Agenda and draft minutes

That the minutes of the meeting held on Wednesday 13^th December 2023 be taken as read and be confirmed by the Chairman as a correct record.

Resolved – The minutes are confirmed as correct.

Apologies for Absence

Apologies were received from

Councillor Heather Moorhouse with Councillor George Jabbour as substitute

Councillor Sam Gibbs with Councillor Tom Jones as substitute

Councillor Andy Paraskos.

Any correspondence, communication or other business brought forward by the direction of the Chairman of the Committee.

The Chair reminded the Committee of the changes that now apply to Health Scrutiny Committees.

Since 31 January 2024 new rules are in place in respect of the aspect of health scrutiny that relates to reconfigurations of local health services.

Local health overview and scrutiny committees will no longer be able to formally refer matters to the Secretary of State (SOS) where they relate to such reconfigurations.

Instead, the SOS will have a broad power to intervene in local services.

Further guidance on this can be found here Gov.UK

It was noted that the Committee had previously only utilised this method once so felt the change would not be of serious concern.

There were none.

Members of the public may ask questions or make statements at this meeting if they have given notice to Christine Phillipson, Principal Democratic Services Officer (contact details below) no later than midday on Tuesday 5^th March 2024. Each speaker should limit himself/herself to 3 minutes on any item. Members of the public who have given notice will be invited to speak:-

·       at this point in the meeting if their questions/statements relate to matters which are not otherwise on the Agenda (subject to an overall time limit of 30 minutes);

·       when the relevant Agenda item is being considered if they wish to speak on a matter which is on the Agenda for this meeting.

There were two public questions received as follows;

Question 1 from Mr Russell Davidson – as the item this question relates to is not on today’s agenda this question will be taken now. Mr Davidson did not attend the meeting and requested a written response be provided.

Why is there no centralised, publicly accessible, council-maintained list of the nearly 1700 North Yorkshire Care Providers? In seeking a suitable care setting for a service user, both parents and social workers are hampered significantly by the absence of such a list.

No business or public authority can function efficiently if it does not have a comprehensive overview of the facilities and resources available to it.

Right now, everything is being left to brokerage to recommend a placement (and they are driven solely by looking at the budget) and CQC ratings (which are often out of date).

I was told by a senior social worker that there used to be a centralised list that social workers could consult, but then some ’Wise Alec’ got rid of that, preferring to leave placement suggestions to social workers.. The consequences are that the social workers don’t know where to place people (they usually have not visited more than a few settings in the county) and just leave it to brokerage to make suggestions - the latter are interested solely in whether the charges for the setting are above a certain scale, not in whether the placement is fit for purpose or for the service user’s needs.

My own, 28 year old autistic lad, has had two awful placements in the last 10 years: each had its provider status stripped from it. His mental health and behaviour went backwards in both.

So we end up with people being placed in settings which sometimes rip off the public purse and do not meet the individual’s need. The consequence, of course, is the parents end up having to do all the work and desperately trying to find out the requisite information. In turn, social workers, who are already overstretched, have their job made more difficult.

The situation is even more idiotic when one considers the Council’s preference for in-county placement, and the frequent turnover of social workers, many of whom have no contact with their service users for months – or even years – on end.

A written response was provided as follows;

The Council follows a robust procurement policy. We only commission packages of care for people from care providers who have been through a rigorous application process and passed the requirements to be on our Approved Provider List (which can be accessed by staff and the public on the Council’s website – https://www.northyorks.gov.uk/adult-care/contracting-adult-social-care-and-health-services/approved-lists-adult-social-care-services-providers ).

As part of the application process all Providers are required to submit detailed information about the services they offer and how their services will provide high quality support to people to reach their outcomes.  In addition to this the Council reviews each provider’s financial information and a breakdown of the costs of their  ...  view the full minutes text for item 289.

Considered – Director of Public Health’s Annual Report

Resolved - The report to note at this stage. The Director of Public Health, Louise Wallace will be attending the June 14th Committee to answer any questions on this  report and discuss in more detail.

Considered – An update from Eleanor Rossiter from Airedale NHS Foundation Trust on the New Hospital at Airedale.

This covered a summary of the most up to date position and points to note were:

·       The current hospital will be replaced with a new hospital by 2030

·       RAAC programme continuing to install a range of structural supports across the hospital to maintain safety and service delivery

·       Build using modern methods of construction – eg the new intensive care unit

·       A summary of the phased construction plan

Phase 1 – Planning And Preparation (Estimated 2023-24)

Phase 2 – Getting The Site Ready (Estimated 2024-25)

Phase 3 – Designing The Hospital (Estimated 2025-26)

Phase 4 – Planning Consent (Estimated 2026)

Phase 5 – Building The Hospital (Estimated 2026-30)

·       A summary of the current position (Phase 1)

·       Public Engagement

·       Next steps

·       Current RAAC update.

Members were then invited to ask questions and discuss the presentation, which included;

Is there confidence in the hospital being delivered on time?

Due to the issues with RAAC there is no room for movement and the hospital will be delivered on time.

Is the current phase 1 on target?

It is.

How will the Integrated Care service look?

Airedale will be working with Bradford to meet patient needs and will update more going forward.

Will there be free staff parking?

It is not possible to confirm that there will be free staff parking, but it is a situation that needs to be carefully considered and look at best practice and possibly a reduced parking charge scheme, all to be confirmed in due course.

There needs to be a good service of public transport and could members be kept informed and involved on this.

Has a feasibility study been conducted on the possibility of a railway station ?

Not aware of this but enquiries will be made.

Update on Neo Natal Services from Matthew Babirecki, Consultant Paediatrician, Airedale NHS Foundation Trust,

Sam Wallis, Consultant Neonatologist, Bradford Teaching Hospitals Trust and

Sarah Halstead, Head of Specialised Commissioning Yorkshire and Humber, NHS England.

Considered – An presentation from Matthew Babirecki, Consultant Paediatrician, Airedale NHS Foundation Trust and Sarah Halstead, Head of Specialised Commissioning Yorkshire and Humber, NHS England.

The presentation served to bring members up to date with the Neo Natal services at Airedale NHS Foundation Trust and highlighted the following elements;

•       Background

•       Overview of Neonatal Care

•       Update on Airedale services

•       Impact for patients and families

•       Activity and travel analysis

•       Patient feedback and system engagement 

•       Summary and next steps

The Trust and NHSE would like to seek the views and support of the Overview and Scrutiny Committee on the change.

There was then the opportunity for members to ask questions and discuss the content, this included;

Airedale has on average carried out an average of 2 days intensive care per month and the recommendations of the Neonatal Critical Care Transformation Review state that:

Local Neonatal Units should aim to undertake a minimum of 500 days of combined intensive and high dependency care per year.

Services providing ongoing high dependency care should be expected to have higher levels of activity and all should work towards becoming services that provide at least 1000 combined Intensive Care/High Dependency days in the long term.

Smaller services would be designated as Special Care Services.

It was noted that units higher activity have better outcomes for babies.

This change will ensure the highest quality of care for premature babies across the region.

It was noted that supporting skills would be utilised across the area  with education days and increased resources.

This situation was not unique to Airedale and is a more common operating pattern.

Resolved – The Chairman thanked the NHS representatives for the presentation that the Committee was supportive of the change.

It was requested that a further update be provided to Committee on the changes at a future date.

Presentation from Naomi Smith, Head of Health and Adult Services Planning, North Yorkshire Council and Kirsty Kitching, Assistant Director for the North Yorkshire Mental Health, Learning Disabilities and Autism Partnership, Humber & North Yorkshire Integrated Care Board.

The Chairman invited Roger Tuckett to ask his question at this point.

Members may recall the questions I asked at its meetings on 17th June 2022 and

13th December 2023. I also asked a question at the Council’s Executive Committee

meeting held on 6th February 2024.

On 30th January 2023 I was told by the Lead for the Consultation that no further time

outside the various consultation sessions would be available to discuss my

fundamental concerns, and within such sessions, she needed to give priority to

others. However, following my question in February, Cllr Michael Harrison has

welcomed my contributions and suggestions and has agreed to meet with me, initially

for one hour, on 19th March 2024 as part of the consultation.

Para 2.4 of the Report to this Committee on 16th December 2022 stated: “CYP have

conducted a Joint Strategic Needs Assessment (JSNA) Special Educational Needs

and Disabilities 2020/21 and HAS have published a JSNA for Learning disabilities

that includes autism.” Yet 80+% of Autistic adults do not have a learning disability.

No-one commented on this at the time. The need for a proper JSNA slipped through

the net.

A recently identified “Autism Data Pack” dated October 2023 first surfaced at the

Executive Members and Corporate Directors meeting on 3rd November 2023, but was never incorporated into the material shared with the public as part of the consultation process. Most public consultees will remain unaware of this important document.

The Data Pack indicates major recent increases in prevalence, diagnosis and need

for adult autism services, this information being absent from the Draft Strategy.

Two written questions to the Consultation Lead (via emails dated 9th and 13th

February) remain unanswered: on Lived Experience numbers within Steering Group

membership and the current status of JSNAs.

I had requested in December for YaaaG’s “Manifesto” be circulated to both

Councillors and the Steering Group. I have later forwarded a 3-page briefing paper

on JSNA matters and a 1-page “Way Forward” document suggesting a Leadership

Summit across the Health and Social care sectors in North Yorkshire and York, on

which some initial feedback has been positive, although no efforts appear yet to have

made to bring one about.

I conclude;

• Notwithstanding the implication in Cllr Harrison’s response in February that there

were several, there appears to be one and only one Autistic individual and no

organisation on the Steering Group representing all of children, adult, learning

disability and parent/carer issues for Autism.

• Statutory Guidance requires first that any Autism strategy includes an up-to-date

detailed Joint Strategic Needs Assessment (JNSA); and secondly that the

process is overseen by the appropriate Health and Wellbeing Board. Neither has

yet happened. Guidance on this latter requirement survives the creation of the

ICBs and its Place Partnership structures.

• No public access has been possible for the meetings and decisions of the

Steering Group, which meets and operates with limited transparency, overall

accountability or public oversight. Those making these decisions must be held to

public account, and  ...  view the full minutes text for item 293.

Report of Christine Phillipson, Principal Democratic Services Officer, North Yorkshire Council

Considered – The Committees work programme.

The objective is to enable to Committee to review the work programme and make suggestions on areas of  scrutiny for inclusion for the following year and prioritise accordingly.

The following were suggested and discussed;

·       It was suggested that maternity services across North Yorkshire were of concern and an update from the CQC inspections would be welcome at Committee.

·       An update from Yorkshire Ambulance Service was expected in June following their briefing to Scarborough and Whitby Area Constituency Committee in relation to the new ambulance station in Scarborough.

·       An update on waiting list data from NHS trusts would be welcomed.

·       Health inequalities in primary and secondary care across North Yorkshire from the ICB.

·       An overview of the 6-month post implementation of electronic records.

Resolved – These items would be added to the workplan for the forthcoming year.  

The following motion from Cllr Andy Brown was withdrawn from Full Council and referred to Scrutiny of Health Committee on 21.02.24.

“To reduce the budget for mowing and spraying by at least £100,000 a year and to cease all purchases of any products containing glyphosate or neonicotinoids.’  In setting the context for the motion, he referred to the human health impacts of these herbicides and the recent financial claims made in the civil courts in the USA against companies and organisations that had supplied and used these products”.

As this motion was withdrawn from Council to be directed to Scrutiny this will be added to the workplan and discussed at the next Committee meeting in June where we will invite Cllr Brown to Committee to propose his motion.

There were no other items of business.

The date of the next meeting is Friday 14^th June at 10am in The Grand, County Hall.