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.

Cllr Perrett declared a personal, non-prejudicial interest in that she has previously volunteered for Healthwatch York.

Cllr Waudby declared a personal, non-prejudicial interest in that her sister in-law works for Healthwatch York.

To approve and sign the minutes of the meeting held on Tuesday 18 June 2019.

Resolved:  That the minutes of the previous meeting of the committee held on Tuesday 18 June 2019 be approved and signed as a correct record.

The Chair noted that information relating to the Public Health

budget and alcohol related admissions to hospital from the

Director of Public Health outlined in these minutes would be

made available to the public.

At this point in the meeting, members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. The deadline for registering is 5:00pm on Monday 29 July 2019.

Filming, Recording or Webcasting Meetings

Please note that, subject to available resources, this meeting will be filmed and webcast, or recorded, including 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: http://www.york.gov.uk/download/downloads/id/11406/protocol_for_webcasting_filming_and_recording_of_council_meetings_20160809.pdf

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

This is the Six Monthly Performance Monitoring Report from Healthwatch York, reviewing the work, development and management of the service.

Catherine Scott was in attendance to introduce the bi-annual performance report from Healthwatch York and answer Members’ questions.

Members were interested in an update on the work Healthwatch were undertaking alongside people with Multiple Complex Needs. It was noted that this piece of work is still being developed and more detailed updates and information would be available at a later date once the direction of travel and aims had been established.

Members were also keen to hear about what happens to reports after they are published and how they are followed up. The officer stated that conversations were on-going with the Health and Wellbeing Board about the best way to report this information. However, it was noted that relevant organisations are required to respond to reports within 20 days of it being published and that this information could be reported to this committee as well. The officer noted that Healthwatch are working on ways in which more regular progress updates can be sought from organisations that have received recommended actions. The Chair asked for this information to be reported on in future.

This is a report from the Executive Member for Health and Adult Social Care, highlighting her priorities and challenges for the coming year.

The Executive Member for Health and Adult Social Care was in attendance to present a report on her priorities for the coming year.

Members were interested to hear more about developing services on the site of the Retreat and Cllr Runciman explained that the hope was for the provider to build an in-patient facility specifically focussing on serious mental health issues, complex personality disorders and eating disorders. In response to a question regarding the duplication of services offered by TEWV, Cllr Runciman noted that the two providers were in contact and that she had confirmed with both providers that they must complement each other.

In response to a question around social prescribing, local area co-ordination and the pressure that this can add to third sector organisations, Cllr Runciman agreed and suggested that this could be an issue for scrutiny to look into, as there are a number of issues that Scrutiny could potentially help resolve. Under further questioning, Cllr Runciman stated that she thought the evidence around the success of social prescribing and its ability to reduce pressure on other areas of the Health System (such as GP’s / Hospitals) was present. However, it was also noted that the inter-relationship of funding and ‘results’ in this area was often complicated and difficult to identify.

Following a question regarding the budget cuts to the substance misuse service, Cllr Runciman highlighted that she was due to visit the provider, Changing Lives, and it would be important to understand the investment required and the impact that it will have.

Following a question around the Healthy Start Programme and the removal of vitamin supplements from this programme, the Director of Public Health addressed the committee. The Director stated that there had been some issues that needed to be resolved with regards to vitamins however some families have had access through maternity services. It was also noted that the programme was not as robust as it should have been. In response to a further question, it was also noted that communication around the future of this programme was currently being planned. Members requested a further report to Scrutiny on the Healthy Start Programme, when available.

The Executive Member was also asked about the importance of encouraging active travel and she stated that there was a great deal of work happening in this area, however it must not be considered in isolation.

Cllr Runciman noted the importance of agreeing the ‘actual cost of care’ in relation to care home provision. In response to questions regarding the closure of care homes and being ’held to ransom’ by private providers, the Executive Member noted that this would only happen in scenarios where a care home has closed unexpectedly. The hope would always be that the Council can agree the actual cost of care and agree the places that the City require at this rate.

Members also put on record their support for the work around the masterplan for Bootham Park and encouraged Members and the public to engage  ...  view the full minutes text for item 11.

This report presents the Health and Adult Social Care Policy and Scrutiny Committee with the 2018/19 Annual Report of the Health and Wellbeing Board. The Annual Report is at Annex A to this report.

The Chair of the Health and Wellbeing Board, Cllr Runciman, was in attendance to present the annual report of the Board.

The Chair noted that the Board is currently reviewing its working operations and that she would report back regarding any decisions taken, after their next meeting.

The Chair was asked whether part of the function of the Health and Wellbeing Board was to help integrate Health and Social Care across organisations and whether she thought it had been successful at this. The Chair noted that it is definitely the role of the Board to assist in the integration of Health and Adult Social Care within the system and if there was any area in which the Board had not been as successful as they would have liked, it would be integration. Cllr Runciman stated that progress in this area had been slow but it had progressed and they would continue to work on this in the coming year.

This report analyses the latest performance for 2018-19 and forecasts the financial outturn position by reference to the service plans and budgets for all of the Health and Adult Social Care services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.

Richard Hartle, Terry Rudden and Mike Wimmer were in attendance to present the 2018/19 Finance and Performance Outturn Report.

Members asked the officers for information regarding a timescale for the review into the Supported Employment Scheme. Officers noted that they would have to report back on this.

In response to a question regarding whether the NHS contribute to the Older People Community Support Budget, officers stated that the NHS will contribute to certain individual’s costs however a piece of work was currently underway to further understand whether the Authority was receiving the correct contributions.

In response to questions regarding deteriorating statistics for Delayed Transfers of Care, officers stated that schemes such as ‘step up, step down’ and ‘7 day working’ have made a difference to the statistics but there was still significant pressure on the system and the statistics were volatile.

In response to a question on why the percentage of adults with a learning disability who live in their own home or with family has deteriorated, officers stated that they would need to report back at a later date.

Members were interested to hear about the reasons for high average sickness absence within Adult Social Care. The Corporate Director addressed the committee and stated that the number is higher than the private sector and the rest of the Council’s figures. It was also noted that a piece of work is underway to help staff manage the absence in a more robust way, but that Sickness absence as a whole was a particular focus for the directorate.

Members were interested to know about the uptake of the sexual health service and about feedback from residents regarding access. It was noted that a recent Public Health survey had been carried out in all clinics and that feedback on access was good. Officers stated they were happy to circulate to Members, should they wish.

In response to a question regarding the low uptake of Health Checks, the Director of Public Health stated that work was on-going alongside GPs and the CCG improve the situation. It was explained that the system was very reliant on GPs interrogating their patient lists to identify the eligible population. It was also noted that a future pilot programme, placing health trainers who carry out the checks inside GP surgeries was soon to be established.

To consider a report of the Corporate Director outlining some initial challenges and priorities for her Directorate at the onset of the new Municipal Year for 2019/20.

The Corporate Director for Health, Housing and Adult Social Care was in attendance to discuss her priorities and challenges for the coming year.

In response to Member questions, the Corporate Director stated that City of York needed to be a Council that becomes ever more responsive to the views and needs of residents. The Director noted that there are some excellent examples here in York of what can be achieved when Members and officers collaborate. However it is often the case that, despite shared goals, different approaches or different paths will be taken to reach that goal. It was noted that staff can still be focussed on their own directorates, which was particularly evident within financial reports relating to adult social care, for which many of the challenges will need to be addressed collaboratively across the Council.

In response to a question regarding York having the fifth highest physical activity rating in the country and what would be required to improve this considering the rise in obesity, the Corporate Director and Director of Public Health made the following comments:

-      The Corporate Director stated that whilst league tables can be a useful indicator, part of the cultural change that she desired to see, was ensuring that the Council do not ‘hit the target and miss the point’

-      The Corporate Director also noted that so much work can often go into the production of statistics around certain health indicators and not enough time and energy goes into the resolution of the key issues.

-      The Director of Public Health stated that this particular indicator was one that was fairly unreliable as it was based on self-assessments from specific areas.

-      It was also noted that there are inequalities within activity levels and work was on-going to develop a Sport and Physical Activity Strategy to help guide work.

-      Finally it was noted that there are examples of good practice in Leeds, particularly around the reduction of childhood obesity, and this was being explored in York, subject to investment that would be required.

In response to what priorities the Council had in terms of reducing health inequality in the City, the Corporate Director stated that it was firstly important to acknowledge the inequalities, as in a place such as York, it is easy for these to be masked. The Director made the point that it was important to look at specific interventions and programmes that could reduce inequalities from a whole Council perspective and that by different departments and directorates working together to solve and fund problems, certain inequalities could be reduced. The process of looking at issues in that way, will help to identify priorities moving forward.

In response to further questions, The Corporate Director highlighted that she thought there would be little use in trying to take one issue or challenge and trying to shape the market with just one organisation’s needs or one section of the population’s needs in mind. Instead the key challenge would be attempting to  ...  view the full minutes text for item 14.

This report invites the Health and Adult Social Care Policy and Scrutiny Committee to nominate a Member to sit on an Ad-Hoc Scrutiny Committee established by the Customer and Corporate Services Scrutiny Committee (CSMC) to investigate food poverty in York.

Members were asked to consider whether Members of the Health and Adult Social Care Policy and Scrutiny Committee would be interested in taking part in an ad-hoc Scrutiny committee to investigate food poverty in York.

It was noted that Cllr Perrett would be the representative from this committee. Cllr Cullwick stated that if a second representative was needed, then he would be happy to take part.

The Committee will be asked to review the work plan for the coming year.

Members considered the work plan for 2019/20.

The Chair confirmed with the committee that the date for the November meeting had been changed. The meeting will now take place on the 11 November 2019.

It was noted that an implementation update for the Scrutiny Review into Substance Misuse would come to the October meeting of this committee and an update on Multiple Complex Needs Network linking into the Substance Misuse Review would come to the December meeting.

Finally it was noted that an update on the Healthy Start Programme would be circulated to Members.