►
Description
AGENDA
1. Declarations of Interest 00:05:59
2. Minutes 00:06:35
3. Public Participation 00:08:37
4. Healthwatch York Six Monthly Performance Report 00:08:44
5. Attendance of the Executive Member for Health and Adult Social Care 00:15:56
6. Annual Report 2018/19 of the York Health and Wellbeing Board 00:58:04
7. 2018/19 Finance and Performance Outturn Report - Health and Adult Social Care 01:03:22
8. Health, Housing, Adult Social Care Directorate Challenges and Priorities as at July 2019 01:20:54
9. Food Poverty Scrutiny Review 01:50:52
10. Work Plan 01:57:58
For full agenda, attendance details and supporting documents visit:
https://democracy.york.gov.uk/ieListDocuments.aspx?CId=968&MId=11636
A
Good
afternoon,
ladies
and
gentlemen,
welcome
to
the
City
of
York
council,
health
and
adult
social
care
policy
and
scrutiny
committee
just
a
few
pieces
of
housekeeping
we're
not
expecting
the
alarm
to
race
this
evening.
So
if
it
does,
we
need
to
leave
by
the
nearest
exits
from
here
down
the
stairs
and
assemble
near
the
hotel
on
the
right.
A
The
meeting
is
being
webcast
that
will
include
anyone
that
comes
to
speak
at
the
table
unless
the
indicate
they
didn't
want
that
to
to
happen,
and
obviously
members
will
be
webcast,
but
no
one
in
the
audience
will
be
de
members.
Have
any
sorry
apologies.
We
don't
have
any
apologies
from
members.
We've
got
a
full
complement
this
evening.
We
do
have
a
apologies
from
Sean
Bolton
who's.
The
HealthWatch
manager
is
unwell,
we're
very
grateful
to
Kathryn
Scott,
who
stepped
in
it
last
minute
to
kindly
agreed
to
come
in
and
and
help
answer.
A
B
C
A
Okay,
thank
you
all
right.
The
minutes
of
the
June
meeting
at
pages
1
to
4
before
us
members,
if
they're
happy
to
for
me
to
sign
them.
I'll,
just
refer
to
page
3,
paragraph
4
members
should
have
received,
hopefully
two
emails
from
the
Director
of
Public
Health
yesterday
in
response
to
requests
for
members
at
the
last
meeting.
So
this
related
to
questions
on
the
public
health
budget
and
where
the
budgets
spent
members
also
asked
for
details
on
York
residents,
specific
alcohol-related
hospital
admissions.
A
B
A
A
Don't
have
any
members
registered
to
speak
today
in
public
participation,
so
it
can
move
straight
to
the
the
first
of
the
items
and
that's
the
HealthWatch
report
pages
5
to
53
52
and
Katherine
Scott's
joining
us
councillor.
Colic
will
recall,
but
the
rest
of
the
memberships
knew
Katherine.
But
Katherine
was
deputizing
last
year
anyway,
so
she's
very
experienced
I
think
hopefully.
D
Obviously
this
is
the
annual
report
that
I
part
covered
that
year,
so
I
think
a
couple
of
highlights
would
be
just
to
note.
The
expansion
of
the
number
of
the
kind
of
kinds
of
people
were
speaking
to
and
the
kind
of
more
disadvantaged
and
harder
to
reach
groups,
which
has
been
really
positive
over
the
last
year,
and
so
we
started
work
with
multiple
complex
needs
network
alongside
changing
lives
and
also
some
of
our
engagement
work
is
expanded.
So
we're
going
to
read
Thailand
very
recently,
starting
to
expand
our
reaching
to
youth
groups
as
well.
C
You,
chair
and
Katherine
I
am
attended
the
annual
meeting
and
yeah.
So
you
that,
as
as
you
did,
and
then
it
was
really
interesting
actually
heard
about
the
multiple
complex
needs,
work
and
the
yes
linked
system
change
things.
But
I
was
wondering
if
it
would
be
useful
for
other
members
to
maybe
get
an
update
report
on
that
when,
when
the
work
comes
forward,
just
because,
obviously
it
will
inform
some
of
the
work
of
the
council.
Is
that
something
that
we
can
request.
I'm
sort
of
looking
for
advice
over
here
as
well
yeah.
A
I'm
sure
Angie
just
to
add
to
that,
because
that
was
going
to
be
one
of
the
questions
that
I
was
in
tears.
I
read
about
the
you
know:
the
meet
the
new
meeting
being
being
set
up.
As
for
multiple
complex
needs
network
I,
just
wonder
whether
the
network
has
any
specific
objectives
or
priorities
that
could
be
monitored,
in
which
case
that
might
be
something
that
we're
interested
in
and.
D
I
think
at
this
point
we
are,
although
we've
been
going
for
a
year
with
we're,
trying
to
understand
a
vision
that
we
want
to
all
work
towards.
So
in
terms
of
monitoring,
specifics,
I
wouldn't
say
that
we're
quite
at
that
point
yet,
but
actually
probably
towards
the
end
of
the
year.
It
might
be
a
better
time
to
give
you
an
update
of
where
we've
got
over
the
last
kind
of
18
months
and
where,
where
we
think
we're
heading
I,
think
just
to
clarify
there.
D
The
broad
aim
at
the
moment
is
to
better
understand
and
support
people
experiencing
multiple
and
severe
disadvantage
and
to
understand
how
we
can
work
together
as
a
system
to
better
support
them
and
understand
the
system
more
to
be
able
to
kind
of
meet
their
needs,
because
I
think
it's
exploring
where
we're
not
quite
doing
that
at
the
moment.
So
I
think
that
there
will
be
some
kind
of
clarity
around
exactly
how
that
looks,
but
I
would
say
probably
towards
the
end
of
the
year.
I
can
give
you
more
of
a
more
detail
on
that.
E
Also
attended
the
HealthWatch
annual
meeting,
it
was
very
interesting.
I
just
had
some
questions
about
the
report
and
the
experiences
of
LGBT
people
in
healthcare.
I
was
pleased
to
see
that
report
disappointed,
but
not
surprised
by
the
results.
Obviously,
now
that
you've
got
a
better
picture
of
the
experience
of
LGBT
people
and
what's
important
is
what's
can
be
done.
What
improvements
can
be
made
and
I
saw?
There
were
responses
reports,
recommendations
from
various
health
providers.
I
was
just
wondering
what
the
next
steps
are.
E
D
They
definitely
can
be
reported
to
you.
I
think
there's
been
an
ongoing
conversation
between
health
watch
and
health
and
well-being
board
as
to
how
we
monitor
responses,
we
get
to
our
reports
and
also
updates.
So
we
get
kind
of
initial
response
after
I
think
it's
21
days
after
their
meeting.
I
might
need
to
be
correct
on
that
20
working
days
and
but
we're
looking
to
see
how
we
can
monitor
their
ongoing
updates
from
those
and
I
think
it.
If
you
would
be
interested,
we
can
definitely
bring
those
to
you
to.
A
Your
question
funders
referring
to
page
8
on
basically
the
recommendations
that
are
followed
up
or
not,
as
the
case
may
be,
sometimes
from
partners
recommendations
that
HealthWatch
makes
I
was
a
little
bit
disappointed
with
the
response
from
the
hospital,
because
it
seems
a
little
underwhelming
I
just
wondered:
is
there
any
any
way,
that's
being
monitored?
What
recommendations
are
being
taken
up
on
which
arms
and
what
the
reasons
for
those
might
be?
And
that's
maybe,
an
area
that
scrutiny
members
might
want
to
delve
into
a
little
bit
more
yeah.
D
I
think
that
would
be.
It
would
be
interesting
to
think
about
how
we
can
better
work
together
to
work
around
that
and
I
think
that
we
obviously
asked
for
inish
initial
response
to
our
specific
reports
and
and
obviously
we're
gonna
try
and
work
better
to
monitor
that
and
but
it
so
I
think
this
report
was
published
autumn
last
year.
D
A
Is
a
scrutiny
committee
I
think
that's
quite
an
important
part
of
what
HealthWatch
would
would
be
doing
and
obviously
is
as
a
major
contributor
to
you.
Your
income
is
a
lot
local
authority.
Then
I
think
that's
something
that
we
should
be
able
to
ask
and
expect
to
to
have
an
answer
for
so
it
would
be
something
I'd
like
to
take
back
and
look
at
providing
that
in
future.
Yeah
I
can
do
that.
Thank
you
any
further
questions.
Members.
Oh
okay,
thanks
so
much
caffeine,
I
hope.
F
Thank
You
chair
and
thank
you
scrutiny
for
inviting
me
yet
again,
I'm
always
pleased
to
come
to
scrutiny.
It's
always
interesting
to
hear
the
questions.
I
have
my
notebook
ready
my
pencil
poised,
but
this
was
a
particular
talents.
You've
also
got
in
front
of
you
the
health
and
well-being
board
report,
and
you
also
going
to
have
a
front
of
you,
the
report
of
the
director
of
adult
social
care
and
health,
and
so
it
was
quite
tricky
to
make
sure
I
didn't
duplicate
everything
that
was
in
those
other
two
reports.
F
F
So
the
older
persons
accommodation
program,
we've
finished
part
one
or
almost
finished
part
one
and
we're
going
into
part
two
and
the
focus
changes
from
making
sure
that
our
old
peoples,
residential
homes,
of
whatever
description,
are
up
to
the
standard
required
by
CQC,
and
it
changes
to
ensuring
that
people
can
live
as
independently
as
possible
in
their
own
homes,
with
appropriate
support
and
health,
and
that
transition
is
very
important.
We
are
not
going
to
build
a
whole
load
of
older
people's
accommodation.
F
That
means
that
the
emphasis
changes
from
adult
social
care
to
housing
and
I
would
hope
at
some
point
that
scrutiny
may
want
to
call
in
the
member
for
housing
to
give
you
some
idea
of
what's
happening
there,
because,
although
I
can
give
you
some
idea,
it
isn't
in
my
portfolio
and
I'm
not
directly
involved
in
the
same
way
as
I
was
when
we
were
doing
part
one
of
the
old
person's
accommodation
program.
So,
maybe
that's
something
you
you
might
like
to
consider.
F
I've
mentioned
mental
health
I
will
always
mention
mental
health.
One
of
the
nice
things
has
happened
in
the
last
couple
of
days
is
that
the
Foster
Park
Hospital,
which
is
the
tube
hospital,
having
invited
me
to
support
them
in
making
a
dementia
garden
they're,
putting
in
a
bid
for
funding
for
dementia
garden?
Some
people
will
know
already
that
Ward
counts
sort
of
which
I
am
one.
Ward
have
been
involved
in
planting
trees,
there
they're
very
little
trees.
F
At
the
moment
they
will
grow
into
bigger
trees
on
that
site
and
now
you've
had
an
email
from
Martindale.
This
morning
said,
would
I
like
to
be
involved
in
in
the
planting
of
a
dementia
garden
or
the
raising
of
funds
to
belong
to
dementia
garden,
and
that's
absolutely
great.
But
of
course,
what
I'm
encouraging
people
to
do.
F
As
with
all
the
services
is
to
put
those
services
into
the
community
so
that
the
provision
of
services
on
the
farc
site
is,
if
you
like,
the
more
serious
end
of
mental
health
assistance
and
I
want
all
the
services
to
pick
up
the
issues.
Much
earlier
than
that
and
to
give
people
help
which
they
can
access
very
easily
and
very
quickly
before
it
ever
gets
to
that
end
of
things,
and
that's
where
I've
mentioned
that
in
Community,
Services
and
social
prescribing
the
local
area
coordinators
doing
a
great
job.
The
service
is
expanding.
F
We've
had
talking
points
established
around
the
city,
one
of
them
in
York,
explore
if
you
ever
go
in
there
when
they're
there
go
and
say
hello
to
them,
but
also
we've
had
pop-up
ones
and
I
went
to
one
again
in
my
own
Ward
and
clásico.
It's
war
for
that
matter
in
the
folk
Hall
in
new
Eric,
and
they
were
having
people
coming
to
talk
to
them,
who
might
not
have
been
so
keen
to
have
a
social
worker
come
into
their
home.
So
it's
more
informal.
F
It's
more
unidentifiable,
if
that
makes
sense
as
Social
Work
intervention,
but
that
is
exactly
what
it
is,
and
services
can
be
organized
very
quickly,
still
working
with
the
local
health
services
and
particularly
good
relationships
with
two
of
I'm
glad
to
say.
In
fact,
the
chair
and
I
went
to
stand
on
the
top
of
the
building.
Didn't
we
before
when
the
rules
were
on
the
inside,
wasn't
done
and
I
think
both
of
us
are
hoping
to
be
invited
back,
see
the
inside
went
when
that's
being
developed.
F
I
can't
emphasize
enough
the
importance
of
working
with
third
sector
partners.
We
couldn't
do
what
we
do
in
adult
social
care
and
health
without
the
input
from
our
third
sector
partners.
They
are
really
absolutely
essential
to
us,
and
we've
recently
put
some
funding
as
an
administration
into
mine
to
more
offer
more
services
in
the
community.
That's
really
very,
very
important.
Indeed.
F
You
will
see
a
little
bit
about
the
booth
and
park
site.
Who
knows
whether
we
should
care
what
we
want
and
we
have
put
out
a
very
detailed
master
plan
and
we
are
getting
comments
about
it.
We've
put
the
link
in
for
you
or
Tracy,
put
the
link
in
for
you,
and
your
comments
will
be
very
welcome.
I'd
love
to
see
something
like
that
master
plan
happen
on
that
site.
F
I'm
very
aware
of
the
fact
that
NHS
property
services
are
mandated
to
get
the
most
money
out
of
that
that
they
possibly
can
to
feed
back
into
the
NHS.
So
whether
those
two
things
will
meet
in
the
middle
is
a
matter
of
speculation.
At
the
moment,
I've
met
all
the
members
of
health
and
well-being
board
to
look
up
ways
forward
and
on
Thursday,
when
the
health
and
well-being
board
meets.
We
should
be
looking
at
Auri
rejigging
reordering
how
the
health
more
being
bored
works.
Those
very
timely
we've
been
there
for
four
years.
F
We
can't
keep
doing
the
same
thing,
getting
the
same
outputs.
We
need
to
look
at
ourselves
again.
You
can
see
there.
The
visits
had
a
very
sudden
village,
a
visit
from
the
Minister
for
care,
who
probably
isn't
the
Minister
for
care
anymore,
but
I
haven't
quite
kept
up
with
that,
but
I
I
really
enjoyed
going
to
talk
to
the
older
citizens
advocacy
service
than
the
older
People's
Assembly,
and
we
had
a
well
over
time
at
the
mental
health
summit,
which
was
very
very
interesting
and
I.
F
Don't
know
if
the
chair
has
been
to
talk
to
the
people
that
retreat,
but
that's
that's
a
very
interesting
development.
I
was
hoping
it
was
wasn't
gonna
duplicate
what
was
happening
at
Frost
Park
and
it
very
obviously
isn't,
and
then
you
can
ask
the
corporate
director
about
the
use
of
assistive
technology
and
robotics.
I
know
very
little
about
it,
but
I
am
very,
very
interested
in
it,
because
I
think
it
has
the
capacity
to
enable
people
to
stay
in
their
homes
for
longer.
It
will
never.
F
As
the
director
said
to
me,
it
will
never
replace
human
beings,
but
it
can
assist
human
beings,
not
only
the
individuals
concerned,
but
the
professionals
concerned
to
help
people
stay
independent
to
pick
up
health
issues
much
much
earlier
than
we
might
otherwise
do
so.
I've
had
a
very
interesting
few
weeks
of
no
wonder
we
needed
to
go
on
holiday
last
week,
but
it's
been
very,
very
busy
and-
and
it's
I'm
very
fortunate,
because
it's
very
interesting
to
have
the
same
portfolio
again.
F
G
F
Basically,
they
have
an
outpatient
service
in
what
you
and
I
would
know,
is
the
retreat
and
they
are
looking
to
build
an
inpatient
facility
and
that
inpatient
facility
would
specialize
in
just
get
the
brain
in
gear
from
him.
It
would
specialize
in
serious
mental
health
issues,
complex
personality
disorders
and
eating
disorders,
particularly
men's
eating
disorders,
which
is
an
under-resourced
area.
F
They
of
course
have
to
go
to
planning
so
they're,
not
talking
to
you
counselor
Kuwait,
because
you're
chair
of
planning,
but
you
may
receive
some
information
from
them.
I
did
suggest
that
members
of
the
planning
committee
were
were
not
dropped
into.
What's
going
to
happen
on
that
site
all
of
a
sudden
but
were
given
some
basic
information
before
it
gets
to
planning.
Now
it's
it's
an
interesting
firm
sure
as
a
German
firm,
it's
a
family-run
firm
and
they
do
offer
similar
facilities
elsewhere.
F
I
think,
probably
that
will
give
you
enough
of
a
flavor
of
what
they're
trying
to
do,
but
I
do
know
if
they're
going
to
make
that
site
wash
its
own
face.
That's
an
awful
expression,
but
you
know
what
I
mean
be
financially
viable
would
be
a
better
expression.
Then
they
would
have
to
have
the
inpatient
facility,
as
well
as
the
outpatient
facility.
G
F
That
was
one
of
the
reasons
I
went
to
see
them.
I
wanted
to
make
sure
they
weren't
duplicated.
What
true
for
doing
on
the
on
the
Foss,
Park
site
and
I
was
reassured
to
hear
that
they
were
in
touch
with
Martindale
and
other
members
of
of
Juve
other
other
professionals
in
tube
and
I've
emphasized
to
them
very
clearly
that
there
mustn't
be
competition.
It
must
be
complementary.
They've
got
that
message
and
they
are
taking
that
message
forward
and
before
I
ever
got
there.
G
Thank
you
for
that.
That's
very
helpful
and
informative
and
reassuring
particularly
that
last
last
point
and
I
for
one
would
certainly
be
pleased
if
the
work
of
the
retreats
certainly
has
a
contributor
to
health
care
in
the
city
continues
in
that
way,
that
does
sound
very
interesting.
I
have
wanted
two
other
questions,
but
I'll
give
others
a
turn
and.
C
So
just
a
plea
really
that
some
thought
is
given
us
to
solve
the
pathways
that
people
take
through
the
health
and
social
care
network
in
the
city,
because,
obviously,
if
we
localized
things
more
and
we
direct
people
more
to
local
groups,
it
does
put
them
under
additional
financial
pressure.
And
the
pot
of
money
is
shrinking
everywhere
and
the
amount
of
time
spent
fundraising
is
in
ordinates
and
a
lot
of
charities
do
feel
under
immense
pressure.
At
the
moment.
Yeah.
F
I
think
actually,
if
I
may
make
the
suggestion
chair
this,
the
area
of
social
scrubbing
is
one
which
scrutiny
could
well
look
at
I
think
there
are
a
lot
of
issues.
Yes,
people
are
referred
to
voluntary
organisations,
whether
the
voluntary
organizations
have
the
capacity
to
deal
with
them.
I
wouldn't
know
because
I
don't
have
that
level
of
detail,
but
it
could
be
something
that
scrutiny
could
look
at
very
usefully
because
it's
definitely
a
way
forward
and
and
if
I
may
say
so
I've.
F
Rather
that
scrutiny
looked
at
services
in
the
community,
then
if
you
like
the
heavy
end
of
things,
because
that
that
requires
a
lot
of
bucks
and
it's
it's
not
really
something
we
can
influence.
But
I
do
think
that
yourselves
as
a
scrutiny,
committee
and
ward
councillors
can
certainly
influence
social
prescribing,
and
so,
although
I
can't
give
you
a
proper
answer,
I
can
make
a
suggestion
that
that's
something
you
have
a
look
at
at
some
point.
A
Thank
you
that
could
well
be
something
that
would
find
it
interesting
just
to
go
on
from
that
on
the
same
subject.
Obviously,
we've
heard
a
lot
from
NHS
England
about
social
prescribing
and
it's
very
much
the
future.
They
see
it,
and
one
of
the
main
benefits
is
meant
to
me
to
give
the
GPS
more
time
to
actually
spend
with
with
with
patients
so
come
to
them
for
appointment
sign.
Is
there
any
evidence,
that's
happening.
F
Do
we
know
as
far
as
I
know,
there
is
I
I,
don't
know
if
any
of
my
colleagues
sitting
behind
me
are
waving
their
hands,
but
as
far
as
I
know
that
there
is
I,
think
one
of
the
complex
things
that
happens
with
social
prescribing
is
that
whoever
funds
it
may
not
get
the
benefit?
It's
like
quite
a
lot
of
activity
in
in
health
and
adult
social
care.
One
service
does
one
thing
talking
points
is
one
and
it
may
save
referrals
to
the
hospital
or
receive
favor
of
Pharos
to
whatever
to
the
GPS.
F
So
there's
a
there's,
an
interrelationship
in
the
funding
for
all
these
issues,
which
isn't
a
straightforward
one,
but
I
would
certainly
rather
have
some
investment
in
whatever
way
in
social
prescribing,
rather
than
giving
people
pills
all
the
time
now.
Ward
activity
does
exactly
that
and
there's
certainly
a
report
which
shows
the
savings
that
can
be
attributed
to
Ward
budget
investment.
In
things
like
again,
we
go
back
to
our
ward
if
I
may
holidays
at
home
people
who
can't
get
away
activity
days.
F
If
you
like,
dropping
cafes,
where
you
get
coffee
and
chat,
all
those
things
which
sounds
so
simple,
which
can
be
done
in
wards
all
around
the
city,
are
another
form
of
social
prescribing
you're,
not
providing
a
load
of
endless
pills.
What
you're
providing
is
an
activity
with
companionship
and
listening
ears,
and
so
on,
and
some
Ward's
have
done
that
extremely
well
in
the
last
four
years
and
I
hope
that
the
ward
budgets
this
year
will
reflect
the
same
sort
of
activity.
You
don't
need
to
do
anything
complicated.
C
I
just
like
to
raise
a
point:
Carol
I'm,
sorry
for
ever
saying
this,
but
I,
don't
think
it's
appropriate
to
say
that
you
know:
there's
not
a
place
for
pills
because
there's
a
lot
of
stigma
about
mental
health
and
some
people
is
absolutely
appropriate
that
they
are
medicated.
So
just
please
yeah
be
a
bit
more
aware
in
future,
just
because
I
don't
want
anybody
to
feel
that
you
know
the
additional
stigma
of
having
medication
there's
a
place
for
both
social
prescribing
and
for
traditional
prescribing
council.
F
Parrots
quite
right,
we
can't
dismiss
all
issues
and
say
if
you
have
cake
in
the
chat,
it'll
it'll
work,
because
you
absolutely
won't,
but
it's
a
start
and
if
you
get
people
like
the
local
area
coordinators
who
turn
up
at
one
of
those
events,
they
are
quite
skilled
in
saying.
Actually
you
need
more
help
than
we
can
give
you
here
and
we
will
walk
alongside
you
to
go
to
the
GP
or
a
counsellor
or
whatever
it
happens,
to
be
so
I'm.
Sorry,
if
I
sounded
dismissive
I
didn't
mean
to
be
I.
Take
your
point.
F
We
just
have,
but
I
can't
say
to
you
that
tomorrow
morning,
ten
o'clock,
the
director
of
public
health,
my
going
to
see
changing
lives
and
I
should
be
very
interested
to
hear
what
they
say
and
what
inputs
they
feel
that
we
should
have
it's
a
very
difficult
one,
because
alcohol
admissions
to
hospital,
the
hospital
doesn't
necessarily
know
where
the
person
came
from.
So
they
might
be
your
residence
or
they
might
not
be
wrong.
F
Yes,
and
we
always
have
this
possible
this
problem
with
with
hospital
stats
that
they
don't
then
they're
not
they're
coded
for
cost
purposes,
they're,
not
coded
for
where
the
person
arrived
from.
So
whether
people
are
coming
in
from
North
Yorkshire
into
any
I
really
wouldn't
know
and
I'm
not
sure
the
hospital
does
either.
E
And
thank
you
for
the
report.
I
was
happy
to
see
you
acknowledge
the
harmful
ramifications
of
the
rollout
of
Universal
Credit,
but
what
I
want
to
ask
you
about
was
Healthy
Start,
pouches
and
vitamins
and
I
believe
the
council
took
over
the
Healthy
Start
program
back
in
April,
2016
I
think
you
were
the
executive
member
and
that
helped
them
have
social
care,
sometimes
I
hope
for
you.
You
know
about
it
when
the
council
took
over
that
service
and
they
removed
vitamins.
E
Vitamin
supplements
as
one
of
the
things
that
vouchers
can
be
spent
on,
which
means
that
for
the
past
three
years
some
of
people
on
the
lowest
incomes
haven't
had
access
to
vitamin
D
and
that
sort
of
thing
and
I
heard
recently
that
that
service
might
be
reintroduced
either
partially
or
fully.
I
was
just
wondering
if
you
could
update
us
on
that
and
how
that's
gonna
be
communicated
and
that
sort
of
thing
yeah.
F
I
I
Families
have
had
access
to
vitamins
because
we've
been
able
to
negotiate
that
with
maternity
services,
but
it's
fair
to
say
that
the
program
probably
wasn't
as
robust
as
it
needed
to
be
so
over
the
last
year.
We've
done
a
lot
of
work
with
community
pharmacies
and
have
managed
to
put
in
place
a
contract
with
community
pharmacies.
I
There'll
be
community
pharmacies
participating
across
the
city,
so
not
every
pharmacy,
but
there
will
be
a
spread
of
pharmacies
and
that
we
will
have
a
contract
in
in
place
to
make
these
vitamins
available
them.
That
message
will
predominantly
be
given
out
through
midwives,
health,
visitors
and
GP
practices,
so
we're
just
looking
at
our
communications
plan
now
for
how
we
can
ensure
that
you
know
ward
councillors
and
others
are
aware
of
those
new
arrangements.
So
that's
a
piece
of
work
that
we're
doing
now.
I
I
Can
certainly
do
that,
if
that's
something
scrutiny
would
would
be
interested
in
and
one
of
the
difficulties
that
we've
got
at
the
moment
is
being
able
to
collect
robust
data
on
the
number
of
families
that
are
taking
up
the
scheme
and
that's
one
of
the
gaps
that
we've
got
at
the
moment
and
which
we're
working
on.
But
I
can
certainly
provide
a
report
to
scrutiny
that
can
either
come
to
scrutiny
or
be
circulated
by
email.
Whichever
members
would
prefer
that
we'll
give
you
some
additional
information.
E
I
I
So
if
we've
had
to
find
the
funding
from
within
the
budget
allocation
for
the
healthy
child
service,
I'm
pleased
to
say
that
we've
managed
to
secure
that
funding
and
that's
been
allowed
us
to
be
able
to
put
this
contract
in
place
with
community
pharmacies
you're,
absolutely
right.
It's
about
communicating
it,
but
and,
and
so
I
think
in
future,
as
we
start
to
gather
more
data,
I'll
be
able
to
give
you
more
assurance
around
how
successful
that
programs
being
what
I
can
give.
G
Of
those
would
have
been
just
picking
up
on
board
budgets
and
and
projects
and
I
actually
did
visit
only
today
a
example
of
that
with
the
Hanalei
at
home
and
witness
firsthand
how
useful
that
is.
But
what
I
want
to
do
is
pick
up
again,
a
line
elsewhere
in
the
report
and
that's
the
reference
to
emergency
phone
line.
G
Support
and
I
do
that,
because
you
will
remember
this
has
been
something
this
committee
in
its
previous
guys
was
very
concerned
about,
and
we
put
quite
a
lot
of
work
in
into
this,
and
a
number
of
us
were
involved
in
that
and
I
wonder
if
there's
any
updates
on
that.
The
emergency
phone
line,
support
for
mental
health,
page
54,
0.6.
F
We've
got
the
wrong
people
there
to
answer
that
question.
I.
Think
what
I
better
do
is
to
take
that
one
ago
away
with
me
and
get
somebody
again
to
send
a
briefing
paper
around
as
far
as
I
know
how
you
looked
at
it
last
time
in
quite
some
detail,
and
it
was
considered
by
officers,
certainly
that
there
was
sufficiency
but
I'll,
ask
the
question
again
and
get
something
brought
through
to
you.
I
haven't
got
a
mental
health
specialist
here
today.
So
I
really.
F
A
K
You
chariot
and
Thank
You
counselor
for
your
report
and
more
of
a
point
than
a
question
in
terms
of
one
thing:
I
felt
was
maybe
missing
a
little
bit
is
about
the
you
know,
the
role
of
transport
and
active
travel
in
preventing
health
problems,
both
mental
and
physical,
and
would
you
be
working
with
your
colleagues
to
ensure
that
active
travel
is
pursued
and
pushed
promoted?
Thank
you.
It's.
F
It's
on
that
the
there
was
a
PR
about
it
today,
which
are
in
which
I
feature,
but
what's
important
is
that
we
don't
ever
look
at
transport
in
isolation
from
everything
else
and
I
when
I
was
at
the
old
people's
assembly,
they
asked
me
about
it
and
it's
not
just
a
matter
of
saying:
can
you
get
from
A
to
B
its
if
you're
waiting
for
a
bus
have
you
got
a
shelter
if
you
get
to
the
other
end?
Is
there
a
seat?
F
A
Thank
you
I
just
like
to
ask
a
question
about
the
the
older
people's
accommodation,
the
the
other
person's
accommodation
and
obviously
Eve
explained
any
report
about
first
affairs
weren't
being
completed.
It's
it's
good
to
see
that
that
works
come
into
fruition
from
work.
The
officers
have
been
doing
for
many
years
really,
but
the
the
program
was
kind
of
set
up
or
started
the
beginning
of
the
previous
administration.
A
F
Think
that
that's
a
very
interesting
questions,
one
I've
thought
about
a
lot.
We
knew
that
our
care
homes,
as
distinct
from
nursing
homes,
were
not
fit
for
purpose,
and
if
CQC
went
in
to
do
an
inspection,
they
would
say
right,
everybody
out,
which
is
what
they
did
with,
doesn't,
hopefully
not
quite
as
quickly
so
to
priam
about
happening.
We
had
to
close
them.
What
we've
done,
then
is-
and
we
were
doing
it
before.
F
For
a
person
stay
in
in
a
home
and
the
the
independent
providers
then
are
able
to
offer
us.
X
number
of
beds
could
be
nine.
It
could
be
fifteen
whatever
at
that
particular
price,
and
that
means
that
the
number
of
beds
that
will
be
available,
the
the
the
council
when
the
council
pays
for
that
bed,
that
that
won't
vary
at
all,
that
that's
the
price
that
has
been
agreed
with
the
independent
prayer
group.
F
But
what
goes
wrong
is
is
for
your
ward
for
start
where
you
get
a
care
home
or
nursing
home
closing
down,
because
when
a
care
home
or
a
nursing
home
closes
down,
the
local
authority
is
responsible
for
placing
those
people
and
they
can't
wait
for
beds
that
the
actual
cost
of
care
to
come
up
fake
n't.
If
there
aren't
any
Baker
says
they've
got
to
put
them
in
wherever
and
so
I
went
on
a
visit
to
the
chocolate
works
very
recently,
which
is
not
a
place.
F
You
would
think
the
local
authority
would
place
people
at
the
actual
cost
of
care
and
of
course,
we
had
to
use
some
beds
there,
because
that's
where
the
spaces
were
and
we
had
to
pay
their
prices,
because
we
don't
have
an
agreement
with
them
on
actual
cost
of
care
beds.
So
it
is
a
very
complex
area,
but
it
is.
It
is
very
clear
that
providers
of
care
homes
want
to
come
to
York.
F
They
want
to
build
provision
here
and
we
can
come
to
agreements
with
them
on
the
number
of
dedicated
beds
that
we
will
purchase
if
you
like,
like
a
block,
purchase
almost
on
actual
cost
of
care
rates,
and
then
the
people
that
goes
into
that
you
go
into
those
beds
won't
be
charged
any
more
than
that.
If
they're
self
funders,
then
it's
it's
a
different
matter.
F
Nursing
homes
are
founded
on
a
slightly
different
basis
because
nursing
homes,
the
nursing
element
of
care,
is
paid
for
by
the
NHS
and
I
have
to
say
only
eight
years,
I
did
Children's.
This
was
a
constant
source
of
problems,
because
how
do
splits
somebody's
care
out
and
say
this
is
nursing
care,
and
this
is
just
care
because
it's
a
whole
person
and
I
think
that's
very
difficult
to
do,
but
there
is
an
agreed
amount
from
government
that
goes
into
nursing
care
beds
which
doesn't
go
into
if
you
like
residential
care
beds.
A
F
I
think
there
is
I
can't
see
in
the
local
authority
building
more
care
homes.
I
can
see
the
local
authority
buying
more
beds
in
care
homes
that
are
built
by
private
providers,
but
what
I
hope
will
happen
is
that
will
build
more
if
you
like,
supported
accommodation,
supported
living
to
retain
people
living
independently,
but
possibly
in
smaller
accommodation
than
they
would
have
done.
Otherwise,
that
again
is
happening
in
our
Ward
Red
Lodge
is
turning
into
new
Lodge,
and
in
in
that
development
there
will
be
some
residential
accommodation.
F
I
can't
remember
if
there's
dementia
beds,
but
there
might
be,
but
there's
certainly
supported
accommodation,
which
is
really
what
Red
Lodge
is
where
you
get
a
lot
of
little
flats
or
or
with
their
own
front
doors,
which
is
the
sort
of
thing
my
mother
lived
in
towards
the
end
of
her
life,
and
you
also
get
some
houses
which
are
built
so
that
they
are
more
accessible
to
people
as
they
get
older,
so
they've
got
lifetime
homes
in
there.
So,
yes,
I,
do
think
it's
fit
for
purpose.
I
think
we
did
exactly
the
right
thing.
F
L
To
go
back
to
the
colleagues
point
earlier
about
perhaps
asking
for
an
update
on
the
mental
health
and
and
the
helpline.
Obviously,
when
members
come
to
the
work
plan,
you
can
discuss
that,
but
it's
worth
to
note
that
this
assistant
director
for
adult
social
care
cane
was
here
last
meeting
and
has
invited
and
members
an
open
session
where
some
of
these
updates
and
deeper
dive
into
mental
health
can
can
happen
and
I
think
Kyra.
L
Err
in
Jacmel
and
Belinda
Jones,
head
of
services
for
adult
social
care
and
operations,
and
dementia
and
safeguarding
her
mental
health
will
be
present
on
the
3rd
of
September,
as
members
should
have
received
invitations
to
that.
So
that
could
be
a
time
to
perhaps
get
those
updates
and
and
reduce
that,
or,
of
course,
members
can
ask
for
a
report
in
the
work
plan.
At
the
end
of
this
meeting,
just.
G
I'm
sure
colleagues
would
welcome
and
support
every
attempt
that
you
are
making
to
keep
booth
and
Park
Hospital
as
a
facility
resource
for
the
people
of
York
and
for
health
benefits
for
the
people
of
York
I
would
want
to
encourage
you
in
that
and
take
the
opportunity,
insofar
as
we
have
it
in
this
committee
to
refer
again
as
you
have
to
the
opportunity.
The
public
have
to
contribute
to
that
consultation
from
September,
and
you
make
reference
there
to
the
the
website.
I
just
wanted
to
highlight
that
I'm
sure
you
would.
You
would
welcome
that.
Yes,.
F
I
would
indeed
and
the
more
responses
they
get.
The
better
I
mean
I
know
because
I've
been
involved
in
this
sort
of
thing
for
a
very
long
time
that
if
you
get
one
composite
response
that
doesn't
carry
the
weight
that
a
whole
lot
of
different
individuals,
all
saying
slightly
different
things
does,
because
everybody
has
their
own
emphasis
and
their
own
priorities,
and
it
may
be
that
one
person
might
support
accommodation
for
key
workers.
They
may
be
another
person
might
support
a
nursery.
F
A
F
F
We
do
have
workshops
which
are
very
informal
and
they
feed
into
the
formal
meetings.
The
health
Morbihan
will
butcher
agenda
and
ministers
in
in
the
normal
way.
It
is
part
of
the
council,
but
almost
not
part
of
the
council,
because
it
includes
so
many
outside
bodies
and
so
with
Tracie
Wallace
who's
sitting
behind
me.
F
We
had
a
meeting
with
every
member
of
the
health
and
well-being
board
to
ask
them
some
questions
about
which
way
it
should
go,
what
it
should
do,
who
should
be
on
it
even
and
Shaun
starts
the
Director
of
Public
Health
pulled
all
that
together
and
that
would
be
presented
to
the
health
and
well-being
board
on
Thursday.
So
I
can't
tell
you
what
they're
going
to
say.
Fortunately,
I
can
tell
you
what
they're
going
to
look
at,
but
not
what
they're
going
to
say.
F
A
No
questions
so
this
one
looks
like
it's
just
amazing
without
I'd,
just
like
to
say,
I
think
it.
The
report
actually
paints
a
generally
very
positive
picture
of
health
care
in
York,
which
is
welcome.
Are
there
any
specific
areas
where
perhaps
planned
or
funded
activity
hasn't
been
so
successful
and
where
things
might
have
been
learned
and
changed,
you
can
think
of
it's.
F
A
very
big
question:
Bookshare
and
I'm-
not
sure
I-
can
answer
it
off
the
top
of
my
head.
Most
things
I
can
but
I'm
not
sure
about
that.
One,
no
I
could
tell
you
about
where
we've
been
particularly
successful.
I'm
not
sure
I
could
tell
you
where
we've
isn't
particularly
unsuccessful,
so
I
think
now
it's
time
you
asked
one
like
that
publicly.
Let
me
know
beforehand
and
I'll
work
it
out.
Well,.
A
G
A
F
That's
a
very
good
question:
cancer
Kovach.
It
is
clearly
the
role
of
the
health
and
well-being
board
to
assist
integration
and
actually
going
back
to
councilor
Doughty's
question.
If
there
was
anything
that
I
would
say,
we
hadn't
been
so
successful
in
achieving
that
would
be
it
achieving
greater
integration
with
the
Health
Service.
We
we
are
making
progress.
It
has
improved
in
the
four
years
that
I
was
doing
it
previously,
but
it's
been
very
slow
and
I
can't
remember
where
it
where
it
says
it,
but
one
of
the
problems
has
been
a
constant
change
of
personnel.
F
The
way
you
make
change
happen
is
to
make
a
relationship
with
the
individual
who
is
a
leader
of
change
and
when
you've
got
constantly
changing
chief
execs
here
there
and
everywhere
and
other
personnel
changing.
It
becomes
very,
very
difficult
to
do
that.
But
it's
very
important
and
again
we
were
talking
earlier
this
afternoon
on
that
exact
subject,
particularly
as
regards
budgets
and
the
BCF,
which
is
another
whole
story.
F
It's
definitely
work
in
progress,
but
it
definitely
hasn't
been
achieved
and
we
have
got
a
CCG
with
particular
challenges
with
the
underlying
budget
deficit
that
they
have,
which
they
inherited
from
the
PCT.
So
they've
got
particular
problems
which
we
must
always
be
mindful
of.
Doesn't
stop
us
wanting
to
integrate
more
and
to
work
with
them
more
closely.
F
A
M
Just
take
a
little
bit
background
of
how
this
generally
works
within
the
authority,
so
the
executive,
on
the
quarterly
basis
received
an
overall
and
Finance
and
performance
report
for
the
whole
council,
and
following
on
from
that,
each
scrutiny
committee
receives
a
so
that
the
subset
about
report
relating
to
the
areas
of
their
of
their
remit
and
to
go
into
sort
of
more
detail
on
specific
items
that
are
a
more
pertinent
to
them.
So
this
is
the
final
report
for
2018-19
on
the
finance
side
of
things.
N
Yep
happy
to
do
that.
The
performance
side
of
it
is
outlined,
as
you
can
see,
we've
both
mics
come
along
this
evening
because
he
has
substantially
revised
the
public
health
side
and
it's
been
a
global
effort
between
us
this
time,
I've
done
the
other.
What
social
care
part
Mike's
written
the
public
health,
the
other
social
care,
is
a
mixed.
A
mixed
picture,
as
it
usually
is
on
a
portly
basis.
N
Things
like
the
top
coat
are
continuing
to
be
a
challenge
for
us
things
like
mental
health.
People
in
settled,
accommodation
is
improving.
Residents
in
nursing,
people
in
residential
and
nursing
care
continues
to
base,
notably
stable,
as
the
2018-19
here
comes
to
a
close,
and
there
are
other
questions
I'm
happy
to
take
from
you.
If
you
service
course
those
that
go
in
any
pain,
it
might
necessary
words
about
public
health,
okay,.
O
Just
on
the
public
health
data,
we
presented
2018-19
data
for
services
that
we
directly
provide
our
Commission
for
wider
health
indicators
across
the
city,
such
as
alcohol
admissions
to
hospital
mortality
data
and
so
on.
We
rely
on
national
data
sets
which
are
released
further
behind,
so
we
have
some
28
17
18
day
in
here
throughout
the
year.
We'll
give
you
the
latest
dates
that
we
have
and
just
weave
it
into
that
reports.
A
I
M
A
M
M
Think
if,
if
you're
aware
of
the
the
council's
supplementary
budget,
it
was
agreed
at
Council
earlier
this
month,
there's
a
specific
project
in
there,
particularly
around
health
contributions
into
social
care,
in
terms
of
establishing
whether
we
are
generating
the
right
amounts
and
whether
we're
going
through
the
right
process
is
to
do
that.
So
I
think
that's
a
one
of
the
venture
fund
allocations
of
funding
with
the
intention
that
generate
more
income
to
the
authority.
So
that's
actually
in
there
as
a
new
specific
project
that
will
be
that
will
be
undertaking.
Could.
A
N
The
figure
has
increased,
it's
not
necessarily
I'm
happy
to
let
others
chip
in
here
as
well.
It's
not
necessarily
that
plans
haven't
worked.
It's
just
that
there
are.
There
is
a
very,
very
big
demand
for
hospital
services
here
which,
as
a
consequence,
results
of
they
talk
increasing
slightly,
as
people
are
finding
difficult
to
be
clicked.
We're
finding
in
the
NHS
is
finding
it
difficult
to
find
places
for
people.
N
A
lot
of
the
delays
are
what
we
call
NHS
achey
are
treatable,
which
means
that
it's
there
there's
a
meeting
every
day
where
people
get
together
and
decide
the
reasons
for
what
main
person
being
lived
in
a
hospital
bed.
A
lot
of
it
is
to
the
review
NHS,
and
it's
well
known
that
the
CCGs
for
a
national
position
isn't
great,
so
they
are
having
difficulties,
placing
people
the
adult
social
care
side
of
it.
N
N
It
certainly
has
been
playing
its
part
in
terms
of
up
what
we
can
do
to
reduce
today's
we've
done.
We've
introduced
schemes
such
as
step
up
step
down,
meds
and
seven-day
working,
which
have
actually
helped
improve
the
position
as
far
as
other
social
care
is
concerned,
it's
the
NHS
side.
That's
this!
They
favor
issues.
N
C
C
N
A
Again
page
80
its,
it
tells
us
that
the
average
number
of
Sigma
stationed
in
alpha
adult
social
care
is
fourteen
point
three,
which
is
if
I'm
reading
it
right
means
almost
three
weeks
sickness
per
year
on
average
and
it's
being
presented
as
stable
to
me
in
that
songs
are
fairly
worrying
number,
there's
very
any
date.
Data
that
can
show
is
it
is
that,
due
to
perhaps
a
small
number
of
people
having
a
long-term
sickness,
that's
having
the
effect
on
the
figures,
or
is
there
any
anything
that
we
can
point
to
what
those
causes.
A
N
P
A
A
P
The
average
rate
of
sickness
that
you
point
to
is
incredibly
high
and
it's
way
above
the
public
sector
average,
which
I
believe
is
something
like
eight
point
one
or
something
like
that.
So
you
can
see
how
high
it
is.
It's
also
very
high
in
relation
to
the
overall
council
figures.
So
it's
something
that
does
caused
me
concern
and
is
already
the
subject
of
a
remedial
plan
within
the
Directorate
you're.
Quite
right
in
that
there
have
been
a
couple
of
very
long-standing
sickness
issues
unresolved
that
have
some
more
skewed.
P
The
figures
but
I
think
the
more
important
thing
to
note.
There
is
the
way
in
which
we
have
historically
perhaps
dealt
with
those
and
dealt
with
sickness
in
a
more
robust
way
in
the
system,
so
actually
applied
the
procedures.
So
we
have
a
piece
of
work
to
do
around.
Helping
managers
understand
that
sickness
absence
management
is
not
about
managing
people's
health
conditions.
It's
actually
about
managing
absence.
P
So
we,
you
know
we
need
to
support
managers
so
that
they're
not
in
a
way
shy
of
challenging
absence
rather
than
the
reasons
for
it,
and
we
we
have
got
some
training
ongoing
about
that.
So
we
run
a
performance
type
clinic
around
sickness
and
management
that
comes
to
our
departmental
management
team.
So
it
is
a
very
particular
area
for
focus,
and
my
own
hope
is
that
we
are
going
to
see
that
figure
reduce
and
month-on-month
that
that's
one
of
my
own
aims.
A
A
O
The
sexual
health
service-
yes
yeah,
we
did
I,
haven't
got
in
front
of
me,
but
we
could
get
it
to
you.
We
did
do
a
survey.
We
did
a
needs
assessment
for
sexual
health
services
that
involved
some
questionnaires.
We
enough
cards
in
all
of
the
clinics,
I
believe
the
feedback
access
was
quite
good
call
yeah,
but
maybe
say
that's
that
was
published.
It's
on
the
Jason
they
website
might
be
something
we
could
circulate
again
afterwards
about
a
fairly
short
access
was
not
highlighted
as
a
particular
issue.
O
We
obviously
brought
the
service
in
from
the
GPS
in
house,
and
that
represents
an
improvement
on
the
previous
year.
It's
still
compared
to
national
averages,
but
is
something
that's
that's
been
looked
at
on.
A
regular
basis
is
how
to
improve
the
offers
the
uptake
of
the
office.
Obviously,
people
are
receiving
offers.
I
So
I
can
tell
you
a
little
bit
about
the
services
change
that
we're
putting
in
place,
which
I'm
sure
will
start
to
improve
these
figures.
So,
as
Mike's
already
indicated,
this
is
our
service.
That's
provided
within
the
council.
Our
health
China
service
provide
health
checks,
but
we're
very
dependent
on
GPS
interrogating.
I
Their
practice
lists
identifying
those
people
who
were
eligible
for
an
NHS
health
check
and
then
referring
them
in
to
the
service,
and
so
we've
tried
various
ways
of
trying
to
encourage
GPS
to
refer
more
people
through
and
over
the
past
year,
we've
been
working
with
some
practices
who
were
sending
out
text
messages
to
encourage
people
to
attend
and
I.
Think
it's
fair
to
say
that
the
success
of
that
has
been
go
able
and
some
practices
have
been
more
engaged
than
others.
I
We've
recently
changed
the
service
model
through
the
through
working
much
more
closely
with
the
CCG
we're
hoping
to
or
not
hoping
we're
planning
to
do,
a
pilot
program
whereby
we
actually
base
our
health
trainers
in
GP
practices,
so
that,
rather
than
a
GP,
is
having
to
refer
people
in
if
we
have
health
trainers
actually
working
alongside
GPS.
Being
able
to
access
the
GP
systems,
then
that
will
remove
some
of
those
barriers
and
we
are
planning
to
do
that
as
a
pilot
program
and
with
the
GP
practices
in
the
north
and
that
hasn't
started.
I
Yet,
we've
got
to
recruit
some
additional
stuff
to
be
able
to
burn
that
pilot
program.
We've
recruited,
those
additional
stuff
who
will
be
coming
in
to
post
shortly
and
then
I'm
very
much
looking
forward
to
establishing
that
pilot
program.
Once
we
have
evaluated
that
we'll
be
able
to
see
whether
that
significantly
improves
take-up
of
the
service,
we
own
we're
strengthening
our
relationships
with
the
GP
practices
and
the
other
pouch,
and
also
thinking
about
how
we
strengthen
some
of
our
communications
and
because
people
come
directly
with
the
it's
not
entirely
dependent
on
ownership.
A
Health,
housing
and
adult
social
care,
Directorate
challenges
and
priorities
pages
109
to
form
one
six
like
to
welcome
there.
Sharon
Holden,
the
corporate
director,
some
of
the
new
members,
possibly
an
answer
where
that
Sharon
joined
us
I
think
he
was
it
beginning
of
February
officially.
So
this
is
a
first
report
and
about
getting
your
feet
are
at
the
table:
I
guess
and
getting
stuck
in
a
briefing
somewhat
guessing
that
members
will
have
read
it.
A
P
So
thank
you
and
thank
you
for
the
opportunity
to
come
and
share
some
of
my
observations.
I
think
the
the
value
of
the
slot
is
really
going
to
be
about
taking
questions
and
and
helping
me
test
out
some
of
my
assumptions
and
views
about
what
we
need
to
be
doing
in
New
York.
So,
just
very
briefly,
to
put
some
context
around
it.
You
would
have
heard
from
councillor
Ron's
mother's
portfolio
holder
what
hers
and
the
executives
priorities
are
in
terms
of
adult
social
care.
P
It
falls
to
me
and
my
teams
to
work
with
the
portfolio
holder
to
actually
make
that
happen,
and
what
I've
attempted
to
do
in
in
this
commentary
is
to
point
to
some
of
the
ways
in
which
we
will
want
to
focus
in
order
to
make
that
happen
and
the
sort
of
priority
areas
that
we
would
want
to
look
at,
but
welcome
the
views
of
scrutiny
members
in
terms
of
giving
us
some
direction
about
how
we
might
do
that.
Thank.
H
P
We
all
want
to
do
we're
very
often
saying
the
same
thing
and
have
the
same
intention,
but
we're
very
often
not
going
about
it
in
the
same
way
and
I.
Think
much
of
that
comes
down
to
was
still
working
in
silos
and
being
very
fixed
on
our
own
departmental.
Certainly
within
I
can
speak
just
for
council
officers,
but
we
are
still
very
focused
on
our
own
departments
and
the
way
in
which
were
structured
actually
doesn't
help
that
and
it
doesn't
lend
lend
itself
to
collaboration.
P
So
you've
heard
you've
just
taken
a
report
on
finance
in
relation
to
the
Directorate
so
and
there
will
be
typically
when
we
examine
our
finances,
we
will
do
that
in
a
not
so
much
adversarial
way,
but
you
can
put.
You
can
clearly
see
that
adult
social
care
has
got
some
financial
challenges
that
perhaps
other
colleague
departments
don't
have,
and
that's
an
example
of
how
we
focus
on
something
very
much
in
terms
of
individual
departments
and
not
necessarily
in
terms
of
collaborating
across
the
whole.
P
So
I
do
think
it
started,
but
I
think
it's
very
difficult
for
any
organization
to
recognize
and
review
where
it
needs
to
improve
and
then
Institute
that
change
itself
and
I
think
we
need
some
a
variety
of
different
types
of
independent
support
in
terms
of
a
whole
cultural
change.
To
do
that,
and
that's
something
that
I
would
welcome
more
elected
member
interest
in
and
whether
that
would
be
a
suitable
subject
for
scrutiny.
I'm
not
sure,
but
it
may
be
a
cross-cutting
scrutiny
and
project
that
I'd
certain
like
to
see
and
contribute
to.
A
G
You
Czech,
thank
you
for
this
opportunity
that
the
report-
and
it
gives
me
the
opportunity
to
just
pick
up
one
thing
from
the
previous
report.
Even
if
I
could
I
was
particularly
pleased
to
see
on
page
87
48.
That
York
is
the
fifth
highest
physical
activity
rate
I'm,
not
sure
who
the
top
before
arm
pure.
G
You
would,
you
would
tell
me,
but
wouldn't
it
be
good
if
we
were
first,
what
would
we
need
to
do
and
particularly
I'm
concerned
I'm
sure
we
all
are
about
young
people
and
young
people's
fitness
and
obesity,
not
only
in
the
adult
population
which
is
highlighted
there,
but,
but
particularly
in
our
schools,
and
the
progress
that
is
being
made
could
be
made
only
a
few
miles
away
in
Leeds
I
think
some
exciting
things
are
happening
and
trends
are
being
reversed.
What
are
your
thoughts.
P
So
I
think
my
colleague,
director
Public
Health,
may
be
able
to
answer
that
more
specifically
in
terms
of.
Why
are
we
fifth
and
not
first,
and
what
would
it
take
to
get
us
to
first,
but
before
she
does
and
I'd
like
to
share
with
you
my
views
about
Lee
tables
in
general,
and-
and
this
is
one
of
them
and
so
are
delayed.
Transfers
of
care,
for
example,
and
I.
Think
part
of
the
league
tables
can
be
useful
indicators,
but
I.
P
A
real
change.
I
think
incredible
amounts
of
time
and
energy
and
I've
seen
this
in
other
systems
are
lost.
Whole
industries
grow
up
around
people,
counting
beans
really
and
not
addressing
the
real
problem.
So,
whilst
I
accept
the
value
of
an
indicator,
I
think
we
need
to
be
very
cautious
about
seeing
it
as
the
be-all
and
end-all,
but
I'm
sure
Sharon
could
could
give
you
a
bit
more
information
about
the
physical
activity.
If
you
would
like
yeah
I.
I
Absolutely
agree
with
what
Jones
just
said
about
the
indicator,
particularly
this
one.
It's
one
of
those
what
we
call
in
public
health,
a
fairly
unreliable
measure,
because
the
indicator
is
based
on
a
national
survey
which
identifies
a
sample
of
people
living
in
a
particular
area
that
they
send
questionnaires
to.
They
fill
out
the
questionnaire
based
on
their
own
self-assessment,
and
that's
what
derives
the
that?
The
data,
if
you
like.
So
it's
useful
information
for
us
and
because
it's
the
same
across
every
local
authority,
it
does
allow
us
to
benchmark.
I
I
So
the
executive
will
be
asked
to
sign
up
to
the
local
authority,
wait
and
we
wait
plan
so
they've
partly
attributed
it
to
that,
so
they
have
a
whole
city.
Whole
council
led
approach
to
that,
and
but
they
also
do
this
targeted
work
with
children
and
define
I
would
love
to
do
that
in
York,
but
we
don't
have
the
investment
that
is
needed
to
deliver
that
program
at
the
moment.
I
Part
of
that
we
do
will
be
looking
at
whether
there
is
more
we
can
do
with
existing
resources
within
the
healthy
child
service
to
be
able
to
do
some
of
this
work
within
the
funding
envelope
that
we
have,
which
is
certainly
something
I'm
committed
to
doing,
however,
leads
have
put
hundreds
of
thousands
of
investment
into
this
over
a
number
of
years,
and
so,
if
we
wanted
to
mirror
their
success
in
York
I'm
afraid
that's
going
to
be
challenging
for
us
with
the
resources
that
we
have
available.
That's
not
to
say
we
can't
learn
from
them.
O
I
I
G
Thank
you.
That's
been
a
very
helpful
and
full
answer.
I
feel
like
maybe
should
apologize
for
picking
up
the
sort
of
leak
tables
at
the
beginning
of
that,
because
it
I
recognize
that
it's
it's
not
the
be-all
and
end-all,
but
I
am
particularly
concerned
about
childhood
obesity
and
would
certainly
hope
that
everything
that
we
can
do
within,
as
you
say,
the
envelope
of
our
budget
we
might
be
doing
but
I
think
I'm,
not
surprised
to
hear
you
say
if
we
really
want
to
take
this
seriously,
we
need
to
invest
in
it.
Thank
you.
C
You
I
wanted
to
ask
about
the
work
to
close
the
gap
between
those
with
good
health
and
well-being
outcomes
and
those
without
have
you
identified
any
sort
of
priority
areas
that
you'd
want
to
focus
on
quickly
because,
obviously
closing
the
gap.
It's
an
incredibly
difficult
thing
to
do,
because
if
it
was
easy,
I'm
sure
it
would
have
already
been
done,
but
and
yeah
I
just
would
be
interested
to
know
if
there
were
any
specific
gaps
that
you
were
going
to
try
and
focus
on
as
an
earlier
stage.
I.
P
Think
you're
right,
even
if
it
was
that
easy,
we
would
have
done
it
already
or
we
would
have
some
very
clear
ideas
and
so
I
think
it's
more
about
what
I
was
referring
to.
There
is
more
about
acknowledging
that
there
are
gaps,
so
it's
very
easy
to
see
York
as
a
place
where
there
is
reaiiy
mean.
Basically,
finances
are
in
quite
good
shape
in
York
by
comparison
to
other
places
in
the
country.
So
it's
very
easy
for
deprivation.
P
Zoar
need
to
be
masked,
so
I
think
it's
why
we
will
get
to
defining
what
would
be
priorities
by
some
degree
of
a
greater
degree
of
working
together
across
the
whole
council
to
identify
those
the
example.
The
challenge
just
given
about
obesity
and
charges
is
a
really
interesting
one,
because
I
think
if
there
is
a
direct
impact
as
a
result
of
us
in
adult
social
care,
which
is
primarily
I,
guess
what
I
was
writing
about
when
I
commented
here.
P
If
we
can
be
very
sure
that,
in
adult
social
care,
we
are
focusing
on
doing
statutorily
exactly
what
we
are
required
to
do
and
that
our
preventive
work
is
assisting
that
that
and
that
we
are
not
investing
in
non
proven
interventions
or
things
simply
because
we've
always
done
it.
That
is
one
way
of
making
sure
that
any
available
funding
can
be
released
to
explore
other
options
like
the
program
that
she's
just
spoken
about,
and
it
may
not
be
that
we
could
fund
whole
programs
from
that.
P
But
it
is
all
about
contributing
and
I
think
that
there
are
other
departments
across
the
council
where
we
would
be
looking
to
other
colleagues
and
saying,
if
there's
a
program
here
and
if
the
Healthy
Start
is
really
important
to
us
and
we're
all
signed
up
to
and
a
healthy
start
in
childhood.
What
can
we
do
as
a
whole
council
to
contribute
to
that
so
I'm,
not
just
looking
to
public
health,
let's
say
to
fund
that,
so
it
in
a
way.
P
I
hope
that
does
answer
your
question
about
inequalities,
because-
and
some
of
that
requires
us
to
think
very
differently
in
the
council,
about
how
we
address
issues
and
I.
Think
if
we
can
give
that
some
focus,
some
of
the
obvious
priorities
may
fall
out
of
that.
I
would
argue
that
priorities
around
a
good
start
in
childhood
have
got
to
be
up
there
as
top
arms.
H
P
Would
say
that
in
the
since
the
period
of
time,
the
period
time
that's
elapsed
between
when
I
first
came
to
well,
when
I
first
came
to
York
actually
as
part
of
the
interview
process
with
this
job,
which
was
back
in
October
during
October
of
last
year
and
even
between
then
and
now.
I
have
noticed
the
difference
in
relationships
across
the
health
and
social
care
system.
So
I
think
that
that
groundwork
has
started
in
terms
of
acknowledgment
of
the
need
for
collaboration.
So
we
are
doing.
P
We
are
doing
several
pieces
of
work
at
the
moment
with
colleagues
in
the
hospital
trust
around
looking
to
increase
the
number
of
step
up
and
step
down,
not
just
beds
that
we
have
got
available,
because
we
we
do
really
need
to
get
away
from
a
bed
centered
model
of
care,
but
focusing
on
how
we
can
support
people
by
providing
health
and
social
care
services
in
the
community
that
actually
keeps
them
in
their
own
home.
If
that's
appropriate,
so
that
we
don't
see
the
level
of
emergency
hospital
admissions
that
we're
seeing.
P
So
we
are,
we
are
doing
some
work
about
that
I
envisage
more
and
more
work
being
done
in,
but
we
will
have
to
put
equal
amount
of
weight
into
an
effort
into
developing
the
care
market,
particularly
the
domiciliary
care
market
and
developing
means
of
both
recruiting
to
the
care
market
and
finding
alternative
means
of
care
and
councillor.
Ron's
Minh
mentioned
earlier,
the
use
of
technology
and
robotics
in
social
care.
P
Yeah
I
would
say
there
I'd,
say,
colleagues
and
across
the
NHS
locally
are
very
excited
by
the
possibilities
of
collaboration
very
willing
to
come
with
us.
In
terms
of
some
of
the
suggestions
we
have
got.
I
think
it
would
be
fair
to
say
that
some
of
the
initiatives
are
our
ideas
and
views,
but
colleagues
very
very
much
on
board
in
terms
of
how
we
would
take
those
forward
collaborative
so
I'm,
very
hopeful
about
the
prospects.
P
There
would
be
little
point,
I
think
in
us
in
as
the
council
trying
to
take
a
section
of
this
issue
or
this
challenge.
For
example,
how
do
we
address
the
shortage
of
domiciliary
care
hours
in
the
community?
How
do
we
recruit
the
right
types
of
people
as
Social
carers
and
how
do
we
contract
with
domiciliary
care
providers,
so
that
element
of
the
work
in
the
system
is
our
responsibility?
P
P
So
what
I
mean
by
whole
system
market
shaping
is
that
there
hasn't
been
an
exercise
in
York
to
date
and
in
fact
there
aren't
many
local
authorities
in
the
country
that
I've
got
proven
experience
of
doing
this,
but
the
work
is
being
done
elsewhere,
where
we
as
a
whole
health
care
system,
go
to
our
independent
providers
and
say
here
is
the
type
of
care
that
we
want
you
to
provide.
Rather
than
what
can
you
give
us
as
care?
So
we've
got
some
work
ongoing
at
the
moment
around
developing
what
we
call
a
hybrid
worker
model.
P
So
rather
than
or
say
as
as
the
local
authority,
we
want
domiciliary
care
workers
and
our
health
colleagues
and
we
want
health
care
assistants
or
we
want
therapy
support
workers.
We
develop
one
type
of
worker
that
can
actually
do
all
of
those
tasks
and
that's
not
an
impossible
thing
to
do,
because
actually
that
has
been
done
over
the
many
we
haven't
called
it
hybrid
workers
over
the
years,
but
there
has
been
many
experiences
of
hospital
home
type
services
where
individual
workers
have
done
any
task
that
is
required.
P
I
know
this
because
back
in
the
dinosaur
age
I
happen
to
be
a
social
worker
in
a
home
from
hospital
team
and
that's
exactly
what
we
did
and
it
was
very
successful,
avoiding
hospital
admission
so
we're
all
all
of
us
in
the
care
system
are
using
the
same
market,
but
we're
actually
not
currently
negotiating
with
providers
together
and
as
a
whole
system.
We
need
to
be
doing
that
and
I
would
say
that
we
actually
need
to
be
I,
think
dictating.
P
The
terms
is
possibly
too
strong
a
way
to
describe
it,
but
we
need
to
be
stating
what
we
want:
independent
care
providers
to
do,
for
the
need
that
we've
identified
in
our
population
and
we
tend
to
view
New
York.
The
York
market
is
very
particular
because
we
have
such
a
as
you.
You
will
know
this
and
we
have
such
a
high
level
of
self
funding
of
care
in
the
city,
but
comparison
to
most
other
areas
in
the
country.
P
It's
quite
skewed,
so
I
think
there's
been
a
tendency
in
the
past
for
us
to
take
a
view
of
what
the
market
actually
dictates.
The
terms
here,
because
there
are
providers
in
the
city
who
will
never
have
to
work
with
the
local
authority
because
they
have
such
a
client
base
and
that
they
don't
need
a
publicly
funded
business.
It's
quite
the
reverse
in
most
of
their
areas,
but
that
isn't
to
say
that
we
can't
use
that
as
an
opportunity.
P
So
we
need
to
start
looking
at
our
market
differently
and
we
need
to
start
doing
that
together
and
we
need
to
start
carving
out
the
opportunities
ourselves
and
setting
out
the
boundaries
for
what
we
want
ourselves
rather
than
taking
what's
already
there.
If
that
makes
any
sense,
that's
what
I
mean
about
reshaping
the
market
actually
take
acclaiming
back
some
of
the
way
in
which
we
describe
demand
not
going
to
be
easy
because
almost
the
way
I'm
talking
about
it
almost
sounds
quite
adversarial
in
terms
of
independent
providers
and
ourselves.
P
H
P
So,
in
my
view,
you
very
boldly
and
bravely
experiment
with
pooling
of
budgets.
Yes
and-
and
you
do
that
or
we
do
that
in
the
knowledge
that
much
of
this
would
be
test
and
learn.
So,
and
you
know
we
actually
approach
the
pooling
of
funding
in
a
way
that
allows
ourselves
to
try
things
that
don't
work
but
I.
Don't
I,
don't
believe-
and
this
is
a
very
general
comment
really
that
we
are
inclined
in
health
and
social
care
outreach
to
say
things
that
we
will
wait
for
that
was
30
and
Social
Care.
P
We
wait
for
the
green
paper
and
then
we'll
see
what
that
gives
us
and
as
a
sector.
My
very
strong
view
is
that
we
need
to
turn
that
around
and
we
need
to
be.
We
need
to
be
deciding
what
it
is
that
we
want
and
how
we
locally
are
going
to
pay
for
that,
and
that
is
brave
and
bold,
and
some
of
it
means
at
time
some
of
it
will
mean
putting
what
we
now
call
the
interest
of
the
local
authority
secondary
to
the
interest
of
the
whole
system,
and
that
really
is
brave
and
bold.
G
Thank
You
chair
I'm
very
pleased
to
hear
that
I
warm
to
that
I'm
excited
by
that.
Do
you
feel
that's
possible,
even
in
a
your
context,
with
our
different
geographies
in
terms
of
working
with
with
with
with
with
partners,
we're
not
in
the
Fortin
position
that
somehow
the
places
are
where
those
boundaries
are
shared.
You
still
feel
that
could
be
achievable.
P
Yes,
I
do
feel
it's
achievable,
I
think,
like
most
things,
I
suppose
that
are
worth
striving
for
it's
not
easy
and
I.
Suppose
yeah
I
would
want
to
make
the
distinction
between
achievable
and
easy
I
really
don't
think
it's
easy
and
I
think
there
will
be
many
and
we,
if
we
are
prepared
to
try
things
and
if
we're
prepared
to
try
them
and
then
walk
away
from
them
because
they
didn't
work
particularly
well,
but
use
them
as
a
learning
experience,
then
I
do
think
it's
achievable.
A
Thank
you
for
no
further
questions,
I,
just
like
to
say
that,
referring
to
page
hundred
and
nine
and
110
the
bullet
points,
you've
listed
they're,
actually
very
positive,
I.
Think
when
he's
speaking
about
York,
see
you,
we've
got
relatively
stable,
healthy
population,
virtually
full
employment
and
a
thriving
economy
and
I
think
these
are
things
that
we
should
be
really
grateful
for,
but
particularly
pleased
that
you've
got
the
ambition
there
to
build
on
that
and
I
think
it
would
have
been
really
nice.
A
A
A
A
A
It's
a
referral
from
the
the
customer
and
Corporate
Services
scrutiny
committee,
who
have
been
discussing
the
possibility
of
looking
into
doing
a
food
poverty,
scrutiny,
review
and
subsequently
they've
decided
that
it's
something
that
crosses
committees
and
would
be
useful
for
members
of
other
committees
to
to
take
part
in.
So
essentially
it's
it's
an
invite
to
us
to
innominate
a
member
to
sit
on
an
ad-hoc
scrutiny
committee
established
by
the
CCS
SC
to
investigate
food
poverty
in
New
York.
A
A
Now
at
the
children,
education,
community
policy
scrutiny
committee
has
sat
and
discussed
it
already
and
to
members
of
different
parties
strongly
wanted
to
be
part
of
the
committee,
so
it
hasn't
been
decided
yet
how
that
will
who
they
will
be
for
certain
I'll.
Be
sorry
for
the
the
chairs
to
discuss.
I
think
that
this
yes
I
see,
but
we
have
well
have
at
least
one
person
to
nominate
and
possibly
to
depending
on
what
happens
so
keen
to
initially
see
the
interest
from
colleagues
around
the
table.
A
A
The
other
committee
that
interested
in
doing
it
so
depending
on
whether
they
original
committee
resistance
on
just
one
member
it
may
be
that
it
could
be
either
party
or
one
from
each
potentially,
that
might
be
the
fair
solution
for
us
to
pull
forward.
So
many
members
are
interested
in
being
on
that
committee.
G
Yeah,
if
we
were
looking
for
a
second
I,
would
offer
not
that
I'm
teens,
if
I
guess
more
to
do,
but
it
is
an
era
in
which
I
have
an
interest,
but
I
did
I
did
share
the
working
group
to
set
up
the
food
banks
in
York,
and
it
would
seem
rather
strange
if
I
didn't
have
an
interest
in
the
subject.
I'm
also
a
trustee
of
Sparrow
gate,
which
has
recently
begun
something
called
the
sparrow
gate
pantry,
which
is
just
one
of
many
of
the
provisions
in
the
city.
G
A
A
A
A
In
fact,
myself,
while
we're
discussing
that
counselor
colic
will
be
chairing
than
its
September
meeting
to
have
a
work
commitment
that
I
I
can't
the
out
of
this
etc.
It's
the
November
date,
that's
changed!
So
that's
now
the
11th
of
November
Monday,
the
11th,
but
all
the
dates
up
to
an
including
February
should
now
be
set.
L
Also
just
to
confirm
in
the
work
plan,
the
the
substance
misuse
review
that
was
conducted
or
concluded
in
March
is
now
coming
up
to
its
six-month
update
implementation
update,
so
I
have
spoken
with
the
Director
of
Public
Health
and
we
should
be
getting
an
implementation
update
sometime
in
October
just
to
see
where
we
are
and
then
obviously
ask
any
relevant
questions
from
there.
So
that's
gonna
be
on
the
work
plan
in
October.
L
A
L
E
A
A
L
L
Is
that
that's
the
first
kind
of
introduction,
a
meeting
about
that
about
the
CCG
and
then
hopefully,
they'll
be
looking
in
the
new
year
to
also
have
another
invitation
for
members,
particularly
the
scrutiny
members,
but
all
members
talking
more
about
then
the
issues
that
are
facing
them
and
hopefully
that
should
give
you
guys
more
things
to
think
about
with
respect
to
what
should
be
on
the
work
plan.
But
of
course,
after
these
meetings
you
can
always
speak
to
the
chair
about
items
to
be
put
into
the
work
plan.