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 invited to declare at this point in the meeting any personal interests, not included on the Register of Interests, or any prejudicial interests or disclosable pecuniary interests that they might have in the business on the agenda. Councillor Cannon declared that she was a member of the Health and Wellbeing Board.

To approve and sign the minutes of the meeting held on 19 April 2017.

Resolved:  That the minutes of the Health and Adult Social Care Policy and Scrutiny Committee held on 19 April be approved and signed by the Chair as a correct record.

At this point in the meeting members of the public who have registered to speak can do so. The deadline for registering is 5.00pm on Tuesday 30 May 2017. Members of the public can speak on agenda items or matters within the remit of the Committee. To register to speak please contact the Democracy Officer responsible for the meeting, on the details at the foot of the agenda.

Filming, Recording or Webcasting Meetings

Please note this meeting may be filmed and webcast, or recorded, and that includes any registered public speakers, who have given their permission. This broadcast can be viewed at: http://www.york.gov.uk/webcasts or, if recorded, this will be uploaded to the Council’s website following the meeting.

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 (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 no registered speakers under the Council’s Public Participation Scheme.

This presentation details how York Teaching Hospital NHS Foundation Trust handled pressures on the service during the winter months 2016/17.

Members received a presentation outlining the hospital’s performance during the Winter period 2016/17. Mandy McGale, Deputy Chief Operating Officer of York Teaching Hospital NHS Foundation Trust, was in attendance to deliver the presentation and answer Member questions.

In response to detailed questions from Members she stated:

·        York Accident and Emergency Department (A&E) had been extended at the front door to allow for 24/7 ambulance handover and assessment. There had been an increase in staffing to support this and this had led to a significant improvement in ambulance waiting times. Now this was fully established it was expected this would lead to further improvements over the coming winter.

·        There was rarely a need to move ambulances from York to the East Coast.

·        There was ongoing work with Yorkshire Ambulance Service. A Clinical Team Leader from YAS had been seconded to A&E in order to support staff. There were also regular welfare checks on YAS staff by the hospital.

·        There was now a nurse at the front door of A&E to assess whether patients were accessing appropriate care. Managing expectations was difficult as this was the only department in the NHS where patients could self-refer. There were cases where people were using this system to ‘side-step’ primary care services.

·        There was reduced access over the last winter period, which may be due to patients recognising a system in difficulty. However, patients who did access the system were more unwell and needed longer stays in hospital.

·        There was a definite need to be more creative with care packages and to move away from acute hospital care.

·        Communicating the plan to staff had been an issue, as highlighted in the Staff Survey. Ways of improving this communication, and ensuring clarity and consistency, were being considered moving forward.

·        Most areas in this region had faced similar pressures. York were part of a national project with access to ‘best practice’. However, one size did not fit all and the plan in York was based on tried and tested best evidence practice.

·        In terms of norovirus and other infections, several measures had been implemented, including chemical cleaning of wards in York (this was not possible in Scarborough as there were no empty wards), additional staff training, altering ward configurations and revising the infection control policy.

Resolved: That the report be noted.

Reason:     To keep Members updated on the pressure faced by York Teaching Hospital NHS Foundation Trust during the winter months in 2016/17.

This report sets out the performance of Healthwatch over the past six months.

Members considered a report outlining Healthwatch York’s performance over the past six months. Sian Balsom, Healthwatch Manager, was in attendance to present the report and answer Member questions. It was noted that, at the Committee’s request, the report now featured an impact assessment.

Members queried the decision of the Vale of York Clinical Commissioning Group (CCG) to ask Healthwatch York (HWY) to step off their governing body and asked whether this was a permanent change. The HWY Manager clarified that the decision was permanent as it was felt by the CCG that better ways to increase public engagement should be considered.

In response to questions regarding ‘co-production’ HWY explained that a draft co-production strategy was available and that this was a discussion document with suggestions for improvement welcome. With respect to Archways there would be no further changes without a co-production approach.

Some Members highlighted that service users had raised issues around communication and access to information, particularly a lack of hard copies of publications and no access to on-site terminals or wifi at the hospital. HWY clarified that they were always considering ways to address this and their most recent publication was a guide to dementia services. They used ‘readability’ volunteers to ensure that simple information was available and endeavoured to make sure that everyone could access support if necessary.

At this point, it was noted that the HWY’s Customer Relationship Management System (CRM) had only just been implemented and there was a possibility that some issues recorded in the report could have been duplicated (split into two separate categories).

Finally, in response to a query about the Pain Management Support Group, HWY stated that the group had been approached and offered the use of a draft survey they had produced. However, the support group had chosen to go in another direction. It was suggested that individuals could approach HWY for access to the survey at any time.

Resolved: That the report be received and noted.

Reason:     To update Members on the performance of Healthwatch over the past six months.

City of York Council requested that the Yorkshire and Humber Association of Directors of Adult Social Services (ADASS) undertake an Adult Safeguarding Peer Challenge at the Council, and with partners, which took place in January 2017. This report contains details of the review and the CYC Safeguarding Adults Peer Review Action Plan.

Members considered a report containing details of the Adult Safeguarding Peer Challenge which took place in January 2017 and the CYC Safeguarding Adults Peer Review Action Plan. The Assistant Director – Adults and Social Care was in attendance to present the report and answer Member questions.       

In answer to Member questions on scrutiny processes in light of the broader remit of the committee going forward, the Assistant Director confirmed that a disciplined approach to future meetings should be adopted. Officers could offer more in terms of member briefings, there needs to be clarity between officer/Member roles and the Committee could consider co-opting people with specific expertise. Looking ahead was of even greater importance to ensure room was given to larger items and there was a suggestion that Members could raise questions ‘offline’ for some reports. This could be combined with a greater focus on use of Task groups.

Some Members queried the sustainability of Adult Social Care in its current form. The Assistant Director stated that there was recognition of this lack of sustainability and that much of the ‘Future Focus’ work being undertaken was looking at enabling independence and allowing people to stay in their homes for longer. He also explained that providing staff members with Mental Capacity Act training could improve access to advocacy, particularly for residents with no alternative means of voicing concerns.

Resolved:  That Members note the report and request updates on actions taken particularly in relation to the ‘Future Focus’ programme.

Reason:     To provide further scrutiny to support CYC and partners in improving outcomes for people with care and support needs and developing the sustainability of the health and social care system.

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

Consideration was given to the Committee’s draft work plan for 2017/18.

Members queried the reasons for withdrawing North Yorkshire Fire & Rescue Service updates from the agenda. It was clarified that these would be circulated as written reports and that Members would still have chance to ask questions and invite NYF&RS to attend if it was felt appropriate.

Some Members highlighted that agendas for this committee were already fairly heavy and that there was a need to be mindful of this moving forward, in light of the committees additional remit.

Members suggested adding the following items to the work plan:

·        Future Focus work

·        monitoring progress on Health & Wellbeing Strategy

·        reviewing public health budget expenditure

The Scrutiny Officer reminded Members of the need to follow the procedures set out in the constitution when proposing items of Urgent Business. He also suggested that further discussion of the Draft Work Plan take place at the next meeting of the committee due to purdah.

Resolved:  That the work plan be approved, with consideration of the points above.

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