Meeting documents

Also present at the invitation of the Chairman

Councillor Andrew Backhouse (Cabinet Member for Technical Services, Highways & Transport, Environment & Coastal and Flood Defences) – for Item 8

Ms Amanda Brown (Locality Director, NHS North Yorkshire and York) – for Item 4

Mr Roger Holmes (Non Executive Director, Yorkshire Ambulance Service Trust) – for Item 6

Dr Bruce Willoughby (Consultant in Public Health, NHS North Yorkshire and York) – for Item 5

Mr Mike Wright (Locality Manager, Yorkshire Ambulance Service Trust) – for Item 6

Members are reminded of the need to consider whether they have a personal or prejudicial interest to declare in any of the items on this agenda.  If so, the nature of the interest must be declared at the start or as soon as the interest becomes apparent, of the meeting.  In addition, the attached form must be completed and passed to the Committee Administrator.  The Officers will be pleased to advise, if necessary, and any request for assistance should be made, in the first instance, to the Committee Administrator whose name appears at the end of this agenda.  Ideally, such advice should be sought before the day of the meeting so that time is available to consider any uncertainty that might arise.

Councillor Abbott declared a personal interest in agenda item 4, Development of a Strategy for Healthcare Services in Whitby since he was a member of Whitby Hospital Action Group.

Councillor Tindall declared a personal interest in agenda item 4, Development of a Strategy for Healthcare Services in Whitby since he was a member of Whitby Hospital Action Group.

Councillor Mrs Jefferson declared a personal interest in agenda item 4, Development of a Strategy for Healthcare Services in Whitby in her capacity as a member of North Yorkshire County Council.

Councillor Mrs Turner declared a personal interest in agenda item 4, Development of a Strategy for Healthcare Services in Whitby since she was a member of Whitby Hospital Action Group.

Councillor Mrs Jefferson declared a personal interest in agenda item 6, Response to the consultation by Yorkshire Ambulance Service Trust on its proposals for operating as an NHS Foundation Trust in her capacity as a member of North Yorkshire County Council.

Councillor Billing declared a personal interest in agenda item 7, Draft Alcohol Reduction Harm Reduction Strategy for Scarborough Borough 2011-2014 in his capacity as a member of the North Yorkshire Coast Community Partnership and the Safer Communities Partnership.

Councillor Jay-Hanmer declared a personal interest in agenda item 7, Draft Alcohol Reduction Harm Reduction Strategy for Scarborough Borough 2011-2014 in his capacity as a landlord of a public house and retailer and purveyor of alcohol.

Councillor Mrs Jefferson declared a personal interest in agenda item 7, Draft Alcohol Reduction Harm Reduction Strategy for Scarborough Borough 2011-2014 in her capacity as a member of the North Yorkshire Police Authority, the Safer Communities Board, and a representative on the North Yorkshire Coast Community Partnership.

To approve as a correct record and sign the Minutes of the meeting held on 28 September 2011.  (Minutes attached).

In respect of Minute 6, Ingham Play Park, Sleights, and the undertaking to bring a report back to this meeting, the Strategic Director reported that she had met with members of the Ingham Play Park Committee to discuss their concerns, and as a result of this meeting, a report would be submitted to the next committee meeting on 25 January 2012.

RESOLVED that the minutes of the meeting held on 28 September 2011 be approved as a correct record and signed by the Chairman.

Public questions of which due notice has been given and which are relevant to the business of the Scrutiny Committee.

The Chairman reported that no public questions had been submitted.

To consider a report by the Locality Director (Hambleton, Richmond and Whitby), NHS North Yorkshire & York, first submitted to the County Council Scrutiny of Health Committee on 18 November 2011 (attached)

The Committee considered a report by the Locality Director (Hambleton, Richmond and Whitby), NHS North Yorkshire and York (NHSNYY), first submitted to the County Council Scrutiny of Health Committee on 18 November 2011, in respect of progress with the development of a strategy for healthcare services in Whitby. Members were advised that there was little additional information to report since the last meeting in September.  However, the report summarised the background and significant events behind the requirement to develop a strategy, the Clinical Commissioning Group (CCG)’s intention to engage patients and the public more effectively, and the plan to complete the development of the business case for day case surgery in the theatres by January, when further updates to both the County and Borough Council scrutiny committees were proposed.  The Locality Director, Amanda Brown added the business case would also be informed by a workshop she planned to hold ideally before Christmas involving local stakeholders, clinicians and technical advisers.  She suggested that the committee nominate two or three members to take part in the workshop.  Members then discussed the report.  In reply to Members’ questions, Ms Brown explained that in order to develop a robust business case for day case procedures, NHSNYY needed to obtain a broad picture of potential activities by a range of service providers which could be delivered at the hospital.  The funding originally intended to refurbish the theatres was received as part of the NHSNYY’s capital budget, and was not specifically earmarked for that purpose.  Issues such as clinical quality, safety and levels of activity all now needed to be considered so NHSNYY as the commissioner could decide whether the best solution was to refurbish the theatres.  The proposed workshop was part of this process.  Councillor Abbott raised concerns that Ms Brown’s report did not refer to the NHS’s requirement to consult as reflected in the statutory rights of public and patients, and also about the future of the out of hours service in Whitby and the surrounding area.  Ms Brown replied that the out of hours service would be considered as part of the strategic review and reminded the committee of the more onerous requirements placed on the new commissioning body, the CCG to engage the public in their decisions.  A programme director had recently been appointed by the CCG, in readiness for the CCG to assume more of NHSNYY’s responsibilities in the new year, when more details of the engagement plan would become available under the umbrella of the strategic review.  Ms Brown assured members that when planning healthcare services in Whitby, the commissioners would take into account the projected growth in population in the area in light of the windfarm and potash mine developments, as well as seasonal variations in population. NHSNYY continued to obtain information from the Borough Council about these matters.  She felt positive about this new more integrated approach to developing services in the area, as opposed to the historical, more piecemeal approach which  ...  view the full minutes text for item 4.

To consider a report by the Strategic Director (Hilary Jones) (Reference 11/547 attached)

The Committee considered a report by the Strategic Director (Hilary Jones) (Reference 11/547) in respect of progress by the Borough Council and NHSNYY against the recommendations of the Diabetes Task Group which had reported in November 2009.  Members were reminded that the Borough Council contributed to the prevention of type 2 diabetes under two themes of the multi-agency Healthy Weight, Active Lives Strategy: building physical activity into our daily lives and creating incentives for better health.  Ms Jones referred in particular to the extensive work the Borough Council undertook in partnership with health professionals, Adult Services and other agencies to promote use of its leisure facilities for specific at risk groups, and to the growing partnership work in relation to strategic health issues in the context of the new health service framework, by the establishment of the Health Partnership Group in May 2011.  Dr Bruce Willoughby, Consultant in Public Health (NHSNYY) then addressed the committee about the NHS’s work in identifying type 2 diabetes outlined in the appendix of the report.  Members were advised that the Health Checks pilot in central Scarborough had now completed.  The programme aimed to invite all 40-74 year olds who do not have existing cardiovascular disease to assess their risk every five years.   In the pilot 44% of those invited had attended for the check.  NHSNYY had now commissioned a GP provided service across the whole of North Yorkshire and York, building on the learning and feedback from the pilot.  The challenge was to ensure that more of the other 56% attended, using the cancer check take up rate of 75% as a benchmark.  Dr Willoughby also referred to the other activities in which NHSNYY was involved to prevent type 2 diabetes such as their weight management services for children and adults.  In respect of the latter, Dr Willoughby noted that there were plenty of services which NHSNYY did not commission.  Another challenge for NHSNYY was to increase its commissioning in this area.  Members then questioned Ms Jones and Dr Willoughby about their reports.  Dr Willoughby explained that NHSNYY did not have the budget to provide equipment for charities’ diabetes screening days, but it could provide the expertise.  In order to increase the uptake of Health Checks, Dr Willoughby recognised that they had to analyse the data of who did and did not attend, identify specific groups, and then use social marketing and other methods to target these groups.  Ms Jones commented that the Health Partnership Group had examined hospital A&E attendance data using Mosaic demographic profiling, and suggested that Mosaic be used to support the Health Checks programme.  This analysis would also help NHSNYY to target specific geographical areas: particular reference was made by Members to isolated rural communities.  Dr Willoughby also explained that Health Checks was designed as a structured call and recall programme by invitation only.  However, the emphasis was now shifting to who did not attend despite being invited, and to start promoting Health Checks to hard to  ...  view the full minutes text for item 5.

To consider a report by the Overview and Scrutiny Manager (attached)

The Committee considered a report by the Overview and Scrutiny Manager in respect of Yorkshire Ambulance Service (YAS) Trust’s current consultation on its proposals for operating as a an NHS Foundation Trust, accompanied by a presentation by Roger Holmes, a Non Executive Director of YAS Trust.  Mike Wright, Locality Manager of the Trust was also in attendance.  Members were advised that by securing Foundation status, YAS Trust would still operate to NHS principles and be subject to Care Quality Commission inspection and Monitor regulation, but would achieve greater freedom to shape how they provide and develop services and would provide greater accountability through new governance structures.  The Trust’s plans and priorities centred on a new NHS 111 number, improving how they deal with major trauma, and improving clinical outcomes for patients with a stroke or heart attack.  Members then questioned Messrs Holmes and Wright about their proposals.  Mr Holmes explained that under the new health service framework, YAS Trust would still have to be held to account by those who commissioned their services.  Subject to the reforms going ahead, he expected the primary care trusts’ places on the new Council of Governors to be taken by the new clinical commissioning groups.  In respect of job creation, Foundation status would not alter the tough economic climate, but at least greater financial freedom would enable YAS to plough surpluses back into the service.  In respect of YAS’s operations, Mr Wright explained that there was no patient choice in emergency care, but rather a clinical imperative which determined to which A&E hospital the patient was transported.  Mr Holmes acknowledged the need for more first responders; however, he was hopeful that the new membership structure could encourage more volunteers to come forward in this area of work.  Mr Wright commented that ambulances’ navigational equipment was not 100% failsafe, but this sophisticated technology had not encountered any significant problems, not even in remote rural locations.  In respect of the proposed minimum age limit of 16 to become a member (and governor) of the Foundation Trust, Mr Holmes commented that YAS was keen to engage young people in the work of the organisation.  The committee shared the County Council’s Scrutiny of Health Committee’s concerns about the proposed level of local authority representation on the Council of Governors, and supported the County Council’s draft response before the committee, in particular that the area of North Yorkshire and York should have some local authority representation on the Council of Governors.  The Chairman thanked Messrs Holmes and Wright for presenting their proposals to the committee.

RESOLVED that:

(i)                 the report be received; and

(ii)               County Council’s Scrutiny of Health Committee’s response to the consultation be endorsed as the Borough Council response.

To consider:

(i)                 the North Yorkshire Coast Community Partnership Draft Alcohol Harm Reduction Strategy 2011-2014 (latest draft attached (November 2011)); and

(ii)               a joint presentation by Jo Ireland, the Community Partnerships Manager and Mandy Chance, the Safer Communities Partnership Manager.

The Committee considered the draft Alcohol Harm Reduction Strategy for Scarborough Borough 2012-2015 accompanied by a presentation by the Community Partnerships Manager, Jo Ireland, and the Safer Communities Partnership Manager, Mandy Chance.  Members were first advised about the seriousness and prevalence of alcohol abuse, both locally and nationally, and its health, economic and social impacts.  Rates of binge drinking were higher in the Borough than the England average.  The Cambridge Centre in Scarborough had a growing waiting list for treatment, some users waiting in excess of six months.  The rate of alcohol related hospital admissions had increased by some 44% from 2008 to 2010.  Since 2005, the alcohol related mortality rate showed a downward trend for males, whilst for females the rate was rising.  Estimated costs to the NHS of dependent drinkers in the Borough were over £5.4M annually.  Alcohol use was also significant among young people, even as young as primary school age.  Members were further informed that a diverse range of services were provided locally, such as specialist alcohol workers; work with offenders, for example the Women’s Community Project; community safety’s four pronged approach of responsible drinking, responsible retailing, enforcement and environment; and work with young people, for example, parental awareness and diversionary activities.  However, the draft strategy concluded that alcohol needed to be prioritised as a public health issue supported by a systematic, coordinated approach to commissioning.  The public sector agencies needed to work together and with the voluntary and private sector.  Too much time was spent chasing short term funding, when mainstream support was required.  The evidence demonstrated that properly targeted investment would save money but this was a long term issue.  Happily, the Borough’s Public Sector Executive had now committed to tackling the problem, and alcohol harm reduction was one of the new Health Partnership’s initial four workstreams.  Members then discussed the report and asked questions.  Various cultural factors were given for the increase in alcohol harm to women, such as that pubs were no longer a male domain, and the increasing availability and accessibility of alcohol.  The 44% rise in alcohol related hospital admissions should be treated with some caution because of some data issues, but the upward trend was irrefutable.  The recently appointed alcohol worker in A&E at Scarborough hospital, as well as doing important work, would also help provide more accurate data.  Licensing, trading standards and the police enjoyed close partnership working to identify problem premises and provide enforcement.  Pre-loading was identified as a significant problem in the Borough among both men and women.  How to effect a cultural shift way from such practices was a major challenge.  Both the Community Partnerships Manager and the Safer Communities Partnership Manager were under no illusions as to the scale of the challenge, but this was a multi-faceted phenomenon that the different agencies could not afford to ignore.

RESOLVED that:

(i)                 the presentation be received; and

(ii)               the draft Alcohol Harm Reduction Strategy 2012-2015 be endorsed by the committee.

To consider a report by the Head of Tourism and Culture (Reference 11/546 attached)

The Committee considered a report by the Head of Tourism and Culture (Reference 11/546) in respect of proposed car parking fees and charges for 2012/13.  Members were advised that this annual report stemmed from the work of the Car Parking Review Group which in summary had tried to increase the competitiveness of the town centre short stay car parks whilst removing the four hour band on some outer car parks, in an attempt to encourage longer stays in these locations.  At the present time income was down 6% on last year’s figure.  By the end of the financial year income was projected to be down by £430K against budget.  The Council needed to make a decision on whether it could make up all or part of this shortfall on fees and charges, but the current package of proposals attempted to do nothing more than to achieve the same budgetary position as this year.  Various factors were cited for the decline in income such as the economic downturn, rise in fuel prices, park and ride, and the weather.  Rather than consider each of the twelve recommendations in turn, Members were asked to comment on any that concerned them.

Recommendation 2a – introduce winter charging on Marine Drive

Councillor Mrs Jefferson felt that such a measure discriminated against visitors and residents in Scarborough, and would affect local businesses in the winter months.

The Parking and Venues Manager, Stuart Clark explained that Marine Drive was chosen as opposed to other remoter, rural car parks in the Borough, because no additional enforcement costs were entailed.  The proposed nominal charge of £1 for an hour and £2 for six hours was felt to be reasonable.  This was one of a number of measures to try and offset the proposed reduction in short stay car park charges.

Recommendation 8a – changes to the coach and car parking arrangements on Marina Back car park

Councillor Abbott asked if more coaches could be accommodated within the West Cliff Car Park.  Mr Clark responded that various options had been discussed previously regarding coach parking on West Cliff; however these had been discounted for a number of reasons. For the lower section of West Cliff concerns had been raised around the possible effect on traffic movement on busier days as coaches manoeuvred into spaces, and in other areas the issue of coaches backing up to the school or leisure centre and discharging fumes meant that these areas had been discounted. Mr Clark explained that options were being explored around more formal parking arrangements at Marina Back as outlined in the report.

Motorhomes

Councillor Abbott voiced concern at motorhomes staying overnight in car parks in the Borough, and suggested the use of the Caravan Sites and Control of Development Act 1960 to help address this problem.  Mr Clark replied that he was consulting with Legal Services about this issue, and would pass on Councillor Abbott’s suggestion.  Any proposals resulting from Legal Services’ advice would be considered by the Car Parking  ...  view the full minutes text for item 8.

To consider a report by the Head of Legal and Support Services (Reference 11/514 attached)

The committee considered a report by the Head of Legal and Support Services (Reference 11/514) to assist Members in planning the committee’s work for 2011/12.  The Strategic Director reported that she would like to deliver a training session on the new health service framework and its implications for the Council and the scrutiny function before the next meeting of the committee on 25 January 2012.

RESOLVED that, subject to the additional item agreed under minute 4, the report be received.