Agenda item

This report provides an update to the Health and Wellbeing Board (HWBB) regarding the work of the York Health and Care Partnership (YHCP), progress to date and next steps.

This edition of the report introduces a proposal developed by the Humber and North Yorkshire Health and Care Partnership which was discussed by the YHCP at their August meeting.

The report is for information and discussion and does not ask the Health and Wellbeing Board to respond to recommendations or make any decisions.

The York Place Director presented the report.

She discussed the success of the 30 Clarence Street Hub, the Conversation Café Forum and the announcement of the £2.4 million next phase of the Mental Health Hub, which had previously been embargoed due to the general election, and the pre-election period, which prevented central and local government from announcing any new initiatives. She discussed the Connecting our City Event, development of YHCP and the future work required to take the partnership forward including digital strategy and integration of teams.

She noted that Lord Darzi’s report on the state of the National Health Service in England highlighted some important issues, including an emerging need for seven new hospital wards in York for people aged 75 or over at a time when the hospital is closing wards due to staffing shortages, and there is simply no room to build new wards on the current hospital site.

The York Place Director stated that another key issue was that specialist staff were retiring across sectors, and many people were going out of area which a regional model would be a more effective solution for. The early intervention model would alleviate this to some degree, but major reform was needed.  Humber and North Yorkshire ICB discussed this in August, a month ahead of the Darzi report and as such had begun to formulate three areas of focus:

1.    Local Integrated Primary, Community and Social Care (including social based and de-medicalised mental health and neurodiversity services) – The ICB want people to be able to access primary, community, mental health, long-term conditions management, outpatients, social care and end of life care in a joined-up way that is local to their place.

2.    Mental Health Learning Disability and Autism – The ICB want people to be able to receive the specialist health and mental health services that they require least often when they need it, which may mean they are provided at scale and could be from a single location.

3.    Acute and Specialist services and care – The ICB want people to be able to receive best quality planned treatment in a timely way, this may require people to travel to receive access to health expertise in specific centres of excellence that maximise productivity and improve people’s outcomes.

The board asked about accessibility of GP surgeries and pharmacies, both with regard to current housing stock, and in view of the number of new housing developments planned, it was hoped that these new houses would also have access to services as a consideration of the planning process.

The York Place Director said that it was difficult to produce integrated care centres for all communities in a short space of time, but that this was a challenge that the partnership recognised and would look at as a long-term issue. She stated that future planning would most definitely consider access to care services, if necessary, via regular public transport.

The Chief Executive, York CVS stated that this report recognised the challenge of statutory partners referring people to the voluntary sector because they didn’t meet threshold, and the necessary investment required for those referrals. Consequently £250,000 had been invested in seven organisations over a period of two years.

The board welcomed this as a positive step, noting that that the voluntary service had hitherto been providing core offer but not being properly compensated for it.

The board asked about the accessibility to all of the Mental Health hub – which was a 24:7 service offer but was not in the centre of York; it would probably not be appropriate for someone experiencing mental health crisis to travel via multiple buses to seek assistance.

Director of Operations and Transformation, Tees, Esk and Wear Valleys NHS Foundation Trust responded that this would be a pilot in one particular neighbourhood, in order to demonstrate its effectiveness for the two-year period, and if successful it would be rolled out citywide, making the service more readily accessible to all. This service will serve as additionality and would not remove existing crisis services; these would remain in place, operating alongside the targeted hub, currently in this one neighbourhood. 

Joint Chair of York Health & Care Collaborative pointed out that primary care estates were currently fragmented, and while co-location was essential there was not a single estate currently fit for purpose. She encouraged partners to collectively get behind this vision, which would require investment, citing the example of Acomb where there were six GP services in under a mile which could all be collocated.

Resolved:   That the Board note the report of the YHCP.

Reason:      So that the Board were kept up to date on the work of the YHCP, progress to date and next steps.