Agenda item

·        Joint Committee and sub-groups

·        HNY ICB update

·        WY ICB update

·        NYC update

Abigail Barron (Corporate Director of Health and Adult Services at NYC), Louise Wallace (Director of Public Health at NYC), Mark Bradley (North Yorkshire Place Director at Humber & North Yorkshire Health & Care Partnership) and Clare Smart (Associate Director, Bradford District and Craven Health and Care Partnership) provided verbal updates on work since the last meeting. The following points were raised.

·         The Ambitious for Health work programme was structured around three key workstreams: healthy people, integrated neighbourhood working and healthy places.

·         Under the healthy people workstream, Members were updated on progress with Prevention Plus, which is supported by external funding and focuses on community based support, prevention and unpaid carers. Members were also advised of targeted investment in initiatives addressing health inequalities through neighbourhood based approaches, with funding delegated through joint arrangements and aligned closely with Prevention Plus to avoid fragmented delivery. An update was also provided on delivery of the Trailblazer programme, including engagement with participants and employers, community grant funding and plans for Year 2 delivery.

·         Members were updated on progress with integrated neighbourhood working, which remained a significant area of focus. This included development of intermediate care hubs, improved integration of rehabilitation and reablement services, proposals to improve the consistency and accessibility of intermediate care beds across a large rural geography, redesign of the community equipment service ahead of a future procurement, collaborative work to improve consistency and efficiency across community nursing services, and the role of the VCSE sector in supporting admission avoidance and hospital discharge.

·         Reference was also made to work under the healthy places workstream, including the need to ensure greater coherence in the use of neighbourhood “hubs” across programmes and partners, in order to avoid duplication and confusion for local communities.

·         Members were advised of progress on the development of a frailty model across North Yorkshire, agreed through the Integrated Care Board, including work to establish a single, countywide frailty crisis response service intended to provide a consistent and proactive approach to frailty and act as a foundation for wider neighbourhood health arrangements.

·         The governance arrangements supporting the Health Collaborative were outlined, including the roles of the Joint Committee, directors’ group and provider led collaboration, alongside links to local care partnerships. It was noted that, as the Integrated Care Board moved towards a more strategic commissioning role, delivery of neighbourhood health would increasingly be driven through providers working collaboratively across the system.

·         Members received an update on Integrated Care Board arrangements following the conclusion of the recent consultation, including progress with implementation of the new structure and the move towards a more strategic commissioning model. It was noted that, while the ICB was undergoing organisational change, delivery of key programmes, including neighbourhood health, frailty and health inequalities, would continue.

·         Members also received an update on West Yorkshire and Bradford and Craven, including recent and forthcoming leadership changes across the Integrated Care Board and partner organisations, confirmation that a place committee would continue during the transition to new provider partnership arrangements, and publication of a listening programme report bringing together insights from engagement with local communities.

During discussion, the Board raised the following points.

·         The importance of ensuring clarity for local communities, particularly in relation to neighbourhood hub models, and making effective use of existing community assets across a large and rural county. Members noted that confusion around the increasing number of “hubs” could be exacerbated by geography, rurality and transport challenges, and emphasised the need to involve local populations in shaping future neighbourhood health arrangements.

·         The need to involve local communities and the VCSE sector in the design and delivery of neighbourhood health approaches was emphasised, including recognising their role in supporting admission avoidance and hospital discharge.

·         Members sought clarity on how West Yorkshire fitted within the Health Collaborative arrangements. It was clarified that West Yorkshire providers were represented within the Joint Committee and Directors’ Group, and that the model operated on a North Yorkshire Council footprint, rather than an NHS geographical footprint, enabling partnership working across Integrated Care Board boundaries.

·         Reassurance was sought and provided that children and families would remain a priority across all programmes of care, including mental health and urgent and emergency care, and would not be limited to those programmes explicitly labelled as family focused. Officers acknowledged the point and agreed that further discussions would take place to ensure that Children and Young People were embedded within the programme.

·         Members also highlighted the importance of understanding how statutory partnership boards, including safeguarding children and adults and SEND arrangements, aligned with the wider Health Collaborative governance framework. Officers acknowledged that further work was required to map these relationships clearly and agreed to undertake follow up work to ensure appropriate alignment and representation.

·         Members raised concerns about reductions in GP practices and pharmacies across North Yorkshire and noted that this increased the importance of getting neighbourhood health and hub models right as services continued to evolve.

·         Members discussed the ongoing Integrated Care Board reorganisation, noting that the consultation had concluded and that partner feedback, including from local authorities and providers, had resulted in positive changes to the proposed structure. It was noted that implementation was underway, with a significant proportion of posts already filled, and that delivery of key programmes would continue during the transition.

·         Members welcomed confirmation that pre planning consultation had commenced on intermediate care hubs in Scarborough and Harrogate, noting this as a positive example of progress from strategic planning to delivery on the ground.

·         Members recognised the increasing role of the Mayoral Combined Authority as a route for funding and emphasised the importance of joint working across the system to deliver funded programmes efficiently, avoid duplication and make effective use of existing organisational capacity.

·         The importance of maintaining strong links with West Yorkshire and Bradford and Craven was emphasised, with Members noting the value of ongoing collaboration and future place focused updates.

Resolved

That the update is noted.