North Yorkshire County Council
Harrogate and Knaresborough Area Constituency Committee
Minutes of the remote meeting held on Thursday, 10th June, 2021 commencing at 10.00 am.
County Councillor John Mann in the Chair, plus County Councillors Philip Broadbank, Jim Clark, Richard Cooper, John Ennis, David Goode, Michael Harrison, Paul Haslam, Don Mackenzie, Zoe Metcalfe, Matt Scott, Cliff Trotter and Robert Windass.
Executive Members in attendance: County Councillors Carl Les and David Chance.
Officers present: Matt O'Neill (Assistant Director – Growth Planning and Trading Standards) and Ruth Gladstone (Principal Democratic Services Officer).
Other Attendees: Simon Cox (Director of Acute Commissioning, North Yorkshire Clinical Commissioning Groups) and Beth Barron (Operational Director for Elective Care, Harrogate and District NHS Foundation Trust).
Apologies: County Councillor Gareth Dadd and Caroline Dickinson (Executive Members).
|
Copies of all documents considered are in the Minute Book
|
|
92 |
Minutes of the Committee meeting held on 18th March 2021
Resolved –
That the following be proposed to the Chief Executive Officer for consideration under his emergency delegated powers - That the Minutes of the meeting of Harrogate and Knaresborough Area Constituency Committee held on 18 March 2021, having been printed and circulated, be signed as a correct record.
|
|
93 |
Declarations of Interest
County Councillor Philip Broadbank declared that his wife was a Nurse at Harrogate District Hospital, employed by the Harrogate and District Foundation Trust.
|
|
94 |
Public Questions or Statements
There were no questions or statements from members of the public.
|
|
95 |
Outcome of Changes to Stroke Services at Harrogate Hospital
Considered –
A presentation by Simon Cox (Director of Acute Commissioning, North Yorkshire Clinical Commissioning Groups) advising of the background to changes made to stroke services at Harrogate Hospital in 2019, the impact of Covid, future work, and future engagement with the Area Constituency Committee.
Key issues within the presentation were:-
· Stroke services for the Harrogate area had been reconfigured in 2019. This had followed wide engagement and national research which had identified the mortality benefits of having Hyper Acute Stroke Units (HASUs) to provide specialist intervention during the first 48-72 hours of a stroke, and greater focus on providing therapy and rehabilitation to patients in their own homes. As part of the reconfiguration, Harrogate District Hospital had moved away from providing the hyper acute phase of stroke care and instead patients were transported directly to their nearest HASU which, for the majority of the Harrogate population, was at Leeds, and, for others, was at York. For the majority of patients, once the hyper acute phase was finished, they were transferred back to Harrogate District Hospital for rehabilitation.
· Simon Cox advised that, at this stage, two years on, ideally he would have wanted to provide a detailed analysis of figures and patient numbers. However, this was difficult because Covid issues had tended to skew some of the numbers. For example, nationally, during 2020, the numbers of patients presenting with stoke, had significantly reduced, which was worrying. (Consequently, the NHS was putting out the message that anyone having stroke-like symptoms must telephone 999 or go to hospital.) One of the other problems arising from Covid-19 was that hospitals had had to change how they organised themselves to make themselves Covid-safe, such as separate Wards for quarantining. This had made analysing some of the data around stroke in Harrogate difficult. Simon Cox suggested that, in a year’s time, he should bring to Members a full set of data to look at the Stroke Admission Pathway. In the meantime, a lot of work was continuing about stroke care, both nationally and in North Yorkshire, including through the “Getting It Right First Time” (GIRFT) programme and the Sentinel Stroke National Audit Programme. Simon Cox advised that he wanted to continue to work with stakeholders to assess things like patient satisfaction, do surveys, and get patient experiences of the Stroke Admission Pathway, and to share that with communities to evaluate the changes. He was keen to engage with the Area Constituency Committee to obtain patient experience around changes to flex or support how NHS services were changed to make them better for patients.
Members asked Simon Cox questions and received responses. The issues which arose during discussion included the following:-
· It was confirmed that Harrogate patients would continue to be taken to either the Leeds HASU or the York HASU, and this would not be impacted by the changes to the Integrated Care Systems in 2022.
· Simon Cox undertook to obtain the latest breakdown figures showing the number of people from Harrogate who had gone to the Leeds HASU, and the number who had gone to the York HASU, and to send these to Ruth Gladstone for forwarding to Committee Members. Simon Cox emphasised that these figures would not be representative due to Covid.
· In response to expressions of disappointment from some Members that more data was not available today about the impact of the greater time spent travelling the longer distances to Leeds and York, Simon Cox offered to attend another meeting of the Committee later in 2021 to provide data regarding the previous 12 months, although such data would be heavily caveated because it was difficult to say, due to Covid, whether that data was a true reflection of the outcomes of changes which had been made to the Service.
· Regarding prevention measures, it was acknowledged that the promotion of good nutrition was one aspect in respect of which the NHS worked with partners, such as local authorities and schools. Simon Cox added that, similarly, a lot of work was being undertaken to tackle blood pressure, atrial fibrillation, obesity and smoking. However, it needed to accepted that, in reality, some preventative measures eg blood pressure, were age related and significant illness could be deferred, but not avoided completely. Simon Cox offered to arrange for a Dietitian colleague to attend a future meeting of the Committee to have a more detailed discussion about nutrition. County Councillor Paul Haslam expressed support for this suggestion because he felt that the NHS, in partnership with other organisations, could do more preventative work around nutrition.
· County Councillor Jim Clark advised that he had been, and continued to be, supportive of the Hyper Acute Stroke Units and that the reconfiguration of stroke services in Harrogate had been the correct thing to do. He added that Harrogate residents received tremendous service from Harrogate District Hospital and asked for his view to be placed on record.
· County Councillor Michael Harrison commented that he would prefer to be taken to the best place to deliver the best clinical outcome, regardless of where that was located. He also commented that, where the clinical outcome prediction demonstrated a best clinical outcome, it was the responsibility of elected Members to support Health partners when they wanted to make such changes.
Resolved –
(a) That Simon Cox be thanked for attending this meeting and his excellent presentation.
(b) That the following arrangements be made with Simon Cox:-
(i) Simon Cox to provide a copy of the slides used during his presentation to Ruth Gladstone (Principal Democratic Services Officer) for forwarding to Committee Members.
(ii) Simon Cox to obtain the latest breakdown figures showing the number of people from Harrogate who have gone to the Leeds HASU, and the number who have gone to the York HASU, and send these to Ruth Gladstone (Principal Democratic Services Officer) for forwarding to Committee Members, recognising that these figures will not be representative due to Covid.
(iii) Simon Cox to attend another meeting of the Committee later in 2021 to provide the previous 12 months’ data regarding the impact of the greater time spent travelling the longer distances to Leeds and York, recognising that this data will be heavily caveated because it is difficult to say, due to Covid, whether that data is a true reflection of the outcomes of changes which have been made to the Stroke Service.
(iv) Simon Cox to bring to elected Members, in a year’s time, a full set of data to look at the Stroke Admission Pathway.
(v) Simon Cox to arrange for a Dietitian colleague to attend a future meeting of the Committee to have a more detailed discussion about nutrition.
|
|
96 |
Length of Waiting Times for Operations etc at Harrogate Hospital
Considered –
The verbal report of Beth Barron (Operational Director for Elective Care, Harrogate and District NHS Foundation Trust) concerning waiting times for clinical procedures at Harrogate District Hospital as a consequence of the impacts of Covid, and advising of the actions being taken to address the situation.
Key issues within Beth Barron’s report were as follows:-
· Harrogate District Hospital had prioritised waiting lists into 6 priority categories:- P1 was coded for emergency patients; P2 to P4 related to a period of time in which it was clinically appropriate for patients to wait before having their procedure; and P5 and P6 related to patients who wished to delay their procedures. P2 patients should wait no longer than 1 month; P3 patients should wait no longer than 3 months; and P4 patients were the least urgent and could wait over 3 months for their procedure.
· The Hospital was currently prioritising treatment for P2 patients. It had agreed to forecast the P2 waiting list to a standard of under 28 days. As such, patients who were not able to be treated within time should not wait longer than 28 days passed that date for treatment. At Harrogate District Hospital, currently 16% of P2 patients (approximately 59 patients) waited longer than 4 weeks. There might be clinical reasons why such patients waited longer, eg they might be awaiting other procedures. However, such patients, during this time, were under constant clinical review by Consultants.
· P4 patients continued to be reviewed to ensure that, since being added to the waiting list, there was no change regarding their clinical care. Approximately 2,000 to 3,000 patients were coded as P4 on elective waiting lists, the majority awaiting an Orthopaedic procedure. The Hospital was doing a lot to talk to those patients clinically, eg conducting virtual or telephone clinical reviews with those patients and, where necessary, ensuring they had access to other Services if they needed them eg Physiotherapy. The Hospital continued to look at its 18 week RTT waiting list and currently there were approximately 1,000 patients who were waiting longer than 52 weeks, most being P4 patients.
· The actions being taken by Harrogate District Hospital to address the situation included the following:-
· Collaborative working with other Trusts across Humber, Coast and Vale, and West Yorkshire. For example, Harrogate District Hospital was offering, and accessing, mutual aid where capacity had been identified eg Harrogate District Hospital had Endoscopy capacity which was being offered to patients from York and Leeds. · Harrogate District Hospital was working very closely with the Independent Sector eg with BMI Duchy Hospital to transfer some P4 patients to them with the consent of the patient to transfer. · The Hospital was reviewing how it could work differently with Humber, Coast and Vale eg there was joined-up working to look at an elective Orthopedic centre in Bridlington which would potentially be staffed jointly. · Within West Yorkshire, an elective co-ordination group had been set up, with each organisation leading on a specific Speciality. Harrogate was leading on Ophthalmology. These groups were not to lead on the treatment of the patient but instead were working through models of shared staffing to see how capacity could be maximised across the West Yorkshire patch. The priority was to treat patients at place first. However, if a Hospital did not have the patients to treat at place, it would open-up that capacity to long-waiting patients from surrounding Trusts. Hospitals were engaging with patients to ascertain which patients were willing to travel.
· There were risks in trying to work through the elective backlogs, such as the resilience of the workforce, and Covid measures as set out in IPC guidelines. Protecting against such risks inevitably restricted the number of patients who could be brought through Hospital services.
Beth Barron responded to Members’ questions, which included the following:-
· County Councillor John Ennis sought information about what was involved in the diagnostic process ie when patients were waiting to get onto a waiting list. Beth Barron undertook to obtain information from the Directorate for Diagnostics. She emphasised however that patients who were waiting were being assessed.
· With regard to recent media reports which suggested a huge variation across the country in waiting times for Othopedics, Beth Barron advised that Harrogate District Hospital compared well at getting P2 Orthopeadic patients in within the national standard of 4 weeks. Harrogate had smaller waiting lists due to good Pathways and because Harrogate Orthopaedic Consultants were very engaged with the ICSs across Humber, Coast and Vale, and West Yorkshire. She added that P4 patients requiring treatment for hips and knees were being talked to and, where possible, were being transferred to the BMI Duchy Hospital and the Nuffield Hospital in York.
· With regard to managing patients who were awaiting elective surgery, Beth Barron advised that there was an outpatient transformation group which worked with the CCGs and GPs. A lot of work was being undertaken with the CCG looking at the criteria for referral, and harmonising the criteria across North Yorkshire.
· Compared to pre-Covid times, Harrogate District Hospital now had some newer machines and increased capacity to support the numbers of patients who required a diagnostic.
Resolved –
(a) That Beth Barron be thanked for her detailed and reassuring report.
(b) That the report be noted.
(c) That it be noted that Beth Barron has undertaken to provide information about what is involved in the diagnostic process through which patients wait to get onto the waiting list.
|
|
97 |
Initial Approach to Economic Recovery Following the Pandemic
Considered –
The report of Matt O’Neill (Assistant Director – Growth Planning and Trading Standards) providing an update on the initial approach to economic recovery following the pandemic.
Matt O’Neill introduced his report and gave a slide presentation to provide:- a brief recap on some of the economic issues and analysis which had been undertaken; an overview of the actions being taken to assist economic recovery from the pandemic by the LEP, the County Council, Harrogate Borough Council and Public Health; and information which looked forwards into the future in terms of business growth and new opportunities as the country came out of the pandemic.
Key issues from the presentation were as follows:-
• In Harrogate and Knaresborough, the business sector which was most at risk due to the pandemic was the accommodation and food sector, which consequently was particularly susceptible to downward contraction.
• Harrogate district had 23,500 people on furlough in July 2020, which reflected the nature of the district’s economy. That number had decreased to just over 11,000 at the start of March 2021.
• For those in employment in Harrogate district, there was a differential in terms of gross weekly pay between those employed in retail, leisure and hospitality and other low paid jobs, verses those who lived in Harrogate and Knaresborough and typically worked outside the district either in part or in full.
• To support businesses through the pandemic, work had included:- working with businesses to stop outbreaks; giving advice to help businesses understand new measures to ensure they could operate in a Covid compliant way; promoting access to finance and fiscal measures; and influencing Government and lobbying where appropriate.
• Strategic infrastructure work was being undertaken to benefit the economy eg:- improving digital connectivity by rolling out Superfast Broadband through NYnet; taking part in a national Test Bedded Trail programme looking at 5G superfast connectivity across North Yorkshire; investing in strategic infrastructure such as the rail network and the strategic road network; encouraging private investment and working with private sector partners; and a programme of improvements across market towns to provide free WiFi for residents and businesses.
• During the pandemic, businesses across a broad sector in the economy had been tremendously resilient in terms of how they had adapted, accessed funding and maintained continuation to generate profit for themselves and maintain delivery. Of the companies who had adapted during the pandemic, examples were cited of various businesses located in the Harrogate and Knaresborough area.
• In terms of the future:- the focus was on enabling a Green future; there were massive pent-up savings which could be spent within the local economy; there was huge up-take in staycations; there was major private sector confidence and investment in the A1 corridor; the outsourcing of Government departments, such as the Bank of England campus in Leeds, would provide financial jobs and opportunities tied into the Harrogate district; there were ambitious levelling-up opportunities for town centres, eg the County Council was submitting a bid, including over £430k worth of projects earmarked for the Harrogate district, to the Government’s Community Renewal Fund; and local government reorganisation offered the opportunity to get a Devolution Deal to accelerate plans and progress investment into key employment areas across North Yorkshire.
Matt O’Neill responded to Members’ questions, during which the following information was provided:-
• Matt O’Neill advised that, for him, internet and mobile connectivity was the number one priority to increasing economic growth and helping the economy. He cited the example of people from London and the South East, who were enquiring about locating to North Yorkshire, and asked firstly about the speed of Broadband connectivity. He advised that connectivity provided a different landscape in terms of labour markets, with people being able to live in Grassington and work, for example, for Google, travelling into London and beyond a couple of days a week. He highlighted that the a contract had just been let for Superfast North Yorkshire for a further £20M of investment which would lead to an increase in coverage, across the county, to 97%. However, the aim has for 100% coverage and was included in the Devolution Deal. Similarly for mobile connectivity, there should be 95% coverage of 4G across the county by 2025.
• Matt O’Neill confirmed that free WiFi would be available in Knaresborough town centre by the target date of 31 December 2021, subject to contractual vagaries and any delivery issues relating to attaching infrastructure onto lampposts and street furniture. He added that the delivery programme was currently on-track in terms of scheduled dates and therefore he felt the end of 2021 was eminently achievable and realisable. County Councillor David Goode asked that local Members be updated if there were any change of dates.
• Matt O’Neill provided more detail about blue and green infrastructure, which related to flood alleviation land management measures such as forestry planting in the Dales to benefit other locations downstream. He added that, as part of the 5G project, sensor monitoring would be provided to give real-time information for when floods occurred, allowing a quicker response in dealing with flooding.
• Matt O’Neill confirmed that the free WiFi for town centres focussed on core centres and would also link into business parks where appropriate.
• County Councillor Paul Haslam suggested that the new 5G facility might incorporate sensors for monitoring air quality outside schools and in town centres. Matt O’Neill undertook to send information to County Councillor Paul Haslam following this meeting, regarding the current 5G Test Bed and Trials programme, although that programme related to areas that had no connectivity whatsoever in North Yorkshire. Matt O’Neill added that this was a trial and, as such, learning would come back for feeding back to DCMS who might then look to expanding the uses of real time monitoring to include such issues as air quality.
Resolved –
(a) That Matt O’Neill be thanked for a very detailed and informative presentation.
(b) That it be noted that Matt O’Neill will provide, to County Councillor Paul Haslam following this meeting, further information in respect of the current 5G Test Bed and Trials programme.
|
|
98 |
Verbal Updates from Executive Members
Considered –
Verbal updates of Executive Members on the issues identified below:-
· County Councillor Carl Les (Leader of the Council):- · Covid, including the recent increase in the Delta variant, the progress made with vaccinations, and the excellent support provided in North Yorkshire throughout the pandemic. · Helen Simpson who had been appointed as the new Chair of the York and North Yorkshire LEP. · The Government’s Levelling-Up Fund and the development of a cross-county transport proposal to go to the next round of that Fund. · The Government’s Community Renewal Fund, to which the Executive had agreed to submit over 20 bids. · The Rural Commission which was scheduled to publish its report in July 2021 and would include recommendations which were likely to be challenging for NYCC and partners. · His fortnightly meetings with the six MPs representing North Yorkshire and their now broadened meeting agenda which included the national Bus Back Better Strategy, Grant Shapps’ Plan for Rail, and Freeports. · Remote meetings, and the NYCC response to the Government consultation. · His thanks to Councillor Richard Cooper and Harrogate Borough Council for their very rapid response to the Afghan Locally Employed Staff Relocation Scheme. Councillor Richard Cooper responded.
· County Councillor David Chance (Executive Member for Stronger Communities):- · NYCC’s agreement to participate in the Afghan Locally Employed Staff Relocation Scheme, through which between 30 and 50 people would be relocated to North Yorkshire from July 2021. · Community Support Organisations’ work was now focussing on helping people gain their mobility and confidence to leave their homes.
· County Councillor Michael Harrison (Executive Member for Adult Social Care and Health Integration, including Health and Wellbeing Board and Extra Care):- · Covid, in respect of which the situation in North Yorkshire Care Homes had significantly improved compared to earlier in the year, reflecting the success and high take-up rate of the vaccination programme. · North Yorkshire Health Sector’s response to a Government consultation about mandatory vaccination, the response supporting mandatory vaccination but making the point that mandatory vaccination should be sector-wide, and that any mandatory vaccination should be limited to this pandemic.
· County Councillor Don Mackenzie (Executive Member for Access):- · NY Highways’ commencement of operations as contractor for highways maintenance in the County. · The summer highways repair programme was underway, having commenced in Harrogate with resurfacing works during evenings on Leeds Road. · Junction 47 works continued on the A59, Flaxby. · Sustainable travel and three current initiatives:- (i) the introduction of Active Travel Fund schemes at the A59 out of Knaresborough towards Starbeck, and at Victoria Avenue; (ii) the £8M upgrade for sustainable travel in Station Parade aka the “Harrogate Gateway Project”, and (iii) the NPIF Otley Road improvements. · Public transport (rail) – the rail improvement scheme at Cattal had been completed under budget and on-schedule and it was hoped that Northern Rail would introduce double frequency, two trains per hour in each direction, between York and Harrogate with effect from December 2021. · Public transport (buses) – a demand responsive service was starting in Ripon on 1 July 2021. · Public Wifi was being introduced into Harrogate, Knaresborough and Ripon, backed-up by NYCC’s local full-fibre network.
Resolved -
(a) That Executive Members be thanked for their updates.
(b) That the updates be noted.
|
|
99 |
Appointments to Local Bodies (Extension of Existing Appointments)
Considered –
A report of the Assistant Chief Executive (Legal and Democratic Services) which:- · recommended the extension, in light of the deferment of the planned County Council elections to May 2022, appointments to Local Bodies in the Harrogate and Knaresborough Area Constituency Committee area; and · sought Members’ recommendation on whether the vacant NYCC position on the Richard Taylor Educational Foundation, which had arisen on the death of County Councillor Geoff Webber, should be filled.
Ruth Gladstone (Principal Democratic Services Officer) introduced the report. In response to questions, Ruth Gladstone clarified that the Richard Taylor Educational Foundation was listed, in the County Council’s Constitution, as a Category 3 Local Body and, as such, it was for the local Members to make a nomination to the Area Constituency Committee. The Chairman moved the nomination of the local Members for the Bilton and Nidd Gorge Division, (ie to nominate County Councillor Matt Scott to the vacant NYCC position on the Foundation). The Vice-Chairman seconded that motion. No Member voted against the motion.
Resolved –
That, the following be proposed to the Chief Executive Officer for consideration under his emergency delegated powers:-
(a) That the current appointments to the Category 2 outside bodies, as listed at paragraph 3.2 of the report and duplicated below, be extended to the end of the current Council in May 2022:-
· Craven and Harrogate Districts Citizens Advice Bureau – County Councillor Cliff Trotter · Harrogate and District Community Safety Local Delivery Team – County Councillor Cliff Trotter · Knaresborough Community Centre Committee – County Councillor Zoe Metcalfe · Nidderdale AONB Joint Advisory Committee – Substitute: County Councillor Paul Haslam · Renaissance Knaresborough Management Committee – County Councillor Zoe Metcalfe
(b) That County Councillor Matt Scott be nominated to the vacant NYCC position on the Richard Taylor Educational Foundation.
|
|
100 |
Committee Work Programme
Considered –
The report of the Principal Democratic Services Officer which invited Members to consider, amend and add to the Committee’s Work Programme.
Ruth Gladstone (Principal Democratic Services Officer) introduced the report and advised that Mr Philip Allott (the newly elected Police, Fire and Crime Commissioner) was available to attend the beginning of the Committee’s meeting on 16 September 2021.
Resolved –
(a) That the Work Programme be noted.
(b) That Members contact the Chairman, the Vice-Chairman or the Principal Democratic Services Officer with any suggested business for future meetings.
|
The meeting concluded at 12.55 pm.