►
From YouTube: Health and Wellbeing Board, 30 July 2020
Description
AGENDA
Declarations of Interest 00:04:59
Minutes 00:05:11
Public Participation 00:05:25
Outbreak Management Advisory Board and the Outbreak Control Plan 00:05:28
Assessment of Health Impacts of Covid 19 in North Yorkshire and York 00:48:54
Positives and the Learning Arising from the Emergency 01:18:45
The Focus and Next Steps for the Health and Wellbeing Board 01:45:40
For full agenda, attendance details and supporting documents visit:
https://democracy.york.gov.uk/ieListDocuments.aspx?CId=763&MId=12324
A
We
are
going
to
have
a
minute
silence,
which
I
will
talk
about
in
a
moment,
and
please
could
you
keep
your
video
on
throughout
that
silence,
so
I'm
not
going
to
introduce
everybody,
but
I
would
ask
that
people
do
introduce
themselves
when
they
speak
and
for
those
that
are
watching
remotely.
You
should
have
everybody's
name
on
the
screen,
which
shows
their
face.
B
A
So
I
would
like
to
hold
a
minute
silence
in
memory
of
those
who
have
died,
not
only
the
health
workers
and
the
care
workers,
but
their
families
as
well,
and
also
everybody
else,
who's
been
involved
in
the
hospitals
in
the
care
homes
everywhere.
It's
affected
everybody's
life
and
also
to
remember
the
exceedingly
hard
work
of
all
those
who
have
been
involved.
A
A
A
C
Thank
you,
chair
apologies
to
those
people
on
the
call
who
will
be
very
involved
with
this
and
will
have
heard
what
I
have
to
say
before.
I'm
sure,
but
I'm
going
to
go
through
this
in
a
little
bit
of
detail
and
so
that
anyone
watching
and
the
the
the
meeting
can
be
informed
of
the
work
that
we're
doing
at
the
moment.
C
So
and
all
local
authorities
with
responsibilities
for
public
health
were
required
to
develop
and
publish
covid19
outbreak
control
plans
by
the
30th
of
june
and
to
ensure
the
local
delivery
of
the
nhs
test
and
trace
program
for
covid
and
but
also
set
out
how
we
are
going
to
deliver
across
the
system.
An
effective
local
outbreak
response,
and
we
didn't
have
very
long
to
develop
these
plans.
C
The
document
as
published
on
the
council's
website
is
intended
to
be
a
flexible
document
and
we
had
to
publish
our
plan
by
the
30th
of
june.
As
I've
said,
but
it's
intended
to
be
what
we
call
an
iterative
or
living
document.
So
as
we
do
learn
more
about
the
virus.
As
we
develop
our
local
response,
there
will
be
an
opportunity
to
review
and
update
that
plan,
and
indeed
it
has
a
review
date
for
march
next
year.
C
Fourth
area,
then,
is
around
our
contact.
Tracing
in
complex
settings
and
ensuring
that
we're
able
to
respond
quickly
to
contain
any
local
outbreaks,
the
fifth
is
around
data
integration,
so
members
of
the
board
and
anyone
listening
may
well
have
read
in
the
national
media
some
of
the
difficulties
there
were
early
on
in
the
pandemic
and
in
terms
of
sharing
data,
and
certainly
as
director
of
public
health
for
york.
I
was
raising
concerns
locally
around
some
of
the
data
that
we
had
access
to.
C
And
then
the
final
area
is
around
our
local
boards
and
governance
structures.
So
I'm
going
to
say
a
little
bit
about
the
outbreak
management
advisory
board
and
then
how
I
feel
that
board
needs
to
link
with
the
health
and
well-being
board
and
what
I
feel
to
be
the
role
of
the
health
and
well-being
board
going
forward,
so
that
we
can
then
have
a
discussion
about
that
as
a
group.
C
This
has
a
different
remit
to
what,
in
public
health
and
in
the
nhs
we
traditionally
think
of
as
an
outbreak
control
board.
The
outbreak
management
board
for
covid
is
really
intended
to
be
a
system-wide
group
that
looks
at
our
city-wide
response
across
all
of
those
seven
themes,
and
it
has
two
key
three
key
responsibilities.
C
The
board
also
has
the
option
to
co-opt
other
partners
for
particular
agenda
items
or
or
discussions
and
and
then
the
third
area,
a
key
area
of
responsibility
in
to
ensure
that
residents,
particularly,
but
also
people
working
in
in
the
city,
have
access
to
good
information.
So
communication
and
engagement
is
another
key
theme.
C
C
C
C
But
if
we
could
see
that
we
had
a
rapid
increase
in
the
number
of
cases
and
we
had
evidence
that
the
nhs
particularly
was
under
a
great
deal
of
stress
or
threat
and
in
in
terms
of
being
able
to
respond
to
those
coded
cases,
then
that's
what
we
would
consider
to
be
a
serious
and
imminent
threat
to
public
health.
If
we
could
see
that
our
services
were
in
danger
of
being
overwhelmed.
C
And
then
and
the
final
one,
is
that
the
prohibitions,
requirements
or
restrictions
imposed
by
the
direction
are
a
proportion.
It
means.
So
that
means
that
the
local
authority,
in
consultation
with
partners
and
in
particular
police,
would
need
to
be
involved
in
policing.
That
lockdown
are
satisfied,
that
we've
exhausted
all
other
measures
and
that
we
have
evidence
to
suggest
that
those
measures
are
not
sufficient
and
therefore
a
lockdown
is
a
proportionate
response.
C
In
making
any
lockdown
a
local
authority
has,
and
the
police,
together
with
the
police
and
other
partners,
have
to
agree
how
long.
We
think
that
lockdown
needs
to
be
in
place
for,
and
there
needs
to
be
a
review.
At
least
every
seven
days
as
to
whether
that
lockdown
is
still
is,
is
still
required
and
then
prior
to
issuing
a
direction.
C
How
the
board
ensures
that
all
the
partners
and
the
public
that
as
agencies
we
represent,
are
sufficiently
informed
and
involved
in
our
outbreak
control
planning.
So
we
all
have
a
responsibility
for
that
as
representatives
of
our
various
organizations
and
then
thinking
about
those
lockdown
measures
and
those
three
tests.
A
Thank
you
sharon.
I
think,
particularly
the
latest
update
on
how
we
locked
down
was
something
we've
been
waiting
for
for
some
time
and
obviously
it's
got
to
be
evidence-based
and
considered
very
carefully,
so
I'd
like
to
have
any
questions
or
comments
to
sharon.
If
anybody
would
like
to
raise
their
virtual
hand.
D
E
D
Now,
I
think,
when
the
when
the
outbreak
first
came,
the
messages
from
government
particularly
were
very
clear
and
as
the
control
measures
have
changed,
I
think
the
messaging
feels
less
clear.
So
I
think
that
there
is,
I
think,
what
sharon
was
sort
of
talking
about
in
terms
of
us
sharing
information.
I
think
it's
really
important
that
we
have
clear
messages
about
what
we
want
people
to
do.
I
know
even
just
myself
walking
around
at
the
moment
I
feel
like.
I
am
very
much.
D
This
will
surprise
people,
I
am
a
rule
follower
and
actually
I'm
finding
it
really
hard
to
to
know
when
I'm
following
the
rules
at
the
moment
and
when
other
people
are
or
are
not
following
the
rules-
and
I
think
this
paper
does
sort
of
talk
about
some
of
the
public
attitudinal
stuff-
that's
happening
at
the
moment
about.
We
all
believe
nobody
else
is
going
to
do
it,
but
we
think
we're
doing
it.
D
D
I
haven't
made
any
of
the
meetings
so
far
because
they
are
evening
meetings
and,
like
many
other
working
parents
at
the
moment,
I
am
struggling
with
keeping
my
work
and
personal
life
balance
in
check,
but
I
think
you
know
there
are
lots
of
people
out
there
who
are
in
similar
situations
trying
to
do
the
same
sorts
of
things.
So
it's
a
bit
of
a
reality
check
for
me
in
terms
of
my
willingness
and
my
ability
to
do
my
job
properly
at
the
moment.
A
Thank
you.
Thank
you
very
much
sean
and
thank
you
for
for
your
comments,
because
I
think
the
comms
are
absolutely
key
to
this
and
I
think
part
of
the
problem
we've
found
in
the
council
is
that
the
messages
change
very
quickly
and
we've
just
got
to
keep
up
with
them.
I
think
that's
a
big
issue
and
I'm
sure
sharon
will
want
to
comment
on
that
in
a
moment,
but
I'm
going
to
take
anna
next
council
anna
parrott.
E
C
C
If
we
had
to
make
it
last
for
18
months,
which
is
you
know
what
we're
planning
for
at
the
moment
in
in
terms
of
needing
a
pandemic
response,
and
the
split
was
purely
because
we're
already
partway
through
2000,
you
know
2021,
so
you
don't
need
a
full
12
months
of
spend
for
this
year.
So
all
we've
done
is
taken
a
proportionate
amount
for
the
remainder
of
this
year,
and
then
it
seemed
that
we
would
need
those
costs
for
all
of
next
years.
C
So
that's
just
why
the
money
looks
different
for
this
year
than
next
year,
and
at
the
moment
the
budget
is
sitting
in
a
ring.
Fenced
budget
called
covet
19
within
the
council
and
we
have
and
and
and
the
detailed
planning
of
how
we're
going
to
spend
that
it
will
be
in
response
to
our
risk
assessments
and
issues
that
may
crop
up
as
the
as
the
pandemic
develops.
C
So
I
have
as
director
of
public
health.
I
hold
that
budget,
I'm
going
to
be
very
prudent
in
how
we
spend
it
so
that
we
we
don't,
spend
it
early
and
and
then
find
that
we
need
more
money
for
further
down
the
line,
and
so
that
just
explains
that
the
difference
between
this
year
and
next
year
in
terms
of
spend
in
terms
of
communications
and
engagement.
I
absolutely
agree
with
what
sean
has
said
and
I'm
sure
everyone
on
the
call
would
agree
with
that
as
well.
C
Communications
is
astounding
item
on
the
outbreak,
management,
advisory
board
and
we've
had
two
meetings.
So
far.
At
the
first
meeting,
claire
fole,
the
head
of
comms
in
the
council,
outlined
the
communication
strategy
and,
at
the
last
meeting,
claire
did
a
joint
presentation
with
york
bid
the
business
improvement
district
around
some
of
the
work.
That's
been
done
with
businesses
in
terms
of
opening
shops,
etc
in
the
city
safely
and
alison
cements
made
the
point
at
the
last
meeting
about
this
is
not
just
about
communications.
C
In
terms
of
what
more
can
public
health
do
to
support
their
organizations
in
having
kind
of
bite-sized
pieces
of
information
that
can
be
shared
with
their
stuff,
and
so
that
you
know,
we
can
start
to
embed
those
key
messages
into
every
contact
that
we
have
with
the
public
wherever
wherever
that
may
be.
So
I'm
certainly
happy
to
make
that
commitment
from
public
health,
but
we'll
need
help
and
from
people
to
be
able
to
do
that
really
really
well.
A
Yes,
thank
you
sean
at
the
end
of
this
item,
I'm
going
to
ask
for
everybody
to
commit
to
this
plan
and
in
that
will
come
the
communication
strategy
so
that
we
are
all
giving
the
right
messages
to
the
right
people
in
the
right
language
at
the
right
time.
So
I'll
just
warn
you
of
that,
but
I
would
like
to
take
a
few
more
comments.
A
H
Thank
you
very
much
chad
and
just
to
introduce
myself
david
harbour,
and
I
chair
york
cvs
and
I'm
standing
in
because
alison
simmons
is
on
holiday
this
week.
I
I
very
much
appreciate
the
the
papers
that
have
been
presented
today
and,
of
course,
like
everybody
else,
in
this
meeting,
I
will
I
praise
the
rapid
response
that
there
has
been
across
the
city
of
york
and
the
engagement
of
all
the
services,
statutory
and
otherwise
in
helping
us
to
get
to
where
we
are
today.
H
Quite
rightly,
the
the
plan
that
we're
looking
at
at
the
moment
is
focusing
on
the
heart
of
the
problem,
which
is
the
management
of
covid19
itself.
And
what
happens
when
there
is
an
outbreak,
and
then
you
start
to
ripple
outwards
to
cover
many
of
the
points
that
are
actually
towards
the
end
of
this
plan
regarding
vulnerable
people,
and
I
just
wanted
to
make
a
point
which
actually,
I
could
have
raised
here
or
indeed
under
the
next
item.
H
When
we
hear
from
peter
roderick
that,
of
course,
we
did
respond
very
quickly
to
setting
up
ways
of
helping
people
who
might
be
isolated,
especially
those
who
are
deliberately
shielding
during
an
outbreak.
York.
Cvs
itself
had
the
the
the
phone
line
which
linked
in
with
gp
surgeries
across
york,
that
allowed
people
to
seek
immediate
access
to
non-medical
support,
and
within
the
first
week
we
supported
200
people
over
time.
It's
approaching
a
thousand
now
through
that
route,
and
we
are
by
no
means
alone
in
providing
that.
H
I
know
that
age
uk
changed
its
priorities
almost
overnight
to
supporting
people
through
the
refunding
service
shopping
weekly
for
people
and,
of
course,
continuing
with
their
work.
In
the
field
of
home
from
hospital,
what
we've
learned
through
this
process
is
in
some
cases
some
senses
not
surprising
that,
of
course,
the
the
there
are
different
needs
according
to
different
parts
of
the
community.
So
there
are
adults
with
learning
difficulties.
H
There
are
people
living
with
dementia,
all
of
whom
require
something
of
a
tailored
service
and
tailored
support,
and
in
many
cases
it
is
voluntary
organizations
who
are
already
providing
that
who
are
best
placed
to
provide
it.
But
what
we
also
found
was
that
many
volunteers
and
here's
a
sweeping
generalization,
but
nevertheless
that's
grounded.
In
truth,
a
lot
of
volunteers
tend
to
be
towards
the
older
end
of
the
spectrum
and
some
of
those
themselves
had
to
cease
volunteering
because
of
shielding.
H
H
I
Thank
you
chair.
Firstly,
I'd
like
to
congratulate
sharon
and
her
team
on
their
hard
work
at
producing
this
outbreak
plan.
It's
been
a
lot
of
effort,
I'm
sure,
and
also
thanks
to
the
voluntary
services
and
across
the
david
who
have
worked
pretty
hard
with
our
primary
care.
Colleagues
to
ensure
we
protect
and
support
some
of
the
most
vulnerable
in
our
communities.
I
Many
of
you
might
be
familiar
with
the
academy
of
medical
sciences
report
which
forecasts
we
could
have
a
difficult
winter.
It
flew
and
covered
combined
with
that
in
mind,
if
we
are
thinking
of
lockdown
or
the
need
for
local
lockdown
and
for
outbreak
measures,
speed
is
key.
Timeliness
of
action
is
key.
I
It's
a
very
lonely
place
to
be
to
have
to
make
that
call,
and
I
would
like
us,
as
a
health
and
wellbeing
board,
to
be
clear
about
our
priorities.
If
we
get
to
that
stage
for
the
ccg
during
the
covet
period,
we
had
three
simple
priorities:
call
it
a
mission
statement,
it
was
to
save
lives,
protect
the
vulnerable
and
keep
services
going,
and
I
would
recommend
that
we
are
clear
likewise
as
a
health
and
wellbeing
board.
What
our
guiding
priorities
are.
G
G
We
we
very
much
support
the
outbreak
control
plan,
but
I'm
wondering
whether
it
might
be
helpful
to
have
our
input
on
the
actual
membership
of
the
board,
because
I
think
we're
involved
in
other
areas,
but
I
don't
think
correct
if
I'm
wrong
that
we've
got
any
linkage
in
with
york,
particularly
yes,
cabs
is
one
of
the
key
seven
key
themes.
I
wonder
if
people
think
our
input
would
be
of
some
assistance.
C
And
so
I'm
just
wondering
in
response
to
mike's
point
about
and
I'd,
be
interested
in
other
people's
views
on.
This
is
that
if
we
establish
that
professional
covered
19
health
protection
board,
that
sits
as
underneath
the
health
and
well-being
board
and
the
outbreak
management
advisory
board.
So
the
group
kind
of
operates
with
a
virtual
relationship
to
to
this
board
and
the
outbreak
management
board.
That
brings
health
and
social
care
professionals
together.
C
Who
will
be
looking
at
the
scientific
evidence
and
the
local
intelligence
and
service
understanding
of
what's
happening
in
terms
of
a
pandemic,
and
that,
I
think,
would
strengthen
our
decision
making
around
not
just
lockdown,
but
whether
we
needed
to
put
in
place
any
additional
measures
to
contain
the
virus.
To
me
lockdown.
C
I
feel
that
if
the
board
is
supportive
and
I'd
be
interested
in
simon's
view
from
the
hospital
as
well
on
this,
if
we
can
pull
together
that
professional
group
and
then
it
would
obviously
the
independent
care
group
would
be
key
in
terms
of
that.
I
I
kind
of
feel
that
would
probably
tick
a
number
of
boxes
for
us,
but
would
be
interested
in
others.
Views.
A
J
So
what
we
wouldn't
want,
necessarily
there
is
pulling
three
different
groups
together
to
form
a
view
that
may
well
complicate
our
ability
to
make
a
a
quick
and
decisive
and
decisive
view.
So
I
think
absolutely
sharon.
Let's
have
a
kirby
19
expert
group
as
you
as
you,
as
you
suggested.
He
did.
Many
other
areas
have
got
those
I've
got
those
in
place,
but
just
be
really
clear
in
the
plan
and
what
their
contribution
would
be.
J
If
we
were
to
see
a
rapid
increase
in
in
in
in
transmission
across
across
europe,
because
I
think
we'd
find
that
we'd
need
to
be
calling
together
the
outbreak
advisory
board
very
quickly
and
making
a
decision
quite
quite
quickly
in
those
in
those.
In
those
circumstances.
So
just
not
to
confuse
the
governance
of
the
decision.
Making.
A
F
You
chair
picking
up
on
what
simon
has
just
said,
and
I
guess
this
this
is
it's
just
an
observation
as
one
of
the
things
that
we
all
commented
on
throughout
the
management
of
the
emergency
element
of
the
pandemic
across
the
system
was
the
the
way
in
which
we
all
as
a
system
and
partners
came
together
and
some
of
the
decision
making.
That
was
done
at
speed
with
some
great
pace
to
it,
and
people
describe
it
like
a
cutting
out
of
all
the
unnecessary
stuff
around
our
decision-making.
F
We
actually
did
things
so
my
only
cautionary
note
about
another
board
or
another
group
of
people
would
be
that
it
feels
a
little
bit
like
the
way
we
used
to
do
things
if
we're
not
quite
sure
about
what
to
do
set
up
another
group
to
talk
about
it
and-
and
I
would
just
want
to
be
really
sure
that
there
was
a
very
specific
and
helpful
purpose
to
that
group.
The
way
sharon
describes
it.
A
So
I
think
that
there
is
work
to
be
done
on
that.
So,
in
conclusion,
on
this
item,
if
you
have
the
papers,
paragraph
22,
we
are
asked
to
be
committed
to
the
the
plan.
As
you
have
heard,
it
explained
to
you
and
to
take
that
back
that
commitment
back
to
the
organizations
we
represent
and
you've
heard
quite
regularly
and
we'll
still
go
on
hearing.
I
think
about
the
importance
of
communication
and
get
the
right
messages
out
as
quickly
as
possible.
A
K
K
Assessment
following
a
disaster
is
often
done
around
the
world
globally
and
what
we
did
was
to
to
do
it
on
a
north,
yorkshire
and
york
footprint
and
to
feed
into
some
of
the
regional
leadership
groups
that
were
established.
But
what
I'm
presenting
today
is
mainly
york.
Specific
data
try
to
make
it
as
york
specific
as
we
can.
There
may
still
be
some
bits
and
pieces
in
here
which
refer
both
to
north
yorkshire
and
york.
K
But
I
will
try
to
pull
out
some
of
the
main
points
for
partners
around
the
table
to
hopefully
kick
off
our
discussions
on
it,
and
we
did
some
data
analysis,
gathered
lots
of
intelligence
from
partners
in
the
system
for
the
assessment
and
also
did
a
public
survey
across
vail
of
york,
ccg
area
which
had
about
600
responses
which
really
went
to
inform
the
needs
assessment
as
it
was,
and
hopefully
that
should
be
clear
on
that.
Second
slide,
which
summarizes
all
I've
said
so
far.
K
This
third
slide
gives
a
a
a
sense
of
how
we
conducted
the
assessment
and
the
model
that
we
used
thinking
about
the
pandemic
across
four
waves
that
I
guess
have
landed
on
society
and
and
are
still
with
us.
So
thinking
about
the
direct
wave.
The
way
in
which
direct
infections
from
coffee
19
have
caused
harm
and
and
need
emerging
in
our
community
and
still
do
and
still
might.
K
If
we
see
an
uptick
in
a
number
of
cases
in
the
future,
thinking
about
the
immediate
wave
that
lighter
bluer
line,
you
can
see
so
really
thinking
about
the
ways
in
which
society
and
life
changed
so
rapidly.
Healthcare
changed
so
rapidly
and
that
there
were
needs
which
would
have
emerged
from
those
changes
which
affected
people's
health
and
then
thinking
about
that
the
gray
line,
the
chronic
needs.
K
K
If
it
is
such
that
examples
such
as
suicides
which
may
potentially
have
been
linked
to
mental
health
issues
caused
by
lockdown
or
timely,
urgent
care,
not
always
being
as
available
or
people
not
seeking
it
in
such
a
timely
manner
and
seeing
some
upticks
in
some
deaths
from
myocardial
infarction,
heart
attack
and
stroke,
that
might
be
due
to
that
and
then
thinking
about
the
direct
infection
and
and
over
3000
people
across
north
yorkshire,
new
york,
hospitalized
and
then
the
discharge
needs
and
the
aftercare
needs.
What
people
are
often
calling
long
covered.
K
That
kobe
doesn't
just
go
away
immediately,
that
there
are
often
are
months
and
months
of
difficulty
following
and
then
we
listed
for
each
section
possible,
mitigations
and
key
gaps
which
partners
can
read
in
the
report.
This
next
slide
I'll
just
pause
for
maybe
five
or
so
seconds
on
each
of
these
slides
summarizing.
What
partners
told
us
and
what
the
public
told
us
in
response
to
each
of
these
waves.
K
K
We've
tried
to
intersperse
the
needs
assessment
with
the
views
of
the
public
all
the
way
through
and
there's
a
wider
document
available,
which
summarizes
everything
that
the
public
told
us
within
that
thinking
about
the
immediate
impacts
again
listing
who's
the
most
vulnerable
at
the
top
there
and
picking
out
a
few
things
from
the
list
that
we
really
sort
of
were
emphasized
when
we
would
talk
to
people-
and
we
looked
at
the
data
thinking
about
areas
of
health
care
which
saw
real
reductions
in
the
amount
of
people
that
were
accessing
it.
So
general
practice.
K
Dental
healthcare
attendance
at
a
e
people
who
are
on
an
inpatient
ward
with
mental
health
problems
and
safeguarding
all
saw
quite
large
reductions
in
the
number
of
people
accessing
care,
and
some
of
that
will
have
had
implications
for
their
immediate
health
and
then
some
possible
mitigations
and
gaps
again,
which
have
been
listed
at
the
bottom
there.
And
this
is
what
partners
and
what
the
public
said
on
that
point,
and
again
just
leave
five
seconds
to
read
that.
K
Thinking
of
the
chronic
impacts
of
covid,
so
the
things
that
were
emerging
and
maybe
an
existing
long-term
condition
or
an
existing
health
problem
or
existing
societal
problem.
That
was
exacerbated
to
pick
out
a
few
things
here
within
healthcare:
a
lot
of
reductions
in
referrals
across
the
board.
If
we're
talking
about
referrals
with
a
suspected
diagnosis
of
cancer,
with
we're
talking
about
elective
attendance
and
elective
operations,
if
we're
talking
about
improving
access
to
psychological
therapies,
I
act
within
mental
health.
The
first
line
of
support
for
people
with
depression
and
anxiety.
K
K
11
and
13
those
key
transitional
years
and
the
mental
health
implications
of
uncertainty,
anxiety
at
particular
key
moments
in
life
and
seeing
our
our
children,
adolescent
mental
health
services
stepping
up
to
that
through
a
massive
increase
in
remote
consultation
and
support,
but
still
seeing
lower
numbers
through
those
services
and
aware
that
some
of
the
the
harm
and
the
need
maybe
be
stored
up
for
later
points.
Again
I'll
put
up
this
slide
for
just
five
seconds.
What
partners
in
public
told
us
about
the
chronic
impacts
of
kobit.
K
K
And
moving
on
to
the
long-term
impacts
of
which
there
are
so
many
and
it's
difficult
to
pick
out
the
key
ones,
thinking
about
negative
impacts
of
of
of
health,
behaviors
and
lifestyle
choices
which
may
have
hit
harder.
A
classic
that
has
been
noted
in
many
places
would
be
smoking
and
smoking
in
the
home
and
the
risk
of
second-hand
smoke
when
people
are
obviously
locked
down
or
isolated,
and
thinking
about
people's
out
alcohol
purchasing
habits
which
have
increased
trends
within
substance
misuse.
K
There
are
some
risks
that
we've
identified
and
some
intelligence
and
insight
that
we've
got
from
policing
partners
around
how
the
impact
of
kovid
has
been
on
their
services
around
homelessness.
Bearing
in
mind
that
every
single
recession
that
we
can
recall
has
seen
a
rise
in
homelessness
in
the
the
last
century.
So
so
there
are
worries
there
around
housing
issues,
certainly
into
the
long
term,
and
then
some
positives,
and
there
are
some
positives,
one
of
which
being
air
quality
which
improved
quite
markedly
in
the
city
during
covid.
K
And
then,
of
course,
we
couldn't
neglect
to
talk
about
the
economic
aspects
and
some
aspects
in
the
report
that
were
an
early
indication
around
universal
credit
uptake
and
around
the
large
proportion
of
population
who
were
furloughed
at
any
one
point,
and
obviously
the
job
insecurity
arising
from
that
and
the
health
need
that
we
may
see
in
the
long
term
and
again,
some
possible
mitigations
and
key
gaps
at
the
bottom
noted
and
then
on
this
next
slide.
What
partners
have
told
us
what
the
public.
K
Said
and
so
finally,
we
concluded
that
there
was
impacts
on
mortality
or
morbidity.
There
were
impacts
that
were
around
the
unintended
consequences
of
the
system
response
to
covid
what
we
did
in
healthcare,
what
we
did
in
other
parts
of
the
system
within
the
council
within
the
voluntary
sector
or
what
we
were
forced
to
do.
K
The
recommendations
that
we
made
were
four
areas
in
which
we
we
found
that
the
need
was
really
high
and
we
really
wanted
partners
to
take
into
account,
as
they
were
thinking
about
recovering
and
resetting
you're
thinking
about
infection.
Minimization
and
we've
talked
about
the
outbreak
control
plan
this
morning.
K
Thinking
about
mental
health,
thinking
about
access
to
health
care
and
then
thinking
about
prevention
of
long-term
conditions
and
building
a
healthier
society,
and
then,
additionally,
noting
some
other
recommendations
around
health
and
digital
literacy
and
and
not
seeing
people
left
behind
by
the
rapid
shift
to
digital
delivery
of
services.
Thinking
about
taking
a
demand.
Sorry,
a
population
led
rather
than
a
demand,
led
approach
to
recovery.
K
Thinking
about
that
wider
approach
to
vulnerability
that
isn't
simply
just
dividing
the
population
into
shielded,
vulnerable
and
everybody
else,
but
thinking
about
the
the
different
nuances
within
that
categorization
and
how
we'd
work
in
different
ways.
Potentially,
if
and
when
a
rising
cases
comes
and
then
a
commitment
to
keep
on
basing
the
work
we
do
on
need
to
to
do
further
work.
Around
health
needs
assessment
covering
in
the
next
phase.
K
Second,
wave
readiness:
how
ready
we
are
as
populations
and
thinking,
particularly
about
community
services
in
the
nhs
and
social
care
as
sectors
and
then
the
final
slide.
There
two
messages,
a
message
of
hope
and
a
message
to
galvanize
which
came
from
our
partners
as
we
were
conducting
this
piece
of
work
and
I'll
close
their
chair
and
pass
over
to
you
for
comments.
A
A
L
L
I
know
that
we
are
having
increasing
mental
health
presentations
and
it
is
quite
stark
the
rise
that
we
that
we
are
seeing
and
also
just
a
reflection
is
we
are
seeing
late
presentations
of
of
of
illnesses
that
we
wouldn't
have
seen
for
many
many
years.
So
there
is
an
increase.
There
is
going
to
be
an
increased
pressure
on
health
services.
L
On
the
comment
of
the
last
slides,
which
is
to
get
to
population
need
and
and
and
residents
need-
and
we
go
for
that-
not
in
their
demand
way
and-
and
I
think
we
need
to
keep
that
in
the
forefront
of
our
minds
as
we
go
forward,
because
we're
always
challenged
on
numbers
in
waiting
lists
or
in
demand
lists.
We
need
to
get
to
need,
and
so
I
think
that's
really
really
important
and
it
could
be
a
bit
a
bit
of
a
time
for
a
refresh
and
a
reset
around
that.
Those
are
my
comments.
Chair,
hope.
M
Thank
you.
Thank
you
chair.
I
thought.
Peter's
presentation
was
fascinating
and
my
only
observation
is
that
it
would
have
been
really
useful
to
have
seen
it
before
the
meeting,
because
there's
so
much
there
and
it
was
such
a
different
form
of
helicopter
view
from
what
we've
had
of
the
pandemic
from
a
purely
public
health
perspective.
M
So
I
think
that
that
was
really
would
be
really
helpful
to
circulate
this.
Secondly,
the
point
about
that
nigel's
just
made
about
the
presentation
of
a
late
presentation
of
illnesses
that
we
haven't
seen
for
a
long
time.
Does
that
just
mean
a
late
presentation
such
as
you
haven't
seen
or
are
we
suggesting
there
are
some
new
illnesses?
A
E
Thank
you
chair,
I
think
for
me.
The
thing
that
came
out
really
clearly
is
them:
how
much
capacity
we
sort
of
need
to
sort
of
maintain
in
the
system
potentially
just
because
we
saw,
as
others
have
touched
on.
You
know
people
not
presenting
to
the
nhs.
I
don't
know
whether
that
was
a
conscious
choice,
because
they
didn't
want
to
overwhelm
a
service
that
they
felt
was
going
to
be
under
huge
pressure,
but
it
is
you
know.
E
Obviously
it's
a
worry,
isn't
it
that
there
is
going
to
be
this
surge
of
people
coming
forward,
whether
it's
making
disclosures
about
any
sort
of
abuse
in
relationships
right
through
to
a
yes
late
diagnosis,
so
a
challenge
to
everyone
sort
of
sitting
around
the
table.
Really,
how
do
we
sort
of
maintain
capacity
so
that,
if
people
are
coming
forward,
we
can
make
sure
that
they
receive
really
timely
help?
Now,
thank.
D
D
So
I
think
it's
really
really
good
to
have
seen
that
theme
coming
through
strongly.
I
think
there
are
two
different
challenges
that
we
face,
and
these
were
summed
up
for
me
in
one
email
I
received
from
somebody
around.
They
personally
have
some
routine
appointments
around
monitoring,
a
potential
skin
issue,
and
they
are
currently
too
anxious
to
seek
their
usual
routine
care
for
that.
D
D
Against
a
backdrop
of
we
know
this
isn't
normal
yet,
and
we
might
be
some
way
from
normal.
How
do
we
start
putting
out
messages
that
enable
the
public
to
be
confident
that
we
are
going
to
start
addressing
some
of
these
longer-term
impacts
in
a
way?
That
is
fair
that
actually
meets
the
needs
that
people
have
rather
than
that,
responds
to
those
of
us
who
are
best
at
shouting
out
and
getting
the
response
we
want.
A
I
Thank
you
chair,
so,
firstly,
thanks
peter
for
your
hard
work
on
this
health
needs
assessment
for
those
of
the
board
who
aren't
aware
it's
actually
been
used,
not
just
in
europe
but
across
other
local
authorities
in
the
humber
coast
and
vail
region.
So
it's
it's.
It's
really
been
an
insightful
piece
of
work
completely
agree
with
sean
about
the
the
needs
and
the
welfare
of
carers
in
particular,
as
well
as
those
who
do
not
have
a
voice
or
who
tend
not
to
be
heard.
I
So
when
we
carried
out
this
health
needs
assessment,
especially
the
public
consultation
bit
public
survey
bit,
we
were
keen
to
hear
those
voices
and
they
remain
in
my
mind,
a
need
group
really
going
forward.
Two
two
things
I
want
to
flag
to
the
group.
Firstly,
it's
around:
how
do
we
get
some
realistic
sense
of
expectations
of
services
from
members
of
the
public?
I
I
see
simon's
there
and
simon
you
and
I
have
the
same
problem
in
the
sense
that
it
is
nigh
on
impossible
to
get
back
to
pre-covet
levels
anytime,
soon
we're
working
hard.
But
it's
difficult
and
just
to
give
you
an
example
in
primary
care
previously
to
take
a
blood
test.
It
might
take
us
six,
seven
minutes
to
do
now.
I
H
Thank
you,
chair
yeah,
two
quick
points.
If
I
may,
one
is
the
emphasis
on
the
wraparound
support
the
so,
for
example,
in
terms
of
discharge
and
aftercare
needs
of
people
who
are
discharged
from
hospital
or
who
are
recovering
from
whether
it's
covered
or
another
condition.
Also
needs
may
well
be
practical
and
social,
as
well
as
medical
who's
going
to
cut
the
grass.
H
H
I
would
just
like
to
ask
if
anyone
would
comment
on
how
we
make
sure
we
look
after
the
mental
and
physical
health
of
the
people
who
are
working
in
the
nhs
in
residential
care
and
in
domiciliary
care,
because
we
know
that
covid
has
had
a
disproportionate
impact
on
those
parts
of
our
workforce
and
our
community,
and
I
just
want
to
make
sure
that
we
have
systems
in
place
that
we're
really
going
to
look
after
them
as
we
move
forward.
Thank
you.
Chair.
K
Yeah
well
thank
everyone
for
for
comments
and,
and
it's
a
fascinating
discussion
and
incredibly
important
stuff.
I
I
guess
all
I
would
say
is
you
know
I.
I
came
into
public
health
as
a
field
and
one
of
the
things
that
motivated
me
was
the
making
of
the
invisible,
visible
and
actually
showing
and
highlighting
need
and
vulnerability,
and
and
I'd
like
that
conversation
to
continue
particularly
around
some
of
the
groups
that
have
been
identified.
K
K
Had
had
poor
health
outcomes
but
also
had
what
we
often
talk
about
the
inverse
care
law,
they
they
received
less
health
care
in
general.
They
they
maybe
didn't,
seek
it
as
quickly,
and
I
think
it
is
about
prioritization,
and
it
will
be
about
some
hard
decisions
about
some
of
the
messages
that
we
send
out
that
actually
inappropriate
access
of
healthcare
has
a
knock-on
effect
for
those
who
who
would
be
using
that
clinician's
time
and
so
having
a.
K
A
Lovely
thank
you
very
much
peter.
It's
a
really
fascinating
presentation
and
I
know
people
will
reread
it
when
it
comes
round
right.
I
want
to
go
on
to
the
next
item
and
I
want
to
just
point
out
that
this
links
with
the
second
item
item
seven
that
follows
because
what
I'm
going
to
ask
now
is
what
we've
learned.
N
You
so
so,
I
think,
in
terms
of
the
the
real
positives
has
been
how
systems
have
pulled
together.
As
you'll
be
aware,
my
role
is
actually
yeah
now
across
all
of
northeastern
yorkshire,
and
so
actually,
not
just
within
the
york
system.
But
systems
generally
across
the
patch
have
really
really
pulled
together
and
worked
immensely
hard
and
to
rapidly
implement
changes,
and
I
think,
there's
been
benefits
in
terms
of
the
use
of
technology.
N
O
So
I
think
that
was
absolutely
commendable.
I
think
the
other
element
again
in
support
of
our
nhs
at
the
start
of
this,
when
we
felt
that
the
nightingale
hospital
would
have
been
filled
and
the
way
that
that
was
brought
together
in
in
in
harrogate
worm
was
extremely
professional,
extremely
well
done
by
by
the
group
as
well,
and
I
think
the
sign
of
success
from
that
from
the
first
element
was
actually
that
we
didn't
have
to
use
that
at
all.
You
know,
I
think,
the
way
we
thought
fantastic.
O
The
fact
that
the
nhs
and
our
partners
pulled
together
and
didn't
have
to
use
that
facility,
I
think,
was
very,
very
positive
in
terms
of
that.
The
other
thing
I
would
like
to
do
is
obviously
say
a
huge
thank
you
as
well
to
all
of
our
communities,
because
actually,
the
other
reason
why
I
think
that
the
nhs
nightingale
hospital
hasn't
had
to
be
used
in
the
way
that
we
thought
it
would.
And
now
you
know
talking
about
500
beds.
O
O
J
What
what
this
pandemic
has
accelerated
is
that
sort
of
sense
of
collaboration
between
nhs
organizations
and
primary
and
secondary
care,
and
between
between
hospitals,
thinking
about
how
we
use
our
clinical
teams,
how
we
use
our
capacity
and
our
estate
more
creatively
and
more
effectively,
and
I
hope
that
that
will
well.
I
know
that
will
continue
going
forward,
but
what
we've
seen
is
a
sort
of
little
a
little
boost,
really
a
booster
rocket
that
that
has
accelerated
some
of
those
conversations-
and
the
third
point
is
is-
is
the
work
between
between
partners.
J
We
we've
been
able
to
do
things
in
the
last
12
weeks
that
the
people
like
me
and
people
like
sharon,
have
been
talking
about
for
many
many
many
years
and
because
of
that
speed
of
decision
making,
and
that
commitment
and
willingness
to
to
make
to
make
changes.
We
we
we
put
in
place
a
range
of
measures
and
and
and
changes
that
that
that
I
would
have
thought
we
would
have
still
been
working
on
for
the
next
three
three
or
four
years.
J
So
the
the
work
we've
done
around
how
we,
how
we
manage
effectively
manage
discharge
processes
and
flow
through
the
hospital
has
has
has
been
revolutionary
really
and-
and
yes,
it's
been
helped
by
the
government's
commitment
to
to
to
resource
packages
of
care.
But
I
absolutely
know
that
there's
a
commitment
in
the
system
for
us
to
think
of
ways
in
which
we
can
sustain
those
those
measures
going
going
forwards.
So
the
general
message
has
been
about
effective
working
between
all
partners
and
sectors
and
that
that
that
outflow
of
public
support
for
the
service.
G
Yes,
thank
you
chair
just
briefly,
then
I
think
I'd
echo
what
a
lot
of
other
people
said.
I
think
working
together.
Partnership,
critical
has
been
good
technology
as
well,
and
also
lessons
learned
for
the
future
because,
as
we
know,
this
virus
isn't
going
anywhere
to
get
us
better
prepared
for
the
second
wave
really.
But
again
you
probably
would
expect
to
say
this.
G
H
Thank
you
yes
well.
You'll
expect
me
to
say
the
next
bit.
The
voluntary
sector
responded
remarkably
quickly
to
the
challenges
presented,
and
there
is
so
many
organizations
that
ought
to
be
thanked
that
it's,
it's
almost
envisious
to
single
them
out,
but
clearly,
at
a
time
when
we
concerned
about
issues
such
as
domestic
abuse,
then
the
independent
domestic
abuse
services
survive
come
to
mind
on
the
mental
health
challenges
york.
Mind
samaritans.
Of
course.
H
H
The
other
side
that
you
won't
be
surprised
about
is,
of
course,
we
at
the
same
time
that
there
was
an
urgent
need
for
the
voluntary
sector
to
step
up
and
to
work
in
close
collaboration
with
our
statutory
sector.
Colleagues
and
friends,
we've
also
suffered
financially
and
those
charities
which
rely
on
fundraising,
weren't
able
to
go
ahead
with
events.
H
Charity
shops
have
been
closed.
Other
commercial
activities
haven't
been
feasible
and
one
of
the
issues
for
york
cvs
through
the
contacts
that
we
have
is
our
concern
that
some
of
the
organizations
that
have
provided
the
most
help
are
actually
now
the
most
vulnerable,
and
we
as
a
that
very
quick.
We've
appreciated
the
additional
help
that
the
government
provided
to
frontline
services
for
safeguarding
and
for
the
help
for
saint
leonard's
hospice.
For
example,
100
and
the
national,
the
big
lottery
has
stepped
up
to
riding's
community
foundation
has
been
fantastic.
H
There
is
a
lot
more
still
to
be
done,
though,
but
I
really
want
to
stress
the
positive
in
fantastic
the
way
people
have
stepped
up
and
the
last
point
to
make
4
000
people
volunteered
spontaneously
who,
whether
they've
volunteered
in
the
past
or
not.
I
think
that
sets
us
in
tremendously
good
stead
when
we
look
to
the
future.
If,
if
we
could
just
bottle
that
willingness
to
help,
yes
really
help
us
move
forward,.
F
And
now
we
talk
about
that
a
lot,
and
I
know
I
talk
about
that
a
lot,
but
probably
the
pandemic.
Experience
is
our
first
experience
as
a
system
of
actually
seeing
that
happen,
and
so
I
I
would
invite
us
all
the
next
time
a
decision
is
being
made
which
isn't
necessarily
going
to
be
the
best
decision
for
your
own
organization
or
your
own
role.
F
Let's
all
have
the
courage
to
make
that
decision.
If
it's
the
right
thing
to
do-
and
the
other
thing
I
would
say
about
that
is-
that
is
really
not
easy,
and
we
know
that
so
I
think
we're
going
into
the
not
easy
territory-
and
I
hope,
and
that
we're
all
going
to
be
in
that
together.
That's
what
I'm
really
looking
forward
to.
M
Thank
you
chair
from
my
own
perspective.
The
big
positive
that's
come
out
of
this,
for
me,
has
been
the
willingness
of
our
schools
and
public
health
teams
and
volunteers
and
and
support
teams
in
schools
to
reach
out
as
best
they
can
given
the
degree
of
separation
with
the
to
the
children
and
families.
If
you
like
in
their
care,
that's
perhaps
an
over
a
strong
use
of
the
word
care,
but
it
is
a
significant
thing.
M
But
otherwise
I
mean
I'm
amazed
at
the
contribution
made
by
by
volunteers
by
public
services
across
the
spectrum,
and
it's
reassured
me
that
actually
the
britain
I
I
knew
as
a
child
and
as
a
young
person
after
the
second
world
war,
is
actually
capable
of
bringing
itself
back
into
existence
again,
don't
want
to
be
too
self-congratulated,
but
you
know
I
think
that
sums
it
up
quite
fairly.
Thank
you,
chair.
I
Thank
you,
chad.
I
think
my
one
reflection
about
what's
gone
well
is
it's
a
real
sense
of
community
spirit
that
has
emerged,
and
I'm
not
talking
about
just
community
in
the
singular
in
york.
We
have
a
community
of
communities.
I
guess
even
those
of
us
on
the
call
here
we
are
a
community
in
that
regard,
and
it
is
not
by
accident
that
we
have
had
a
low
rate
of
infection
now
yeah.
I
I
think
many
members
of
the
public
out
there
who
are
listening
in
and
beyond,
who
have
have
supported
and
been
compliant
with
the
advice
due
to
socially
distance,
the
hand
wash
and
so
forth.
They've
made
the
difference
and
exactly
as
davis
mentioned,
that
the
4
000
volunteers
have
put
themselves
forward,
I'm
mindful
that
some,
not
all
of
them
would
have
been
been
place,
but
the
the
the
fact
that
they've
been
willing
that
that's
amazing
and
going
forward.
I
E
Thank
you
chair,
I
think
for
me
it's
mostly
about
how
people
have
really
stepped
up.
You
know
whether
you're
providing
a
service
or
whether
you've
been
receiving
one.
I
think
people
have
really
gone
over
and
above
what
anybody
could
have
reasonably
expected
and
they've
done
so
really
quickly.
I
think
everybody's
had
to
adapt.
E
L
Thank
you
chair
just
echo
simon's
point
around
the
public,
valuing
the
nhs
staff
and
and
how
thank
thankful
I
am
for
for
for
the
public
doing
that
and
and
and
how
that's
been
shown,
and
the
other
thing
really
picking
up
on
sharon.
Holden's
point
about
doing
the
right
thing.
I
think
that's
absolutely
right
going
forward
from
now
on.
It's
about
how
we
all
link
together
as
communities
as
andrew
said
to
to
do
the
right
thing,
and
and
that's
why
I
would
really
want
us
to
be
focusing
on
there.
P
Hi,
yes,
thank
you
chair.
I
think,
what's
gone
well
again,
echoing
a
lot
of
what
other
people
have
said,
we've
shown
that,
where
the
system
is
focused
on
the
shared
objectives
and
goals
of
what
we
can
actually
do
possibly
do,
I
think
the
the
agility
and
the
organizations
have
shown
we've
broken
down
barriers.
We've
brought
forward
service
developments
that
we've.
P
You
know
the
the
the
way
that
staff
have
adapted
and
the
public
to
the
use
of
digital
ways
of
working
as
well
through
health
and
so
whilst
challenging
and
not
universal
by
any
means,
I
think,
they're
a
huge.
You
know.
We've
had
plans
around
that
for
a
long
time
and
that's
been
brought
forward
being
used
successfully
in
in
some
areas,
so
huge
thanks
to
the
public
and
communities.
P
I
think,
certainly
from
our
perspective,
in
the
trust,
the
staff
that
who
have
planned
to
retire
or
have
retired
and
returned
to
us
to
help
us
through
difficult
times,
volunteers
staff
have
adapted
and
changed
what
they're
doing
to
meet
new
needs.
So
we
we
set
up
the
24
7
helpline
within
days,
yes
edge.
We
opened
a
hospital
in
the
middle
of
this,
so
I
think
it's
huge
thanks
to
the
skills
and
knowledge
of
the
staff
and
also
local
businesses.
P
Q
A
D
I
think
that
real
sort
of
swelling
of
enablingness
and
wanting
to
know
that
the
people
living
very
close
to
you
are
doing.
Okay
have
everything
they
need.
I
think
again,
I
would
like
to
echo
many
of
david's
sentiments
around
the
voluntary
sector
that
lots
of
the
individuals
we
were
speaking
to,
who
had
needs
to
be
met
in
some
way,
shape
or
form
were
connected
with
voluntary
and
community
organizations
who
could
help
them,
enabling
our
statutory
services
to
focus
on
those
who
who
needed
their
sort
of
support.
D
I
think
for
me,
I
think
I
recognize
some
of
councillor
cuthbertson's
comments
around
schools.
I
think
there
were
lots
of
schools
who
did
some
really
good
things,
but
I
think
some
of
the
negatives
for
me
would
be
around
consistency
of
support
and
people
knowing
what
would
be
available
to
them,
and
I
think
I
think
schools
have
had
a
really
tough
time
of
it.
But
I
do
think
there
wasn't
a
consistent
approach
across
our
schools
to
providing
support
for
our
children
and
understanding
what
they
could
be
offering
in
a
more
digital,
more
virtual
world.
D
It
would
be
wonderful
if
some
of
that
sleekness
of
foot
and
willingness
to
do
things
differently
can
stay
part
of
our
new
normal.
Whatever
that
looks
like-
and
I
guess
also
to
say
thank
you
to
the
people
who
are
responsible
for
commissioning
services
for
being
willing
to
accept
that
you
weren't
going
to
get
the
service
that
you'd
paid
for,
because
that
service
couldn't
be
provided.
D
But
actually
the
service
that
you
needed
to
provide
was
much
more
useful
at
that
time.
So
I
think
not
being
tied
up
by
paperwork
and
contracts
and
being
happy
to
do
what
was
necessary
was
really
really
useful.
And
we
should
maybe
try
and
remember
that
when
we're
going
forward
that
doing
the
right
thing
is
better
than
doing
the
wrong
thing.
But
that
ticks
the
right
boxes.
A
Q
Thanks,
chair
yeah,
I
think
it
echoing
lots
of
what
a
number
of
people
have
said.
I
think
particularly
what
stands
out
as
the
most
positive
thing
has
been
just
a
fantastic
partnership
working
across
all
agencies
and
and,
as
a
number
of
people
have
said,
a
real
willingness
to
to
work
differently
and
work
above
and
beyond,
and
and
to
do
things
at
speed
and
at
risk,
because
it
was
the
right
thing
to
do.
A
Q
I
think
really
notable
in
that
was
the
establishment
of
the
community
hubs.
You
know
they
they
happened
very
quickly.
People
were
very
willing
to
go
and
work
in
roles
that
was
not
their
typical
day-to-day
job
and
provided
support
to
you
know
some
of
the
most
vulnerable
people
in
the
community
in
terms
of
food
medical
support,
but
also
that
kind
of
emotional
support.
You
know,
members
of
staff
that
went
and
did
shopping
for
people
who'd
got
particular
health
needs.
Excuse
me
our
particularly
dietary
needs.
Q
So
you
know:
they've
been
they've,
been
really
important
and
valuable
and
have
been
a
combination
of
you
know:
existing
community
groups,
voluntary
groups,
partners,
staff
and
city
of
york,
council
staff
all
working
together.
So
I
think
they've
been
been
really
really
positive.
We've
heard
a
lot
today
around
social
care.
Let's
not
forget
social
care
happens
in
children's
services
as
well,
and
children's
social
care
went
to
virtual
working
in
three
days,
which
is
pretty
remarkable
and
the
front
door.
Q
The
multi-entity
safeguarding
hub
has
been
operating
virtually
since
then
and
has
improved
its
timeliness
has
improved
its
way
of
working
during
a
really
really
difficult
period.
So
you
know
many
congratulations
to
all
the
staff
that
work
in
there,
which
are
city
of
york
staff,
but
also
part
partner
staff
as
well.
One
of
the
things
that
we
will
see
and
are
seen
as
a
consequence
of
this
is
an
increase
in
referrals
into
social
care.
Q
Q
I
think
the
other
aspect
that
that's
in
that
part
of
the
world
that's
worked
really
well
has
been
remote
working.
We
are
seeing
much
faster,
much
better
decision
making
as
a
consequence
of
people
working
virtually
so,
for
example,
if
there
is
a
concern
around
the
safety
of
a
child,
we
have
a
strategy
discussion.
Ordinarily,
that
would
be
a
face-to-face
meeting
which
would
involve
people
having
to
travel,
etc
and
clearly
some
staff
for
gps,
for
example,
aren't
able
to
leave
surgery
to
do
that,
so
historically
have
had
low
attendance.
Q
We
are
now
seeing
really
good
multi-agency
attendance
in
those
sorts
of
meetings,
so
those
are
things
that
we
want
to
hang
on
to
and
keep
as
we
as
we
go
forward
and
come
out
of
the
other
side
of
this.
Hopefully-
and
lastly,
I
just
want
to
talk
about
schools.
I'd
have
to
disagree
a
little
bit
with
what
I
think
sean
was
saying
around
inconsistency
in
schools,
because
I
think
york,
schools
and
academies
board
has
has
worked
together
in
a
in
an
astonishing
way
during
during
this
period
they
normally
meet.
Q
Once
every
six
weeks,
they've
been
meeting
three
times
a
week,
they
have
taken
a
citywide
approach
to
how
how
they
can
work
with
children
safely,
have
taken
a
citywide
approach
to
undertaking
risk
assessments,
sharing
good
practice,
sharing
resources
across
across
schools
and
we've
had
no
outbreaks
in
any
of
our
schools,
and
we've
also
had
one
of
the
highest
numbers
of
vulnerable
children
in
our
schools
across
the
region.
So
you
know
I
I
think
we
need
to.
Q
So,
whilst
it
might
technically
be
school
holidays,
they
are
all
still
working
on
on
what
they
need
to
do,
so
that
most
children
can
get
back
to
school
in
september,
and-
and
I
think
that
really
my
last
point
would
be
picking
up.
What
we
heard
in
terms
of
the
longer
term
impacts
from
peter
of
of
this,
and
what
we
know
is
that
the
best
thing
we
can
do
to
safeguard
a
child
and
the
best
thing
we
can
do
for
a
child's
life
chances
is
to
support
them
to
be
at
school
and
be
at
school
safely.
Q
A
C
Okay,
thank
you
chair.
I
mean
I
would
agree
with
everything
that
everyone
has
said
and
we
often
talk
about
public
health
being
everyone's
business
and
I
think
sometimes
we
struggle
to
clearly
articulate
what
we
mean
by
that.
But
what
I
think
we've
seen
over
the
last
few
months
and
what
we've
heard
over
the
last
you
know
hour
and
a
half,
is
how
york
has
demonstrated
that
public
health
is
everybody's
business
and
you
know
at
its
core.
C
Public
health
is
about
keeping
people
safe,
and
I
think
we've
demonstrated
that
very
well.
So
I
will
probably
end
that
that
bit
just
by
saying
that,
in
terms
of
seamlessly
moving
into
the
next
agenda
item,
then
the
final
agenda
item
is
having
had
all
of
the
discussion
that
we've
had
this
morning.
You
know
peter's
presentation
etc.
C
What,
as
a
board,
do
we
now
want
to
focus
on
maybe
for
the
next
six
months
or
or
longer
term?
If
that's
what
people
want
to
focus
on,
so
we
have
a
health
and
well-being
board
strategy,
a
joint
health
and
well-being
strategy.
We
refreshed
that
strategy
earlier
in
the
year
in
response
to
the
care
quality.
C
We've
talked
about
some
of
the
impacts
of
that
about
health
and
social
care,
but
also
the
wider
determinants
peter
in
his
presentation,
suggested
some
recommendations
that
I
I
think
it
would
be
help
helpful
to
just
spend
a
minute
looking
at
those.
So
in
the
recommendations
they
there
were
four
areas
particularly
summarized
one
was
clearly
we
need
to
carry
on
with
what
we've
been
doing
around
minimizing
the
spread
of
the
virus
and
implementing
our
outbreak
control
plans.
So
that's
a
given.
We
have
to
continue
to
do
that
here.
C
There's
a
highlight
on
mental
health
services
and
and
the
approach
that
we
need
across
our
mental
health
provision
and
to
focus
on
the
new
disease
prevalence
patterns.
What
we're
seeing
and
experiencing
that
has
been
shared
from
our
staff
and
also
and
from
residents
in
terms
of
the
impacts
on
their
mental
health
and
the
other
is
around
healthcare
access.
C
So
we've
talked
about
some
of
the
really
positive
ways
in
which
decisions
have
been
made
quickly
and
to
services,
and
someone
made
a
comment
that
you
know:
we've
done
in
weeks,
what
might
have
taken
two
years
in
in
our
old
way
of
working.
So
how
can
we
hold
on
to
that
and
and
capture
that
going
forward?
C
C
A
Thanks
sean
I'd
like
people's
views
on
two
things,
please:
firstly,
what
we
should
consider
in
our
next
formal
webcast
meeting
and
secondly,
if
you
would
like
to
have
an
informal
unagended
workshop
to
discuss
any
particular
points
that
we
can
then
take
forward
to
a
formal
meeting.
Can
I
have
anybody's
views?
Please
I've
got
two
hands
I'll
just
find
them.
P
Hi
thanks
chair,
I
think,
obviously,
mental
health
is
a
key
element
of
husband
needs
assessment
and
obviously
that
was
taken
at
a
point
in
time.
It
was
really
helpful
presentation,
peter
I'm
sorry.
I
just
came
in
at
the
end
of
that.
But
since
that
point
in
time
we
have
seen
drastic
increases
in
levels
of
acuity
and
crisis
presentations
across
the
whole
of
north
yorkshire
and
york.
P
I
don't
know
whether
it
would
be
useful
for
the
board,
but
as
an
organization
we've
been
doing
a
lot
of
work
around
forecasting
and
what
that
may
mean
and
working
as
part
of
the
system
with
that.
Obviously
other
colleagues
and
partners
around
how
we
will
build
this
back
to
both
pre-corvid
levels
and
also
the
anticipated
mental
health
surge.
And
I
think
what
we
know
and
recognize
is
that
no
one
organization
will
be
able
to
respond
to
to
that.
P
So
how
and
where
do
we
develop
that
and
also
maybe
to
give
an
update
if
it's
helpful
for
the
board?
Obviously,
we're
currently
engaging
with
humber
course
unveil
colleagues
around
the
development
of
the
resilience
hubs
and
the
options
of
prayers
that
will
be
put
forward
which
will
respond
to
the
social
care
staff
care,
home
workers
and
domiciliary
staff
that
have
already
been
mentioned
in
this
meeting.
Yes,
but
if
that
would
be
helpful,
helpful
I'd
be
willing
to
bring
some
information
to
the
next
meeting.
A
F
I'd
encourage
us
to
go
back
to
that
now
and
pick
up
that
conversation
and
use
that
as
a
starting
point
for
where
we
want
to
take
this,
it
was
really
inspirational.
I
think
we
were
all
really
fired
up
by
the
work
we
were
going
to
do
and
then
the
pandemic
hit
us.
So
I
I
would
like
us
to
go
back
to
that
and
pick
up
from
there.
F
F
I
think
I'd
be
guided
by
sharon
and
andrew
really
as
to
how
that
would
be,
but
it
may
well
be
or
it
may
be
a.
I
don't
know
how
you
feel
about
chair
having
perhaps
less
gender
items
on
the
board
on
some
meetings
and
but
more
discussion
around
oh
yeah,
which
I
guess
you
know
is
tantamount
to
a
workshop.
Isn't
it
but
it's
just
a
different
way
of
focusing.
Yes,.
I
A
Right,
I'm
going
to
have
to
close
the
meeting
because
several
people
have
had
to
leave.
I
think
we've
got
enough
ideas
to
work
on,
but
if
there
are
any
more
ideas,
if
you'd
like
to
email,
myself
or
or
tracy
wallace,
we
can
pull
those
all
together
and
then
come
back
to
you.
So
I
just
like
to
say
it's
been
a
very
interesting
meeting
and
everybody
has
contributed
and
I'm
extremely
grateful
for
that
and
we
will
set
up
both
a
workshop
and
another
formal
meeting
and
we'll
notify
that
to
everybody
as
soon
as
that's
done.