Agenda and minutes

Due to the absence of the Chair (Cllr Doughty had sent his apologies for the meeting), Cllr Hook was acting as Chair. It was therefore decided to elect a Vice Chair for the meeting, Cllr K. Taylor nominated Cllr Heaton, who was elected Vice Chair for the meeting.

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 interests that they

might have in respect of the business of the agenda. None were

declared.

To approve and sign the minutes of the meeting held on 11 May 2021.

In response to a query from members around the Chair’s ongoing concern around the style of minutes, the Monitoring Officer stated that the issue was not discussed at the last Scrutiny Chairs meeting, but noted that a discussion of minutes would be held as part of larger discussions on the Council’s constitution at the Audit and Governance Committee meeting on Wednesday 8 September 2021.

Resolved: That the minutes of the previous meeting held on 13 April 2021 be approved as a correct record 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 5:00pm on Tuesday 27 July 2021.

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 were no registrations to speak under the Council’s Public Participation Scheme.

Local health and care services are facing unprecedented challenges including increasing demand across all delivery settings. Additionally, the workforce continues to be reduced in capacity and is fatigued, with many professions continuing to work in settings constrained by the requirements for robust infection control.

This Committee will hear from local NHS leaders about this situation and will offer an opportunity to discuss this and also any specific issues that may have been raised previously and are now changed in the context of the pandemic.

The Accountable Officer, NHS Vale of York Clinical Commissioning Group, and the Chief Executive, York Teaching Hospital NHS Foundation Trust gave a verbal update on the current challenges facing health services in York. Alongside them to respond to questions were the Director for Primary Care, NHS Vale of York Clinical Commissioning Group, the Director of Public Health, City of York Council and the Clinical Chair of the Vale of York CCG.

During the presentation of the update, it was noted that:

·        Health services will be managing with Covid-19 for the foreseeable future.

·        There were currently 37 Covid patients in York hospitals, with the rate of admissions growing, and that there were 5 patients in critical care.

·        Resources for the recovery plan were finalised for the first half of the financial year, but funding would be allocated for the second half in late summer/September.

·        The national ask for 2021-22 was to prioritise the most clinically urgent (P1/P2) patients for example surgical and cancer treatments, to reduce waiting times and to get to 95% of 2019-20 elective activity levels.

·        The total waiting list was increasing in size, but at a lower level than the expected modelled trajectory – there had been a significant increase in demand as Covid-19 levels reduced.

·        The numbers of patients waiting 52 weeks and P2 patients waiting over 4 weeks were decreasing, with a peak of 2,500 people waiting 52 weeks down to 1,488 at the end of June. Initial cancer treatment wait times were also reduced.

On elective activity levels, it was reported that:

·        In the first half of 2020/21, almost all elective activity ceased, however the expectation for the second half of that year was to continue to try to deliver elective activity wherever possible while managing pandemic response.

·        96% of planned elective inpatient activity was achieved in the second half, and 108% of planned levels was achieved between September 2020 and March 2021.

·        In July 2021, two theatres were opened to focus specifically on resuming planned elective orthopaedic activity.

·        There were risks in maintaining the current trajectory, in that urgent care demand was higher than pre-Covid levels; that GP referrals could not be maintained at the current level which would increase backlog; that prioritising P2 patients would cause those waiting the longest for treatment to continue to wait; that there were staffing challenges across all services due to a variety of factors including self-isolation and that there was a risk of the current increased levels cancer fast track referrals continuing (the highest ever number of such referrals had been recorded in 2021).

·        There were several actions being taken, such as the Building Better care Programme, the Cancer Delivery Group and the Outpatient Transformation Programme.

On activity in the primary care sector, it was reported that:

·        The primary care community were focused on restoration/recovery plans, but had been interrupted by each wave of the pandemic. Staff were fatigued and susceptible of ill health.

·        There was an unprecedented demand which was outstripping supply.

·        There had been an  ...  view the full minutes text for item 4.

This report presents the findings of the ADASS/LGA Peer Challenge into the use of resources in Adult Social Care in City of York Council, highlighting both good practice and recommendations intended to help CYC improve its approach. It also includes the high-level action plan developed from the recommendations.

The Committee considered a report which presented the findings of the ADASS/LGA Peer Challenge into the use of resources in Adult Social Care in City of York Council, highlighting both good practice and recommendations intended to help CYC improve its approach. It also included the high-level action plan developed from the recommendations. The Corporate Director of People was in attendance to present the report and respond to questions.

Key points raised during the presentation of the report included:

·        That the Use of Resources Peer Challenge, assembled by the Local Government Association, was comprised of people working in adult’s social care in multiple local authorities and at multiple levels. The Challenge was always led by an experienced director of adult’s services and also contained other managers and elected members.

·        ­That the Challenges main focuses were: Leadership, Strategy and Vision; Business Processes and Long-Term Support and Recovery.

·        That the Challenge had found York’s adult’s services’ leadership to be insightful and committed to delivering excellent services, with an engaged, briefed and experienced portfolio holder, but that significant challenges lay ahead to achieve the ambitions of the leadership team, which was expected to take up to 3 years.

·        The Challenge had applauded the New Alliance with key partners to deliver effective place based services in York.

·        It was recognised that more investment was needed in data quality, business intelligence and finance, and that investment was being put in place.

·        That frontline staff had been working well in extremely difficult circumstances, but there was a danger of exhaustion. Therefore, additional resources were being allocated to ensure that differing skills were well distributed and support for staff was available.

·        That a Corporate Board for the development of People’s Services, including adult’s services had been established.

·        In children’s services, there was a much more well defined data set than in adult’s services. Therefore, work was being done to develop team level dashboards for managers in the service to provide them with up to date data.

·        That social services had worked well and more closely with partners and the community throughout the pandemic, and that was to continue long-term. There had been a shift away from working in specialisms to working on a community, neighbourhood based approach.

·        The Challenge noted that York needed to be more flexible in its commissioning, which was one of the reasons for the creation of the Director of Commissioning post.

In response to questions from members, it was noted that:

·        ­­A cross-sector approach to recruitment was needed given the staff shortages across all services, and that work was ongoing to make employment in the care sector in York a career of choice. Exhaustion levels amongst staff were high following the pandemic, but the staff group was also very committed to their work and the city. Therefore, it was important to offer increased support to staff, particularly in the area of trauma recovery in order for York to continue to be an attractive place to work in the care profession.

·        The Peer Challenge self-assessment  ...  view the full minutes text for item 5.

To review the Committee’s work plan for 2021/22.

The Chair noted that there had been a request at a meeting of Scrutiny Chairs on Monday 26 July 2021 to ask whether the Committee would support the Customer and Corporate Services Scrutiny Management Committee endorsing the recommendations of Scrutiny meetings so that they could continue to be held virtually.

The Monitoring Officer explained that there were concerns raised at the Scrutiny Chairs meeting around the frequency of formal scrutiny meetings, which are currently held quarterly, and the capacity issues within Democratic Services due to sickness and leave commitments, and suggested that the Committee sought further clarification with the Chair of CCSMC.

Some members indicated that they were happy for meetings to continue virtually in light of absences in Democratic Services, and others raised concerns that the holding of virtual scrutiny meetings could become entrenched in future, suggesting that the arrangement could be subject to review every six months.

It was also noted by the Chair that a Joint Meeting of the Health and Adult Social Care and Economy and Place Policy and Scrutiny Committiees was proposed for Monday 25 October 2021 to discuss Blue Badges.