Agenda item

The following report provides an update on York Pathways, a partnership committed to improving the response to individuals experiencing ‘complex distress’ placing a high demand or at risk of placing high demand on services within the City of York.

Board Members received an update report from York Pathways, a partnership who were committed to improving the response to individuals experiencing ‘complex distress’ placing a high demand or at risk of placing high demand on services. These individuals were often those who had mental health challenges and suffered with alcohol and drug problems.

Tim Madgwick introduced the presenters and informed the Board that the Pathways project had been nationally recognised. However, it could no longer rely on unsustainable funding resources.

Sarah Owen Rafferty and Samantha Durrant from Together York presented the report and informed the Board using sound clips that it was often difficult to actively listen to service users because of the way that they presented themselves to services. They carried out an exercise amongst Board Members which asked them to think of vulnerable people in York and write down their priorities.

Following the exercise, it was noted that break down in relationships and reliance on alcohol were some of the issues faced by service users in York. However, it was felt, that attention needed to paid to those groups who did not currently use services.

Some further areas that were important to service users identified were;

·        Resilience

·        Wellbeing

·        Motivation

·        Change

·        Interpersonal Trust

·        Hope

Prior to Pathways, service users showed negative responses across all of these areas, and seemed worse than other groups surveyed such as prisoners. Therefore it was felt that a more holistic intervention approach was needed.

Sarah and Samantha shared a service user’s story with the Board.

The Chair informed the presenters that although the Board supported the work and aims of Pathways, they did not have a budget.

The issue of social prescribing was raised and it was felt further discussion was needed, in regards to positive outcomes from further individual interventions, it was noted that there were those who felt their needs were not addressed by any services and work to bring services together, could only be a positive thing.

It was noted that that City of York Council and NHS Vale of York Clinical Commissioning Group had developed a way forwards in regards to a Mental Health Strategy for the city and the work of the Pathways project should link into this. Early low level intervention it was felt should be brought back within an action plan.

Tim Madgwick underlined the significance of the Pathways work in that it worked with groups who were often regular presenters at A&E. It was about making use of the two years worth of work, and about working in an interagency way, particularly given that there was not an infinite amount of money.

Sarah Armstrong volunteered to meet with the representatives from Pathways and report back to the Chair regarding this.

Resolved: (i) That the report and presentation be noted.

                 (ii) That the learning from the meeting be followed up and future discussions take place in an additional informal meeting between the Pathways presenters and the Chief Executive of York CVS, on behalf of all Health and Wellbeing Board Members.

Reason:    The learning from the evaluation in process and strategic board partners informs us that we need to focus on addressing system wide issues if York’s ambitions are to be achieved. Embedding system change at all levels, including those who are directly supporting service users and their managers. We will do this by seeking permission from agency CEO’s (for example health, housing, police, substance misuse, third sector) for Pathways to engage with their staff on a regular basis over the year. 

It is imperative that we reach relevant Boards and forums to articulate parts of the system that we know are not working and help prevent the potential misalignment of resources.  As a result we want to see a shift in a system focused on budgets and outcomes to a system that has the service user at the heart and is fully accountable for individual journeys.