Meeting documents

Also present at the invitation of the Chairman

Ms Abi Barron, Senior Transformation Project Manager, NHS Hambleton, Richmondshire and Whitby Clinical Commissioning Group – for Item 7

Mr Paddy Chandler, Deputy Chief Executive, Cambridge Centre – for Item 5

Mr Danny Glew, Head of Operations, DISC – for Item 5

Ms Debbie Newton, Chief Operating and Financial Officer, NHS Hambleton, Richmondshire and Whitby Clinical Commissioning Group – for Item 7

Dr Lincoln Sargeant, Director of Public Health, North Yorkshire County Council – for Item 6

No declarations of interest were received.

To approve as a correct record and sign the Minutes of the meeting held on 30 July 2014.  (Minutes attached).

RESOLVED that the minutes of the meeting held on 30 July 2014 be approved as a correct record and signed by the Chairman.

The Chairman reported that no public questions had been submitted.

To receive a presentation by Scarborough and Ryedale Clinical Commissioning Group

The committee was advised that this item had been cancelled because Scarborough and Ryedale Clinical Commissioning Group was still in the ‘cooling off’ period of the procurement exercise for the new urgent care centre, and so was still bound by commercial sensitivities.  However, the CCG had agreed to meet with councillors informally to discuss their concerns about the Castle Health Centre interim arrangements which were voiced at the meeting.  These included the reduced hours of operation, the low number of appointments available, confusion about what conditions the CHC would treat, and the fear that as a consequence of the reduced service, there would be an increase in inappropriate presentations at A&E which would end up costing more.

To receive a presentation by Danny Glew, Head of Operations, DISC, and Paddy Chandler, Deputy Chief Executive, Cambridge Centre

The committee received a joint presentation by Danny Glew, Head of Operations at DISC (Developing Initiatives and Supporting Communities) and Paddy Chandler, Deputy Chief Executive at the Cambridge Centre on the new integrated drug and alcohol recovery and treatment service centred on five hubs across North Yorkshire, including one in Scarborough.  Members were advised that the new service greatly simplified the previous model, was very much focused on recovery, sought to identify and overcome clients’ barriers to abstinence and sobriety from substance misuse, and ensured equity of provision across the locality both in towns and outlying rural areas.  The different elements of the model were then described: early intervention and prevention; assessment and engagement up to 16 weeks; recovery coordination; the recovery and mentoring service delivery model; clinical support to recovery; the single point of contact for all enquiries in respect of treatment and recovery; recovery peer mentoring and volunteering; and recovery communities development.  Clients would have the opportunity to recover from the moment they walked through the door.  The service built on the nationally acclaimed harm reduction work in Scarborough, and extended its outreach work beyond opiate and crack cocaine users also to engage with users of new psychoactive substances, image and performance enhancing drugs, and alcohol. The nationally recognised gender specific approach in Scarborough exemplified by the Women’s Community Project would also be extended across North Yorkshire.  Assessment and engagement was based on a triage system, assertive outreach and comprehensive assessment and recovery planning which linked with the criminal justice system, and provided support for carers, housing and employment advice and enabled both psycho-social and medical interventions.  GPs and community nurses would be embedded in the system to allow people in rural areas to access the same level of service.  The model could support clients to detox in their own homes.  Carer and family involvement in recovery planning was key.  The model also encouraged service users and peer mentors to create self-sustaining visible recovery communities which were integrated within the wider community by sharing resources with local businesses and other organisations.  Members then questioned Messrs Grew and Chandler about their presentation.  In the ensuing discussion, Members were advised that there were some 500 people currently in treatment in the Scarborough and Whitby areas, but the new service also aimed to reach through strong marketing and communications the hidden populations who misused legal substances such as alcohol, NPAs and steroids.  Many people with alcohol problems still presented through A&E, but there were those, for example elderly people who developed alcohol problems in the privacy of their own homes.  Indeed substance misuse occurred across the age spectrum.  There was a large increase in heroin use in the 1980s and 1990s, but there were still those addicted who were now in their fifties.  Cannabis use had remained constant through the decades, with many unaware of the dangers to mental health and of escalation to more powerful drugs.  The single point of contact, triage based model was accessible to  ...  view the full minutes text for item 5.

To consider a report and presentation (both attached) by the Director of Public Health, North Yorkshire County Council

The Director of Public Health, Dr Lincoln Sargeant presented his Annual Report to the committee which focused in particular on the contribution of the voluntary, community and social enterprise (VCSE) sector in helping to address the challenges of promoting and protecting the health of North Yorkshire’s population.  This focus accorded with the increasing role of the VCSE as partners in delivering services to residents within a context of a continuing reduction in public sector budgets.  For example, the key goal of the County Council’s Stronger Communities programme was to enable communities to effectively use their skills and assets to manage the delivery of some services that were previously operated by the County Council.  However, there needed to be investment to make effective use of these assets.  Dr Sargeant then explored some of the implications of the report’s recommendations for the Borough Council.  The first recommendation concerned the implementation of NICE guidance by the different agencies including district councils to provide an integrated approach to preventing and managing obesity – a particular issue for the Borough with levels of physical inactivity and adult obesity significantly higher than the national average.  In this respect, Dr Sargeant referred to the Borough’s key role as the spatial planning authority in determining an environment that was conducive to walking, cycling, and other regular physical exercise.  In respect of recommendation three which concerned mental health, Dr Sargeant encouraged the Borough Council to promote positive mental health among its staff and so help combat stigma and discrimination.  Members then asked questions and discussed the report.  Asked to comment on the widening gap in life expectancy between Hambleton and Scarborough between 2000 and 2012, Dr Sargeant explained there was an historical legacy of deprivation which needed to be tackled but progress was being made.  One problem was that Scarborough had its share of deprived, transient communities which residents tended to leave when they obtained better paid work.  In his capacity as a school governor, Councillor Ritchie referred to the difficulty in obtaining data about children to apply for the Pupil Premium since the introduction of free school meals for all four to seven year olds, and more generally to the issue of how to improve information sharing between different agencies.  Dr Sargeant commented that last year’s measles outbreak had highlighted that there was not enough local data about take up of the child immunisation programme.  The Child Health Information System (as per Recommendation 2) would help address this gap in information for the benefit of health visitors, but more widely for the benefit of local authorities.  Councillor Ritchie also commented on the problems associated with different services protecting their budgets which stifled a joined up approach to public health.  He cited the example of improvements to the A64 along Seamer Road which created the opportunity for a new cycle lane, if only there had been funding in the appropriate budget.  Dr Sargeant commented that Better Care Fund schemes were enabling partner organisations to break down barriers and pool  ...  view the full minutes text for item 6.

To receive a presentation by Abigail Barron, Delivery and Implementation Manager, Hambleton, Richmondshire and Whitby Clinical Commissioning Group

The committee received a presentation by Abi Barron, Senior Transformation Project Manager, and Debbie Newton, Chief Finance and Operating Officer, Hambleton, Richmondshire and Whitby Clinical Commissioning Group, which provided an update on the CCG’s procurement of new Community and Out of Hours GP Services and plans to develop a new hospital in Whitby.  Members were reminded that the new contract would combine numerous separate contracts including in-hospital services; rehabilitation and physiotherapy; community and specialist nursing; minor injuries and out of hours; prevention, advice and support under a single lead provider for a period of seven years.  The contract term would bring stability whilst enabling the lead provider to innovate and to develop new services in partnership with local organisations.  Three bidders had been shortlisted: Humber NHS Foundation Trust, Northern Doctors Urgent Care, and Virgin Care Services.  The competitive dialogue process would now continue until the shortlist was reduced to two and eventually the final contract was awarded in March 2015.  The bids were being evaluated according to a range of criteria covering both quality of service and finance.  The preferred option for the redevelopment of Whitby Hospital was to remodel the building on the existing site and work with the County Council to explore possible options for extra care housing / supported independent living, with a smaller proportion of the site being sold for commercial development.  The extensive public engagement exercise on the proposals was continuing.  Methods included public meetings, drop in sessions at GP surgeries, mailshots, Whitby Tourist Information Centre, and consulting with local voluntary organisations such as Whitby Mind and Whitby DAG.  After the Community and Out of Hours Service contract was awarded in July 2015, the CCG would be working with NHS Property Services and the new service provider to drive forward the redevelopment of the hospital.  Members then questioned the speakers about their presentation.  Members were advised that the current site was of sufficient size to enable services to continue while the building was remodelled, although plans were still in the early stages of development.  The vast majority of feedback from the public consultation supported the creation of a health and social care hub on the current site, although there were accessibility issues which would need to be addressed.  The Chairman thanked the speakers for attending and echoed other Members in commending the CCG for their efforts to engage with the public and local communities on their developing plans.

RESOLVED that the report be received.

To consider a report by the Director of Democratic and Legal Services (Reference 14/220 attached)

The committee considered a report by the Director of Democratic and Legal Services (Reference 14/290) in relation to the committee’s work programme for the current year.

RESOLVED that the report be received.