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. 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 attached to the agenda, that they might have had in the business on the agenda.

No interests were declared.

To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on Wednesday 10 July 2013.

Resolved:  That the minutes of the Health and Wellbeing Board                 held on 10 July 2013 be signed and approved by the               Chair as a correct record subject to the following                          corrections and amendments;

·        Attendance List- Siân Balsom is Manager of Healthwatch York not York HealthWatch.

·        Minute Item 10 (Anti Poverty Update): Delete “One Board Member” and replace it with Councillor Healey

·        Delete “the bottom percentile of the population” and replace it with the bottom quartile of the population.

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 5.00pm on Tuesday 1 October 2013.

To register please contact the Democracy Officer for the meeting, on the details at the foot of this agenda.

It was reported that there had been no speakers to speak under the Council’s Public Participation Scheme.

This report asks the members of the Health and Wellbeing Board to note and make comment on the progress made on providing a Place of Safety for York and North Yorkshire. An update has been provided and is at Annex A to this report.

Board Members received a report which asked them to note and make comments on the progress made on providing a Place of Safety for York and North Yorkshire.

Concerns were raised regarding the speed of the completion of the work on site. The Board wished to receive a definite date for completion of building works and the date for the opening of the suite at Bootham Park Hospital.

The Chair stated that concerns had been expressed by both the Home Office and Department of Health about the lack of an appropriate facility in York and North Yorkshire and about the apparent delay in establishing one.

Further questions were asked about what processes needed to be carried out before the Place of Safety could open.

It was noted that Leeds and York Partnership NHS Foundation Trust needed to confirm their requirements before a planning application was submitted. The Clinical Commissioning Group and regional Foundation Trust also needed to sign off the final specifications for building work and planning permission needed to be granted before building works could commence. The Chair asked that the relevant people involved in the development of the Place of Safety share all information about the completion date.

It was reported that if NHS Property Services agreed that works could proceed at risk then everything would be completed by the start of November. If not, the completion date would be 10 January 2014. The Chair asked that the Board receive a letter from NHS Property Services confirming that all relevant and necessary information had been shared and giving the date of opening.

NHS Property Services agreed to provide such a letter within 7 days. The Chair stated that failure to send that letter or failure to comply with the latest stated opening date of 10 January 2014 would necessitate a letter from her to the Home Secretary highlighting the delays caused by the NHS organisations.

Resolved:  (i)      That the report and associated annex and the                           progress made be noted.

                   (ii)      That all partners involved in the development of                        the Place of Safety suite from Bootham Park                                    hospital share information on the completion and                            expected opening date.

                   (iii)     That a confirmation letter from NHS Property                                       Services be received by the Board, informing                                      them of shared information between all involved                            parties and confirmation and details of the Place                         of Safety suite’s opening date.                                 

Reason:     In order to inform the Health and Wellbeing Board of                progress made towards providing a Place of Safety for                   York and North Yorkshire.   

This report sets out current government policy and direction on the move towards Integrated Health and Social Care and the creation of the Integrated Transformation Fund.

Board Members received a report which set out current government policy and direction on the move towards Integrated Health and Social Care and the creation of the Integrated Transformation Fund.

Discussion took place on the Integrated Transformation Fund, it was emphasised that half of this fund was from money already committed to local services, and that the other half would be new money.

It was noted that the geographic area covered by Vale of York Clinical Commissioning Group would receive approximately £12 million out of the fund, to spend on the entire area rather than just on York. Therefore further detailed work needed to be carried out on how this money would be distributed in the city. It was strongly felt that all partners on the Health and Wellbeing Board should be involved in this work.

Further discussion took place about the implications of the funding towards the pattern and shape of acute services. Some Board Members felt the fund would not resolve issues in the long term and that it was particularly important to take this message to government. Therefore it was very important to tell the local population that the services in health and social care in York which they would have expected to be provided in the past might change.

Resolved:  (i)      That the report be noted.

                   (ii)      That the national direction of travel towards                                health and social care integration with the                                     creation of Integrated Pioneers and the                                             establishment of the Integrated Transformation                         Fund be noted.

                   (iii)     That the creation of the Collaborative                                           Transformation Board which will oversee the                                       creation of the Integration Plan for the Vale of                                  York CCG footprint working alongside the                                  Integrated Commissioning Board for NYCC area                       be endorsed.

                   (iv)    That the timetable for preparing the Integration                          Plan be noted.

                   (v)     That the final Plan be brought to the Health                                and Wellbeing Board for initial approval on 29                                   January 2014 and then for final approval on 2                                       April 2014.

Reason:              To ensure that Health and Wellbeing has full and                      formal ownership of the Integrated Plan and use                         of the Integrated Transformation Fund.

This report presents the Health and Wellbeing Board with some information about some additional monies to support hospitals through winter.

Rachel Potts, the Chief Operating Officer at the Vale of York Clinical Commissioning Group and Mike Proctor from York Teaching Hospital NHS Foundation Trust will give a verbal update at the meeting as at the time of writing the report there is very little detail available. 

Board Members received a report which presented them with information about some additional monies to support hospitals through winter.

Rachel Potts, the Chief Operating Officer at the Vale of York Clinical Commissioning Group and Mike Proctor from York Teaching Hospital NHS Foundation Trust gave a verbal update at the meeting. In their update they stated that;

·        It was unclear about what the monies would be specifically used for and what performance targets would be needed to deliver services using these funds.

·        That hospitals should be looking ahead to next winter and about which models should be tested.

·        That hospitals in York were not ‘sustaining national standards’ but had been overwhelmed by the numbers of patients in Accident and Emergency (A&E) during the winter months and so still needed to ‘achieve national standards’.

Board Members felt that the general issues around pressures on services during winter were well known but due to new arrangements in NHS, a whole system approach was essential to serving the local population. For example the commissioning of services for alcohol during this winter would have an effect on the next year. It was felt that drive in demand for alcohol services should be examined by the Board at a later date.

Further discussion took place in which Board Members expressed concerns that the reasons for why people were automatically using A & E were not being examined. Others asked whether admissions for trips and falls (which increased during winter months) could be correlated to figures for gritting of roads and pavements. They requested that further information could be given to the Board at a future meeting, alongside a general update on the monies for A & E.

 Resolved: (i)      That the report be noted.

                   (ii)      That a further update be provided to the Board                          on the A & E Winter Money at their next meeting.

Reason:     To keep the Board up to date with winter funding                       allocations.

This report asks the Health and Wellbeing Board to consider the Independent care sector’s response to the Francis Report. Mike Padgham, the Chair of the Independent Care Group will present this response at  the meeting.

Board Members received a report which asked them to consider the Independent Care Sector’s response to the Francis Report. The report was presented alongside a Powerpoint presentation by Mike Padgham, the Chair of the Independent Care Group. Slides from the presentation were attached to the agenda, which was subsequently republished following the meeting.

During his presentation, Mike told the Board that;

·        By 2025 an extra 60,000 people would need to be recruited to deliver social care.

·        All nurses that delivered social care (not just within the NHS) needed a stronger voice.

·        A wider culture of change was needed in social care to avoid a situation like Mid Staffordshire occurring again.

·        That providers of social care needed to be open with one another, in that experiences and challenges faced by different providers were not always similar.

·        That the Independent Care Sector appreciated feedback from all partners on the Board.

·        That providers of social care could do more to prevent early hospital admissions.

·        That pay and remuneration of people in the front line of social care needed to be standardised, for instance should there be a national minimum wage for social care work?

·        If there was more stability in social care, it would cost less.

Discussion following the presentation focused around poor pay for those in social care work and how this affected recruitment and staff morale and personal development.

Resolved:  That the report on the independent care sector’s                       response to the Francis Report be noted.

Reason:     To keep the Board appraised of ongoing work in the                 city around implanting the recommendations contained            within the Francis Report.

This report presents information on progress against refreshing the JSNA.

Board Members received a report which presented them with information on progress against refreshing the Joint Strategic Needs Assessment (JSNA).

It was noted that all partners involved in refreshing the JSNA needed to take into consideration previous and current work on this, and to work within the parameters set by the Health and Wellbeing Board and associated Partnership Boards.

Board Members were also informed that although the JSNA was solely for the City of York, that they also had a responsibility for co-ordinating and sharing information on population in other areas within the Vale of York Clinical Commissioning Group’s geographic area. It was felt that this could be challenging.

Resolved:  (i)      That the report be noted.

                   (ii)      That all partners of the Health and Wellbeing                                       Board commit the relevant resources to support                        the deep dive work where there is specifically                                 related to their own commissioner or provider                                  responsibilities e.g. (health care, CCG and social                       services, local authority).

Reason:     To keep the Board appraised of ongoing work to                       update the Joint Strategic Needs Assessment.

This report asks members of the Health and Wellbeing Board to agree the Constitution, Terms of Reference and Membership for the Mental Health and Learning Disabilities Partnership Board.

Board Members received a report which asked them to agree to the Constitution, Terms of Reference and Membership for the Mental Health and Learning Disabilities Partnership Board.

The Board were informed that as the Chair of the Mental Health and Learning Disabilities Partnership Board (Doctor Cath Snape) had now left her position at the Vale of York Clinical Commissioning Group (VOYCCG), a new Chair was needed.

Rachel Potts reported that although the CCG were willing to continue to provide the Chair for the Board, that the position would be filled by a Chief Officer or Nurse.

Discussion took place on Mental Health Transitions. It was reported that the Government now saw Children’s Mental Health as going up to the age of 25. Some Board Members felt information on the challenges of transition between child and adult Mental Health Care needed to be looked at by the Board. Members agreed the Terms of Reference but asked that it was made explicit within them that this Board’s responsibility was around Adult Mental Health. YorOK Board would continue to take the lead on Children’s Mental Health, however in terms of transitions (age 18-25) there may be times when both Boards needed to work together.

Some Board Members felt that there was very little contained within the Board’s Action Plan for those with Learning Disabilities.

All Board Members thanked Doctor Snape for her excellent work as Chair of the Mental Health and Learning Disabilities Board. The CCG agreed that it would provide the new Chair of the Partnership Board and the Chair underlined the need for the new Chair to have relevant clinical knowledge of Mental Health and Learning Disabilities.

Resolved:  (i)      That the report be noted.

                   (ii)      That the Mental Health and Learning Disabilities                        Partnership Board be formally established.

                   (iii)     That the Constitution/Terms of Reference and                                     Partnership Board’s membership be                                            approved. In addition, the Board’s responsibility                     for Adult Mental Health also be made explicit                                       within the Terms of Reference. 1

                   (iv)    That the Vale of York Clinical continue to chair                           the Mental Health and Learning Disabilities                                       Partnership Board.

Reason:     To finalise the arrangements for setting up this                          Partnership Board.

Any other business which the Chair considers urgent under the Local Government Act 1972.

The Chair informed the Board that she had been asked by the Chief Executive of York MIND for all the partners involved in the Health and Wellbeing Board to sign up to MIND’s Mental Health Challenge Charter.

As a result of this she had invited the Chief Executive, David Smith and a colleague to the next meeting of the Board where the Board would formally sign up to the Challenge.

She felt that the profile of Mental Health needed to be more visible to all those involved in Health and Wellbeing in York.