Agenda and minutes

Introductions were carried out. The Chair welcomed new Board Members, Kevin Curley, Martin Farran and Ruth Hill who attended as a substitute for Martin Barkley from Tees, Esk and Wear Valleys NHS Foundation Trust. She thanked Leeds and York Partnership NHS Foundation Trust the previous provider of mental health services in the city and former Board Member Chris Butler, the Trust’s Chief Executive.

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 that they might have had in the business on the agenda other than their standing interests. None were declared.

To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on 15 July 2015.

Resolved:  That the minutes of the meeting of the Health and Wellbeing Board held on 15 July 2015 be signed by the Chair as a correct record.

Board Members identified no issues arising from the action points.

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 Tuesday 20 October 2015 at 5.00 pm.

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 this meeting will 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: https://www.york.gov.uk/downloads/file/6453/protocol_for_webcasting_filming_and_recording_council_meetingspdf

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

This report provides information on the work of the Safeguarding Adults Board over the course of 2014/15. A summary of the report can be found at Annex A of this report and the full annual report at Annex B.

Kevin McAleese CBE, the Independent Chair of the Safeguarding Adults Board will be in attendance at the meeting to present the report.

Board Members received the Annual Report of the Safeguarding Adults Board. Kevin McAleese CBE, the Independent Chair of the Safeguarding Adults Board presented the report and answered questions from Board Members.

Some headlines from the presentation included;

·        That it was the first Annual Report in which all partners on the Adult Safeguarding Board had contributed.

·        A review of membership had been completed and the probation service had requested a place on the Board.

·        The general growth in concerns and alerts (concerns was the new word for referrals) was due to public awareness.

·        That due to work from Healthwatch York a new strategic plan for joint safeguarding was in place.

The Chair of the Safeguarding Adults Board requested that the Annual Report be considered by the Health and Wellbeing Board, nearer to its date of publication in the future.

Discussion took place and the following comments were raised;

·        There was no excuse for a lapse in information sharing between partners.

·        In domestic abuse cases where women pressed charges for example, how do you measure the will of the individual and whether its in the best interests of them?

·        How many adults recorded in the data were ex offenders, as some of them might have vulnerabilities themselves?

·        Had the Board been aware of the issues at Bootham Park Hospital?

In regards to domestic abuse, Tim Madgwick advised that the Board needed to recognise that for example seeing a person in uniform was not the best person to persuade those who had suffered from domestic abuse to report it. Professional conversations needed to be had in order to determine how far could be gone in order to get evidence, and traditionally the courts had been the way for the Police to get this.

The Board were informed that the Safeguarding Adults Board were due to receive a report on suicides in the city and that the Partnership Commissioning Unit had appointed a Suicide Prevention Officer to investigate the reasons for this. A report would be received at their meeting in December.

In response to whether the Safeguarding Adults Board were aware of the issues at Bootham Park Hospital, it was noted that a member of Leeds and York Partnership NHS Foundation Trust sat on the Safeguarding Adults Board. Following the opening of the Section 136 suite, the Board had no reason to think that the Hospital would close.

The Chair, on behalf of the Board, thanked Kevin McAleese CBE  for presenting the report and answering Board Members questions.

Resolved:  That the report be noted.

Reason:     To keep the Board appraised of the work of the Safeguarding Adults Board.

Ruth Hill, Director of Operations, from Tees, Esk and Wear Valleys NHS Foundation Trust, Dr Mark Hayes, Chief Clinical Officer and Rachel Potts, Chief Operating Officer, from Vale of York Clinical Commissioning Group will provide a verbal position statement to the Board following the recent closure of Bootham Park Hospital.

Ruth Hill, Director of Operations from Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust, Dr Mark Hayes, Chief Clinical Officer and Rachel Potts, Chief Operating Officer from NHS Vale of York Clinical Commissioning Group (CCG) gave a verbal position statement to Board Members on mental health facilities following the closure of Bootham Park Hospital.

Ruth Hill reported that;

·        The remaining patients from Bootham were being treated in 28 beds, some had been moved to Roseberry Park in Middlesbrough and some to Acomb Gables.

·         Some patients still needed inpatient care, and as of Tuesday 20 October, 21 patients still needed bed based care.

·        Those patients that needed to use the Section 136 suite would go to either Harrogate, Northallerton or Scarborough.

·        They had increased the use of street triage.

·        Alternative arrangements had been made for outpatients across the York vicinity .

·        Limetrees was being used as the main base for outpatient appointments.

·        ECT treatment was being managed at York Hospital.

·        TEWV were supporting carer travel arrangements.

·        The Care Quality Commission visited the Bootham Park estate on 9 October as part of re-registration process to see what parts of the buildings could be re-used, hoping to re-instate Section 136 suite after further estate works and hoping to do this within 2 months

·        A review was being conducted on outpatients and whether patients could be moved back to Bootham Park in the long term.

·        A medium term option being explored was to use Peppermill Court which would create 24 beds.

·        It was recognised that these were changes for staff and TEWV did not want to affect their morale.

·        They were also only interim solutions there was a necessity for a new hospital in 2019 and there needed to be a community based rather than bed based approach.

Dr Mark Hayes thanked the staff at Bootham Park Hospital and thanked Ruth Hill for the verbal position statement.

Tim Madgwick commented that street triage was a sensible way forward but felt that the challenge was how to get constant provision against irregular demand.

Kevin Curley asked if a detailed statement on mental health facilities in York could be passed on to voluntary groups and also asked if there was the capacity to evaluate what had been happening to people as a result of there not being enough beds and what could be learnt?

In response, it was reported that readmission rates were being logged through TEWV’s Crisis Line.

The Chair thanked Ruth Hill for her position statement.

Resolved:  (i) That the verbal position statement be noted.

                 (ii) That TEWV provide a written statement that can be circulated widely.   

Reason:    In order that the Board are kept updated on the status of current mental health facilities in York.

This report provides Board Members of the Health and Wellbeing Board with a brief progress update on the production of York’s new Children and Young People’s Plan 2016-19. 

Board Members received a report which provided them with a brief progress update on the production of York’s new Children and Young People’s Plan 2016-19.

Jon Stonehouse commented that the work on the Plan had primarily been steered through the YorOK Board, and he urged Members of the Health and Wellbeing Board to attend the ‘No Wrong Door’ Conference on 27 January 2016 where the Plan would be launched.

Questions and comments raised by Board Members included;

·        Would the loss of working tax credits for families be dealt with within in the Plan? Would the JSNA also fit in?

·        It was particularly good to see a strong health focus as children could not learn effectively if they lived in cold homes.

·        Would the Plan be informed by any Equalities strands such as sexuality, Black, Minority, Ethnic, issues around those caring for parents with disabilities.

It was felt that it would be useful to make more explicit links with the loss of tax credits as it underlined the link with narrowing the gap. It was also felt to be helpful to look at how to use Council Tax Support to support those on the lowest incomes and those who were eligible for Free School Meals.

Resolved:  (i) That the report be noted.

                  (ii) That the approach taken set out in the report be supported.

                 (iii) That the consultation process be supported and engaged with.

                 (iv) That the final CYPP draft be received at a meeting in the New Year.

Reason:   To keep the Board appraised of progress to date and to engage partners in the CYPP planning process.

This report provides the Health and Wellbeing Board with comments on the two previous Healthwatch reports presented to the Board in July, which were “Who’s Who in Health and Social Care” and “Consistency and Confidence in Patient Led Assessments of the Care Environment  (PLACE)”.

 Also included is information on two new Healthwatch reports on “Accident and Emergency Department and Alternatives” and “Discharge from Health and Social Care Settings”.

The Board received a report which provided them with comments on two Healthwatch reports which had been presented to them at the previous meeting which were “Who’s Who in Health and Social Care” and “Consistency and Confidence in Patient Led Assessments of the Care Environment (PLACE)” and information on two new Healthwatch reports “Accident and Emergency Department and its Alternatives” and “Discharge from York Hospital”.

The Interim Director of Public Health informed Board Members that the new reports would be discussed at the next meeting. The Chair suggested that going forward if the Board were in agreement, it would be best to receive Healthwatch reports and discuss them at the same meeting.

Resolved: (i) That the responses in the report be noted.

                 (ii) That all future Healthwatch reports be scheduled on the Board’s Forward Plan to be received and considered at the same meeting.

Reason:    To follow up on the recommendations of the Healthwatch reports.

This report presents an update on developing integration, which captures various elements of our joint plans to develop services that maximise the health and wellbeing of our population.

The Board received a report which presented them with an update on developing integration, which captured various elements of a joint plan between the CCG, the Council and other partners to grow services to maximise the health and wellbeing of the city’s population.

It was noted that it was key to look at future planning as in fifteen years, there would be an over 50% rise in over 75 year olds. There was also recognition from the CCG that where there were scarce resources for care that work could be carried out with neighbouring authorities such as North Yorkshire or East Riding.

Questions and comments from Board Members in relation to the report included;

·        At what point was integrated demand reached in order to get integrated delivery? Only those who were articulate could describe their needs more than the needy.

·        The use of acronyms were offputting and there were still those who did not meet criteria for their needs.

·        Could there be more involvement from the voluntary sector, for example on the System Leaders Board and the Integrated Commissioning Executive?

·        An underlying principle of this work was to continue to tackle health inequalities, avoidable deaths and avoidable poorer outcomes

One Board Member questioned the purpose of the Better Care Fund. Discussion ensued and the Chair concluded that it was not just about spending money wisely, it was about better care for the city.

The Board requested a further report be added to the forward plan for a future meeting.

Resolved: That the content of the report be noted and the Health and Wellbeing Board continue to support the strategic direction of travel around system integration.

Reason:   To keep the Health and Wellbeing Board up to date with progress around integration.

This report will give the Health and Wellbeing Board (HWBB) an indication of key areas of work undertaken by the Safeguarding Children Board during 2014/15. A copy of the report is at Annex A to this report.

Board Members received the Annual Report of the City of York Safeguarding Children Board (CYSCB) 2014/15. The Chair notified Board Members that all comments they made on the report would be passed on to the Chair of the CYSCB, Simon Westwood.

Comments from Board Members on the Annual Report included the need for greater liaison between the Children and Adults Safeguarding Board, particularly in areas such as domestic violence. One Board Member felt that the priorities identified in the report overlapped with that of the Council’s Children and Young People’s Plan (CYPP).

Resolved: That the report be noted.

Reason:    So that the Health and Wellbeing Board is kept up to date with the work of the Safeguarding Children Board.

Board Members are asked to consider the Board’s Forward Plan

for 2015/16.

Board Members were asked to consider the Board’s Forward Plan.

The Chair reported that she had recently been asked to attend and speak at a conference on young people’s mental health and the conference organisers in turn wanted to attend a Board meeting. They would attend the March meeting. She felt that as the organisers had some apprentices working for them from York St John University, that they could also be invite to attend.

Tim Madgwick informed Board Members that North Yorkshire Police had qualified for a national research grant around mental health issues and were helping York University with the contribution of data.

Resolved: That the Forward Plan be approved with the following amendments;

·        The change of schedule for Healthwatch reports so that they are received and considered at the same meeting.

·        For the Board to receive a presentation on Young People’s Mental Health in March and for York St John students to be involved in this if possible.

Reason:   To make sure that there is a planned programme of work in place.