North Yorkshire Council
North Yorkshire Health and Wellbeing Board
Minutes of the remote meeting held on Friday, 16 May 2025, commencing at 10.31am.
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Board Members |
Constituent Organisation |
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Councillor Michael Harrison (Chair) |
Executive Member for Health and Adult Services, North Yorkshire Council |
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Councillor Simon Myers |
Executive Member for Culture, Arts and Housing, North Yorkshire Council |
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Councillor Janet Sanderson |
Executive Member for Children and Families, North Yorkshire Council |
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Richard Webb |
Corporate Director of Health and Adult Services, North Yorkshire Council |
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Stuart Carlton |
Corporate Director of Children and Young People’s Services, North Yorkshire Council |
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Louise Wallace |
Director of Public Health, North Yorkshire Council |
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Nic Harne |
Corporate Director of Community Development, North Yorkshire Council |
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Mark Bradley |
Acting Place Director North Yorkshire, Humber and North Yorkshire Health and Care Partnership |
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Ashley Green |
Chief Executive Officer, Healthwatch, North Yorkshire |
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Jonathan Coulter |
Chief Executive, Harrogate District NHS Foundation Trust |
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Dr Sally Tyrer |
Chair of the North Yorkshire Branch, YORLMC (Primary Care Representative) |
In attendance:
Dena Dalton, Head of Health Collaboration, Community First Yorkshire.
Dr Victoria Turner, Public Health Consultant, North Yorkshire Council.
Helen Farmer, Director of System Transformation, West Yorkshire Integrated Care Board.
Islam Mostafa, Public Health Registrar, North Yorkshire Council.
David Smith, Senior Democratic Services Officer, North Yorkshire Council.
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Copies of all documents considered are in the Minute Book
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13 |
Welcome by the Chair
The Chair informed Members that the Council is in a pre-election period with the Eastfield by-election being held on 19 June 2025 and highlighted that whilst the business of the Council continues, Members need to avoid giving an individual or a political group a platform by which they can influence public opinion in the lead up to the election.
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14 |
Apologies for absence
Apologies for absence were received from Jill Quinn, Zoe Campbell and Matt Sandford. Helen Farmer substituted for Matt Sandford during Item 9: Humber and North Yorkshire and West Yorkshire Place Updates.
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15 |
Minutes of the meeting held on 14 March 2025
Resolved
a) That the Minutes of the meeting held on 14 March 2025 are approved as a correct record.
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16 |
Declarations of interest
There were none.
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17 |
Public questions/statements
There were none.
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18 |
Rural Health and Care Summit update
Dena Dalton and Ashley Green provided the Board with a presentation, the key points of which are summarised below.
· The summit was prompted by awareness of several reports, including the 2021 North Yorkshire Rural Commission report and the 2023 Healthwatch report on rurality and access to healthcare, and knowledge that over 50% of North Yorkshire’s population lives in rurally defined locations. · It helped attendees understand how reports and data are being used to drive change and how organisations can work together to mitigate the impact of rurality as a health inequality. · The following key findings arose from the summit. - Rural health issues are not just about access to health services but also linked to wider determinants like transport, digital connectivity and housing. - Integration across care sectors (primary care, local authority, voluntary, community) is crucial. Concerns were raised regarding the transfer of patients between hospitals. - Workforce shortages are a pressing issue, especially for community transport. - People may be reluctant to seek help because of limited access to healthcare. There is a lack of local provision, a predominantly older population, a high cost of transport and fuel, a reliance on others for transport (but a difficulty in getting taxis), and extreme weather can prevent people from attending appointments. Concerns about ambulance services in remote areas were also raised. - The withdrawal of local services, not just health but also shops, is contributing to loneliness and isolation. Unreliable digital access can cause issues as health services move online. - Concerns about confidentiality in small communities may make people less likely to share mental health concerns with local contacts. Safeguarding and domestic violence may go unnoticed in rural communities. - Poor road infrastructure (lack of lighting, potholes, and narrow lanes) may act as a barrier physical activity. - Old housing with poor conditions and heating can contribute to worse health.
· The following improvements were suggested at the summit. - The development of appointment clusters and the improvement of transport. The potential of holding appointments in village halls and community centres. Reviewing models of care like district nursing and health visiting to better meet rural needs. - Utilisation of technology to offer virtual wards and digitised health records. - Enhancing the appeal and viability of rural areas through the development of affordable and key worker housing to help address workforce shortages. - Utilising Integrated Neighbourhood Teams and involving communities in the design and delivery of care. - Making better use of local premises through colocation of services (i.e. NYC and the NHS).
The discussion also covered Healthwatch’s report on understanding the challenges and promoting help-seeking in farming communities. This report highlighted that 79% of North Yorkshire's land is used for farming and it sought to understand why farmers often present late with health issues. Key findings included high rates of muscular pain (nearly 75%), stress, anxiety, depression (just under half), and sleep problems (about a third).
· The following barriers faced by farmers were highlighted. - The 24/7 nature of farming makes it hard to arrange and attend appointments. - Access difficulties are significant. - Concerns about losing gun licenses if diagnosed with a mental health issue. - There is a tendency to not think their problems are severe enough. - Farmers are often more likely to talk to their vets about their health than GPs, highlighting the importance of trusted relationships and professionals who visit them.
· The following solutions were suggested. - Delivering services directly to rural communities through mobile health units offering drop-in clinics at locations like auction markets and farm sites. This approach is being piloted. - Utilising local venues such as community hubs, pubs, and village halls to share information about available services. - Ensuring confidentiality to build trust and encourage engagement. - Communicating in clear, accessible, and culturally appropriate language. - Equipping rural professionals with training and resources to guide and refer farmers to relevant services. - Offering flexible appointment options to accommodate varying schedules and needs.
Regarding next steps from the summit and the report, there was a consensus on the need to build on this work. The idea of reviewing the 2021 Rural Commission recommendations was discussed, noting that whilst they didn't focus specifically on health, they had relevant insights on housing, environment, and schooling, and perhaps should have covered health. There was a discussion about how these topics could be integrated into existing work (e.g. through organisations such as the local care partnerships, community anchor organisations and Neighbourhood Health Joint Committee). The consensus moved towards anchoring the above points to the recommendations within the Health and Wellbeing Strategy, ensuring explicit actions are delivered and monitored. Board Members were asked to take the findings of the summit and report to their respective organisations.
It was proposed that a task force – led by Dina and Ashley, and including Naomi Smith, Louise Wallace, and Mark Bradley – be convened to review the outcomes of the summit and the report. The group will assess the existing commitments and identify new areas to be addressed, with the aim of reporting back within 6 to 12 months.
It was also suggested
that, similar to the inclusion of an Equality Impact Assessment
(EIA) appendix in reports, a Health Impact Assessment (HIA) should
be incorporated into reports of the Council. Resolved
a) That the update is noted. b) That the above task force is established.
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19 |
Health Protection Assurance Group annual report
Louise Wallace introduced the report and Dr Victoria Turner raised key points which have been summarised below.
· Key achievements include an increase in vaccination uptake, restarting the military health group with close collaboration on sexual health and a significant work on air quality which led to a reduction in air quality management areas. · Assurance work, including responding to the COVID inquiry, funeral director assurance visits and conducting peer reviews was highlighted. An update on the North Yorkshire Local Resilience Forum was provided. · Challenges noted included avian flu outbreaks, winter storms and the impact of wider system changes and financial challenges. · The priorities for the 2025/26 year were highlighted.
Members discussed how water quality issues are dealt with and it was highlighted that environmental health lead until health concerns are reported. This was noted as being particularly relevant considering the prospect of a dry summer.
Resolved
a) That the update is noted.
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Better Care Fund 2025/26
Louise Wallace introduced the report, explaining the Board’s statutory requirements.
Resolved
a) That the Better Care Fund 2025/26 Planning Requirement submission is signed off and the two conditions are noted.
b) That the Quarterly Returns for Quarters 1, 2 and 3 of 2024/25 are signed off.
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21 |
Humber and North Yorkshire and West Yorkshire Place Updates
Mark Bradley and Helen Farmer introduced the report, outlining the key points within. Following this, Louise Wallace, Richard Webb and Nic Harne provided an update on North Yorkshire Council’s related work. The following points were raised during the discussion.
· There are significant changes upcoming for ICBs. A national blueprint has been published and ICBs have until the end of May to respond. While ICBs will remain, they are expected to radically change. For example, the Humber and North Yorkshire ICB is due to cut its running costs by 40% by the end of Q3. ICBs are still awaiting the 10-year plan and what the role of NHS England will be. Staff are being kept informed as updates become available. · Mark went over the H&NY Strategy and highlighted areas that are likely to remain controlled by the ICB and those areas that may change hands. They are hoping to stick with the previous desired outcomes and expect to move towards a more strategic commissioner role. · NYC are preparing for the imminent spending review which may impact rural funding and cause significant financial challenges. · NYC are working with the Mayor’s office regarding a trailblazer for removing health barriers to work. This cannot fund health intervention. · Scoping work has started for the two care and support hubs in Harrogate and Scarborough. · Members were made aware of the upcoming Pharmaceutical Needs Assessment and the Board’s statutory duties. · A positive voluntary public health peer review was completed which provided recommendations across the Council. The recommendations are going to be turned into an action plan and brought back before the Board. · The new Local Plan Issues and Options consultation will start on 19 May 2025. The Plan will incorporate principles of climate change and health & well-being. · NYC is looking to secure grant funding through The Social Housing Decarbonisation Fund to improve health outcomes.
Resolved
a) That the updates are noted.
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22 |
Verbal update on CQC assurance
Richard Webb updated the board on the ongoing CQC adult social care assurance review of the council's responsibilities. He reported that fieldwork has started and that the CQC will contact partners. The process involves detailed questioning and reviews of the service.
Resolved
a) That the update is noted.
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23 |
Work programme
The Chair introduced this item, requesting that Members suggest future agenda items and keep the November date free for an in-person meeting.
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Any other items
There were none.
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25 |
Date of next meeting
Friday, 18 July 2025 at 10.30am via Teams.
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The meeting concluded at 12.11 pm.