Agenda and minutes

At this point in the meeting, Members and co-opted members are asked to declare any disclosable pecuniary interest, or other registerable interest, they might have in respect of business on this agenda, if they have not already done so in advance on the Register of Interests. The disclosure must include the nature of the interest.

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

[Please see attached sheet for further guidance for Members].

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

agenda. None were declared.

At this point in the meeting members of the public who have registered to speak can do so. Members of the public may speak on agenda items or on matters within the remit of the committee.

Please note that our registration deadlines have changed to 2 working days before the meeting. The deadline for registering at this meeting has been extended at the discretion of the Chair and will now be at 5.00pm on Tuesday, 19 September 2023.

 To register to speak please visit www.york.gov.uk/AttendCouncilMeetings to fill out an online registration form. If you have any questions about the registration form or the meeting please contact the Democracy Officer for the meeting whose details can be found at the foot of the agenda.

Webcasting of Public Meetings

Please note that, subject to available resources, this public meeting will be webcast including any registered public speakers who have given their permission. The public meeting can be viewed on demand at www.york.gov.uk/webcasts.

During coronavirus, we've made some changes to how we're running council meetings. See our coronavirus updates (www.york.gov.uk/COVIDDemocracy) for more information on meetings and decisions.

It was reported that there were five registrations to speak under the Council’s Public Participation Scheme.

ManarMutisiak spoke on the Healthwatch York report representing Living Autism’s Autistic and Neurodivergent clients in York and North Yorkshire. Manar commented on York’s All Age Autism Strategy 2017-21 and how there was no current strategy in place since the last one ended in 2021. She expressed that waiting lists for diagnoses were growing and that new criteria for referral on the Pilot Pathway would mean fewer people would be helped with a referral for diagnosis.

Helen Jones spoke on the Healthwatch York report as the Chair of Yorkshire Disability Rights Forum (YDRF). She mentioned that YDRF has worked with people and autism and ADHD since the Healthwatch Pilot began. Helen noted that issues that were raised onrisk, consultation, or data protection have not affected the pilot. Helen also commented on the ability to scrutinise the Humber & North Yorkshire Integrated Care Board (ICB) and questioned how people could hold the ICB to account.

Hazel Kerrison spoke on the Healthwatch York report. She commented on the new criteria for referral in the Pilot Pathway and stated that only people with a crisis plan in place would count as a person at risk, but lots of people did not have a crisis plan and would be left without a referral under these criteria. Hazel also commented on misdiagnosis and stated how many people have received incorrect diagnoses which caused even more harm for the individuals.

Gemma Barstow spoke on the Healthwatch York report. She spoke about students and stated that 2.4% of the student population have Autism, and that autistic students were ten times more likely to drop-out of their studies than students without autism. Gemma mentioned that the Government provided funding through a disabled students allowance to remove barriers to education, but to access this funding students must have had a diagnosis, meaning people who were on waiting lists and who did not fit under the new criteria would not be eligible. Gemma noted that this funding allowed people to be put on waiting lists, but that this was not available in York.

The Chair read out a statement from Catherine Owens. The statement urged the board to consider their responsibility for system redesign, and stated how the simplification of points of access and care pathways were key priorities, but the report showed the redesigned pathway had become more complex, and less accessible. Catherine’s statement stated how important it was for people to be communicated in a way they understand. It was stated that In England, 43% of adults did not have the literacy skills to routinely understand health information, which rose to 61% for numeracy.

This paper is designed to summarise key issues and progress which has happened in between meetings of the Health and Wellbeing Board, giving board members a concise update on a broad range of relevant topics which would otherwise entail separate papers.

The Chair presented the report. The Chair confirmed that the City of York Council four-year Council Plan was approved at the Executive Committee meeting on 14 September 2023.

The board discussed the recommendations in Annexe A of the report.

The Managing Director of Tees, Esk, and Wear Valleys NHS Foundation Trust informed the board that the crisis line service had updated, and that they were working with those in the voluntary sector to deliver this service, this meant that response statistics were increasing. Voluntary sector workers would deliver the initial phone call assessment before transferring the call onto a trained professional if needed.

In response to questions from the board, the Managing Director stated that their volunteers had the support of qualified clinicians, and that volunteers were trained before they answered any calls, with access to qualified clinicians at all times.

Resolved:

i.                The board was minded to collectively recommit to the council motion to recognise a social model of disability.

ii.               The board was minded to embed a compassionate culture towards all people experiencing mental ill health.

Reason: So that the board was updated on a broad

range of relevant topics which would otherwise entail separate papers.

A presentation on the implementation of the Dementia strategy.

The Corporate Director Adult Social Care and Integration presented the report and provided a summary of the Dementia Strategy. It was noted that the dementia strategy was brought in 12 months ago to support people and families with dementia.

The Community Liaison for Dementia Forward stated that Dementia Forward had held the Commissioning Service for dementia support across the whole of North Yorkshire for the past few years, and that the commissioning service was commissioned for ten years.

The Community Liaison stated that it could be a difficult and long process for people awaiting dementia support, and that there was a Dementia Forward helpline for people to call and speak to a member of staff to help. A support advisor was allocated to all those who did not want to be referred to their services. Support advisors would work with the individual and families all through the process, and would be based within the area the person lives in.

The Corporate Director Adult Social Care and Integration noted that City of York Council and the ICB were looking at how they could commission jointly and were looking at how they could support people to get a working diagnosis sooner.

In response to questions from the board, it was noted that:

·                 Dementia Hubs being set up in York and North Yorkshire were well attended and many hubs had waiting lists. Dementia Forward worked to make sure activities were appropriate for all attendees.

·                 Diagnosis for Early-Onset Dementia was improving, and in many rural areas without adequate services communities were important in helping and setting up community dementia services.

·                 The delivery plan was being updated to include support for carers.

·                 Dementia Forward were finding more and more diagnosed and un-diagnosed people were attending their education sessions.

Resolved: That the board received the update on the implementation of the dementia strategy.

Reason: So that the board were kept up to date on the implementation of the dementia strategy.

This report provides an update to the Health and Wellbeing Board regarding the work of the York Health and Care Partnership, progress to date, and next steps.

The Place Director of NHS Humber & North Yorkshire Health and Care Partnership (YHCP) presented the report to the board.

The Place Director listed the Place board’s six focus areas as: Integrated community offers, integrated urgent care, primary and secondary care interface, children and young people, integrated prevention offers, and broader social and economic development.

The Place Director then spoke about the YHCP Winter Plan, highlighting that their focus was ensuring resilience in the NHS. She then mentioned that technology could support the care that could be given at a consultant level, and how this helped offer support to people in their own home. It was also mentioned that the winter plan included responding to surges in acute respiratory illness.

The Consultant in Public Health highlighted how over the past few years since COVID-19 people have been vaccinated more than ever, and that there could now be an issue with vaccination fatigue within the population. He indicated it was important to ensure winter resilience and that the importance of winter vaccinations should be emphasised.

Councillor Webb raised the issue that people should be encouraged not to treat flu and illnesses like a common cold, and live and work through them as normal, Councillor Webb stated that instead people should be more cautious with these illnesses through the winter.

Councillor Runciman commented that Health and Care infrastructure was important and that many areas of the city did not have adequate infrastructure. Councillor Runciman noted that this should be looked into, as well as what would be needed in the future.

In response to questions from the board, The Place Director confirmed that:

·                 All organisational partners were asked to circulate details of the Joint Workforce Recruitment Event to their young people; and there was promotional material online via social media.

·                 YHCP were using the Local Development Plan and were working on highlighting where services were stretched.

Resolved: The Board noted the report of the YHCP.

Reason: To ensure the Board were up to date with the work of the YHCP, their progress to date, and next steps.

This paper is intended to present to the Board the current data on inequalities in life expectancy and healthy life expectancy in York.

The Consultant in Public Health presented the report, explaining the gaps between Life Expectancy and Healthy Life Expectancy between different groups, noted the increasing need to reverse this trend.

The Consultant in Public Health issued a correction to the report. The correction stated that on page 53 of the report, the table should read “Older people in poverty (IDAOP), 4.0% (Heworth Without), not (Heworth) as published.

The Chair and Councillor Webb commented on the pressures effecting people’s health, and the need to target support at the most vulnerable and those who need it. Councillor Webb highlighted how many behaviours were influenced by living conditions, and that there needed to be a focus on destressing people’s environments.

Resolved:

·                 That the board noted and commented on the current data on inequalities in life expectancy and healthy life expectancy in York.

·                 That the board discussed where and how the inequalities arise, and ‘where to look’ for solutions.

Reason: So that the board are kept up to date on health inequality data in York.

This report shares local experiences of adults seeking an Autism and/or ADHD diagnosis in adulthood during the piloting of a new pathway.

The Healthwatch York Manager presented the report.

The Healthwatch York Manager noted that the Health and Care system worked better for people when it was designed with them, and that the report found that there was a failure to do this in York. It was commented that without change in the care system, there was potential for waiting lists to grow exponentially. The Healthwatch York Manager also stated that their vision as a health and care system was early intervention and prevention.

The Place Director for NHS Humber & North Yorkshire Health and Care Partnership noted that communication surrounding the Pathway for Autism and ADHD could have been better, and that lesson would be learned from this. She then commented that the Pathway was a pilot, and it was brought about due to growing demand on services. It was noted that amendments had already been made, and the criteria had been expanded.

In response to questions from the board, it was confirmed that:

·                 The Healthwatch York Manager would provide an update at a future meeting regarding feedback on the service’s communication and progress.

·                 The commissioned service had been maintained in terms of the level it was commissioned at, there had been no reduction in service.

·                 The Equality Assessment was being continually updated.

·                 There was a plan in place to have a place online where all pathways were accessible.

·                 People would still have access to waiting list when participating in the Pilot Pathway.

Resolved:

i.                That the board received Healthwatch York’s report, “I want to know, I want a diagnosis, I want help” - Pilot Pathway for Autism and ADHD: Independent evaluation August 2023.

ii.               That the board was minded to confirm the best avenue for further consideration of this matter.

Reason: So that the board was minded of the Pilot Pathway for Autism and ADHD.

A presentation introducing members of the Board to the Care Quality Commission’s (CQC) Operating Model, and the CQC’s New Single Assessment Framework.

The Corporate Director Adult Social Care and Integration and the Head of Transformation presented an introduction to the Care Quality Commission (CQC) Operating Model and noted that this Health and Adult care inspection would be the first inspection since 2010, and the first one under the new framework.

The Head of Transformation noted that CQC had created a single framework where before there were many, and all of Health and Social Care would be inspected under the same new framework. Under the Health and Care Act 2022 the CQC had regulatory powers to inspect local authorities (LAs).

In response to questions from the board, officers confirmed that:

·                 Under the care act, the Council had a duty to have a sustainable long-term care market.

·                 The CQC inspection would look at the Council’s financial management, how the Council were helping people and feedback received on their services, as well as looking at the volatility of care markets and the Council’s response to this.

·                 The mock inspection and the real inspection should not add any pressure to workloads as they would be a continuation of day-to-day working. Preparation was being done to work in a way that mimics the inspection process as much as possible.

Resolved: That the board receive the Introduction to the CQC Operating Model presentation.

Reason: So that the board was aware of the new single framework CQC Operating Model.