Meeting documents

Also present at the invitation of the Chairman

James Hayward, Programme Director – Capital and Infrastructure, York Teaching Hospital NHS Trust – for Item 4

Dr Lincoln Sargeant, Director of Public Health, North Yorkshire County Council – for Item 5

Mark Husler, Chair of Scarborough Voluntary Group, Diabetes UK – 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.

No declarations of interest were received.

To approve as a correct record and sign the Minutes of the meeting held on 31 July 2013.  (Minutes attached).

In respect of Minute 4 and Government proposals to phase out Minimum Practice Income Guarantee (MPIG), the Overview and Scrutiny Manager reported the response to communications by the Chairman, Councillor Jeffels, and by Councillor Abbott, Chairman of the Northern Area Committee, which had considered the same matter. Local MP, Anne McIntosh had forwarded a reply from Earl Howe, Parliamentary Under Secretary of State at the Department of Health.  He stated that MPIG had always been a temporary solution to assist some GP practices in moving to the new General Medical Services contract.  From April 2014 MPIG would be phased out and redistributed to increase basic funding that all practices received.  Funding would be weighted to take account of factors such as age of population and rurality.  Mr Geoff Day of NHS England had given similar assurances in his reply to Councillor Abbott, and also that there would be consultation with those GP surgeries for which MPIG formed a significant part of their income.  The Chairman of the LGA Rural Commission had replied that the LGA continued to make representations to the Government on the impact of centrally imposed funding cuts and was also encouraging Government departments to ‘rural proof’ their policies.  Following contact made with the Rural Services Network, both Dr Fester and Councillor Jeffels had been invited to a special meeting of the All Party Parliamentary Group on Rural Services at Westminster on 16 January.

RESOLVED that the Minutes of the meeting held on 31 July 2013 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 receive a presentation by Mike Proctor, Deputy Chief Executive and James Hayward, Programme Director – Capital and Infrastructure, York Teaching Hospital NHS Foundation Trust

The Committee received a presentation by James Hayward, Programme Director – Capital and Infrastructure, York Teaching Hospital NHS Foundation Trust which gave an overview of York Trust’s expanding portfolio of assets including York, Scarborough, Bridlington, Malton, Whitby and Selby Hospitals, but in particular focused on the capital investment plans for Scarborough Hospital made possible by the integration with York Trust.  Mr Hayward noted that there were some good facilities at Scarborough Hospital, for example, some of the operating theatres, but others, such as the Nightingale ward where paediatrics was currently located required redevelopment.  Key aspects of the plans were a new focus on clinical care at the western end of the site, a new outpatients department in one location rather than dotted around the site, a new paediatrics unit, and an Emergency Assessment Unit (EAU) which would operate adjacent to Accident and Emergency and streamline care for A&E patients.  He also referred to the new car park, the second Maple Ward, and the £1m refurbishment of the maternity theatre.  The current operating theatre servicing the maternity unit was at the end of its serviceable life and would shortly close for a period of 16 weeks to enable the refurbishment.  The Maternity Led Unit (MLU) had closed to free up extra staff while the theatre was out of operation.  He added in reply to Members’ questions that the MLU would reopen when the maternity theatre was recommissioned in March /April 2014.  The Special Care Baby Unit would remain open during the redevelopment.  Asked whether the capital investment would entail that more services would be provided at Scarborough Hospital, Mr Hayward responded that the hospital would remain a general hospital to be distinguished from tertiary specialist centres such as Hull Royal Infirmary.  That said, Scarborough would take on some services such as fitting pacemakers, currently provided by HRI.  He further commented that the planned EAU was very much in accordance with the latest thinking on emergency care as evidenced by a recent report by the Royal College of Physicians, and would enable faster access to senior clinicians and more efficient and improved quality of care.  Mr Hayward was not the appropriate person to comment on reports of a management restructure at York Hospital Trust which apparently would mean a significant increase in managerial positions and loss of expert clinical posts.  However, on another matter, he acknowledged the complexity of new commissioning arrangements – York Hospital Trust worked with four Clinical Commissioning Groups with differing commissioning objectives – but the Trust endeavoured to deliver services tailored to these objectives within the CCGs’ resource limits.  Questioned about historical underinvestment in Whitby Hospital, Mr Hayward noted the recent CCG public consultation event on the future of community health and social care services in the Whitby area, that the current facility was too large, that different localities had different clinical needs taking into account such factors as population and rurality, but that York Hospital Trust would continue to work  ...  view the full minutes text for item 4.

To receive a presentation by Dr Lincoln Sargeant, Director of Public Health, North Yorkshire County Council

The Committee received a presentation by Dr Lincoln Sargeant, Director of Public Health for North Yorkshire about the transfer of the statutory duty for public health to upper tier local authorities, the new public health outcome framework, the role of Scarborough Borough Council, the voluntary sector’s role in improving public health and place in the new health service landscape, and possible ways in which engagement with the sector could be increased.  Members were advised that there were two broad public health outcomes: (i) increased healthy life expectancy and (ii) reduced differences in life expectancy and healthy life expectancy between communities.  North Yorkshire County Council now had a ring fenced budget of £19m per annum to contribute to the achievement of these outcomes, but the wider determinants of health and wellbeing, such as lifestyle, social, economic and environmental factors, meant there were many organisations which also had a role to play, including the Borough Council for example through its planning, housing, leisure and regeneration functions.  Dr Sargeant referred to the marked health inequalities across North Yorkshire.  For example, in Scarborough borough the incidence of cardiovascular disease premature mortality (per 100,000) was 77.02, whilst in Craven district it was 51.81.  Social and economic deprivation was a well-established factor in affecting health outcomes, but Dr Sargeant also cited the comparative wealth of charities across districts.  For example, in Ryedale, which had a population of less than half that of Scarborough borough, charities’ expenditure was more than double that in its neighbouring coastal district.  A challenge for the statutory sector was how to nurture and encourage the voluntary sector and so help strengthen civic society.  Dr Sargeant then outlined the differing roles of the voluntary sector in relation to the County Council’s public health and social care responsibilities.  He distinguished between the mandated public health services the County Council provided or commissioned, such as sexual health services and the NHS Health Checks screening programme, and other commissioned services such as drug and alcohol misuse services.  All public health services were under review and would need to be retendered by 2015.  Throughout this challenging period of transition the County Council had maintained dialogue with voluntary sector service providers.  A second important role of the voluntary sector was as partner to build community resilience and social capital, but also to provide flexible and innovative responses to the needs of the most vulnerable.   He cited Social Services which was seeking to move social care more towards the community, by supporting people in their own homes, and avoiding the unnecessary creation of dependency.  The voluntary sector had an important part to play in the achievement of this goal.  Dr Sargeant explained the distinctive contribution of the voluntary sector in four areas of work with the statutory sector: (i) bonding social capital by bringing individuals together, (ii) bridging social capital by bringing different groups together e.g. socio-economic or age groups, (iii) linking social capital by advocating on behalf of groups and linking them  ...  view the full minutes text for item 5.

To receive a presentation by Mark Husler, Chair of Scarborough Voluntary Group

The Committee received a presentation by Mark Husler, Chair of Scarborough Voluntary Group of Diabetes UK, about the work of the local group and issues affecting people with diabetes.  Members were advised that some 3m in the country had diabetes and that number was rising.  850,000 people were unaware they had the condition which placed them at considerable risk.  Free NHS health checks for over 40s were helping to increase the number of diagnoses, and Mr Husler encouraged people to make use of this service.  In the Borough, 9000 people were estimated to have the condition, however only 250 were on the local group’s lists.  This was a cause of frustration for Mr Husler, despite all the awareness raising work carried out by the local group, including with local charities such as the Rotary Club.  The local group did not demand subscriptions from members, but was there to offer support.  The low take up he attributed to various factors: an ‘ostrich’ mentality and perhaps to the stigma and embarrassment of difference.  Despite this, the local group was very active, raising money for holidays for children with diabetes, and undertaking lobbying.  Mr Husler highlighted their successful campaign to ensure test strips remained available in GPs surgeries, and his support for the Council’s scrutiny review in respect of the identification and prevention of Type 2 diabetes.  The onset of Type 2 diabetes - when the body does not produce enough insulin to use the glucose in the blood to give energy – was affected by lifestyle factors such as diet and exercise and was becoming increasingly common.  Councillor Abbott referred to the work carried out by Whitby District Lions to offer testing for diabetes which since its inception had led to some 750 referrals to GPs.  Members acknowledged the gravity of the situation with so many unaware of a condition which could have such a devastating impact on their health, and welcomed Mr Husler’s suggestion of a briefing for Members, which may perhaps generate further ideas.  The Chairman thanked Mr Husler for this presentation.

RESOLVED that:

(i)                 the presentation be received; and

(ii)               Mr Husler be invited to deliver a further awareness raising session to Members as part of the new monthly programme of Member briefings.

To consider a report by the Director of Service Delivery (Reference 13/369 attached)

The Committee considered a report by the Director of Service Delivery (Reference 13/369) which reviewed the performance of the Welcome to Yorkshire Tourism Partnership during its second year of operation 2012/13.  Members were reminded that the key aim of the partnership was to increase visitor numbers and visitor spend through the development of marketing campaigns, events and festivals and in general to raise the profile of the coast to new and existing markets.  Activity was delivered through both the regional office in Leeds and the local area tourism office based in Scarborough.  The Borough Council invested £20k pa in the partnership and received £60k back for the benefit of the Borough supplemented by contributions from Ryedale and in 2013, the North York Moors National Park Authority.  The Area Tourism Director, Janet Deacon then outlined the main areas of the partnership’s activity in 2012/13.  The local area office supported the Local Hospitality Association’s Scarborough/Whitby/Filey Holiday Guide by providing funding for additional copies and distribution.  A page turning pdf format was also produced reflecting the shift to electronic access.  The Discoveryorkshire coast website continued to be developed and attracted over 1m visitors.  Two themed marketing campaigns on food/drink and arts/heritage proved very popular, and journalist familiarisation visits arranged by the partnership led to valuable coverage in both national and regional newspapers.  The local area and regional office also supported various events, some of which were scheduled to extend the season and so meet a key output.  The UK Pro Surf Championships in October was a great success, attracting a younger demographic and making a direct economic impact of some £207k.  The Whitby Railway Wartime Weekend was less successful, in part because participants were unwilling to move their assets from the main location in Pickering, and visitors preferred to stay in, or nearer the main location.  This event was not repeated in 2013; however was being reassessed in the light of the planned arrival of a second railway line in Whitby.  Of the extensive regional marketing activity outlined in the report, Ms Deacon highlighted the product placement in the ITV soap Emmerdale – the first for a tourism organisation.  The key issue for the Council identified in the report was that, in light of diminishing public sector funding support for tourism organisations, that the partnership continued to encourage local businesses to become members and participate in marketing activity.  In reply to Members’ questions, Ms Deacon was pleased to report that in 2012/13 membership of the partnership had continued to grow reaching some 700 members.  One of the challenges for the partnership was attracting sponsors without large tourism organisations in the area; however, sponsorship for the Open Air Theatre had been secured.  In respect of the partnership’s performance against its key objective of achieving 5% growth in visitor spend per annum, Ms Deacon commented that since the demise of the Regional Development Agency (and regional model), the partnership had adopted the Cambridge Model to quantify visitor spend since 2011.  Regional  ...  view the full minutes text for item 7.

To consider a report by the Director of Democratic and Legal Services (Reference 13/302 attached)

The Committee considered a report by the Director of Democratic and Legal Services (Reference 13/302) in respect of the Committee’s work programme for the current year.  Various amendments were reported.  Following a request for a report on the future of Castle Health Centre, Scarborough and Ryedale Clinical Commissioning Group had agreed to consult the Committee in December on their new draft urgent care model in Scarborough and Ryedale – ‘Right Care, First Time’.  The outcome of the public consultation and the development of the new model would have an important bearing on the future of the Castle Health Centre, whilst also taking into account other services commissioned from this facility.  Hambleton, Richmondshire and Whitby Clinical Commissioning Group would also be attending the same meeting in December to seek the Committee’s views on their draft vision for the future of community health and social care services in the Whitby area.  The drop in attendance by the over 50s age group at the Council’s leisure facilities highlighted in the Council’s Annual Report had prompted a monitoring report to the February meeting to assess the measures the Council was taking to address this decline.  In discussing the work programme, Members noted the role the Committee performed in providing a platform for local voluntary support groups for example in respect of epilepsy and brain tumours, to raise awareness and lobby on their behalf.  The Deputy Chief Executive welcomed the suggestion to signpost residents to this kind of support group through the Council’s website.  The issue of making better linkages through the website with partner organisations had been discussed at the Public Service Executive, and would be taken into account as part of the redevelopment of the Council’s website.

RESOLVED that the report be received.