►
Description
AGENDA
1. Declarations of Interest 00:01:48
2. Minutes 00:02:50
3. Public Participation
4. The Clinical Commissioning Group Report on the Primary Mental Health Team Closure 00:04:16
5. Proposal to develop a City of York Council Corporate Safeguarding Policy 00:05:05
6. Health Protection Assurance Report 00:26:38
7. Children's Oral Health Improvement Strategy 00:57:43
8. Work Plan 01:27:20
For full agenda, attendance details and supporting documents visit:
https://democracy.york.gov.uk/ieListDocuments.aspx?CId=968&MId=11639
A
Policy
and
scrutiny
committee
just
a
couple
of
pieces
of
housekeeping
we're
not
expecting
the
alarm
to
erase
tonight
too,
so
if
it
does
need
to
leave
by
the
nearest
stairwell,
which
is
just
through
the
steps
here
and
congregate
near
the
hotel,
if
anyone
does
use
D
to
use
the
toy
facilities-
the
nearest
oh
they're
just
through
here
and
if
you
can
avoid
going
that
direction,
because
you're
you'll
end
up
in
the
abyss
right,
we
have
apologies
from
France
the
parrot
and
councillor
Callum
Taylor
who's
familiar
with
this
committee.
It
makes
a
return
for
this.
B
A
C
A
E
A
Thank
you.
Okay,
we
don't
have
anyone
registered
to
speak
in
public
participation
today,
so
we'll
move
on
to
the
agenda
items
now:
item
4,
which
is
the
community
mental
health
item
the
CCG
you're
going
to
be
attending
or
work.
However,
as
members
will
be
aware,
we
had
a
deferral
request
following
the
concern
that
attendance
and
discussion
might
infringe
NHS
perder
guidance
and
officers
at
the
council
also
agree
that
this
item
ought
to
be
deferred
until
after
the
general
election.
The
meeting
is
the
week
after
the
general
election
that
December's
meetings.
A
So
we
move
on
to
the
next
item,
which
is
item
5.
The
proposal
to
develop
such
of
your
council
corporate
safeguarding
policy,
which
is
pages
5
to
10
of
the
agenda
and
I'd
like
to
welcome
Kara
air
who's,
the
head
of
service
safeguarding
and
who
Michael
Melvin
who's.
Our
assistant
director
for
social
care
join
us
good
evening,
I'd
like
to
give
a
brief
introduction.
Please.
F
So
City
of
York
council
over
a
number
of
years
have
worked
with
partners
around
developing
an
approach
to
safeguarding
in
the
city
and
as
part
of
that
Chiron
particulars
led
quite
a
lot
of
regional
and
local
work,
around
multi-agency
policy
and
procedure
and
the
implementation
of
that
locally
and
as
a
committee
you
receive
updates
from
ourselves
around
that
which
we'll
continue
to
do.
This
is
a
slightly
different
subject.
In
addition
to
that,
really
in
that,
as
a
council,
a
law,
we
have
those
multi-agency
procedures
which
we
lead.
F
G
Okay,
so
you'll
see
in
my
report
and
that
we
have
set
out
the
objectives
of
the
document,
because
it's
still
in
a
very
draft
form
I
didn't
want
to
actually
share
the
draft
as
yet,
but
I
can,
if
it
would
be
helpful,
go
through
the
proposed
headings
and
areas
that
the
report
is
going
to
cover
and
so
I.
Think
importantly,
it's
about
the
council
making
a
statement
to
its
commitment
to
not
tolerate
abuse
and
to
be
sure
that
both
officers
and
members
know
how
to
recognize
signs
of
abuse
and
know
what
to
do.
G
Should
they
come
across
it.
So
the
document
will
also
contain
information
about
what
to
do.
If
you
are
concerned
about
either
a
vulnerable
child
or
adult
now
it
it's
quite
a
difficult
policy
to
write
in
that.
I
have
been
looking
at
other
policies,
and
some
of
them
are
really
quite
complicated
and
I
think
that
what
I've
done
could
probably
be
simplified.
But
there
is
a
lot
to
get
in
there
as
well.
G
Related,
it
obviously
refers
to
related
documents.
It
sets
out
principles.
It
sets
out
statutory
obligations
that
we
have
a
council
as
Council.
It
sets
our
outcomes
of
roles
and
responsibilities,
including
functions
of
key
officers
and
members
and
statutory
directors
of
services,
line
managers
and
contractors,
and
subcontractors
as
well,
because
I
think
there
is
a
minimum
standard
that
we
expect
that
everybody
would
have
who's
coming.
A
D
You
Chet,
thank
you.
It's
it's
really
helpful
to
be
involved
in
the
process
of
this,
rather
than
just
being
presented
with
something
that
we
note,
which
is
often
the
case.
My
first
question
was:
don't
we
already
have
this
I
mean
it
seems
incredulous
that
there
isn't
something
of
this
this
or
and
if
there
isn't,
why
hasn't
there
be?
But
the
question
I
really
want
to
ask
is:
is
around
consultation,
because
within
this
on
page
seven
point,
nine,
no
consultation
has
taken
place.
What
consultation
will
be
taking
place?
It
would
be
interesting
and
helpful
to
well.
G
G
I
have
done
some
work
with
some
internal
colleagues,
so
I
have
spoken
to
somebody
from
Children's,
Services
and
HR,
and
our
workforce
development
unit
and
I
haven't
actually
set
down
a
plan
for
consultation
but
I.
Think
given
something
as
important
as
this
it,
it
will
need
to
be
widely
consulted
upon,
and
in
answer
to
your
question,
no
I
don't
think
we
do
have
anything
like
this.
At
the
moment
we
we
have
bits
and
pieces
in
different
places,
so
we
have
expectations
in
policies
and
procedures,
but
it's
not
brought
together
in
the
form
of
a.
F
Just
I'll
answer
that,
sir
a
bit
more
to
give
a
bit
of
bit
of
reassurance
as
well.
So,
as
Kyra
said
within
the
commissioning
arm
of
the
council,
there
are
safeguarding
standards
which
you
put
into
contracts
in
terms
of
the
recruitment
process.
There's
references
within
there
too,
to
safeguarding
but
I.
F
Think
some
of
it
is
that
we've
got
to
focus
on
multi-agent
procedures
and
and
the
responsibilities
under
the
Care
Act's
around
safeguarding
adults,
particularly
in
don't
imagine,
safeguarding
children's,
but
actually
the
job
of
bringing
together
our
own
internal
workings
around
safeguarding
as
a
job
which
you
know
hasn't
as
yet
being
done.
Some
you
know,
but
please
that
is
something
which
we
will
pull
together.
D
C
Thank
You
chair
and
don't
want
to
get
into
the
territory
of
debating
the
meanings
of
words,
but
I
wondered
if
there
was
any
room
for
debate
on
it
will
be.
The
second
bullet
points
on
page
7,
where
it
says
manage
services
in
a
way
which
promote
safety
and
prevents
abuse.
I
wondered
if
there's
any
scope
to
sort
of
firm
up.
The
word
promotes
into
something
closer
to,
if
not
insures
or
something
along.
The
line
towards
that
I
think
promote
is
a
bit
weak,
yeah,
sorry,
I
think.
C
Thank
you,
I'm
gonna
have
one
more
question:
if
that's
the
right
chair,
thank
you
on
the
next
bullet
points
and
it
touches
on
training
and
I.
Guess:
I'm
curious
as
to
council.
The
council's
current
training
capacity
are,
we
are
we
doing
all
right
in
terms
of
making
sure
that
all
staff
are
up
today
or
are
we
struggling
to
meet
that
demand,
because
it's
count
as
a
huge
organization?
There
must
be
a
considerable
degree
of
churn
in
staff
coming
in
going.
G
B
On
that
there's
quite
a
lot
of
focus
in
this
report
on
who
kind
of
cyc
staff
taking
this
training
is
there?
Have
you
got
any
thought
of
extending
that
out,
so
that
we
can
also
safeguard
people
who
may
be
vulnerable,
but
don't
have
much
contact
with
council
services.
I
know
in
some
parts
of
the
country,
this
sort
of
training
is
rolled
out
to
other
people
like
hairdressers,
barbers
now
beauty
that
technicians,
those
are
people
who
people
tend
to
see
every
few
months
and
have
conversations
with
and
that
sort
of
thing
I.
G
Mean
that's
something:
reaching
reaching
lots
of
people
that
aren't
necessarily
aware
of
safeguarding
and
of
the
processes
is
certainly
something
that
we
talked
about
at
the
board
quite
a
lot,
so
we
we
have
safeguarding
week
once
a
year
where
we
have
various
initiatives
to
kind
of
raise
awareness,
but
yeah
I
think
there's
always
room
to
do
more
and
a
lot
of
it
does
depend
on
capacity.
Obviously,
but
yes,
we
would
want
to
reach
as
many
people
as
possible.
Yeah.
H
Thank
thanks
for
the
report.
Obviously,
if
we
raise
awareness
of
safeguarding
issues
across
contractors
and
council
staff
etc,
they
will
inevitably
lead
to
an
increase
in
the
number
of
cases
that
are
reported
to
require
intervention,
which
is
going
to
mean
that
we'll
need
a
lot
more
capacity
for
people
to
take
action.
In
these
cases.
Will
the
resources
being
there
to
be
able
to
enact
the
policy.
F
F
Often,
the
solution
to
issues
which
are
presented
to
the
safeguarding
team
were
often
dealt
with
by
the
community,
with
support
and
advice
in
the
team,
not
necessarily
by
the
provision
of
a
service
and
so
being
able
to
build
the
capability
of
particularly
community
and
voluntary
sector
and
partners
to
respond
is
key
because
I
think
as
you're
pointing
out.
If
it
all
falls
on
the
council
to
respond.
H
As
opposed
to
transfers
are
released
if
we're
going
to
build
capacity
in
the
voluntary
sector
in
the
community,
that
will
require
more
resources
from
the
council
to
build
that
capacity.
So
it's
a
question
of
whether
or
not
that's
forthcoming
and
you'll
decide.
If
it
really
is
that
I
mean
policy
I'm
sure
when
it's
finalized
and
everything
will
be
great
or
while
I'm
sort
of
here
in
history,
we
can't
afford
to
look
after
or
vulnerable
people
and
we're
relying
on
others
to
do
it.
For
us.
F
No,
so
if
that's
the
impression
I've
given
then
and
apologies-
that's
that's
not
what
not!
What
I'm
saying
what
I'm
saying
is
this
I
believe
that
people
are
often
most
comfortable
receiving
help
from
the
people
who
closest
to
them,
they're
well
supported
by
the
council
and
its
partners,
and
that
statutory
intervention
is
an
approach
which
we
often
which
we
need
to
do.
F
H
F
So
I
think
some
of
this
is
about
so
it's
it's.
It's
an
internal
procedure
which
is
around
raising
the
the
profile
of
safeguarding
in
the
in
the
council
and
I'll.
Give
you
your
you
assurance,
but
if
that
generates
more
work
for
our
safeguarding
team,
then
that
will
be
dealt
with
yeah.
It's
it's
so
to
give
that
assurance.
If
we
run
into
any
difficulty
around
that
that
will
be
escalated
and
I
think
what
I'm
talking
about
is
the
nuances
of
the
approach
to
that.
But
I
certainly
give
you
an
assurance
that
you
know
as
of
today.
A
I
You,
chair
report
and
ocean
one
bringing
obviously
this
is
a
proposal
to
develop
the
policy
and
are
you
gonna,
have
the
systems
in
place
to
measure
how
how
well
the
policy
is
being
put
in
place?
For
example,
are
there
any
kite
marks
or
standards
that
we
can
achieve
and
work
towards,
and
is
there
anything
specific
that
we
can
be
doing
to
measure
it?
Thank
you.
G
I
think
that's
a
really
good
question:
I'm,
not
sure
that
there
are
some
kite
marks
or
standards
out
there,
but
there
are.
There
are
indicators.
There
are
things
that
we
look
at.
We
do
benchmark
our
own
figures
and
we
look
at
those
of
other
local
authorities
as
well,
and
if,
following
the
implementation
of
this,
we
see
a
sudden
rise
in
referrals,
then
yes,
that
would
show
that
it's
working
and
I
think
that's
something
that
we
do.
Would
you
need
to
think
about
how
we
tell
whether
it's
made
a
difference
or
not?
G
I
B
Unfortunately,
we're
a
bit
limited
in
this
meeting
because
of
the
general
election
and
perder,
because
I'd
like
to
talk
about
potential
change,
the
national
policy
to
do
with
those
proposed
changes
to
mandatory
training
for
health
and
social
care
workers
to
do
with
safeguarding
specifically
of
people
with
autism
and
learning
difficulties.
So
I'm
hoping
we
can
come
back
to
this
another
time
when
we
could
have
a
more
open
conversation
when
we're
not
so
limited.
F
Absolutely,
and
so
that's
really
important
to
us
because
we're
both
a
provider
of
direct
provider
of
services
to
to
that
group
of
ross'll
Commissioner
as
well,
and
we
also
have
our
readers
a
there's,
the
safeguarding
blade
in
the
city.
So
certainly
look
forward
to
having
that
conversation
when
we
are
able
to.
A
G
A
A
J
Thank
you,
and
since
this
report
really
is,
gives
you
an
overview
around
health
protection
which
really
describes
what
we
mean
in
terms
of
protecting
our
residents
from
infectious
diseases,
outbreaks
and
environmental
hazards.
The
responsibilities
around
health
protection
sit
with
a
number
of
organizations
from
public
health,
England,
the
NHS
and
local
authorities
and
in
a
local
authority.
The
Director
of
Public
Health
has
a
duty
to
assure
that
that
system
is
working
well
to
make
sure
that
our
residents
are
protected
against
any
threats
to
health.
J
So
the
aim
of
this
report
really
is
to
just
give
you
an
overview
as
to
what
our
priorities
around
health
protection
are
in
New
York
and
really
provide
an
opportunity
to
engage
you
in
this
conversation
really
and
enable
you
to
have
input
in
terms
of
how
we
take
those
priorities
forward,
and
so
Philip
hearth
in
the
public
health
team
leaves
on
much
of
this
work
for
us.
So
I'm
gonna
hand
you
over
to
Philip
her.
To
give
you
some
of
the
highlights.
E
E
So
the
beginning
of
the
report
I
just
wanted
to
give
an
overview
really
and
I'm
not
intending
on
going
through
that,
but
some
of
the
national
and
regional
issues
that
this
that
are
out
there,
but
really
just
to
focus
on
where
those
sit
within
the
city
of
York,
really
Public
Health
and
the
particularly
health
protection
is
that
has
a
wide
range
there.
As
Fiona's
already
said
it's,
you
know:
health
protection
in
terms
of
infectious
diseases
right
throw
to
hazards,
including
chemical
and
radiation.
E
E
So
I
just
wanted
to
kind
of
make
the
point
that
the
World
Health
Organization
states
that,
after
clean
water
vaccinations,
is
the
most
effective,
Public
Health
intervention
that
we
have
to
save
lives
and
promote
good
health.
And
this
is
why
it's
one
of
the
Plutonian
priorities
not
only
nationally
but
globally,
that
we
make
sure
that
our
uptake
around
vaccinations
is
it
creates
that
herd
immunity
and
is
at
its
optimum
pandemic.
Influenza
is
at
the
top,
is
the
top
risk
on
the
national
register
of
civil
emergencies.
E
So
that
means
that
if
you
don't
need
nuclear
war
to
kill
us
actually
pandemic
flu
will
do
it
for
us
very
very
easily.
Thank
you
very
much.
So
we
really
need
to
be
aware
of
that
of
the
hazards
and
how
we
can
actually
protect
ourselves
against
that
influenza
spreads
quickly
and
easily
it's
promiscuous.
It
changes
it
mutates
very
quickly
and
to
actually
try
and
put
together
a
vaccine
takes
time.
E
We
have
a
multidisciplinary
and
multi-agency
task
group
on
which
we
sit
and
our
key
for
City
of
York
Council
from
public
health
is
looking
at
how
we
ensure
vaccination
across
our
staff,
particularly
those
who
work
with
the
most
vulnerable
and
also
how
we
increase
vaccination
within
care,
homes,
domiciliaries
homes
with
that's
nursing
or
residential
and
the
staff
that
work
within
them.
So
that's
both
residents
and
staff.
E
Other
people
within
that
group
work
with
the
school
vaccination
service,
so
we
ensure
that
school
children
are
vaccinated.
As
per
the
child
vaccination
program,
our
GP
practices
and
our
CCG
colleagues
obviously
look
at
how
we
can
vaccinate
pregnant
women
over
65
and
those
who
are
at
risk
because
of
long
term
conditions.
E
So
the
flu
virus
that
can
last
up
to
24
hours
so
I'm
really
pleased
to
say
that
we
have
in
the
City
of
York
Council
our
hand
sanitizers
on
the
hard
surface
white.
So
part
of
the
campaign
that
we'll
be
doing
as
part
of
this
winter
is
encouraging
staff
to
use
that
and
actually
taking
care
of
yourself.
E
The
other
issue
around
that
the
uptake
of
vaccines
is
that
the
UK
lost
its
measles
free
status
in
the
beginning
of
2019.
So
that
means
that
we
have
not
been
able
to
eliminate
measles,
which
is
another
very
infectious,
obviously
and
other
infectious
disease
and,
as
a
result,
probably
helping
the
different
in
a
rubella
and
measles
strategy.
E
We
will
be
translating
that
into
what
local
actions
we
require
to
do
from
that.
But
I
hope
that,
within
the
bundle
of
papers
that
you've
that
you
had
that
the
case
of
the
on
page
24
actually
highlights
how
quickly
and
easily
measles
can
spread
just
from
one
index
case
and
health
and
the
importance
of
actually
having
people
vaccinated
against
these
infections.
E
The
recommendations
that
we
made
in
the
report
was
really
to
ask
you
to
think
about
how
you
could
promote
the
uptake
of
vaccines
within
your
constituencies
to
look
at
and
think
about
having
the
flu
vaccinations
yourselves
as
a
personal
responsibility
and
hopefully
assist
in
sharing
the
advice
and
guidance
regarding
the
public
health
messages
and
the
Health
Protection
messages
that
remembered
in
the
report.
Thank
you.
Thank.
A
You
very
much
before
I
open
to
member
questions.
I
just
want
to
just
state
myself
that
I
was
a
little
bit
surprised
that
this
was
referred
to
scrutiny
rather
than
my
health
and
well-being
board,
given
that
the
health
and
well-being
board
actually
has
provider
specialists
who
deliver
the
emergency
responses
and
clinical
services,
that's
a
lot
of
what's
contained
in
here
refers
to
so
I
actually
think
myself.
They,
it
should
still
go
there
for
operational
oversight.
I
mean
I,
think
it's
useful
from
it
for
members
to
receive
this
report
for
information
purposes,
but
I
think.
A
E
E
Unfortunately,
we
don't
hit
that
we're
only
at
about
86
percent
for
MMR,
2
and
I.
Don't
know
whether
that's
complacency,
people
had
MMR
born,
so
they
think
that
that's
enough
protection,
whether
we
haven't
promoted
that
as
much
you
know,
there's
lots
of
different
things
that
I
think
are
going
on
there.
E
We
work
very
closely
with
our
GP
colleagues
to
ensure
that
people
are
called
and
recalled
for
that
that
vaccination
and
that's
given
at
three
years
four
months,
whether
that's
a
particularly
busy
time
for
parents
and
children
to
school,
I'm,
not
sure,
but
but
we're
not
we're,
not
alone.
It
isn't
just
your
kids.
It's
indicative
across
the
country
that
MMR
two
is
has
a
much
reduced
it.
Take
it
right.
H
E
B
You,
chair
and
page
16
of
our
documents
lays
out
ten
national
strategic
priorities.
The
UK
over
the
next
five
years.
Strategic
karate
number
six
is
to
build
evidence
to
address
infectious
diseases
linked
with
health
inequalities,
and
it
gives
the
example
of
certain
pathogens
disproportionately
affecting
homeless
people.
For
example,
it
doesn't
mention
anything
about
the
dressing,
those
inequalities
just
building
evidence,
so
I
was
just
wondering
whether
our
locally
we're
going
further
than
that.
B
E
So
locally
we
have
what
we've
called
a
screening:
an
immunization
local
implementation
plan,
which
kind
of
slips
off
the
tongue,
and
that
shows
us
why
we're
not
meeting
some
of
those
targets
for
all
the
screening
and
immunization
programs.
So
we
then
target
those.
So
we
do
have
action
plans
in
place
to
do
that.
So
at
the
moment,
we're
trying
to
work
with
our
substance
misuse
providers
to
provide
flu
vaccinations
through
them.
E
We
work
with
the
infection
for
age
control
team
who
work
around
TB
and
work
with
the
homeless
and
that
so
we
there's
lots
of
different
ways
that
we're
trying
to
sort
of
get
it
get
it
get
through
that
and
probably
have
a
it
doesn't
really
say
very
much
there.
But
we
actually
do
have
an
action
plan
to
work
on
that.
Yet
I.
B
Suspect
a
lot
of
those
inequalities
will
also
be
geographical.
It
would
be
different
in
different
parts
of
the
city,
so
I
think
it
might
be
useful
for
us
to
have
that
information
so
that
you
know,
because
real
members
from
different
wards,
we
can
work
locally
on
improving
those
inequalities.
Certainly.
E
A
K
Will
be
thank
you
chair
and
thank
you
for
the
reports
and
on
page
21.
You
refer
to
the
trial
of
crack
in
York
and
could
I
just
ask
a
few
questions
on
this
trial
and
has
that
trial
now
ended?
How
successful
was
it
and
could
you
give
us
an
update
on
what
current
national
funding
situation
is
for
prep?
So.
E
We
only
have
responsibility
for
providing
services
around
sexual
health,
not
the
treatment
and
management
of
sexual
I
love
ever
of
HIV
that
becomes
that
comes
under
NHS
England.
So
my
understanding
is
that
that's
that's
continuing
I,
no
longer
work
in
that
particular
area
of
work,
but
but
I
think
that's
still
that's
still
there.
Yes,.
B
Thank
You
chair
the
penultimate
paragraph
on
page
20
about
local
priorities,
says
the
public
health
team
have
also
worked
with
our
occupational
health
and
human
resources.
Colleagues
to
extend
the
offer
of
a
free
flu
jab
to
all
staff
who
work
for
cyc,
I'm,
aware
that,
obviously
the
council
provides
a
lot
of
really
essential
services,
and
especially
in
this
building,
there's
lost
people
working
and
a
warm
building
in
close
proximity.
There's
lots
of
moving
around
and
hot
desking.
So
if
there
was
a
flu
outbreak,
it
could
have
quite
a
large
impact
on
the
services
we
provide.
B
So
I
had
a
bit
of
a
wander
around
the
building
talking
to
staff
in
West
offices
about
whether
they
were
where
they
were.
They
could
get
a
free
flu
vaccination
and
how
that
was
offered
to
that
sort
of
thing
and
the
feedback
I
got
from
you
know,
wasn't
a
huge
sample
size.
I
just
spoke
to
a
few
people
was
that
most
them
were
aware
they
could
get
a
flu
jab.
So
that's
great,
but.
B
It
didn't
seem
like
it
looked
like
the
responsibility
had
been
given
to
managers
to
disseminate
that
information
among
their
team,
rather
than
anything
going
out
to
all
staff.
So
I
was
wondering
if
you,
you
know,
I
know
this.
It's
ongoing
it's
flu
season
right
now,
whether
you're
aware
whether
all
staff
are
aware
of
this
and
the
other
thing.
One
person
told
me
that
they
hadn't
realized
it
was
available
to
all
staff.
B
They
had
been
told
that
if
they
want
a
free
free
job,
they
could
put
in
a
request
to
see
if
they
were
eligible
to
get
one
and
the
final
thing
it
was
that
I
also
spoke
to
the
person
who
thought
that
it
wasn't
available
to
all
cyc
staff
and
that
had
only
been
offered
to
people
working
in
West
offices
or
hazel
core,
and
they
weren't
sure
that
people
who
didn't
work
in
those
two
buildings
who
may
be
working
more
in
the
community
of
people.
They
weren't
sure
that
those
staff
had
been
offered
it.
B
E
Okay,
and
so
a
couple
of
years
ago,
we
started
because
I'll
go
back
one
step.
The
local
authority
has
policy
whereby
a
vaccinates,
those
staff
that
work
with
rural
people,
so
health
and
social
care
staff,
social
workers,
all
of
those
sorts
of
people.
A
couple
years
ago
we
asked:
could
we
widen
that
out
to
other
local
authority
staff
and
over
the
last
few
years,
that's
gradually
increased?
E
E
It
has
gone
in
the
managers
packs
for
them
to
remind
to
remind
their
staff
that
they
are
eligible
to
have
a
it's
actually
done
via
a
flu
voucher,
so
they're
presented
with
the
voucher,
which
then
they
present
to
a
local
pharmacy
and
they
will
give
them
the
the
flu
vaccination
for
free,
so
I
think
we
we
have
tried
to
do
lots
of
lots
of
work
on
it.
I
take
your
point.
E
Think,
there's
always
more
that
we
can
do,
and
it's
proved
really
really
positive
and
people
really
want
to
have
it
so
we've
gone
from
having
only
two
or
three
hundred
people
having
the
flu,
vaccination
I
think
currently
were
at
700
this
year.
So
it's
it's
made.
A
massive
impact.
I
think
there's
still
work
that
I
could
do
with
hazel
court
and
I
think
some
of
the
workers
that
work
there.
E
E
Yeah
so
at
the
moment
a
particular
primary
schools,
there
is
a
school-based
service
which
offers
flu
vaccination
for
all
all
years
in
skåne
primary
school
and
as
part
of
that
they
do
do
some
work
with
the
teachers
as
well
to
actually
encourage
them
to
to
have
a
flu
vaccination.
It's
not
part
of
that
service,
but
you
know,
as
you
can
have
a
flowback
for
under
ten
pounds
in
the
local
pharmacist
that
they
are
encouraged
to
do
that,
and
we
have
looked
at
whether
we
could
vaccinate
staff
while
were
there,
but
then
there's
the
payment
issue.
E
It's
not
covered,
so
it's
so
it's
you
know.
As
ever
it's
complicated
in
secondary
schools.
We've
certainly
put
information
into
headteachers
newsletters.
You
know
offered
advice
on
where
they
could
actually
get
the
flu
vouchers
one
for
staff,
but
other
than
that.
That's
that
that's
as
much
as
we
we
do
really.
D
D
And
of
course
the
council
has
a
significant
part
to
play
in
that,
because
all
sorts
of
messages
are
communicated
in
all
sorts
of
ways,
things
that
might
go
out
with
council
tax
letters,
things
that
might
be
on
the
council
website,
things
that
are
on
the
side
of
the
council's
fleets,
where
we're
giving
messages
of
all
all
kinds
at
all
of
the
time.
Is
there
a
strategy
of
Public
Health
communication
around
some
of
these?
These
issues,
flu
jams,
would
be
an
obvious
example,
but
there
are
so
many
others.
E
So
with
with
this
particularly
do
we
have
a
set
of.
We
have
a
communication
strategy
looking
at
key
public
health
messages
that
were
going
to
publicize
over
the
year
and,
of
course
all
of
not
all
of
them
are
to
everybody
they
are.
Some
of
them
are
to
targeted
groups
in
terms
of
the
flu
messages
and
same
well
join
winter.
E
We've
put
lots
of
information
in
things
like
one
city
and
other
publications
that
the
the
local
authority
give
out
this
information
on
the
website
and
all
that
sort
of
thing,
but
we've
tended
to
focus
on
staff
having
the
vaccine
and
care
homes.
Those
have
been
our
two
priority
areas
really
around
this,
and
the
NHS
does
quite
a
lot
of
work.
Around
I've
had
my
flu
job
and
I'm,
promoting
it
there,
and
also,
obviously,
our
pharmacy
colleagues
promoted
within
there.
A
K
Thank
you,
chair
and
I
was
just
wondering
if
you
had
like
on
your
recommendations
about
whooping
cough
and
rubella,
and
everything
like
that
and
I
was
just
wondering
if
you
had
any
posters
that
the
wall
camp
could
put
out
in
their
notice
boards,
and
then
we
could
let
people
know
at
the
general
public.
No
more.
There
absolutely.
E
Think
these
these
are
from
the
the
libraries
in
resilience
forums
that
have
put
this
together
as
their
top
risk,
I.
Think
industrial,
actually
I
guess
it
depends
on
whether
that
puts
us
at
risk.
So
if
it's
the
electric
is
or
the
the
gas
or
whatever
that,
could
you
know
that
that
could
have
an
effect
on
us
and
I
can't
think
of
anything
why
they
put
that
at
that
in
their
the
run,
hightail
is
more
around
the
sort
of
terrorist
attack
issues
and
that
was
proposed
by
the
Mets,
the
Metropolitan
Police
in
London.
E
B
E
B
H
The
answer
was
that
there
was
a
lot
of
anti
vaccination
news
out
there,
so
so
part
of
the
reason
that
some
of
the
children
in
York
are
not
being
immunized
is
because
their
parents
or
carers
are
opposed
or
think
that
the
vaccination
poses
some
a
greater
risk.
I
I,
just
wonder
if
you
had
any
message
for
people
who
think
that.
E
Yeah
so
there's
as
I
said,
there's
the
the
measles
elimination
strategy
and
also
the
World
Health
Organization,
together
with
public
health
England
and
put
together
replies
for
the
anti-vaxxers,
and
they
call
them
vaccine
denier,
so
they're
denying
the
medical
and
scientific
evidence.
That's
there
that
says
that
actually
vaccines
are
safe,
that
they
are
our
best
form
of
protection
and
that
actually
they're
not
looking
at
the
scientific
evidence.
E
So
with
Emma,
my
particular
there
that
would
be
dealt
with
through
the
GP
practice,
though,
if
there's
any
particular
issues
why
the
children
would
be
so
if
they're
immunocompromised,
so
if
they
didn't
go
through
chemotherapy
or
that
they
have
something
other
than
then
that's
you
know,
then
they
might
not
be
a
be
vaccinated.
That
would
be
up
to
the
general
practitioner.
I
think
the
fact
that
children
have
to
be
brought
by
a
parent
or
carer
and
they're
not
bringing
them.
It's
very
difficult
to
know
why
they've
not
brought
them
when
they're
in
school.
E
We
ask
for
consent,
forms
for
flu
vaccinations
of
what
have
you
I
mean
we
get
a
little
bit
of
feedback
then,
but
were
able
to
work
on
that
and
unable
to
counter
that,
and
when
it's
about
the
M
among
the
childhood
vaccinations
childhood
vaccination
schedule,
it's
really
up
to
the
GP
practice
practice
nurse
to
actually
find
out.
Why,
but
a
that
data's
not
really
captured
as
such,.
I
E
Think
that's
something
that
nationally
they're
looking
at
as
to
why
because
I
say
this
is
not
just
a
York
issue:
it's
across
its
across
the
country
and
the
NMR
isn't
it
is,
is
well
down
and
I
think
that
they're
looking
at
how
we
deal
with
that
as
part
of
this
elimination
strategy,
what
messages
do
we
have
to
get
out
there?
What
other
ways
can
we
act,
encourage
parents
to
bring
them
back
and,
as
I
say,
don't
know
whether
that's
because
they
think
or
they've
had
one
so
I?
A
H
A
J
Okay,
so-
and
there
was
a
previous
performance
report
that
came
to
scrutiny
meetings
every
year
ago,
which
highlighted
that
tooth
extractions
for
decay
were
higher
in
New
York
in
the
north
for
age
range,
and
so
we
were
asked
to
go
away
and
do
some
further
work
to
look
into
this
and
try
and
understand.
Why
were
we
seeing
this
in
New
York?
And
what
should
we
do
about
it
really.
So,
since
that
meeting,
we've
established
an
oral
health
improvement,
Advisory
Group,
which
brings
together
a
number
of
experts
and
partners
around
oral
health.
To
look
at
this.
J
The
first
piece
of
work
that
that
group
did
was
to
carry
out
a
oral
health
needs
assessment
to
really
understand
all
the
data
that
we
have
and
understand,
really
what
it
was
that
it
was
telling
us
and
then,
following
on
from
that
piece
of
work,
to
look
at
the
data
to
develop
a
strategy
to
look
at.
What's
our
strategic
response
to
that
data
across
York.
J
So
in
terms
of
the
piece
of
work
that
we
did
to
look
at
the
data,
I
guess
just
to
update
you
on
some
of
the
key
headlines
from
that
piece
of
work.
So
we
didn't
find
any
evidence
that
the
oral
health
of
five-year-olds
was
worse
in
York
than
than
anywhere
else.
In
fact,
it
was
slightly
better
than
the
England
average.
J
We
found
the
attendance
levels,
a
dentist
in
York
and
for
young
people
was
high,
apart
from
potentially
in
the
year
in
the
not-too
age
range,
which
is
actually
sort
of
a
national
phenomenon.
People
don't
realize
at
that
very
early
age.
It's
actually
quite
good
practice
to
just
get
your
child
used
to
sitting
in
a
dentist's
chair,
even
if
they've
only
got
a
couple
of
teeth,
maybe
just
starting
to
poke
through
it's
just
part
of
that
getting
used
to
sitting
in
the
dentist's
chair
and
not
being
afraid
to
go
to
a
dentist.
J
So
that
was
the
one
age
group
where
attendance
was
low,
but
otherwise
it
was
generally
good
and
then
the
issue
around
higher
rates
of
extractions
in
hospital
under
general
anaesthetic.
We
couldn't
really
fully
explain
that
when
we
looked
at
the
data
and
so
what
the
data
was
telling
us
is
that
we
don't
have
necessarily
children
who
have
worse
oral
health
but
for
some
reason
in
York.
J
J
J
We
do
have
a
very
small
budget
within
public
health
to
Commission
and
oral
health
promotion
services.
So
as
part
of
this
work,
we
will
be
re-examining
what
we
spend
our
budget
on.
In
terms
of
this,
to
look
at
making
sure
that
we're
targeting
and
the
areas
that
we
need
to
and
getting
the
most
effective
service
from
that
small
budget.
J
We
need
to
have
a
focus
around
improving
the
knowledge
of
professionals
who
work
with
children
and
young
people,
so,
whether
that's
our
school
nurses,
our
midwives
or
social
care
services,
so
that
when
they're
talking
to
you
parents,
those
sort
of
key
intervention
points
that
they've
got
oral.
Health
in
their
mind
is
something
that
they
might
want
to
ask
people
about
whether
they
take
their
child
to
see
a
dentist,
whether
they
their
children
brush
their
teeth
regularly.
So
using
all
those
available
sources
in
the
workforce
to
put
those
messages
out
there
to
families.
J
There's
more
work
that
we
need
to
do
around
the
environment
that
children
are
living
in
as
well,
and
that
links
with
some
of
the
other
work
that
we
take
forward
in
public
health
and
across
the
local
authority
as
a
whole.
So,
obviously
any
case
of
dental
decay
in
a
child
age
naught
to
4
is
entirely
preventable.
So
it
links
very
well
with
some
of
the
work
that
we're
doing
around
healthy
weight.
So
what
children
are
eating.
J
Also
looking
at
some
of
the
food
policies
that
we
have
in
our
early
years
settings
and
how
they
can
support
this
agenda
as
well,
and
then
also
some
of
the
other
policies
that
we're
working
on
in
public
health,
around
infant
feeding
and
how
that
links
into
the
advice
that
mothers
are
given
in
terms
of
ways
of
feeding
babies.
That
will
have
an
impact
in
terms
of
how
their
teeth
develop,
so
the
oral
health
improvement
advisory
group
will
be
leading
on
implementing
this
strategy,
so
they
will
be
developing
an
action
plan
to
put
this
into
reality.
J
So
one
of
our
asks
from
you
really
is
as
well
as
receiving
this
strategy.
It's
whether
you
have
any
comments
around
the
implementation
of
this
strategy.
I'd
be
very
happy
to
take
that
back
to
that
group
to
consider,
and
then
also
that
kind
of
unanswered
question
around.
Why
do
we
have
so
many
and
children
who
are
being
admitted
to
hospital
for
teeth,
extractions
and
I
guess?
A
Thank
you
very
much
for
your
honour
reading.
This
I
mean
it
struck
me
that
the
first
thing
that
came
to
mind
is-
and
it's
very
generalized
questionnaires,
but
in
your
opinion,
do
you
believe
that
it's
all
children
York
have
an
NHS
to
insist?
If,
if
the
need
one
and
in
your
opinion,
can
they
access
them
quickly
with
appointments
at
times
up
fit
without
disrupting
school
attendance?
Would
you
have
that
kind
of
formation.
J
So,
as
I
said,
attendance
at
a
dentist
is
quite
high.
It's
about
86
percent
of
children
attend
a
dentist
in
York
regularly,
and
that
is
higher
than
the
the
national
rate
and
there
isn't
such
a
thing
as
being
registered
with
the
dentist
anymore,
in
the
way
that
you
register
in
and
sort
of
stick
with
a
GP
practice.
They
don't
hold
lists
in
the
same
way
that
they
used
to
in
the
past,
and
we
do
anecdotally
here
of
some
people
who
say
that
they
have
to
drive.
You
know
they.
J
They
have
a
dentist
that
they
forms
a
relationship
with
and
then,
if
they
move
their
end
up
sort
of
wanting
to
keep
that
relationship
and
drive
a
long
way.
To
still
see
that
dentist,
and
obviously,
as
I
mentioned,
there
is
a
relationship
between
poor
oral
health
and
inequality.
So
imagining
if
you're
in
a
family,
where
you
don't
have
ease
of
ease
of
transport,
you
may
struggle
more
to
do
you
get
access
to
a
dentist,
but
I
think
it's
probably
not
quite
as
simple
as
that.
J
There
probably
is
something
about
people
seeing
the
value
of
going
to
a
dentist
regularly.
So
if
you
take-
and
if
you
take
one
of
our
highest
deprived
Ward's
of
Westfield
as
an
example
actually
the
access
there
is
really
good
and
there
is
a
dent.
A
local
dental
practice
in
Westfield
and
people
do
attend.
So
there
is
probably
something
about
where
exactly
dentists
are.
If
local
people
have
a
relationship
with
that
dentist,
so
it's
quite
a
complex,
a
complex
picture
and
I
think
there
will
always
be
occasions
of
of
where
people
do
struggle
to
access.
J
C
Thank
You,
chair
and
I
wondered
if
you
could
elaborate
further
on
the
on
page
43,
when
we're
looking
at
strength
and
in
community
actions
and
the
first
bullet
point
about
exploring
opportunities
with
targeted
support
by
a
community
champions
could
deliver
all
of
our
health
messages,
particularly
in
the
most
deprived
wards
in
the
city.
Now
I
might
be
getting
old
and
cynical,
and
all
my
time
on
the
council
I
mean
thought.
C
Maybe
it's
just
a
sign
of
the
times,
but
whenever
I
see
the
term
community
champions
I
feel
like
getting
sick
booked
it
out
and
it
feels
it
feels
a
bit
wishy-washy
and
vague.
Sometimes
these
things
work,
but
what's
the
grand
plan
behind
this
because
it
sounds
nice,
but
what?
What
might
that
look
like
in
reality.
J
So
we
do
have
a
program
of
community
champions
within
the
local
authority.
I
would
struggle
to
tell
you
exactly
how
many
we
have
at
the
moment,
but
I
think
on
my
last
conversation
with
colleagues
in
adult
social
care
who
you
kind
of
oversee
this
program,
there
were
plus
50
champions
who
had
been
trained.
They
go
through
training
which
is
based
on
the
Royal
Society
of
public
health
training
which
equips
them
with
some
knowledge
around
key
public
health
issues,
and
the
idea
is
that
these
are
people
who
live
in
the
communities.
J
They
know
the
people
who
are
the
kind
of
people
in
communities
who
who
know
lots
of
people
tend
to
have
lots
of
conversations
with
people
and
it's
about
them
having
you
know,
having
those
conversations
and
having
opportunities
to
get
health
messages
into
the
interactions
that
they
have
within
their
communities.
So
at
the
moment,
these
community
champions
have
been
very
much
involved
on
the
work
around
our
local
area
coordination
and
supporting
some
of
that
work.
So
I
think
one
of
the
opportunities
that
we've
got
is
to
look
at.
C
B
You
Jeff
and
I'm
glad
that
the
figures
in
New
York
on
child
dental
yeah,
the
child,
a
mental
health
figures
in
your
can't
worse
than
national
figures
that
actually
I
think
the
national
figures
are
a
little
irrelevant,
because
the
fact
is
that
there
are
children
in
New
York
who,
within
two
or
three
years
of
having
teeth,
they're
having
to
have
their
teeth
decayed
so
badiy
they
need
to
be
extracted
which,
as
he
said,
is
entirely
preventable.
I've
got
a
couple
questions.
B
B
I've
got
another
questions,
do
with
figuring
out
why
so
many
children
are
having
new
teeth
extraction
under
general
anesthetic
in
hospital
rather
than
under
local
anesthetic
and
dentists?
Do
we
have
data
on
where
people
are
being
referred
from
for
tooth
extractions?
Do
we
know
if
it's
lots
of
referrals
from
dentists
or
GPS
or
a
knee
or
one
one
one
should
we
know
where
the
referrals
are
coming
from?
And
my
third
question:
sorry
I,
don't
mind
paying
them
all
on
at
once
and
with
more
to
four-year-olds.
That's
you
know.
B
Children
preschool
before
they've
got
any
contact
with
teachers
or
school
nurses
or
that
sort
of
thing.
So
do
we
know
whether
it's
people
who
are
falling
through
the
net
because
they
were
socially
isolated.
They
don't
go
to
nursery,
they
don't
have
a
health
visitor
or
is
it
people
who
do
access
those
services,
but
those
services
just
aren't
providing
the
information.
J
J
This
is
this
is
part
of
the
issues,
so
the
data
that
we
get
access
to
is
what's
known
as
hospital
episode
statistics.
So
it's
quite
bland.
It
basically
tells
you
it
will
give
you
a
postcode
of
where
the
person
lives
and
the
age
and
sex
and
what
the
reason
for
the
admission
was,
and
that's
literally
all
we
have
so
in
terms
of
being
able
to
kind
of
look
at
who,
where
did
the
refer
will
come
from
or
any
of
that
other
data?
We
just
don't
have
access
to
that
kind
of
data.
J
So
I
understand
that
NHS
England
have
been
doing
a
piece
of
work
regionally
across
Yorkshire
and
Humber
to
look
at
this
issue
and
obviously
they
would
probably
have
access
to
more
data
than
we're
allowed
access
to,
which
was
partly
in
my
point
about
whether
you
wanted
to
question
and
it
just
and
further
around
that
issue,
because
they
may
have
more
data
than
we
get
and
then
so.
Similarly,
in
terms
of
knowing
whether
those
children
are
the
kind
of
children
who
are
like
say
falling
through
other
services,
we
just
can't
do
that.
J
I
J
Okay,
so
yeah,
so
this
shows
you
for
children
aged
nought,
15,
and
this
is
the
kind
of
percentages
of
those
children
who
are
accessing
a
dentist
in
those
wards,
so
yeah,
so
for
some.
So
whilst
it's
87
percent
overall,
that
will
be
much
less
in
some
wards
than
in
others.
So
it's
not!
It's
not
equal
across
the
city.
J
J
C
Thank
You
chair
just
to
build
a
fad
and
I
know
you
response
and
I'm
just
thinking.
Surely
the
proximity
is
and
the
sort
of
end
of
the
conversation
you
could
have
a
dentist
nearby,
but
you
know,
is
it?
Have
we
also
looked
into
how
oversubscribed
these
dentists
are
where
they
are
near
to
particular
areas?
Because
just
because
you
can
point
another
map
and
say
well,
it's
nearby,
so
there
must
be
other
things
going
on.
It
doesn't
seem
to
be
enough.
C
J
I
understand
and-
and
there
are
some
dentists
who
will
say
that
they
can't
see
any
more
patients,
and
so
that
would
be
a
factor
we
haven't
been
able
to
to
do
that
within
this
report.
But
as
I
say
is,
it
is
isn't
straight
as
simple
as
having
a
dentist
nearby.
There
are
lots
of
other
factors
that
that
would
influence
that.
A
J
It's
a
difficult
one
because,
as
I
say,
the
dental
services
are
commissioned
by
NHS
England
and
they
will
do
calculations
in
terms
of
where
they
think
there
is
a
need
for
dentists,
but
essentially
because
dentists
are
private
businesses,
they
have
to
want
to
open
a
practice
in
an
area
and
then
NHS
England
would
commissioned
them
to
provide
that
service.
So
it
is
complex
if
there
is
a
community
dental
service.
J
So
if
there
were
a
child
who
were
experiencing
dental
pain
and
was
not
able
to
access
and
a
dentist
to
be
seen,
then
a
GP
or
another
health
professional
could
refer
them
to
the
community
dental
service,
which
is
based
in
Mont
gate.
So
hopefully
there
wouldn't
be
a
situation
where
a
child
was
left.
You
know
completely
without
being
able
to
see
somebody.
H
Thanks
Jay
and
thanks
for
the
report
Fiona
the
world
were
performing
worst,
which
is
the
under
four-year-olds,
having
the
teeth
out
and
poor
kids,
mainly
by
the
looks
of
it.
Do
we
do.
We
have
a
figure
for
that
roughly
sort
of
how
many
under
four
year
olds,
are
having
teeth
out
in
a
year
in
your
if
it
is
in
there
up,
misty
I.
J
Don't
think
the
number
is
there
and
I
and
I
can't
remember
off
my
head,
so
I
don't
want
to
make
things
up,
but
we
can
share
they're.
Full
I
didn't
put
the
full
needs
assessment
in
here,
because
it's
a
fairly
long
technical
document
but
I'm
happy
to
make
that
available
to
you
and
point
you
in
the
direction
of
the
table.
That
shows
you.
What
number
of
children
are
we
talking
about
here,
so
I
can
do
that
thanks.
J
H
Paula
yeah-
and
you
said
earlier
that
it
was,
he
thought
it
might
be
something
to
do
with
custom
and
practice
of
children
that
age
being
sent
to
hospital
for
teeth
extractions
now
again
this
moment
just
the
way
my
brain
works,
but
that
seemed
to
imply
that
some
of
those
extractions
were
unnecessary.
I
mean
another
all
should
be
preventable
in
under
four
year
olds,
but
that
may
be,
some
teeth
have
been
taken
out
unnecessarily.
Is
that
so
what
you
meant.
J
Some
of
the
conversations
we've
had
in
the
oral
health
improvement
group
is
whether
is
it
because
we
have
dentists
who
are
working
in
the
community
who
don't
feel
confident
to
take
out
a
child's
teeth
in
their
dental
practice
and
therefore
they
refer
them
in
to
hospital
to
have
it
taken
out
under
general
anaesthetic,
rather
than
it
being
done
in
the
community.
So
not
saying
the
truth
doesn't
need
to
be
taken
out.
It's
just
where
that,
where
it
happens,
I.
H
Don't
know
it's
the
community
dental
practice
at
Monkey,
they
have
dentists,
who
specialize
basically
and
working
with
kids
and
particularly
kids,
who
are
terrified
of
dentists
as
I'm
sure
we
all
wear
at
some
point
in
our
lives.
I
was
anyway,
so
is
there
any
sort
of
training
that's
available,
because
it
may
be
that
some
of
the
it's
all
God's
dentists
don't
go
because
they're
really
scared
of
the
process.
So
is
there
anything
in
the
pipeline
to
train
dentists
to
be
able
to
work
better
with
kids
yeah.
J
I
think
that's
a
that's
a
really
good
point.
Obviously
that,
yes,
as
you
say,
there's
a
specialist
work
force
there
who
will
work
with
children
with
learning
disabilities
special
needs
and
just
sort
of
phobias
of
dentist,
so
they're
highly
trained
to
be
able
to
work
with
those
children.
So
there
may
be
something
about
how
do
we
roll
out
and
share
some
of
that
knowledge
from
these
practitioners
to
their
to
the
general
dental
practitioners?
So
yeah,
that's
a
good
point.
A
D
So
much
a
question
we've
just
hopefully
beginning
to
to
tie
things
up
because
first
of
all,
I
just
want
to
say
thank
thank
you.
An
awful
lot
of
work
has
been
done
since
this
committee
asked
the
question
right
at
the
beginning
of
previous
incarnation
of
this
committee,
and
maybe
only
the
chair
and
I
go
back
all
that
far.
D
But
it
is
gratifying
that
the
work
done
here
actually
does
on
occasion
lead
to
actions
and
changes,
and
improvements
and
I
think
that
in
this
case,
we've
seen
that,
but
just
seems
that
there
is
still
some
unfinished
business.
Whilst
it
is
really
gratifying
and
reassuring
that
York
is
not
worse
than
elsewhere,
as
was
feared
when
we
began
this
questioning,
but
actually
may
even
be
better
than
most
other
places,
and
it
is
good
to
hear
that.
But
there
are
still
so
many
concerns
that
have
been
expressed
and
unearthed,
and
the
question
still
remains
well.
D
Why
are
there
so
many
referrals
for
removal
of
teeth
in
very
young
children
under
general
anaesthetic
in
hospitals
that,
as
you
say
in
this
across
well
over
50
million
pounds
a
year
and
I,
think
that
it
is
probably
good
for
us
as
we
look
at
our
recommendations
that
we
still
consider
inviting
NHS
England
to
report
to
scrutiny
on
the
work
they're
undertaking
on
tooth
extractions
and
across
the
region?
Absolutely.
A
D
A
You
I
think
it's
a
very
good
summary
that
you
can
counsel
acrylic
and
obviously
the
recommendation
is
clearly
there
for
us
to
invite
consider
inviting
NHS
England
which
to
suggest
to
me
that
officers
think
there's
value
in
doing
that
and
you've
referred
to
that
several
times.
I
think
in
discussion
this
evening,
so
I
think
that's
something
we
should
definitely
do
okay.
A
A
L
Should
be
just
about
to
go
into
the
work
plan
are
kind
of
fits
with
that,
but
it
might
be
helpful
for
the
democratic
officer.
If
perhaps
there
is
a
bit
of
a
clear
steer,
even
if
it's
just
a
abroad,
we
would
like
to
invite
you
to
address
a
B
and
C
and
that's
a
start
and
could
always
obviously
discuss
further
with
other
areas
that
the
any
Testament
could
cover
a
report.
So
if
you
discuss
that
in
the
work
plan
that
I'd
be
very
helpful
and,
of
course,
Fiona
still
here
to
help
iron
out
any.
A
Nicely
slip
into
the
work
pub
then,
and
we'll
stay
with
that
point,
so
obviously
the
the
recommendation
was
to
ask
them
to
invite
us
they'd
invite
them
to
undertake.
Tell
us
about
the
work.
That's
been
the
taking
on
tooth
extractions
under
anesthesia
across
the
region,
so
obviously
that
would
be
the
main
area,
but
we
could
include
you
know,
what's
being
done
on
work
for
preventative
reasons,
to
avoid
get
to
that
stage.
B
It's
about
what
preventative
work
is
being
done
so
that
it
doesn't
get
to
the
stage
where
teeth,
to
need
extracting
and
then
also
on
the
occasions
where
it
does
get.
Your
teeth
need
extracting.
Why
so
it's
happening
so
much
under
general,
aesthetic
in
hospitals,
rather
than
under
local
anesthetics,
the
dentists,
because
I
think
that
is
an
area
that
really
needs
addressing.
At
the
moment.
We
don't
have
the
information
to
know
why
it's
happening
to
know
how
to
address
it.
H
A
A
Sure
that
for
us,
obviously
in
terms
of
for
next
month's
meeting
on
the
17th
of
December,
we
will
have
the
CCG
mental
health
GP
services
closure
added
to
what's
already
there.
So
the
older
person's
accommodation
over
for
you
councillor,
Mellie,
added
email,
us
or
yesterday,
highlighting
what
you
know.
Some
potential
concern
that
a
report
might
have
gone
to
executive
ahead
of
us
and
but
we've
learned
that
that
will
happen
until
at
least
January.
So
will
we
have
the
information
before
he
decisions
are
made
by
the
executive,
tailor
Thank.
A
C
Yeah
because
on
I
know,
I
know
I'm
I'm,
a
guest
of
yours
today
and
I'm
no
longer
on
this
committee,
but
I'm
sure
this
all
the
persons
accommodation
of
if
you
will
touch
on
I'll,
cave
in
and
other
care
sites
in
the
city.
But
given
that
we
know
the
council
is
gearing
up
to
a
decision
of
sort
on
our
caving
in
in
early
2020.
It
would
be
good,
if
possible,
to
get
more
than
just
a
paragraph
or
two
and
I'll
cave
and
specifically
so
an
indication
as
to
what
the
council
is
considering
for
that
site.
A
L
A
Okay,
anything
else
members
wanted
to
see
in
the
immediate
future.
Some
of
us
that
were
able
to
attend
the
the
pre-briefing
without
were
thankful
to
for
Michael
for
just
beginning
conversations
about
some
of
the
areas
that
we
might
want
to
consider.
Looking
at,
perhaps
a
little
bit
more
detail,
including
potential
areas
that
we
might
want
to
look
at
for
a
skill
review,
conscious
that
we
haven't
won
and
array
currently
and
that's
something
that
will
won't
be
wanting
to
to
look
at.
A
Anything
else
on
the
work
problems.
Okay,
I,
don't
have
any
further
emergency
business,
but
I
would
just
like
to
say
a
few
words
in
thanks
to
David.
I.
Don't
want
to
embarrass
him,
but
David
is
has
accepted
the
position
with
North
Yorkshire
police
and
we
believe
in
the
council
shortly,
which
is
a
huge
shame
for
us
and
I'm
sure
that,
though,
that
those
that
have
been
on
the
committee
for.
A
David's
been
here,
he
found
that
he's
been
extremely
enthusiastic
and
particularly
keen
on
community
aspects,
and
you
know,
he's
gonna,
be
a
great
loss
to
us
and
he'll
obviously
be
a
great
benefit
to
North
Yorkshire.
Please
let
me
show
you
they're
very
lucky
to
have
him
I'm
sure,
we'll
all
agree
with
that.