Agenda and minutes
Venue: Remote Meeting
Contact: Michelle Bennett
Declarations of Interest
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.
Members were asked to declare, at this point in the meeting, any personal interests not included on the Register of Interests or any prejudicial or discloseable pecuniary interest that they might have in respect of the business on the agenda. None were declared.
To approve and sign the minutes of the meeting held on 18 February 2020.
The Chair stated that since the last public meeting held pre-Covid, in February, a series of informal meetings had been held to consider areas of work that fall under the remit of this committee. The Chair was keen to formulate a work plan for this committee, at the earliest opportunity.
Resolved: That the minutes of the previous meeting of the
committee held on 18 February 2020be approved and signed 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 5:00pm on Friday 6 November 2020.
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 relevant Democracy Officer, on the details 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 had been no registrations to speak under the Council’s Public Participation Scheme.
Verbal update on how GP Practices are coping with the Covid emergency
Dr Nigel Wells, Chair of NHS Vale of York Clinical Commissioning Group will provide a verbal update outlining how GP Practices have been coping with the Covid emergency.
The Chair of NHS Vale of York (VOY), Clinical Commissioning Group (CCG); the Accountable Officer, NHS VOYCCG and the Acting Director for Primary Care and Population Health for NHS, VOYCCG, gave a verbal update on how GP practices were coping with the Covid emergency.
Dr Wells explained that in March their priorities had been: saving lives; protecting the vulnerable and keeping services going, which is what Primary Care services have done for the last 9 months.
He outlined how they had protected the vulnerable and staff by providing telephone triage, remote working, and continuing to provide essential services via text messaging and phone calls. There had been some video consultations however, the technology for this was not available as yet. The priority had been caring for the most vulnerable and end of life patients.
It was reported that the current activity at GP practices had included:
· Attending to routine clinical demand; catching up with the deferred backlog of appointments and need arising from the first wave of Covid and helping those with long term conditions and mental health concerns.
· Responding to the increase in take up for the flu vaccination which had increased from approx. 60 per to over 75 per cent.
Some of the challenges currently faced by GP practices (during the second lock-down) had included:
· Staff absenteeism: practices have been subject to the same staff absences as can be seen in other workplaces for reasons such as needing to self-isolate, Covid fatigue, child care arrangements.
· Wellbeing of staff: and providing support, building resilience for the winter. National and regional online resources were available. The CCG had recognised the additional pressure that GP receptionists were under and had put in place ‘wellbeing champions’ and were doing a media campaign on the back of national campaigns, encouraging patients to be kind to the GP receptionists. Practices were signposting service users to 111 and encouraging patients to self-care, where appropriate. It was explained that due to budgetary constraints it was not possible to recruit additional staff.
· Face to face appointments - twice as long due to the time taken in relation to PPE and cleaning.
· Service user’s expectation and communication:
o Urban myth nationally that GP practices had closed its doors. In March, the number of patients seen had been reduced. Currently service had been restored and busier than ever, with more consultations undertaken than at the same period of time in the previous year. York Medical Group had received 42k phone calls in September 2019, in September 2020 they had received over 50k phone calls. That was replicated with telephone and face to face contact.
o The City of York was fortunate in that they had a service which was rated good or better, which was important in the context of discussions around patient expectation. There are a number of practices which are larger than others. Their combined resources had created a resilience that smaller practices cannot reach. That hot and cold service is not available in other regions. ... view the full minutes text for item 4.
This report analyses the latest performance for 2020/21 and forecasts the financial outturn position by reference to the service plans and budgets for all the relevant Health and Adult Social Care services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.
Members considered a report which analysed the latest performance for 2020/21 and forecasted the financial outturn position by reference to the service plans and budgets for all the relevant Health and Adult Social Care services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care, the Head of Finance: Adults, Children & Education and the Strategic Support Manager (Adults and Public Health), were in attendance to present the report and to respond to questions.
Key points arising from discussion of this item included:
· Overspend in quarter one was due to carried forward overspend from last year when the budget was set for 2021. The Covid emergency had impacted upon the ASC budget.
· Healthy Child Service had continued to operate throughout the pandemic adapting its service in the first wave of the pandemic. Routine home visits and new births were prioritised and then given continued support online and via telephone.
· Delayed Transfers of Care: The Department of Health and Social Care had suspended the monitoring of that information as it was considered that this was not a productive way to address performance concerns. The department does measure the length of time a patient remains in hospital once they are deemed fit – which should be hours not days.
· Haxby Hall: Members requested further explanation on the projected overspend, to its next meeting.
· Sickness rates of Adult Social Care staff had fallen officers considered this had been due to the flexibility of working from home. Measures to reduce this further included encouraging staff to get away from their desks, taking regular breaks and measures to support their physical and mental wellbeing.
· Health Checks: Members expressed concern regarding York’s underperformance in undertaking these checks as compared with the regional and national averages. These were NHS health checks that the government transferred for commissioning to local authorities, however the health checks were provided by GP practices. The local authority is reliant on GP service data to identify those invited for checks in the 40 – 75 age group. There had been a number of obstacles to getting this process underway. This had been a five year cycle which had started last year. The programme had been halted due to safety concerns in relation to Covid and Health Trainers had been re-deployed to support the contact tracing.
· Continuing Health Care (CHC) funding concern regarding ongoing issues of customers no longer qualifying for 100% CHC funding and responsibility passing across from Health to ASC – the Directorate assured Members that a lot of work had been done to ensure customers were receiving all of their entitlements.
· Psychological therapies (IAPT): Q2 data on improving access to this in the Vale of York CCG area shows the referrals to IAPT (504 per 100,000) are lower than the England average (953 per 100,000) this data is compiled by the NHS CCG as referrals are made by GPs . The Committee were advised to write to the Accountable Officer, NHS VOYCCG should they required ... view the full minutes text for item 5.
Members will receive the Winter Plan for the City of York Council, developed in response to the Government policy paper Adult social care: our COVID-19 winter plan 2020 to 2021, published in September. This plan has been prepared with the support of partners across the health and social care system.
Members received the Winter Plan for the City of York Council, which had been developed in response to the Government policy paper Adult social care: our COVID-19 winter plan 2020 to 2021, published in September and its requirement for all councils to have a plan in place. The Assistant Director Joint Commissioning (CYC
and VOYCCG) was in attendance to present the report and to respond to questions.
The following information was provided in response to questions from committee members:
· This plan has been prepared with the support of partners across the health and social care system.
· Officers confirmed that although the York Dementia Alliance (YDA) work was coming to an end in September 2020, the programme of work around supporting people with dementia and their carers remained in place and that this area of work had evolved into other projects.
· Peppermill Court was opened as a residential care setting for people who had been diagnosed with Covid-19 in care settings and had already existed, funded through the NHS. It will be used by service users in North and East Yorkshire as necessary. It currently held 3 service users and had 7 service users in total since mid-October.
· Care homes in York had managed extremely well. Whole site precautionary measures had been in place since May and onsite testing of staff. Where staff had been symptomatic, Covid-19 had not been passed on to service users due to staff’s professional practice and adherence to guidelines, which had been excellent.
The Chair and Members thanked the Assistant Director, Joint Commissioning for the tremendous effort of staff in care homes throughout the whole of the Adult Social Care sector during the Covid-19 pandemic .
Resolved: That the Committee noted the City of York Council’s Adult Social Care Winter Care Plans.
Reason: To keep the Committee informed of arrangements in
place for Adult Social Care over the winter.