Agenda and minutes
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Declarations of Interest
At this point in the meeting, Board 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. A list of general personal interests previously declared is attached.
Board Members were invited to declare any personal, prejudicial
or disclosable pecuniary interests, other than their standing
interests, that they had in relation to the business on the
Sian Balsom, Manager, Healthwatch York, declared a personal non-prejudicial interest in agenda item 6, the Better Care Fund Update, as Healthwatch York sits within the York Centre for Voluntary Service (CVS). This interest was declared during discussion of this item.
To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on1 August 2019.
Resolved: That the minutes of the previous meeting of the Health and Wellbeing Board held on 1 August 2019 be approved and signed as a correct record.
It is at this point in the meeting that members of the public who have registered their wish to speak can do so. The deadline for registering is by 5.00 pm on Tuesday 10 September
To register please contact the Democracy Officer for the meeting, on the details at the foot of this agenda.
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
Ms Amber Graver, a Steering Group Member from ‘Our Minds, Our Future’ spoke to encourage local decision-makers to support the objectives of this campaign.
In her speech Ms Graver:
· Outlined what the campaign is.
· Explained how this campaign links in with this Board’s objectives.
· Made a request that the Board considers further action with regard to its commitment to #MyRightsMyMind Pledge.
The ‘Our Minds, Our Future campaign is totally youth-led and recognises and aims to tackle the disparity between young people’s needs and access to mental health support by taking a rights based approach, using human rights to stand up for better mental health care. The campaign demonstrates that failures within the mental health system do not only let young people down but breaches our human rights in the UK.
As a growing Campaign, it continues to highlight the need for age appropriate services, local provision, youth-participation in decision making and early identification and intervention and currently has a live Petition with almost 800 signatures. Volunteers do this for free, visiting schools, meeting with young people directly to peer educate on human rights to increasingly build young people power and influence.
Ms Graver explained that the Campaign is national and depends on local advocates and decision-makers to make a difference.
Ms Graver explained how this campaign links in with this Board’s objectives for every resident of York to enjoy the best possible mental health and wellbeing throughout their life and explained that this directly links to our human right to health, which is the number one priority for the Our Minds Our Future Campaign and one of the top three priorities identified by the residents of York. She referred to this Board’s latest annual report, having a key priority to improve services for children and young people alongside ensuring that York is a mental health friendly environment and to get better at spotting the early signs of mental ill health and to intervene earlier.
Ms Graver was grateful that the individual organisations within the Board had either signed up to or were considering signing up to #MyRightsMyMind Pledge, which was building on the rights based approach York is already taking, but also specifically to respect the rights of young people in the UK to access better support for their mental health and promise to do all in your power to address the barriers to young people accessing our right to the highest attainable standard of mental health - a commitment ratified by the UK Government.
Ms Graver considered that taking the pledge, was a great first action and wished to request that the Board consider further action, for example, could the Board release a statement expressing commitment to the rights-based approach; or agree to meet local young people to begin a more user-led process offering young people the chance to participate in decisions made around their future care needs.
Board Members expressed their wish to contact Ms Graver to discuss these point further.
The Chair, on ... view the full minutes text for item 49.
Members of the Health and Wellbeing Board (HWB) are to receive the above report for information, sharing details about the activities of Healthwatch York in 2018/19 (Annex A refers) and providing details of plans for work throughout 2019/20 (Annex B Refers).
The Board considered a report from the Manager at Healthwatch York, which shared details about the activities of Healthwatch York in 2018/19 and their work plan for the year. In particular, the Board gave consideration to the findings for the NHS Long Term Plan engagement work undertaken in March and April this year.
During discussion of this item a number of various points were raised which included:
(i) A concern that even where organisations had pledged support for the Times to Change initiative, it does not necessarily follow that employees of that organisation know about it.
(ii) The direction of care regarding mental health is that, where applicable, it is preferable for that patient to receive care within their home rather than to be moved from hospital to a permanent care situation.
(iii) In response to questions on p32 of the agenda under the heading ‘emerging issue’ regarding finding suitable care for people with “challenging behaviour” Dr Wells spoke about how lack of access to GPs is a national issue. In York patients were waiting for up to two weeks for an appointment which would impacted on this concern. NHS Vale of York Clinical Commissioning Group had recently publicised an on line service for appointments classified as non-urgent. Board Members considered there were still issues of concern regarding vulnerable patients and for those not able to access or use on line services. During this discussion, Dr Wells spoke of the need to get the patient to the right person and place in terms of their care and to get better at talking about an advanced care plan so that carers and family know what to do.
(iv) Regarding access to GP services, a Member highlighted that this was a great concern in Micklegate, where residents are frequently reporting evidence of this. It was agreed that Dr Lee would look in to this matter further and communicate directly with this Member.
(v) A Member mentioned how the “challenging behaviour” concern had been discussed previously in relation to elderly people with advanced dementia and that the Dementia Forum were considering this.
(vi) Where provision is outside of York it is not so accessible for carers who find it challenging to keep in touch. This is a particular concern for carers in York.
The Manager at Healthwatch York, thanked Board Members for the issues raised from this discussion.
Within the Healthwatch York workplan, there were references to two initiatives of importance to the city. Healthwatch York requested that the Board consider making commitments of support to these initiatives which were:
(i) being a ‘Time to Change’ organisation; and
(ii) confirming the Board’s commitment to ‘no permanent placements’ and a system that thinks Home First.
With regard to the recommendation proposed in this report at option (7a) that Board Members consider pledging their support to the ‘Time to Change’ initiative, within their organisations. Committing to supporting our collective workforces by being mental health friendly employers, using our shared learning to help other ... view the full minutes text for item 50.
Members of the Health and Wellbeing Board will receive the first annual report of York’s Mental Health Partnership covering the period May 2018 to August 2019. This will be presented by the Independent chair of the partnership.
The Independent Chair of York’s Mental Health Partnership presented the findings of the first annual report of York’s Mental Health Partnership covering the period May 2018 to August 2019. The report provided the Board oversight of the work of the Mental Health Partnership and assurance in relation to strategy delivery. It set out the progress that the partnership had made against its identified priorities and delivery against the All Age Mental Health Strategy 2018-23 and the Joint Health and Wellbeing Strategy 2017-22.
The Independent Chair of York’s Mental Health Partnership, shared a short film with the Board on the Connecting Our City Conference held at York St John (YSJ) University in April 2019. https://www.youtube.com/watch?v=pqe0OcaL1Fg
He explained that the purpose of that day had been to launch a programme of work for the next five to ten years that that would aim to transform the way that York supports mental health and wellbeing. He emphasised how this objective is everybody’s business. This conference was able to initiate the change programme, bring people together, to energise and motivate all to gain a better understanding of mental health.
Matters arising from discussion on the above included:
(i) Discussion on the Suicidal Prevention Conference held on 10 September 2019 and the transformative work this initiative were achieving through sharing and informing.
(ii) The high numbers experiencing mental health issues in York which are not in line with the rest of the UK and the need to understand this better.
(iii) North Yorkshire Police representative spoke about the significant demands on the Police service as a result of mental health concerns and how Police Officers experience mental health concerns in relation to the nature of their work. He considered this work to be of great benefit and expressed his endorsement and support. The chair of the Mental Health Partnership responded that there was a need for early intervention particularly around low level crimes or cannabis use and that he would welcome a response to this challenge.
(iv) In relation to the above point a Council Member considered that there had been a lot of work and initiatives undertaken in relation to this area but that, unfortunately, a lot of that had fallen by the wayside due to lack of funding, however, they were put in place in the first place because a need had been identified and because they worked.
(v) Board Members discussed how services that improve mental health are not always ‘mental health’ services, a point which had been made in the film. Board Members considered that it is often the arts and community services such as the work at Tang Hall SMART Community Interest Company and at York Saint John University which contribute so much to the wellbeing of those with mental health concerns and their families. Board Members discussed the need to link and sign post patients to these services so that they continue to provide benefit.
In response to a question regarding the preventative agenda for under four year olds, ... view the full minutes text for item 51.
Members of the Health and Wellbeing Board will receive the Report of the Corporate Director of Health, Housing and Adult Social Care and Accountable Officer of Vale of York Clinical Commissioning Group (CCG). This report is intended to inform the Health and Wellbeing Board of the Better Care Fund (BCF) Planning Requirements 2019-20 and to provide the annual overview of the York BCF 2018-19.
Board Members received the report of the Corporate Director of Health, Housing and Adult Social Care and Accountable Officer of Vale of York Clinical Commissioning Group (CCG) which informed Board Members of the Better Care Fund (BCF) Planning Requirements 2019-20 and an annual overview of the York BCF 2018-19.
The Ways to Wellbeing Project Manager explained that they were a small team with three part time staff members. Their aim was to reduce the number of people accessing GP services for the wrong reason. They provide a bespoke service to find a social solution that fits with the individual, in line with their wishes. She shared a case study with the Board, which provided an example of this. This discussion led Board Members to discuss the benefits of social prescribing in improving wellbeing and the benefits of helping support people to function well within their own homes.
(i) That the Health and Wellbeing Board received the annual report about the Better Care Fund (BCF) and considered the timetable for the planning assurance process.
(ii) That the Health and Wellbeing Board agreed to delegate responsibility for signing off the BCF Plan 2019-20 to the chair and vice-chair of the Health and Wellbeing Board supported by the Corporate Director of Health, Housing and Adult Social Care and the CCG Accountable Officer.
Board Members received the report of the Head of Adults Commissioning, City of York Council on the York Carers Strategy 2019 – 2024. Key Members of the Carers Centre were in attendance at the meeting to answer questions.
Board Members received further information on how the Carers Strategy encompassed all of the key messages about what matters most to carers. This strategy would now help to shape and develop the specific ‘carers offer’, as well as enable the delivery of the other strategies identified within the strategy and was intended to build on recent developments such as the City of York Council’s commitment to championing the new national Employer’s for Carers scheme, which the adults commissioning team were actively leading on in terms of roll-out across the city.
The key points from consideration of this item included the following:
(i) The Carers group is not officer or councillor led.
(ii) There is a significant increase in the number of carers in York and at the same time a significant depletion in adult services.
(iii) During the course of their work colleagues had visited a number of various groups of carers such as: substance abuse carers or dementia carers.
(iv) Board Members discussed various groups of carers and the need for carers to be able to access respite in an emergency.
(v) In response to questions around how to make the needs of carers embedded in the work that the various organisations within the Board, the Lead Officer for this report explained that the CCG had supported extensive training at West Offices.
(i) That the Health and Wellbeing Board (HWB) approved the York Carers Strategy 2019 – 2024 on behalf of all HWB partner organisations.
(ii) That an annual update report be presented to the Health and Wellbeing Board.
Members of the Health and Wellbeing Board will receive a short presentation from Dr Andrew Lee and Dr Nigel Wells on the Primary Care Home and Networks.
The Executive Director, Primary Care and Population Health, NHS Vale of York Clinical Commissioning Group gave a presentation which introduced the emerging primary care networks and how this national development could integrate into the community place based delivery models in the city of York (the presentation is attached to the agenda).
The presentation included further information on the following: the Vale of York (VOY) General Practices and numbers of patients, challenges facing primary care, primary care networks generally and in York and their role and the five-year framework for GP Contract Reform.
A Board Member noted that the role of Primary Care networks was to deliver care close to homebased on natural geographies, population distribution and need rather than organisational boundaries and considered that York networks did not reflect that aim. The Acomb ward for example, does not have any GPs. The Executive Director, Primary Care and Population Health agreed to follow up this concern and to respond to that Member directly.
Resolved: That a further report be presented to the Health
and Wellbeing Board detailing the development of Primary Care Networks.
Members of the Health and Wellbeing Board are to receive the report of the Humber, Coast and Vale Health and Care Partnership Director which provides a briefing about the development of the Partnership’s Long Term Plan. The briefing is at Annex A to this report.
Chris O’Neill, Partnership Director and Linsay Cunningham, Strategic Lead for Engagement and Communications will be in attendance at the meeting to present the report.
The Partnership Director and the Strategic Lead for Engagement and Communications presented the above report. They explained that an extensive programme of engagement with stakeholders had been undertaken to enable a range of voices and perspectives to inform the plan and the priorities identified within it.
The Chair thanked them for attending this meeting and suggested that either a workshop be held to enable the Health and Wellbeing Board Members to give their views on the developing plan prior to submission or to invite them to come back to the Board in approximately 6 months’ time for further discussion on how their ambitions and priorities fit with the Boards own strategic vision and priorities. The Health and Wellbeing Board agreed that further discussion take place at a workshop prior to submission of the Long Term Plan.
Resolved: That the Health and Wellbeing Board:
(i) Considered the report on the Humber, Coast and Vale Partnership Long Term Plan.
(ii)Endorsed the ambitions and priorities contained within the briefing at Annex A for inclusion within the submission to NHS England.
(iii) Invited the Partnership Director and Linsay Cunningham, Strategic Lead for Engagement and Communications to a workshop to discuss the plan further and to consider howtheir ambitions and priorities fit with the Boards own strategic vision and priorities.