Agenda and minutes

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.

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.

To approve and sign the minutes of the last meeting of the Health and Wellbeing Board held on Wednesday 5 May 2021.

There was a suggestion for one amendment to Minute 40, which now reads ‘In response to questions from Board Members, it was noted: That the Covid-19 pandemic had caused a large increase in operation waiting times, and that work around preventing or minimisingdeconditioning would therefore be vital in optimising patients’ health during that period.’

Additionally under Minute 40, there was a query as to whether the Older People’s Survey should be revisited or repeated.

This was discussed at the June meeting of the Ageing Well Partnership and the following response was given:

The Ageing Well Partnership considered the option to carry out a follow up to the Older People Survey. It was agreed that this would not be appropriate as all the actions from the survey have been aligned with the Age Friendly York project action plan and any follow up survey questions are included within the Age Friendly York project surveys. To carry out an Older People survey in addition would be a duplication.

At their May meeting the HWBB also expressed concern over the timeline for the last domain of the Age Friendly City project and it has been confirmed that flexibility has been built into the timeline.

Finally, since the last meeting of the HWBB the chair of the Ageing Well Partnership has changed and going forward it will be chaired by Joe Micheli, Head of Communities from City of York Council.

Resolved: That the minutes of the meeting held on Wednesday 5 May 2021 be approved with the addition of the above amendment and signed by the Chair at a later date.

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, in order to facilitate the

management of public participation at remote meetings. The

deadline for registering at this meeting is at 5.00pm on Monday

19 July 2021.

To register to speak please visit

http://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 Remote Public Meetings

Please note that, subject to available resources, this remote

public meeting will be webcast including any registered public

speakers who have given their permission.

The remote public meeting can be viewed live and 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 no registrations to speak under the Council’s Public Participation Scheme.

The Health and Wellbeing Board will consider a report which provides a summary of the information it received at an April 2021 workshop on the impact of Covid-19 on health inequalities. The Board is asked to identify the actions and/or work streams that they would like to see taken forward.

The Board considered a report which provided a summary of the information it received at an April 2021 workshop on the impact of Covid-19 on health inequalities. The Board was asked to identify the actions and/or work streams that they would like to see taken forward. The Consultant in Public Health – NHS Vale of York Clinical Commissioning Group was in attendance to present the report.

Key issues raised in the presentation of the report included:

·        That deprivation levels are useful in highlighting health inequalities, for example over the past decade the gap in life expectancy between the richest and poorest groups in society have widened and life expectancy increases have largely stalled in 2011/12. The ‘inequality cliff edge’ was discussed, wherein the most disadvantaged in society have a significantly lower life expectancy than those in the next higher percentile.

·        Issues reported since the onset of the Covid-19 pandemic included an increase in perinatal mental health conditions; carers who are working with fewer breaks and increased isolation; increased poverty around technology, with some without the means to pay for broadband or smartphones; the increased risk of exposure of those with multiple complex needs to Covid-19; limited social contact amongst the elderly leading to increased loneliness and an increase in poor mental health amongst the Traveller community.

·        That there were three layers/causes to health inequalities as identified by the Department for Health and Public Health England: attributable risks, causes and causes of causes.

·        Feedback from the workshop, which highlighted both York’s greatest challenges and assets, as well as how to protect the next generation, with the first 1,001 days of a child’s life, from conception to around two years old, being one of the most critical for long term health.

·        The Marmot Framework was especially emphasised as a means of producing a fairer and healthier society.

Key points arising from discussion of the report included:

·        That the exemplar city around the Marmot Framework was Coventry, who have adopted it as a city-wide framework in all areas, not just in health and wellbeing. It was suggested that some collaboration between York’s and Coventry’s Health and Wellbeing Boards in future could be looked into.

·        The importance of the first 1,001 days of a child’s life in improving long term health was emphasised by multiple Board Members, with a need for increased discussion of maternity services and more work around pre-conception care also highlighted. Furthermore, it was noted that a whole-family approach was needed on this issue.

·        That a key failure in York’s health services had laid in co-production: that was not enough engagement with local residents around their needs. The Manager of Healthwatch York out herself forward as a sponsor of work to improve and develop new ways of co-production in the city as part of a partnership between Healthwatch York and York and Scarborough Hospital to create a Voice and Lived Experience Collaborative.

·        In response to queries around availability of and changes to access in the primary care sector, it was noted  ...  view the full minutes text for item 46.

The Board will consider a report which will provide an update on the progress of the York Health and Care Alliance, including minutes of Alliance meetings for Board members to note.

The Board considered a report which provided an update on the

progress of the York Health and Care Alliance, including minutes of Alliance meetings for Board members to note. The Consultant in Public Health – NHS Vale of York Clinical Commissioning Group was in attendance to present the report.

Key points raised during the presentation of the report included:

·        That a summary of some of the incoming NHS reforms were included in the report, such as details of the Health and Care Bill which was progressing through Parliament and the Integrated Care System Design Framework.

·        That the NHS Vale of York Clinical Commissioning Group was to be abolished in April 2022, and that the York Health and Care Alliance was formed to determine how NHS place functions will operate within the Humber Coast and Vale Integrated Care System.

·        That the ambition of the Alliance was that York should retain local control of decision making around healthcare and how best to make a local integrated care system.

·        That since the Alliance was a sub-group of the Health and Wellbeing Board, its minutes would be brought to meeting for member’s approval.

The Chair thanked the Consultant in Public Health for presenting the report.

Resolved:

(i)           That the update on the NHS reforms and the work of the York Health and Care Alliance be noted.

(ii)         That the minutes of the York Health and Care Alliance be noted and received.

Reason: To keep the Board up to date on the work of the York Health and Care Alliance.

The Director of Public Health will give a presentation on the

current situation in relation to Covid-19 including recovery plans.

This item will be in presentation format to ensure that the most up

to date information can be presented to the Health and Wellbeing

Board.

The Director of Public Health gave a presentation on the

current situation in relation to Covid-19 including recovery plans.

This item was in presentation format to ensure that the most up

to date information could be presented to the Health and Wellbeing

Board.

Key points raised during the presentation included:

·        That York was currently in the fourth wave of the Covid-19 pandemic.

·        That cases had been increasing recently, but the rate of that increase was slowing. York had the third lowest 7 day rate per 100,000 people in Yorkshire and Humber regions local authorities.

·        That there were Covid-19 cases amongst all age groups, however the low incidence of cases amongst older sections of the population was evidence of the success of the vaccination programme. Younger sections of the population had a higher rate of Covid-19 infections, which could be attributed to the fact that they had only recently become eligible for the vaccine.

·        That the most recent figures for hospital admissions due to Covid-19 in York were 17 in hospital and 1 in the Intensive Treatment Unit. Current levels were much lower than previous waves, but were beginning to rise.

·        That there had been no recent deaths from Covid-19 in York, and that the total excess deaths since the beginning of 2020 were 106.

·        That there were 8 care homes in York currently with a staff member or resident who had tested positive for Covid-19. The last outbreak of 2 or more cases was on 2 July, with control measures in York being largely effective.

·        That in the 7 day period up until 19 July, there were 177 school-age children who had tested positive in York across 39 schools.

·        That younger age groups were catching up in vaccination rate since eligibility had been expanded, but remained lower. Disparity in vaccination rates between wards in York could largely be explained by the percentage of the ward that was of a younger age and was therefore not long eligible for vaccination.

·        That the Delta variant was the dominant variant of concern.

·        That York was in Stage 4, and all legal restrictions had been lifted. The importance of the continued encouragement of, hand-washing, social distancing and the wearing of facemasks was emphasised.

In response to questions from Board Members, it was noted:

·        That contact tracing was going well, and that it was encouraged that people in York get themselves regularly tested. However, concern was expressed at recent government changes to local authorities’ involvement in contact tracing, who now received notification of a positive case 4 hours later and could no longer follow up on contacts of positive cases. The Director of Public Health stated that she was in communications with the City of York Council Outbreak Management Advisory Board to see if they were supportive of a letter being drafted and sent to the Secretary of State for Health asking for the reinstatement of the previous policy.

·        That on the 16 August, the government was to change legal advice around self-isolation to those  ...  view the full minutes text for item 48.

The Board will consider a report which provides information and shares details about the activities of Healthwatch York in 2020/21 with the Health and Wellbeing Board, and gives details of plans for work throughout 2021/22.

The Board considered a report which provided information and

shared details about the activities of Healthwatch York in 2020/21, and gave details of plans for work throughout 2021/22. The Manager, Healthwatch York was in attendance to present the report.

Key points arising from the presentation of the report included:

·        That the report reflected on the past 17 months of pandemic, and thanked many key partners. Healthwatch York had improved its working relationship with a wide range of partners during the pandemic.

·        That the evaluation of the work of Healthwatch York was less comprehensive than previously, due to work pressures around staff being involved with pandemic response, but the evaluation included examples of how Healthwatch York has supported people and provided suggestions on how they might improve.

·        The summary workplan included a survey for people with dementia and for people living with/caring for someone with dementia, with an additional 1 page feedback form asking for any information Healthwatch York doesn’t know about dementia. These were to feed into the City of York Dementia Strategy.

·        That as part of work on dentistry, Healthwatch York had engaged with local practices and had found a severe lack of capacity. The next stage was to ask the public about their experience. It was noted that Healthwatch England had flagged this as a national issue. The Director of Public Health gave notice that this issue was to be discussed at the January meeting of the Health and Adult Social Care Policy and Scrutiny Committee, and that she would keep the Health and Wellbeing Board up to date on their discussions.

The Chair thanked the Manager, Healthwatch York for her report and for the work of the organisation over the past year.

Resolved:

(i)           That Healthwatch York’s Annual Report and workplan be received and noted.

Reason: To keep up to date with the work of Healthwatch York

The Board will consider a report which will provide an update on:

·          the national reporting process for the 2020-21 BCF Plan

·          2020-21 Performance report

·          progress of the Better Care Fund Review

·          recommendation on Intermediate Care

·          the planning arrangements for 2021-22

·          recommendation to review the BCF Performance and Delivery Group Terms of Reference

The Board considered a report which provided an update on:

·        the national reporting process for the 2020-21 BCF Plan

·        2020-21 Performance report

·        progress of the Better Care Fund Review

·        recommendation on Intermediate Care

·        the planning arrangements for 2021-22

·        recommendation to review the BCF Performance and Delivery

·        Group Terms of Reference

The Director of Public Health was in attendance to present the report.

Key points arising during the presentation of the report included:

·        That Board was asked to note the report and the progress made on the BCF, as well as to approve the financial plan.

·        That there was no current Intermediate Care Strategy for York, and it was suggested by the Director of Public Health that the Board delegates the development of this strategy to the York Health and Care Alliance and York Health and Care Collaborative.

·        That the new Assistant Director for Commissioning and Prevention should take up reviewing the terms of reference of the Performance and Delivery Group of the BCF once in post.

The Chair thanked the Director of Public Health for presenting the report, and specifically expressed the gratitude of the Board towards the report author, Pippa Corner, who was previously Assistant Director, Joint Commissioning, City of York Council/NHS Vale of York Clinical Commissioning Group, but has now left the Council.

Resolved:

(i)           That the York Better Care Fund update for information, including formal submission of the 2020-21 End of Year Report to NHSEI be received.

Reason: The HWBB is the accountable body for the Better Care Fund.

(ii)         That the financial plan for 2021-22 be approved.

Reason: The HWBB is the accountable body for the Better Care Fund.

(iii)        That the development of a new, multi-agency Intermediate Care Strategy for York be supported.

Reason: York does not currently have a strategy in place to cover the range of services described as intermediate care.

(iv)        That further reports on the progress and outcomes from the Care Rooms Project will be received by the Board.

Reason: The HWBB is the accountable body for the Better Care Fund.

(v)         That a review of the Terms of Reference for the Performance and Delivery Group to reflect changes in the local and national arrangements and to prepare for future requirements be investigated.

Reason: The Terms of Reference have not been updated since 2018.

The Board will consider a report on the work of the York Health and Care Collaborative. 

The Board considered a report on the work of the York Health and Care Collaborative. The Chair of the York Health and Care Collaborative was in attendance to present the report.

Key points arising from the presentation of the report included:

·        That prevention is a large part of the York Health and Care Collaborative’s agenda, with work around holding providers accountable for example around tobacco consumption. It was also noted that a pilot for work on low level drinking problems would begin in late October/early November, and it was hoped that the sponsor of that work, Changing Lives, would be able to attend the next Health and Wellbeing Board meeting with an active update.

·        That mental health was a priority of the Collaborative, and that the work of the Northern Quarter, a community asset based approach to mental health was successfully adapting across the whole city. Additionally, it was noted that more Integrated Care System funding for the impact of Covid-19 on mental health had been made available.

·        That a bespoke workshop on end of life care was being set up, as well as a community response team to aid in ageing well, with a two hour response time.

·        Furthermore, child welfare and learning disabilities were key priorities for the Collaborative.

The Chair thanked the Chair of the York Health and Care Collaborative, and emphasised the work of the Covid Support Hub, which had supported 4,000 people – the importance of raising awareness of the issues around Long Covid was highlighted and the Chair asked for a report to be brought to a future HWBB meeting focused on helping the HWBB to better understand Long Covid and the impact that it has on residents and on health inequalities.

Resolved:

(i)           That the report of the Chair of the York Health and Care Collaborative be noted.

(ii)         That a report be brought to a future HWBB meeting focused on helping the HWBB to better understand Long Covid and the impact that it has on residents and on health inequalities

Reason: There is a shared objective of improving the health and

wellbeing of the population. The York Health and Care Collaborative is unique in bringing together; providers and commissioners of health and social care services (from the NHS and City of York Council), colleagues from City of York Public Health together with the voluntary sector as a means of working on joint priorities to achieve this objective. The York Health and Care Collaborative agreed to provide regular updates on its work and progress.