North Yorkshire Health and Wellbeing Board

 
Minutes of the meeting held via Microsoft Teams, on Monday 28th November 2022

Board Members

Constituent Organisation

County Councillors

County Councillor Michael Harrison (Chair)

Executive Member for Adult Social Care and Health Integration

County Councillor Janet Sanderson

Executive Member for Children and Young People’s Service

Integrated Care Systems

Wendy Balmain

Place Director for North Yorkshire - Humber and North Yorkshire Integrated Care System

Nancy O’Neill, MBE

 

Chief Operating Officer, Bradford District and Craven Health and Care Partnership – part of West Yorkshire Integrated Care System

Local Authority Officers

Louise Wallace

Director of Public Health, North Yorkshire County Council

Janet Waggott

Chief Executive, Selby District Council and Assistant Chief Executive, North Yorkshire County Council (District Councils Chief Executive Representative)

Elected Member District Council Representative

Councillor Richard Foster

Leader, Craven District Council

Other Members

Ashley Green

Chief Executive, Healthwatch North Yorkshire

Co-opted Members

Zoe Campbell

Managing Director (North Yorkshire, York and Selby) - Tees, Esk and Wear Valleys NHS Foundation Trust (Substitute for Brent Kilmurray)

Emma Nunez

Deputy Chief Executive, Harrogate and District NHS Foundation Trust (Substitute for Jonathan Coulter)

Sally Tyrer

Chair, Yorkshire Local Medical Committee (Primary Care Representative)

Lisa Winward

Chief Constable, North Yorkshire Constabulary (Emergency Services Representative)

 

In Attendance (North Yorkshire County Council) unless stated:-

David Dixon, North Yorkshire Fire and Rescue Service and Patrick Duffy (Legal and Democratic Services)

                      

 

Copies of all documents considered are in the Minute Book

 

 

 

 

 

 

12.       Welcome by the Chair

 

The Chair welcomed Members of the Board and confirmed this is a public meeting.

 

13.       Minutes

 

            Resolved -

 

            That the Minutes of the meeting held on 25th May 2022 be approved as an accurate record.

 

14.       Apologies for absence

 

            Apologies for absence were submitted by:

 

·           Amanda Bloor, Chief Operating Officer and Deputy Chief Executive, Humber and North Yorkshire Integrated Care System

·           Jonathan Coulter, Chief Executive, Harrogate and District NHS Foundation Trust

·           Richard Flinton, Chief Executive, North Yorkshire County Council

·           Shaun Jones, Interim Locality Director, NHS England (North East and Yorkshire)

·           Brent Kilmurray, Chief Executive, Tees, Esk and Wear Valleys NHS Foundation Trust

·           Jill Quinn, Chief Executive, Dementia Forward

·           Richard Webb, Corporate Director, North Yorkshire County Council

 

15.       Declarations of Interest

 

            There were no declarations of interest.

 

16.       Public Questions of Statements

 

            There were no public questions or statements.

 

17.       Annual Report of the Director of Public Health 2021/2022

 

          Considered –

           

            A covering report by the Director of Public Health, which introduced her Annual Report for 2021/2022, together with lessons learned from the COVID-19 Pandemic.

         

The report would shortly be published on the North Yorkshire Partnerships website and publicly launched via a press release.

 

In addition, Louise Wallace summarised the key components of her report via a presentation.  You can view both the covering report and the presentation here

 

            The presentation covered these main elements:-

 

·                Health in North Yorkshire today

·                Continuing the COVID-19 response

·                Impact of COVID-19

·                Lessons learned

·                Recommendations

·                Progress on past recommendations

 

Louise Wallace highlighted a number of points, including:-

 

-           A key emphasis has been on engaging with communities to ensure that their voice is captured. She thanked everyone who had taken part in the community conversations.

 

-           There is still disparity in life expectancy, according to where people live.

 

-           The report outlines the timeline of COVID-19 and the continuing response to it

 

-           The health impacts – direct and indirect - are also drawn out, in addition to wider impacts.

 

-           Lessons learned include having learnt about ourselves; our society; what we value; and what is valuable in terms of protecting and improving health and wellbeing.  It is also clear that the true impact of COVID-19 is difficult to quantify; we will know more and understand more in due course,

 

-           The Public Health Team had taken part in a Peer Challenge by the Local Government Association in September 2021 - the feedback from which has been positive.  Some helpful recommendations were made and these are being actioned.

 

-           The report contains 21 recommendations based around six headings:-

 

·                Health Protection

·                Improving Population Health

·                Health and the Environment

·                Inequalities

·                Community Support

·                Communication

 

It was noted that events and webinars are underway locally and nationally to mark the 175th anniversary since the appointment of the first Medical Officer for Health (now known as Directors of Public Health).

 

The Chair asked at what point the Pandemic can be said to be over as a medical event?  Louise Wallace advised that, with the World Health Organisation having declared it as a Global Pandemic, she expects it to be with us for quite some time,

 

Janet Waggott, Chief Executive of Selby District Council and Assistant Chief Executive at North Yorkshire County Council, commented that she had made the link between the Director of Public Health Annual Report and the request for evidence for the national COVID-19 Public Inquiry.

 

Resolved –

 

That the content of the Director of Public Health’s Annual Report for 2021/2022 be noted and that its recommendations be considered in the strategic planning of the Board,

 

18        Updates from Integrated Care Systems

 

a)    North Yorkshire and Humber ICS

 

NOTE: You can view both of the presentations referred to in a) and b) below here

 

 

Considered –

 

 A presentation prepared by Amanda Bloor, Deputy Chief Executive/Chief Operating Officer, Humber and North Yorkshire Health and Care Partnership and Wendy Balmain, Place Director for North Yorkshire.

 

The presentation was delivered by Wendy Balmain. It provided an overview of Integrated Care Systems and information on:-

 

·               Governance and Accountability

·               Functions and Decisions

 

The presentation also provided information on North Yorkshire Place, including its strategic priorities; membership; examples of the work undertaken so far; and the mechanisms for ensuring these priorities are delivered.

 

Wendy highlighted the following:-

 

-           A draft Integrated Care Strategy is being developed by Humber and North Yorkshire Integrated Care Partnership (ICP), with local involvement, and will be available in December 2022.

 

-           North Yorkshire Place is represented at the Humber and North Yorkshire ICP and this ensures that the needs of North Yorkshire communities are heard and reflected as plans are developed.

 

-           The membership of North Yorkshire Place Board is made up from key sectors involved in the commissioning and delivery of health and care across the North Yorkshire geography.

 

-           The Place Board is operating in shadow form and has approved a Transitional Operating Agreement with the Humber and North Yorkshire Integrated Care Board.

 

-           In addition to working through plans related to the four priorities, it is also looking at how to mitigate immediate pressures – linked to discharge from hospital and the care market.

 

b)    West Yorkshire ICS

 

Considered –

 

A presentation by Nancy O’Neill, MBE., Chief Operating Officer, Bradford District and Craven Health and Care Partnership.

 

The presentation outlined:-

 

·               West Yorkshire’s aims and ambitions

·               The responsibilities of Bradford District and Craven Partnership Board

·               The purpose and priorities of Bradford District and Craven Health and Care Partnership

·               How and where the Community Partnerships link into the overall structure

 

Nancy highlighted the following:

 

-           Craven is a key part of the Health and Care Partnership, which is very much linked into North Yorkshire.  For example, the Bradford District and Craven Partnership Board features several Members from North Yorkshire, who attend and actively contribute.

 

-           If the membership is not working for any partners, the Partnership would be happy to review it.

 

-           Staff and meaningful engagement with our population are key to the way the Partnership operates.

 

Lisa Winward, Chief Constable, asked about work on baselining demand.  Is the data multi-agency and does it link to mental health, in terms of demand, as this is an important area for the Force?

 

In response, Wendy Balmain advised that work is being undertaken on a new performance dashboard which will focus on what the data looks like and what we need to collect to drive progress.  The four Locality Partnerships will be the area  where these data conversations take place.

 

The Mental Health Partnership Board has a role to play too.  Zoe Campbell, Managing Director (North Yorkshire, York and Selby) - Tees, Esk and Wear Valleys NHS Foundation Trust, added that, in addition to involvement at executive level, TEWV is involved elsewhere, thereby adding granularity.  She is confident that TEWV is linked in wherever it is required to be.

 

Nancy O’Neill stressed that the Community Partnership has delegated authority to adjust resources to priorities.  Mental Health is a key priority.  She added that if any partners feel it is not being addressed as it might be, they let her know.

 

Ashley Green, Chief Executive of Healthwatch, North Yorkshire, advised Members that Craven is embedded with Healthwatch, as part of a system forum.  Related to this, there had been a listening exercise seeking the views of local people on health services.  Feedback had been positive.  The relationship with the Voluntary and Community Sector is an important one and he will be meeting with Community First Yorkshire to explore how Healthwatch can support them.

 

Councillor Richard Foster stated that work is required to ensure that there is no void when Craven District Council ceases to exist, as part of Local Government Reorganisation.  Bradford is a very urban-based partnership.  In that sense, Craven is an outlier.  The new North Yorkshire Council will, at Member level, need to ensure that links are maintained.  The Chair echoed this comment.

 

The Chair thanked Wendy Balmain and Nancy O’Neill for their presentations.

 

NOTED,

 

19.       North Yorkshire Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy

 

  Considered –

 

A report by the Director of Public Health, which sought agreement for proposals to develop a new Joint Health and Wellbeing Strategy (JHWBS) for North Yorkshire, as required by the Local Government and Public Involvement in Health Act 2007 (as amended by the Health and Social Care Act 2012).

 

Louise Wallace also delivered a presentation and drew Members attention to the following, in particular:-

-       Closely linked to the JHWBS, is the Joint Strategic Needs Assessment (JSNA) – another of the Board’s statutory responsibilities – which helps us to understand the health needs of our population and which will, therefore, inform the JHWBS.  A refreshed JSNA is being developed.

 

-       The JSNA will be system-wide, supporting and informing commissioning needs of organisations.

 

-       A draft of the JSNA will be presented to the next meeting.

 

-       The health system contains several places and boundaries.  The new North Yorkshire Council will need to read across these to ensure synergy.

 

-       The biggest challenges faced are:-

 

·           Recovery from COVID-19

·           Cost of living pressures on people, services and businesses

·           System challenges

 

-       The proposed vision for the JHWBS is: By 2030 we want the people of North Yorkshire to have a more equal chance of living a fulfilling life, free from preventable ill health ('adding years to life and life to years').

 

-       The intention is to target the areas where there is the greatest need, but to shift health within the whole population, so that everyone’s health improves.

 

-       There is a compelling case to invest in prevention.

 

-       Collaboration will be key; we are better and stronger when we work together.

 

-       A strategic approach to the JHWBS is proposed, which would comprise six Ps, plus one:-

 

·                People

·                Population

·                Place

·                Prevention

·                Partnership

·                Performance

 

… all linked by Prioritisation (the plus one)

 

-       Information will be harnessed across the above aspects and, for each, we will state what we want to achieve; what we should focus on; and what are the issues.

 

-       The proposed content will also include looking back at the achievements of the last Strategy and tangible practical actions over next two years.  These will be refreshed for the following two or three years and longer-term ambitions will be signalled.

 

-       The Key Milestones include consultation on the draft JHWBS and approval of it by the Board - culminating in its launch in October 2023.

 

Wendy Balmain, who is part of the Editorial Group working on development of the JHWBS, stressed the importance of the Key Milestones and the importance of not rushing this work.  She acknowledged that there has been a lot of information to digest today.  Those involved in developing the JHWBS now need to distil that information into something joined up, which makes sense, so we understand what is happening across communities, in terms of factors such as the cost of living and what we can do to help address this.

In response to a question from the Chair, it was confirmed that if anyone is interested in joining the Editorial Group, Wendy Balmain would be happy to have a conversation with them about this separately.

 

Ashley Green said that Healthwatch would be happy to help sense check that the proposed content chimes with what the public are feeling and with what is important to them.  He added that, given the wider consultation on the Humber and North Yorkshire ICS and other consultation, it is important that we do not confuse people.

 

Nancy O’Neill commented that inequalities is the golden thread – we need to reduce these wherever possible.

 

In response to a question from the Chair, Louise Wallace outlined the Core 20, plus 5 approach that is being implemented through the ICS.  This focuses on the most 20% deprived areas across 5 priority areas.

 

Nancy O’Neill added that, for West Yorkshire ICS, as with Humber and North Yorkshire ICS, the plus 5 priorities are paramount in terms of how services are accessed for maternity; chronic respiratory disease; early cancer diagnosis and hypertension and how progress can be accelerated in these areas.

 

Wendy Balmain advised that the JHWBS will need to link to the ICS.  A draft of the Humber and North Yorkshire ICS will be brought to the next meeting.  In outline, this will set out what is important to Humber and North Yorkshire; the inequalities that exist; and actions proposed to address these.

 

Resolved –

 

That the proposed approach; content and timescales for the North Yorkshire Joint Health and Wellbeing Strategy, as set out in the report and presentation and as summarised above, be approved.

 

20.       Work Programme

 

Considered –

 

A rolling Work Programme, presented by Patrick Duffy, Principal Democratic Services Scrutiny Officer.

 

Patrick Duffy stressed that the Work Programme is fluid, as circumstances change. It is open to any Member to input into it.  Therefore, if any Member feels that something should be added, they can advise of this now or contact him between meetings.

 

21.       Next Meeting

 

            The Chair confirmed that the next meeting will be on Wednesday 18th January 2023 at 1.00 p.m.

 

22.       Any other business which, in the opinion of the Chair, should be considered as a matter of urgency

 

  There was none. 

 

The meeting concluded at 11:55 a.m.

 

PD