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 that they might have had in respect of business on the agenda. None were declared.

To approve and sign the minutes of the meeting of the Health and Adult Social Care Policy and Scrutiny Committee held on 30 January 2017.

Resolved: That the minutes of the Health and Adult Social Care Policy and Scrutiny Committee held on 30 January 2017 be approved and then 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 Friday 24 February 2017 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/download/downloads/id/11406/protocol_for_webcasting_filming_and_recording_of_council_meetings_20160809.pdf

It was reported that there had been three registered speakers under the Council’s Public Participation Scheme.

Sue Snelgrove from Mental Health Action York spoke in regards to Agenda Item 6 (Developing a new mental health hospital for the Vale of York) about the reduction in specialist mental health facilities in the city. She commented on how the Vale of York used to have 8 units and 121 inpatient beds for elderly people. With the redevelopment of the Peppermill Court, which specialised in treating challenging behaviours in men, she wondered where the service users who previously had used these facilities had ended up. She felt that the proposed service could not replace skilled medical care.

Two speakers spoke in regards to Agenda Item 7 (Update Report on Implementation of Recommendations from Bootham Park Hospital Scrutiny Review):

Ann Weerakcoon, also represented Mental Health Action York and informed Members of the group’s concerns over the closure of Bootham Park Hospital. The main concerns related to the movement of service users away from York, which they felt increased distress and risk, why the repairs were not carried out.They also felt that the CQC’s written response to the Committee was lacking in responsibility.

Joanne Lazenby was concerned that the closure of Bootham Park Hospital suggested that profits were being put before patients, while querying the land value of Bootham Park Hospital itself.

This report analyses the latest performance for 2016/17 and forecasts the financial outturn position by reference to the service plans and budgets for the relevant services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care and the Director of Public Health.

Members received a report which analysed the latest performance for 2016/17 and forecasted the financial outturn position by reference to the service plans and budgets for the relevant services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care and the Director of Public Health.

The Finance Manager, Adults, Children and Education and the Assistant Director Adult Social Care presented the report and were in attendance to answer Members’ questions.

Members were informed that the Care Act Reserve had been created by underspends from previous years and had been built up over four years. This money had now gone into the Adult Social Care grant. The largest spend in the Adult Social Care grant was the Assessment Care Management team.

Questions from Members to Officers related to;

·                    Why the Better Care Fund was not included in projections.

·                    The pilot to speed up Delayed Discharges

·                   Which vacancies were held prior to the public health restructure?

·                   The suitability of a zero tolerance approach to suicide as an STP approach

It was reported that the BCF was not included in the projections as budget discussions were continuing with the Clinical Commissioning Group (CCG). CCG data on schemes would be included within CYC’s data. Members expressed concern that the public would not know who was funding what scheme.

Work to speed up discharges took place with York Hospital and focused on an acute pathway. This allowed for a 32% reduction in delayed discharges. [as amended at the Health and Adult Social Care Policy and Scrutiny Committee on 29 March 2017]

However, there still remained issues in delayed transfers from mental health facilities.

The posts that had been held vacant in Public Health were an Assistant Director and a Suicide Prevention post. Work was underway to arrange a tariff cost for Out of Area treatment with Yorkshire and Humber.

The Director of Public Health commented that through the Suicide Safer City status and the Suicide Surveillance Group, relatives could be supported and lessons learnt. There was an intention to develop a Suicide Prevention Strategy for the city and this would be put on the Council’s Forward Plan.

The Chair thanked the Finance Manager, Adults, Children and Education and the Assistant Director Adult Social Care.

Resolved: That the report be received and noted.

Reason:     To update the Committee on the latest financial and performance position for 2016/17.

This report and its annexes provide the Health & Adult Social Care Policy & Scrutiny Committee with details of the Care Quality Commission’s (CQC) findings (Annex 1) following its inspection of the Yorkshire Ambulance Service NHS Trust (YAS).

Members received a report and Powerpoint Presentation which provided them with details of the Care Quality Commission’s (CQC) findings following its inspection of the Yorkshire Ambulance Service NHS Trust (YAS).

The Chair congratulated YAS on their good inspection and improvement that had been made since the last CQC inspection.

Karen Warner, Deputy Director of Quality and Nursing and Mark Inman, Locality Director, Emergency Operations were in attendance to introduce the report and answer any questions.

One Member asked what York could improve on in regards to other areas of the Yorkshire Ambulance area.

Improvement was needed in the better use of volunteers, and the opportunity to work together across the area. In addition, ongoing work with hospitals to send urgent care practitioners out to homes instead of sending patients to Accident &Emergency departments.

The Director of Public Health requested that YAS share information on falls prevention and alcohol with the Health and Wellbeing Board for further discussion. They confirmed that they would discuss this with the Scrutiny Officer, or attend themselves.

In regards to the role played by CYC in delivering and developing volunteers for YAS, it was reported that they could encourage people to become first responders or help with Patient Transport and help train, give kit or fit defibrillators.

The Chair thanked the YAS representatives for their attendance.

Resolved: (i) That the information provided in the

annexes to the report be noted.

                  (ii) That the Trust be congratulated on the work it has been undertaken to raise its rating from Requires Improvement to Good.

               (iii) That the Trust be encouraged to sustain the  improvements that have been made.    

Reason:   (i) To keep the Committee up to date with the work of  the Trust.

                (ii) To recognise the improvements made by YAS.

                         (iii) To ensure residents of York and the wider Yorkshire   region receive the best possible emergency and healthcare services.

This report provides information about the outcome from the formal public consultation into the creation of a new mental health hospital for the Vale of York.

Members received a report which included information from the formal public consultation into the creation of a new mental

health hospital for the Vale of York.

In attendance to present the report and answer Members’ questions were Ruth Hill, Director of Operations for York and Selby, Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) Martin Dale, Project Manager, (TEWV) and Elaine Wyllie, Interim Executive Director of Joint Commissioning, Vale of York Clinical Commissioning Group (CCG).

Members were informed that the new mental health hospital would also be the central point for a Section 136 assessment suite and a base for an adults crisis home liaison team.

It was reported that during the consultation for the new mental health hospital the main concern raised had been the number of beds, particularly with an ageing population, and if community services were robust enough to cope with a proposed reduction in beds.

It was noted that the CCG Governing Body would meet again in March to receive an options appraisal, and in April to receive an update on progression of the business case.

The Chair commented that in his appraisal of the report it appeared there was a favouring of using the Bootham Park Hospital site for the new Mental Health Hospital. He wondered whether the concerns raised by the public speakers in regards to the adequacy of community services following the reduction in bed numbers could be answered.

In regards to the level of current community services, the Director of Operations for York and Selby, Tees, Esk and Wear Valley NHS Foundation Trust informed Members that she was aware that crisis liaison teams were working with patients who would previously need to have been admitted into hospital. Members were informed that TEWV were considering increasing bed numbers and whether the gender mix was correct. Consideration would be given to the optimum size for more beds and more space. In response to a Member’s question, it was confirmed that no patients would be treated out of area.

In regards to the building constraints, such as flooding and land costs, TEWV confirmed that this had been discussed with planners. In addition, any solutions would need to be Disability Discrimination Act (DDA) compliant.

Members asked if the weighting criteria, with comments, for each proposed hospital site would be shared with the Committee. It was confirmed that a business case document would be made available but further details would need to be clarified before being released to Members. It was felt that the hospital should be deliverable.

The Chair thanked Ruth Hill, Martin Dale and Elaine Wyllie for their report.

Resolved: That the report be received and noted.

Reason:     So that Members are kept informed on the details of the formal public consultation into the creation of a new mental health hospital for the Vale of York.

This report provides the Health & Adult Social Care Policy & Scrutiny Committee with an update on the implementation of recommendations from the previously completed scrutiny review into the closure of Bootham Park Hospital (BPH).

Members received a report which provided them with an update on the implementation of recommendations from the previously completed scrutiny review into the closure of Bootham Park Hospital (BPH).

The Chair shared his thoughts with the Committee about the lessons that had been learnt following the scrutiny review. He felt that all organisations wanted to blame one another, and avoid responsibility.

The Scrutiny Officer informed the Committee that the action plan which had been produced by NHS England following the Lessons Learnt Review, which had been agreed by all partner organisations involved in the review, would be available to Members at the next Health and Adult Social Care Policy and Scrutiny Committee.

Discussion took place in regards to whether Members should sign off the recommendations as completed or whether they should continue to receive updates.

Some Members questioned the response to the recommendation to NHS England to name the nominated person to be responsible for sustained improvements to mental health in the city as the Accountable Officer from the Vale of York CCG.

Following further discussion it was suggested that Members might wish to request and see sight of the joint working protocol when they received the action plan.

Resolved: (i)     That the report be noted and that all recommendations from the Bootham Park Hospital Scrutiny Review that have been fully implemented be signed off as completed.

(ii)  That Members have sight of the joint working  protocol within the updated action plan.

Reason:     To complete this scrutiny review.

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

Consideration was given to the Committee’s work plan for the rest of the municipal year.

Discussion took place on the presentation of a strategic overview of mental health services in the city to Members. The Director of Public Health informed the Committee that the Health and Wellbeing Board would appoint a lead to be shared between two named people, Phil Mettam, the Vale of York CCG Accountable Officer, and Martin Farran, CYC’s Corporate Director of Health, Housing & Adult Social Care, to take responsibility for mental health needs and that they could report to Members.

Resolved: That the work plan be noted with the following amendments;

·                   That the Public Health Grant Spending Scrutiny  Review Draft Final Report be received at the March meeting.

·                   NHS England present the updated action plan following the Lessons Learnt Review into the closure of Bootham Park Hospital at the March meeting.

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