Minutes of the meeting held on Thursday 8 December 2022 at 10am.
County Councillor Karin Sedgwick in the Chair.
County Councillors: Joy Andrews, Karl Arthur, Phillip Barrett, Eric Broadbent, Andy Brown, Caroline Dickinson, George Jabbour (as substitute for Angus Thompson) Andrew Murday (as substitute for Pat Marsh), Heather Moorhouse, Andy Paraskos (as substitute for Andrew Lee), Jack Proud, Roberta Swiers and Steve Watson (as substitute for Nigel Knapton)
In attendance: Cllr Michael Harrison
Officers: Ray Busby (Principal Scrutiny Support Officer), Anton Hodge (Assistant Director- Strategic Resources HAS), Carly Walker (Health Improvement Manager), Louise Wallace (Director of Public Health).
Natalie Smith (Head of Service HAS planning) and Michelle Miles (Senior Manager Health and Care) joined remotely
Apologies:
County Councillors: Robert Heseltine, Andrew Lee, Pat Marsh, Nigel Knapton and Angus Thompson
Co-opted Members: Jill Quinn (Voluntary and Community Services) and Mike Padgham (Independent Care Group)
Copies of all documents considered are in the Minute Book
1. Minutes
That the Minutes of the meeting held on 22 September 2022 having been printed and circulated, be taken as read and be confirmed and signed by the Chairman as a correct record.
2. Declarations of Interest
There were no declarations of interest to note.
3. Public Questions or Statements
The committee was advised that no notice had been received of any public questions or statements to be made at the meeting.
4. Chair’s Remarks
The Chair welcomed everyone to the meeting. She advised that the new calendar of meetings is being prepared. She and the group spokespersons would have some work to do at the next briefing meeting in February scheduling the outstanding work.
5. Autism All Age Strategy
Presentation and briefing by Natalie Smith, Head of Service HAS planning and Michelle Miles, Senior Manager Health and Care giving an update on the progress on developing the new “All age strategy for Autism in North Yorkshire”.
Natalie and Michelle explained that the uniqueness of each person with autism makes the experience of living with autism different for each family. But there are some consistent themes or issues that most families should be aware of to be able to provide the best support to the individual and to family members.
The last autism strategy for North Yorkshire was produced in 2015.
Although the strategy for North Yorkshire has lapsed, the work has continued to support autistic people in North Yorkshire, we have a dedicated officer working hard to achieve the vision that within local communities’ people with autism can depend on mainstream services, to understand them and treat them fairly as individuals, therefore improving health and wellbeing.
Members supported the following aims of the proposed new strategy:
· Improving understanding and acceptance of autism within society.
· Improving autistic children and young people’s access to education and supporting positive transitions into adulthood.
· Supporting more autistic people into employment.
· Tackling health and care inequalities for autistic people.
· Building the right support in the community and supporting people in inpatient care.
· Improving support offered within the criminal and youth justice systems.
In response to questions, it was reported that the committee’s interest in autism is equally shared by the Scrutiny of Health Overview and Scrutiny Committee which has, over several meetings, focussed more closely on the current “deep dive” to understand the system, challenges, population needs and gaps in service provision.
During the debate, members raised several issues, on which further information might be made available when the item is before members again (most probably and the Scrutiny of Health Committee):
· It would be helpful to get a fuller picture of the trends in assessments, prevalence and support over the last 5 years, including for example: referrals and waiting list numbers (especially for specialist provision); comparative data form neighbouring authorities; and figures relating to costs for how services meet this known demand.
· The importance of the engagement events.
· Although not a specific issue for this committee, understanding the prevalence amongst young people and how they are supported through transition to adulthood.
· Data - be it quantitative and/or qualitative - that demonstrates the efficacy of early intervention.
a) that the report be noted.
b) Having looked at how the strategy set out to deliver this, the committee concluded that the support available is of a high standard. Most importantly, this has been done with the active engagement of people with autism.
c) that whilst the Scrutiny of Health committee will take the primary responsibility in the context of member level scrutiny, Care and Independence Overview and Scrutiny Committee will lend as much assistance as the Scrutiny of Health OSC feels it needs to ensure that the shortly to be finalised revised strategy is robust and effective.
6. Annual Report of the Older Peoples Champion and Healthy Ageing Planning and Priorities
Report by Cllr Caroline Dickinson, NYCC Older Peoples Champion and Presentation by Carly Walker, Health Improvement Manager and Louise Wallace, Director of Public Health
In giving her annual report as Older Peoples Champion, Cllr Caroline Dickinson facilitated a broader presentation on Healthy Ageing and ensuring North Yorkshire is an age friendly place where people can live healthy and active in later life.
Cllr Dickinson talked through some examples she had come across where, through partnership and collaboration, activities have been fostered that help older people live an independent and active life. So many of these schemes and initiatives that we admire are founded on local action. Small schemes that excel at single things - churches keeping people warm, walking groups, singing and dancing for people with dementia. Her view that we have such a strong community and voluntary sector in North Yorkshire and through HAS and Stronger Communities, as a council, we help these local groups to flourish.
Looking to the future, she expressed the view that whilst LGR presents opportunities not just to bring together all services under one roof - adult services, transport, housing, culture and leisure, through our commitment to localism, we have the platform to encourage older people’s groups to make their voices heard.
Carly Walker highlighted the action taken in support of Age Friendly Communities and the Strategic approach to healthy ageing in North Yorkshire.
Members emphasised how much older people, whilst often portrayed as a problem, were an undeniable resource for the community and volunteering, the economy and the workforce – especially with the country facing a shortage of labour in key areas like social care.
7. Annual Report of the Director of Public Health
Report by Louise Wallace, Director of Public Health introducing the Director of Public Health Annual Report 2021-2022: Lessons learned from the COVID-19 pandemic.
Louise explained that every DPH has a statutory requirement to write an annual report on the health of their population. The Director of Public Health Annual Report is a vehicle for informing local people about the health of their community, as well as providing necessary information for decision-makers in local health services and authorities on health gaps and priorities that need to be addressed. It is the principal means by which an independent assessment is offered and given.
A member reported that, anecdotally, he has heard that fewer and fewer GP surgeries were offering the option of the Covid 19 Booster vaccine. It was agreed that enquiries be made to local HHS partners to ascertain the position.
On the back of that comment, a members suggested it may prove critical to not wholly dismantle the infrastructure built to administer the vaccine roll out and booster programme. Also, we should be doing all we can to motivate those, mostly retired, trained health professionals who had come forward to assist with that programme to stay involved with and contribute to the health and social sector.
That the report be noted.
8. Adult Social Care Charging Reform - Trailblazer
Report of the Assistant Director- Strategic Resources HAS providing a brief update on Adult Social Care Charging Reform, including NYCC’s role as a Trailblazer. It followed on from reports provided to the Committee in June and September of this year.
Anton explained that North Yorkshire had agreed to be one of six “Trailblazers” for the new proposals on Adult Social Care reform and has been working with those other councils and the Department of Health and Social Care (DHSC) to look at the impact of the proposals.
DHSC has recently advised that although Charging Reform was still government policy, its introduction had been delayed - but only until October 2025. Therefore, for the time being at least, the Trailblazer project would be stood down.
Anton highlighted those areas of work begun as a Trailblazer that HAS is looking to continue with, namely:
· Continuing to explore a digital/self-service model where appropriate.
· Working with providers to better understand the self-funder market
· Care accounts for all users.
Much remains to be clarified with DHSC – for example, funding for the extra staff recruited in good faith, and what further work ought to be carried out. So, rather than shelve this as a scrutiny topic, members agreed to return to it later in the year.
a) That the report be noted.
b) Members welcomed the extent of the work the directorate has undertaken to prepare.
c) Given the self-evident significance of this initiative, the committee indicated it would wish to continue to keep a “weather eye” over progress.
d) However, in the light of the delayed implementation, unless in the opinion of the Chair and group spokespersons circumstances warranted reporting earlier, the topic need not come back to the committee for a progress update until September 2023.
9. Work Programme
The report of the Scrutiny Team Leader on the Work Programme.
In response to a suggestion that substance misuse and rehabilitation be added to the work programme, members were advised that on several occasions -usually around September of each year - committee members had approached this issue by receiving service updates from Public Health and from New Horizons, North Yorkshire’s Adult Drug and Alcohol Recovery Service (currently rated Outstanding by the CQC). Arrangements would be made to do this again – ideally in the Autumn of 2023.
Ray Busby drew the attention of members to:
· the response of the directorate to the issues raised by the committee at the last meeting, on Micro providers and unintentional injuries, was included in the narrative of the work programme report.
· The informal briefing session on the new Adult Social Care Framework was to be held on Wednesday 25 January at 11.30am.
· that the topic of current Care Pressures in the social care market may well be reported to the next meeting should group spokespersons deem this necessary when they review the topic with Abi Barron.
· The public health, social care and climate change topic will be taken at the next meeting. A specification/line of enquiry has been agreed between Cllr Andy Brown and the HAS directorate.
That the work programme be agreed.
The meeting finished at 12.35pm