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North Yorkshire Health and Wellbeing Board
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Board Members |
Constituent Organisation |
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Councillor Michael Harrison (Chair) |
Executive Member for Health and Adult Services |
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Wendy Balmain |
Place Director for North Yorkshire, Humber and North Yorkshire Integrated Care System |
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Amanda Bloor |
Chief Operating Officer, Humber and North Yorkshire Integrated Care System |
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Ashley Green |
Chief Executive, Healthwatch North Yorkshire |
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Ali Jan Haider |
Director of Integrated Health and Care, Bradford District and Craven Health and Care Partnership – part of West Yorkshire Integrated Care System |
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Nic Harne |
Corporate Director, Community Development, North Yorkshire Council |
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Bridget Lentell |
Service Manager, Tees, Esk and Wear Valleys NHS Foundation Trust (substitute for Zoe Campbell) |
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Councillor Simon Myers |
Executive Member for Culture, Arts and Housing |
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Councillor Janet Sanderson |
Executive Member for Children and Families |
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John Pattinson |
Chief Executive Officer, Independent Care Group (substitute for Mike Padgham) |
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Jill Quinn |
Chief Executive, Dementia Forward (Voluntary and Community Sector Representative) |
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Sally Tyrer |
Chair, Yorkshire Local Medical Committee (Primary Care Representative) |
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Louise Wallace |
Director of Public Health, North Yorkshire Council |
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Richard Webb |
Corporate Director of Health and Adult Services, North Yorkshire Council |
In Attendance:-
Councillor Carl Les, Leader of North Yorkshire Council, Shanna Carrell, Equalities Manager, Health and Adult Services Directorate, Paul Coleman, Registrar, Public Health Team, Patrick Duffy, Principal Democratic Services and Scrutiny Officer. Legal and democratic Services, Sharon Graham, Housing Strategy Manager, Community Development Directorate, Heather Pearson, Chair, North Yorkshire Safeguarding Children Partnership, Dr, Sue Proctor, Chair, North Yorkshire Safeguarding Adults Board, Andrew Rowe, Assistant Director, Housing, Community Development Directorate and Naomi Smith, Head of Planning, Health and Adult Services Directorate
Copies of all documents considered are in the Minute Book
36. Welcome by Chair
The Chair welcomed everybody to the meeting.
37. Apologies for Absence
Apologies were received from:-
· Stuart Carlton, Corporate Director, Children and Young People’s Service.
· Zoe Campbell, Managing Director, North Yorkshire, York and Selby, Tees, Esk and Wear Valleys NHS Foundation Trust.
· Jonathan Coulter, Chief Executive, Harrogate and District NHS Foundation Trust
· Shaun Jones, Interim Locality Director, NHS England and NHS Improvement
· Mike Padgham, Chair, Independent Care Group
· Lisa Winward, Chief Constable, North Yorkshire Police
38. Minutes of the meeting held on 20th September 2023
Resolved –
That the Minutes of the meeting held on 20th September 2023 be approved.
39. Declarations of Interest
There were no declarations of interest.
40. Public Participation
It was confirmed that no public questions or statements had been received.
41. North Yorkshire Safeguarding Children Partnership – Annual Report 2022/2023
Considered –
A presentation by Heather Pearson, Executive Chair and Independent Scrutineer of the North Yorkshire Safeguarding Children Partnership (NYSCP).
The presentation, which is available here, also included the Annual Report.
Heather Pearson advised that Being Young in North Yorkshire 2021-2024 is the NYSCP Strategy for children and young people living in North Yorkshire. The Partnership recognise the diversity across North Yorkshire and how important it is to harness this when agreeing its delivery plans.
Our children and young people are our future and we want them to thrive in North Yorkshire and achieve the best possible outcomes they can.
The Strategy sets out the Partnership’s vision, which is shaped by the feedback from children and young people living in North Yorkshire and sets out its four key themes for children and young people, as follows:-
· A safe life
· A happy life
· A healthy life
· Achieving in life
Heather Pearson further highlighted the following:-
- There has been good progress against the priorities in each of the Themes. For example, under A safe life, more young people received support from Early Help Services, with a 28% increase in new cases this year and, under A healthy life, there has been an increase in children visiting a dentist, with 53% of children having been to a dentist in the last year, compared to 42% in 2020.
- There has been an 11% increase in the number of children being electively home educated (EHE). The main reasons given for children being EHE were stress and anxiety (22% in primary and 42% in secondary)
- The NYSCP Partnership Awards are an opportunity to showcase the multi-agency work among partners in safeguarding vulnerable children and families. The awards are given to individuals or groups working or volunteering with children and young people.
- Much of the work is undertaken in the sub-groups.
- When partner agencies and individual professionals engage in case auditing, it helps understand:
· the effectiveness of front-line practice in protecting children and young people;
· how well the lessons of Case Reviews and other reviews of practice have been learnt;
· what the impact of locally delivered training has been; and
· importantly, it allows the Partnership to identify good practice and ask questions about whether things could be done differently to improve the safeguarding system.
- Deep dives are undertaken in a number of areas and the learning from these disseminated.
- A lot of work is undertaken with Schools.
The priorities on Multi-Agency Child Exploitation were also covered. North Yorkshire has a really good offer for practitioners in terms of Multi Agency Learning and Training - including Parental Conflict; Working with Gypsy Roma and Traveller Children and Ukrainian Families as Refugees – challenge and opportunities. It is good to see the training being utilised by professionals.
Councillor Janet Sanderson, Executive Member for Children and Families, commented on the broad scope that is covered within the Annual Report. She added that it is good to see people recognised by the Partnership Awards.
Councillor Sanderson also referred to children’s mental health, which is running through every aspect of the Directorate’s work. EHE is a concern and she was pleased to see that this had been picked up in the Annual Report. She concluded by stating that there is great confidence in the Partnership and thanked Heather Pearson and the NYSCP for what they are doing.
Ashley Green, Chief Executive Officer, Heathwatch North Yorkshire, added his thanks. He noted the increase in the number of children accessing dentists but there is still room for improvement. Heather Pearson stated that the position is more positive than in other areas but that this can still be worked on.
Amanda Bloor, Chief Operating Officer, Humber and North Yorkshire Integrated Care Board, advised that the ICB had assumed responsibility for the commissioning of dental services on the 1st April 2023. This was previously with NHS England, and the aim of delegating dental services is to make it easier to deliver joined up and responsive care, delivering high quality primary care services for our population. There are national constraints, but a big piece of work is being undertaken to continue to improve the situation, with a focus on prevention.
In response to a question from the Chair about the three reviews awaiting publication, Heather Pearson advised that these could not be published yet as a result of on-going criminal investigations. She assured the Board, however, that any learning identified from these cases had been shared and acted upon.
Resolved –
That the North Yorkshire Safeguarding Children Partnership Annual Report for 2022/2023 be noted.
42. Updates from Integrated Care Systems
Considered –
Oral updates from the two Integrated Care Systems within North Yorkshire.
Humber and North Yorkshire Integrated Care Board
Amanda Bloor updated:-
- The Strategic Plan has been submitted. It recognises how the system is working and its relationship with its six places and the Voluntary and Community Sector.
- There is a particular challenge around financial risk especially with urgent and emergency care – this is a system issue.
- Much of the work is being led by the places.
- The Integrated Care Partnership is looking at seasonal preparedness across the system and Women’s Health Hubs, in collaboration with partners.
- She and Wendy Balmain, Place Director for North Yorkshire, have been involved in the development of the draft Joint Local Health and Wellbeing Strategy (JLHWBS) for North Yorkshire - the three priorities for which align perfectly with the wider health system.
- The Centre of Excellence for Tobacco will be important as smoking cessation is the single biggest thing we can do to reduce health inequalities. When the Prime Minister announced his recent initiative to make smoking illegal over a number of years, the system had been able to respond with one voice.
- Locality Teams from NHS England are transferring into the employ of the Integrated Care Board.
Wendy Balmain added:-
- The focus is on urgent care.
- She and the Director of Public Health have appointed to a joint post in Population Health. The post holder will assist Local Care Partnerships in examining the key risks and to redesign services accordingly.
- The North Yorkshire Place Board meets this week to review its priorities – she will report back further on this. The priorities will be fused with the JLHWBS and the Integrated Care Partnership Strategy. Therefore, there will not be any surprises.
- Demand in Primary and Secondary Care is unrelenting and discharges from Hospital remain challenging.
- The Service has been requested to make 30% savings in running costs by 2025.
- A new Operating Model is being consulted upon.
- There are five transformation programmes at place level. One example is a focus of CORE20PLUS5 funding on two deprived areas in Craven.
In response to a question from the Chair, Amanda Bloor advised that the new Operating Model is in the process of being reset from 31st March 2024.
Bradford District and Craven Health and Care Partnership
Ali Jan Haider, Director of Integrated Health and Care, Bradford District and Craven Health and Care Partnership, advised that much of the update provided by colleagues in Humber and North Yorkshire chimed with what is occurring in Bradford District and Craven. He had nothing additional to add on this occasion.
NOTED.
43. North Yorkshire Joint Local Health and Wellbeing Strategy 2023-2030
Considered –
A report by Louise Wallace, Director of Public Health, which shared the draft Joint Local Health and Wellbeing Strategy (JLHWBS) for North Yorkshire and sought approval from the Board to take forward the draft Strategy for consultation.
The report contained three Appendices:-
- Appendix 1 – The draft Strategy
- Appendix 2 – Public Consultation Proposals
- Appendix 3 – An Equalities Impact Assessment
The report and the afore-mentioned Appendices are all available to view here
Louise Wallace said that she would not refer in any great detail to the slides as Members were aware of the document from previous updates.
She stressed, however, what a crucial document this will be – built around the three priorities of Think People; Think Place; Think Prevention – all of which have a number of associated actions designed to make the priorities a reality.
Every effort has been made to use information we are already aware of so as to weave people’s voices into the document.
Subject to approval by the Board, the document is now ready to go out for consultation. This will take place between 8th January and 31st March 2024 with a mix of methods to help maximise engagement.
Whilst the document is inclusive, there is a focus on certain elements of the population with particular needs.
The Chair asked if there is there is anything in the document that is dependent on approval before work can commence. Louise Wallace responded that there is nothing that is dependent on awaiting a key decision. There is though plenty for the future. The key will be to involve as wide an audience as possible to get a sense of how connected the draft Strategy feels to them.
The Chair also referred to marginalised groups and asked if there is anything specific planned for engaging with those groups. Louise Wallace advised that other work undertaken with these groups will be drawn upon and that is why the mixed method of consultation is being proposed.
Ashley Green informed Members that Healthwatch North Yorkshire had supported the engagement side. We need to go to people; rather than the other way around.
Shanna Carrell, Equalities Manager, Health and Adult Services Directorate, commented that hearing the voice of marginalised groups is part of on-going engagement partnership work. There is strong ambition for this, with a step-by-step approach.
Richard Webb, Corporate Director, Health and Adult Services, said he was keen to see us in listening mode and for people’s views to help shape the final Strategy. He added that it is good to see the alignment of priorities across the North Yorkshire system.
Councillor Janet Sanderson wanted to know more about the consultation process. Shanna Carrell responded that partners are applying as much creativity to this as possible and highlighted that there will be a variety of methods and formats used, including:-
· Website
· Easy read version
· Copies placed in Libraries
· Face to face drop in events at Libraries
· A comprehensive communications approach
Resolved –
a) That the draft Joint Local Health and Wellbeing Strategy, as set out at Appendix 1 of the report, be approved to go forward for public consultation.
b) That approval be given to the pans for public consultation, as set out at Appendix 2 to the report, to take place between 8th January and 31st March 2024.
44. Draft Housing Strategy for North Yorkshire
Considered –
A presentation by Sharon Graham, Housing Strategy Manager, in the Community Development Directorate, outlining the draft Housing Strategy for North Yorkshire.
Here is the presentation.
Sharon Graham, highlighted the following:-
- The Strategy will help set the strategic direction for the new Council.
- Key challenges include an ageing population (25% of whom are aged 65 or above) and a reduction in the working age population (down by 2.6%).
- Affordability of housing is also an issue, with a reduction in incomes and an increase in property prices threatening to create a perfect storm.
- Fuel poverty is another key challenge. For example, how to retrofit properties to ensure that the people who live in them are warm and well.
- There are a number of opportunities and aspirations. These include:-
· Partnering with the new Mayor and Combined Authority to deliver growth
· Working with York and North Yorkshire Housing Partnership to deliver shared goals
· Being carbon neutral by 2034
· Making the best use of resources
- The vision of the Strategy is To deliver good quality, affordable and sustainable homes that meet the needs of all of our communities.
- To achieve this, the Directorate will work across three themes:-
· Our people (for example, preventing and tackling homelessness)
· Our places (for example, addressing the rural housing crisis)
· Our homes (for example, ensuring that new housing supply contributes to our net zero housing ambitions)
- Consultation runs until 11th December 2023 and the aim is to adopt the Strategy in May 2024.
Councillor Simon Myers, Executive Member for Culture, Arts and Housing, remarked that there is a real enthusiasm in the new North Yorkshire Council to tackle issues. Housing can have an impact on inequality. Therefore, it is important we do what we can to address these inequalities.
He added that people are finding it difficult to keep warm and care workers cannot afford to live in North Yorkshire. The Council intend to use all of the tools at its disposal. He thanked, in particular, Nic Harne, Corporate Director for Community Development, Andrew Rowe, Assistant Director of Housing and Sharon Graham for the hard work that has gone into the Strategy.
Nic Harne commented that North Yorkshire Council provides a single authority for people to talk to and that Housing will move the dial on health outcomes. It may be worth being more explicit about including health in the vision or early on in the document.
The Chair asked if the Directorate was looking for the Board to contribute to this Strategy and the Local Plan. Nic Harne confirmed this is the case. The Local Plan is about place and this draft Housing Strategy is about homes at a targeted level.
Wendy Balmain advised that discussions are taking place at a tactical level between the Community Development Directorate and the Humber and North Yorkshire Integrated Care Board. These relate to two key aspects:-
a) How do we attract and retain key workers?
b) A review of the Primary Care estate. Much of the accommodation is based in residential-style accommodation which is past its sell by date and which is not conducive to integrated care.
Richard Webb talked about the positive initial work with Housing colleagues within the new Council. He welcomed the draft Strategy. Also noted the recent visit by the National Older People’s Housing Task Force.
Richard Webb also mentioned that on 6th December 2023 there will be an online International Recruitment Session. If any colleagues would like to attend, please let him know.
Resolved –
That the draft Housing Strategy for North Yorkshire be noted.
45. North Yorkshire Safeguarding Adults Board – Annual Report 2022/2023
Considered –
A covering report by Dr. Sue Proctor, Chair of the North Yorkshire Safeguarding Adults Board (SAB), which introduced the Annual Report for 2022/2023.
The covering report and the Annual Report itself can be viewed at Item 10 on this link
Dr Proctor highlighted a number of aspects such as:-
- During the last year, the SAB has broadened its membership, with Housing now a Member.
- Risks include workforce and responding to Safeguarding Reviews.
- There has been a 42% increase in the number of referrals. Analysis of this indicates that this increase is not reflected in open cases - much of it is due to repeat referrals.
- Based on feedback from partners, the Strategic Priorities for 2023/2024 build on work that has already been carried out and which the SAB wish to progress over the next years, namely:-
· Reconnect with communities in North Yorkshire.
· Have safeguarding policies and procedures that are in line with best practice.
· Work together effectively with partners and organisations.
· Adapt and respond to changes affecting how we safeguard adults in North Yorkshire.
- The online nature of Safeguarding Week allows for greater engagement.
- Communications work has showcased work undertaken by the SAB nationally.
- The SAB will look at domestic abuse and the vulnerability of older adults and self-neglect and loneliness to identify and support people prior to a crisis situation developing.
- Given structural changes, the SAB is working with localities and connected with the Community Safety Partnership and Local Safeguarding Partnerships. The SAB will support them to help increase the safeguarding of adults across North Yorkshire.
The Chair commented that, whilst the Pandemic had caused so many difficulties, it is good to see that online initiatives have helped.
Dr Sally Tryer, Chair of the Yorkshire Local Medical Committee, welcomed the opportunity for a broader conversation.
Richard Webb mentioned that Dr. Proctor’s term of office would be coming to an end soon. He thanked her for being an excellent Chair and for focusing on a twin-track approach around 1) mainstream safeguarding and 2) issues facing people who were most marginalised/excluded.
Ashley Green advised that a key part of Healthwatch’s communications is around safeguarding work.
John Pattinson, Chief Executive Officer, Independent Care Group, referred to the dangers of modern slavery. Dr. Proctor said this is a recuring theme for the SAB.
Resolved –
That the North Yorkshire Safeguarding Board Annual Report for 2022/2023 be noted.
46. Proposal to support people with lived experience be involved in and contribute to decision making across North Yorkshire
Considered –
A report by Ashley Green which sought approval to this proposal.
Ashley drew the following to Members attention:-
- He had been asked to put together a proposal to explore how people with lived experience could be included in the membership and/or have their experiences shared.
- There are lots of different pieces of work occurring in this area. This report attempted to underline the collaboration and to join up some of the actions and act as a catalyst for this.
- A similar Forum has been set up in Bradford District and Craven and would enable timely insights to the Board
- The aim of the proposal is to build on the original discussions and identified options and ensure that any ‘lived experience model’ suggested supports both the North Yorkshire Place Board, as part of Humber and North Yorkshire Integrated Care System and the Health and Wellbeing Board, to hear from people across North Yorkshire to improve outcomes in population health and reduce health inequalities.
- This Model would also aim to develop reciprocal relations between the public and relevant organisations to embed co-design and mutuality within its structures.
- The initial discussions identified two possible routes:
· A hub and spoke approach, that would tap into existing community networks for any public insight or involvement that the Board wished to undertake, supplemented by bespoke targeted engagement to address identified gaps.
· To invite people to Health and Wellbeing Board meetings, that have previously been engaged with as part of earlier discussions, planned work, etc., when a specific matter is brought to the Board.
- The proposal therefore explores how these two routes could be delivered within existing resources and identifies where new or additional resource may be required.
Richard Webb congratulated Ashley on the initiative. It is good to, as the proposal suggests, build on existing processes and evolve these, rather than creating something new.
In response to a question from the Chair, Ashley confirmed that people can choose to be involved as much or as little as they want to be.
Wendy Balmain commented that it can be easy for organisations to work in silos. Bringing together voices of people with lived experience can shape our services.
Resolved –
That the proposal, involving the three main elements identified, as set out below, be approved:-
a) Network
The establishment of a People’s Voice Network to bring together public/patient involvement or engagement leads from across health and care, and the voluntary sector covering North Yorkshire.
b) Engagement
As well as sharing insight, the Network could advise on targeted engagement with local people across the county.
c) Involvement
The Network could also help to identify people with lived experience if required, who might be willing to participate and/or attend the Board when there was a need to hear from specific communities, and/or ask that they are involved in specific pieces of work, policy development, strategy reviews, etc., being undertaken by the Board or the North Yorkshire Place Board.
47 Rolling Work Programme – 2023/2024
The Chair introduced this report and emphasised that the Work Programme is for the Board to edit and add to as they wish.
NOTED.
48. Any other business which, in the opinion of the Chair, should be considered as a matter of urgency
There was no other business.
49. Date of next meeting – Wednesday 17th January 2024 at 1.00 p.m.
The meeting concluded at 12:25 p.m.
PD