s Public Participation Scheme.

John Yates commented that there appeared to be no link up between dental services offered in the city and the Vale of York Clinical Commissioning Group (VOYCCG). He asked why this was the case.

The Chief Clinical Officer of the CCG said that the CCG did not commission these services (they were commissioned by NHS England) but that they were aware of this division and were looking at carrying out dentistry work with people in care homes.

The Cabinet Member for Health and Community Engagement will be in attendance to give a verbal report on the priorities within her portfolio area.

The Cabinet Member for Health and Community Engagement attended the meeting and gave a verbal report on the priorities within her portfolio area.

She informed Members that she had grouped her priorities around the past (finding solutions to a number of long standing issues and challenges), the present (understanding and implementing the Care Act 2014) and the future (transforming and future proofing health and social care).

Past

Her priorities in this area included;

·        The legacy of the local/regional health funding landscape and other long standing challenges needed to be addressed.

·        There needed to be improved performance in areas where performance was not as high as it might be such as in delayed transfers of care, reablement and personalisation (including the uptake of personal budgets/direct payments).

·        Improving the financial performance (to rectify the recurrent overspend).

Present

Her priorities in this area included;

·        To fully understand the changes and challenges that the Care Act 2014 would bring to the legislative framework for health and adult social care in the city which included;

·        That wellbeing should be at the heart of care but with a wider scope, looking at links to poverty, housing and cultural social aspects.

·        That a statutory Safeguarding Adults Board be established.

·        Increased Carer support.

·        Online self assessment and setting up of care accounts.

·        Increased focus on early intervention, prevention, personalisation and integration.

·        Care cost caps and delayed payments.

Future

Her priorities in this area included;

·        Producing a blueprint to completely transform the delivery model and commissioning of services for health and adult social care in the city (including making £3.5 million plus savings through transformation).

·        Maximising personalisation and creating more flexible, person-centred support.

·        Elderly People’s Home re-provision programme.

·        Health and social care integration through the Better Care Fund.

Some Members asked if the Cabinet Member could submit a written report in the future to be included as part of the published agenda, and that if changes had occurred since publication that she update Members at the meeting.

Resolved:  That the verbal report be noted.

Reason:     So that Members are aware of the Cabinet Member’s priorities.

This report analyses the outturn performance for 2013/14 and presents 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 Health & Wellbeing.

Members received a report which analysed the outturn performance for 2013/14 and presented 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 Health and Wellbeing.

Questions from Members to Officers related to the following;

·        Was it a local view that the number of people receiving Direct Payments continued to be low? In addition, why was there a 3% drop from the 2012-13 performance?

·        What were the efficiency savings in services that offset pressures in Adult and Social Services budgets?

It was reported that the low numbers of recipients of Direct Payments was a national phenomenon but that some York residents did not want them. Officers suggested various reasons for the percentage drop from the previous year such as;

·        There were issues about understanding the options given.

·        There were a number of older people who said that they did want to deal with their own care, particularly those with complex needs.

·        Financial disincentives, i.e. Council provision being viewed as better as the Council can buy services in bulk.

Officers reported that the efficiency savings to some services identified in the report were around day centres.

Questions and discussion took place around the figures for delayed discharges from hospital. Officers explained to Members that there were no direct financial implications that arose from this as any costs remained in the system and were not transferred to the Council. They accepted that the performance overall had been poor but that reassuring figures had been received for April, with a slight increase in May (but lower than in the previous year).

Resolved:  That the report be noted.

Reason:     To update the Committee on the latest financial position for 2013/14.

Following a Carers’ Review completed by the Health Overview Scrutiny Committee in 2010/11 the Committee recommended that they should receive an annual update report on the Carers Strategy. This is the third annual review to be submitted.

Members received their third annual report on the Carer’s Strategy.

The Chair requested that a further update report on the strategy be considered by the Committee in a year’s time.

Resolved:  That the report be noted and a further annual report on the Carer’s Strategy be considered by the Committee in a year’s time.

Reason:     In line with the previously completed Carer’s Review, to provide the Committee with their annual update report on the Carer’s Strategy.

This report presents the Health Overview & Scrutiny Committee with updated plans for alternative premises for Bootham Park Hospital together with proposals for the relocation of child and adolescent mental health inpatient services in York and the future vision of mental health services across York.

Members received a report and verbal presentation which presented them with updated plans for interim alternative premises for Bootham Park Hospital together with proposals for the relocation of child and adolescent mental health inpatient services in York and the future vision of mental health services across York.

A number of Officers from Leeds and York Partnership NHS Foundation Trust and the Vale of York CCG attended the meeting to outline the proposals.

Lime Trees move to Mill Lodge

It was felt that the current Lime Trees Child and Adolescent Mental Health Service property was not suitable as it did not provide private or family space and was not conducive to a therapeutic approach to care. Interim but immediate changes had been made to the building following a number of inspections from the Care Quality Commission (CQC), NHS England and an independent expert. However, although safety had improved it was not felt to be a suitable experience for the service user.

It was reported that Mill Lodge had a number of advantages. These were;

·        More spacious.

·        Safer building fabric.

·        Single gender accommodation.

·        Ensuite facilities.

·        The potential to create a high dependency section and for further expansion of services on site.

Some Members expressed concerns over the cost of the move to Mill Lodge. It was reported that Leeds and York Partnership NHS Foundation Trust would invest more money into Mill Lodge and that Officers would be willing to suggest to the commissioners to make the move permanent.

Interim alternative premises for Bootham Park Hospital

It was reported that there were a number of options in regards to interim alternative facilities for the adult mental health inpatient service. These included;

·        Talks on using facilities at the Retreat.

·        To keep using the hospital building, retaining the Georgian frontage and redeveloping at the back.

Members were informed that a summit meeting had been arranged for 28 July to discuss all options.

Discussion took place on whether to combine both facilities offered by Lime Trees and Bootham Park Hospital on to one site. Some Members felt that as both units were self contained and had never been on the same site or part of a larger mental health institution that they should be looked at discretely.

The Chair asked for regular reports on the progress of the plans, including potential circumstances that could arise. She also asked for further information on consultation with the voluntary sector and how partners in health and social care would be involved.

Resolved:  (i) That the report, including the information provided in Annex 1 to the report, and the verbal presentation be noted.

                  (ii) That further regular detailed reports on the plans for Mental Health Services in the city be received by the Committee.

Reason:    To keep the Committee informed on plans for mental   health services in York.

This agenda item includes the full plan for the Vale of York Clinical Commissioning Group’s Five Year Strategy for Integrated Health Care in York.

Members received the Vale of York Clinical Commissioning Group’s (VOYCCG) Five Year Strategy for Integrated Health Care in York.

Members were informed about Care Hubs, which the CCG hoped would provide a system in which care services could be accessed from a single location. It was reported that the CCG had put forward an interest in co-commissioning of services that the Care Hubs would provide. However, no further information had been provided by the Government.

It was reported that the strategy would be used as an assurance document which the CCG would monitor itself by, it would join up parts which were currently provided separately.

Some Members raised concerns that by pooling budgets, this would lead to the danger of overspending and a postcode lottery. In response, it was noted that there would be no variation in the service of care across the CCG area.

Resolved:  That the strategy be noted.

Reason:     So that Members are kept informed of the VOYCCG Strategy.

This is the third annual report to Health Overview and Scrutiny. The report outlines the arrangements in place to ensure that City of York Council is able to discharge its responsibilities to keep vulnerable adults within the City protected from violence and abuse, whilst maintaining their independence and well-being. Members are asked to consider whether the Council can be assured that these arrangements are satisfactory and effective.

Members received an annual report which outlined the arrangements in place to ensure that the Council was able to discharge its responsibilities to keep vulnerable adults within the City protected from violence and abuse, whilst maintaining their independence and well-being.

It was reported that the next assurance report would contain changes due to the enactment of the Care Act, one of these being the production of an improvement plan.

Discussion took place on when to receive an updated report. Some Members suggested that this be considered at the February meeting.

Resolved:  That the report be noted.

Reason:     So that Members are assured of the arrangements for Adult Safeguarding within the Council.

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

Members considered the Committee’s work plan for the municipal year, along with a number of forthcoming scrutiny reviews.

Discussion took place and it was agreed that;

·        That an annual update review on the Carer’s Review be added on to the work plan for July 2015.

·        Further regular reports be included in relation to the provision of Mental Health services in the city, in particular those services currently provided at Lime Trees and Bootham Park Hospital.

·        That a further Safeguarding Adults Assurance Report be added to the Committee’s February meeting.

·        The provision of medical services for travellers and the homeless be split into two separate reports.

Resolved:  That the work plan and amendments be noted.

Reason:    To ensure that the Committee has a planned programme of work in place.