Agenda and minutes

The Chair welcomed everybody to the meeting.

Apologies were received from:-

-        Cllr Janet Sanderson

-        Sally Tyrer

-        Jonathan Coulter

-        Zoe Campbell, substituted by David Kerr

-        Brian Cranna

That the Minutes of the meeting held on 18 September, 2024 be approved.

There were no declarations of interest.

Members of the public may ask questions or make statements at this meeting if they have given notice to Christian Brennan of Democratic Services and supplied the text by midday three working days before the day of the meeting.  Each speaker should limit themselves 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.

If you are exercising your right to speak at this meeting, but do not wish to be recorded, please inform the Chair who will instruct anyone who may be taking a recording to cease while you speak.

No public questions were received.

Richard Webb presented his update:-

-        Work on the business case for Airedale Hospital was ongoing and he had taken part in conversations between Airedale Trust and Bradford and Craven NHS Place.

-        North Yorkshire Highways and Transport colleagues had linked up with Bradford Council colleagues on implications inherent to the build.

-        In addition to the hospital there was work regarding the development of community services and its links to the hospital, which included a stock-take around Craven.

-        Conversations with Matt Sandford and Helen Palmer had discussed how to maintain a balance between the issues faced by Bradford and Craven in their respective localities.

Matt Sandford introduced himself to the Board, and presented his update:-

-        He noted the work that had gone into the Partnership and Governance Review, which had looked at new personnel, the structure, relationships with partners, and how they would add value.

-        The Airedale Electronic Patient Record had been postponed due to issues that had arisen.

-        The Strategic Outline Case (SOC) for the New Hospital Programme was due in December following timelines set by NHS England.

-        The ICB would sign off on the SOC at its first stage, subject to some caveats around ensuring the co-production of clinical strategies; engagement with partners; and transport for communities.

-        Regarding financial challenges he advised that they had a dedicated programme, Closing the Gap, which focused on immediate concerns for the financial year, in addition to setting plans around transformation and maintaining financial alignment in future years.

The Chair asked, given the new government, how secure the plans were around Airedale Hospital; and what would be delivered with the money? Mr Sandford responded that Airedale Hospital was unaffected by the national review as its issues pertained to RAAC. Further, that they were unsure how the money was going to be designated. From a place perspective this brought uncertainty due to the potential misalignment between a clinical strategy that met the needs of the population, and having the services that may be used to deliver towards that strategy.

Cllr Simon Myers noted the importance of Skipton General and provision in Settle, which served a purpose in addition to Airedale Hospital. Mr Sandford confirmed he was aware of the importance of these centres. Mr Webb added that arrangements had been made within the Council for colleagues to look at what potential opportunities were available with Craven based assets.

Ashley Green asked which authority would be responsible for the issues around Airedale Hospital transport. Further, he highlighted the value and role of the Voluntary, Community, and Social Enterprise sector during the current financial challenges. Mr Webb advised the intention was for Bradford and North Yorkshire to work together.

Wendy Balmain presented her update:-

-          She summarised the We Need to Talk survey to the Board.

-          A draft proposal on place delegation was in development and would eventually be shared with Health and Wellbeing Board partners.

-          There was an ongoing piece of work to define the core offer for primary community services of the six North Yorkshire places which involved harmonising around 150 clinical policies. They were collaborating with the Leaders Forum on what the offer should look like, for example, integrated neighbourhood communities and how these would operate.

-          They were managing the collective action of GP’s, and had arrived at agreements with 63 out of 64 practices. An in-depth review would examine what a longer term offer would look like, which would involve an assessment of local enhanced services. A combined approach around local enhanced services would bring some consistency across the six places and 143 practices across the ICB, of which 64 sit in North Yorkshire.

-          The Winter Plans had been submitted. It was amongst a build up of pressure on hospitals. There were improvements in discharges from hospital beds due to changes in criteria, and were close to the target of 15%, down from 24% over the last year.

Richard Webb gave is update:-

-          That if the place delegation was approved, the Health and Wellbeing Board could hold a workshop session on its implications.

-          There was also an extensive national consultation on the NHS 10-year plan, and shared with others that they were welcome to take part.

-          He spoke of the Workshop in a Box toolkit which, further to consideration, may be of value to the Health and Wellbeing Board.

-          There was significant pressure on adult social care, which had accumulated a £7.7 million overspend mostly from hospital care and partly from pressures in the care market and changes to ordinary resident legal rules.

-          They were currently consulting on the budget and had been focusing on ways to increase independence and care at home such as extra care schemes, prevention, and increased investment into leisure and children’s services. In addition, efforts were being made into creating a single leisure service.

Matt Sandford advised that they planned to utilise existing networks in regard to the Workshop in a Box Toolkit. Alongside this, they intended to increase engagement around their financial challenge and decision making, so that observers could understand the reasoning behind those decisions. He also added that they intended for West Yorkshire Place, on behalf of voluntary and care sector colleagues, to compile a piece on national insurance and living wage increases, to be raised nationally. It would be helpful for the region to have consistency and would therefore speak with Stephen Eames on this.

The Chair asked whether Mr Sandford was sighted on the situation regarding GP collective action. Mr Sandford responded that primary care was under Helen Palmer, but that they had not seen the scale of challenge felt elsewhere.

Louise Wallace introduced the report. She remined the Board it was a statutory responsibility to write a Public health annual report. The focus this year was on healthy aging, which would be reflected in some of the reports recommendations. North Yorkshire did on average have a higher proportion of old people than other parts of the country at 25% of the population, and set to increase to 33% by 2043. She also brought attention to and thanked those who participated in a photo competition which was part of the report and sought to show the ways people remained healthy and well in older age. She summarised the conclusion of the report as highlighting the need for public services to prepare for an increase in older people, to be aware of ageism, and ensure communities were age friendly.

Cllr Simon Myers spoke about how the report was relevant to the Council’s approaches on, for example, housing, which should meet the needs of all residents; or leisure services that have a role in keeping elderly residents healthy. The report would be useful to refer back to and remind decision makers of these issues.

Wendy Balmain thanked Louise for the report which she would share throughout the ICB. She agreed it was important to have reports that educated on issues like frailty and good financial health going into old age. On deprivation and health inequality she felt that the impact of having a large proportion of old people in the region was occasionally overlooked since it imparted a higher level of investment in terms of care.

Richard Webb thought the campaign on positive imagery was beneficial to combatting stereotypes on aging. He acknowledged that there were many people of older age who still worked and contributed to society as well as those who struggled and needed assistance. He emphasised that the work from Louise was crucial in not just adding years to life but also life to years.

Richard pointed towards a housing regeneration report that just been published by the Older People’s Housing taskforce, and would be worth reading for its insight on housing issues effecting older people. He also recalled praise towards the Council’s Market Strategy, and referenced Barnsley Council’s strategy which saw innovation like the moving of out-patient health services into shopping centres, and the conducting of primary care in town centres. He thought that it would be useful to look at where services were located in the community over the next five to ten years.

Noted

Heather Pearson introduced the report and gave a PowerPoint presentation. She invited questions from the Board.

Cllr Simon Myers asked why the number of exclusions and the percentage of young people reoffending was above the national average. Heather responded that the number of exclusions had also increased nationally and that fewer children attending school post-pandemic. they were working with partners in schools and the police to address the issue and hoped to see improvements by the years end. She advised that she could liaise with her colleague to provide a full answer following the meeting.

NOTED.

Adrian Green introduced the report and gave a PowerPoint presentation to the Board. He invited questions from the Board.

The Chair asked a question regarding the increase in safeguarding alerts, specifically, were the duplications regarding genuine cases. Richard Webb advised that this was under review with councils in the Yorkshire and Humber area in terms of how data should be collated. He explained that this work was to improve clarity on when multiple referrals applied to a single individual. Even so, there had been an increase in safeguarding activity locally and nationally. Locally most of these were justifiable; those that weren’t were largely from single a agency, however, this was being addressed.

Richard thanked Adrian for a comprehensive overview, and believed the priorities identified were well informed, and had benefitted from the inclusion of voices from the wider safeguarding group. He also wished to acknowledge the contribution from Sue Procter following her departure as Safeguarding Chair, in addition to the wider team who wrote the report.

NOTED

The Chair advised the Board that it was on the agenda to review the Terms of Reference, and following feedback, a proposal would return to the Board for adoption.

NOTED

To review the Health and Wellbeing Board Terms of Reference regarding the frequency of meetings, which presently take place six times each year.

For information.

The Chair introduced this report and advised members that the Work Programme was open to their input and recommendations.

Any other items which the Chair agrees should be considered as a matter of urgency because of special circumstances

The Chair gave thanks to Wendy Balmain for her contributions to the Board and ICB, prior to her departure, and wished her well.