►
From YouTube: Health and Wellbeing Board, 11 July 2018
Description
AGENDA (To view individual agenda items click on the links below)
1. Declarations of Interest 00:03:10
2. Minutes 00:03:23
3. Public Participation 00:03:48
4. Appointment to Health and Wellbeing Board 00:04:30
5. Inequalities within the Starting & Growing Well Theme 00:05:30
6. Progress on the Starting & Growing Well Theme of the Joint Health and Wellbeing Strategy 2017-2022 00:26:13
7. Student Health & Wellbeing: Progress Report on Student Health Needs Assessment Outcomes 00:37:22
9. Better Care Fund Update 00:45:48
8. Health Protection Assurance 00:53:35
10. Update on Progress of the York Health and Care Place Based improvement Partnership (PBIP) 01:10:25
11. Report from the Health and Wellbeing Board Steering Group 01:23:32
For full agenda, attendance details and supporting documents visit:
http://democracy.york.gov.uk/ieListDocuments.aspx?CId=763&MId=10535
A
And
we
start
with
any
declarations
of
interest
that
are
not
already
declared
or
on
the
council's
declarations
of
interest.
Are
there
any
declarations
of
interest
in
particular?
No,
that's
fine
good!
A
minutes
of
the
last
meeting.
Did
anybody
who
read
the
minutes
see
any
matters
that
needed
correction
or
can
I
accept
them
as
a
correct
record
of
that
meeting,
everybody
content
there.
A
A
So
if
you
could
just
be
aware
of
putting
a
microphone
on
switching
it
off
when
you're
finished,
so
that
other
people's
microphones
can
go
on
and
speaking
clearly
so
that
people
can
hear
you-
and
we
do
actually
have
quite
a
lot
of
people
who
actually
watch
and
listen
to
us
on
the
webcast,
so
it's
good
that
they
do
I'm
pleased
about
that
day
right.
So
the
first
item,
which
is
page
13,
is
the
appointment
to
the
health
and
well-being
board
and
tours
can
take
us
through
that.
B
A
A
A
On
page
17
agenda
item
5
really
important
that
I
say
to
you.
You
should
have
seen
the
email
which
says
that
44,000
children
are
on
page
34
live
in
York.
They
are
not
all
living
in
poverty.
I'm
pleased
to
report,
but
4705
is
the
correct
number
there.
So
I
hope
that
you've
taken
that
on
board,
because
when
I
saw
it
I
was
extremely
worried.
A
C
Think
good
evening,
colleagues,
apologies
I
didn't
spot
that
statistic,
so
the
report
represents
a
new
way
of
working
for
the
health
and
well-being
board
in
two
respects.
Really
we
flagged
both
of
these
at
the
last
board
meeting,
one
in
terms
of
the
health
and
well-being
board
working
in
a
workshop
fashion,
so
you'll
see
within
the
text
of
the
report.
C
The
workshop
folk
primarily
on
the
obesity
part
of
the
report
and
the
workshop
wanted
to
highlight
five
bullet
points
in
section,
13
of
the
report
has
been
particularly
relevant
to
this
issue,
so
those
about
the
role
and
influence
of
parents.
It
is
about
adults,
says
parents,
say
but
I
think
adults
have
been
role.
Models
for
children,
as
I've
said,
more
interventions
are
targeting
the
protagonist
and
approaching
areas
where
needs
are
greatest
and
need
to
tackle
the
contribute
in
factors
to
obesity
and
and
and
fifthly,
recognizing
that
community-based
approaches
are
often
the
most
effective
for
teen.
C
Para
14
goes
on
to
say
that
those
interventions
are
most
effective,
where
they
involve
families,
schools,
primary
care
and
that
we
collectively
work
together
to
promote
and
support
behavioral
change
through
consistent
messages,
so
again,
I
think
an
area
that
we've
previously
reflected
on
as
a
board.
What
we're
really
good
at
in
York
is
when
we
focus
collectively
on
an
issue.
We
know
that
we
can
make
a
big
difference
and
that
a
really
good
example
of
our
two
good
examples
of
that.
C
So
the
workshop
looks
at
particularly
at
obesity,
childhood
obesity
and
within
paragraph
21
we
are
asking
the
board
to
agree
the
direction
they
wish
to
take
for
reducing
obesity
and
related
to
that
to
consider
whether
we
ask
the
existing
healthy
weight
steering
group
to
develop
some
proposed
souls
of
how
best
those
community
interventions
might
work.
Thank
you.
D
D
Surely
there
must
be
role
for
parents
on
that
health
rate
ceiling
group,
so
we
can
start
to
embed
and
include
people
in
the
thinking
the
delivery
of
the
ideas,
because
I
think
that
we
just
need
to
involve
citizens
a
little
bit
more
and
Patrick
wide
support
for
voluntary
and
community
sector
I
was
thinking.
This
is
a
really
good
opportunity
to
be
able
to
do
it
that
way.
I.
C
C
We
could
invite
parents
onto
that
group
or
we
could
ask
the
group
to
make
linkages
with
the
quite
significant
partnership
structure,
a
permanent
partnership
structures
that
were
already
having
the
same.
We
could
possibly
do
both.
We
could
invite
those
representative
groups
to
sit
on
healthy
weight
working
group.
It's
a
good
suggestion.
Thank
you.
E
It's
partly
a
comment
and
partly
a
question
it
again.
It's
about
what
the
healthy
weight
steering
group
does
going
going
forwards
and
I
think
it's
all.
There's
lots
of
different
elements
in
here,
but
I
think
it's
quite
important
to
emphasize
it's
not
just
about
messaging.
Is
it
it's
not
just
a
lot?
A
lot
of
the
things
that
we've
identified
or
potentially
identified
are
about
structural
issues,
about
the
links
between
obesity
and
poverty,
and
you
can't
necessarily
get
around
that
just
with
messaging.
So
it
needs
to
be
a
whole
combination
of
things.
E
Doesn't
it
and
I
also
wonder,
do
we
have
I
might
just
have
missed
it?
Do
we
actually
have
data
for
York
on
the
relationship
between
obesity
and
income
bans?
Do
we
know
what
we're
dealing
with?
How
many
of
the
children
that
are
obese
are
in
low-income
families?
How
many
are
in
higher
income
families,
and
you
know,
can
we
use
that
to
inform
specific
actions.
F
Fiona
Phillips,
the
trustee
of
Public
Health,
is
the
chair
of
the
healthy
way
shut
alive.
Steering
group,
so
I
was
asking
her
there's
anything
they
want
to
like
if
she
wanted
to
add,
but
we
I
think
it
is
an
interesting
point
about
involving
parents.
I
would
tend
to
agree
with
John's
approach
about
asking
the
steering
group
to
think
about
how
they
can
link
into
existing
ways
of
engaging
with
parents
rather
than
inviting
parents
onto
the
group,
and
the
reason
I
say
that
is.
F
We
know
that
the
the
prevalence
of
childhood
obesity
is
not
equal
across
the
city.
We
know
that
there
is
a
link
to
deprivation
and
low
income,
and
Fiona
has
also
been
doing
some
work
with
GP
practices
and
around
primary
care
home,
and
a
number
of
GPS
have
identified
childhood
obesity
is
one
of
the
areas
they
want
to
focus
on.
So
in
my
feeling
is
that
it's
at
that
local
level,
so
I
would
see
the
steering
group
as
having
the
strategic
overview
developing
the
strategy.
F
But
the
actions
we
need
to
undertake
have
to
be
at
that
community
level
and
that
will
allow
us
to
pick
up
John's
point
in
the
introduction
about
targeting
our
efforts
and
targeting
our
resources
to
where
there
is
that
that
greatest
need
so
working
with
those
communities
with
parents
with
GP
practices
with
schools
and
others
in
those
areas.
I
think
is
probably
the
best
way
forward.
G
So
I'd
pick
up
on
the
point
that
councilor
made
about
the
York
experience
of
the
link
between
deprivation
and
obesity.
The
information
that
we
have
about
children
is
based
on
the
weights
that
we
take
when
children
come
into
school
and
when
they
leave
school
at
primary
school
age.
So
we
have
information
about
schools.
G
We
have
information
about
where
those
schools
are.
Would
it
be
it?
We
did
that
it
would
be
quite
wrong
for
us
to
then
reverse
engineer
that
data
to
look
at
whether
or
not
they're
from
poor
areas
there
I
think
there
are
there
are
there
is
research
and
there's
different
surveys
that
have
been
done.
That
show
that
what
the
specific
information
about
the
specific
earnings
of
that
family
we
don't
have
that
directly.
G
What
we
do
know
is
that
the
schools
with
the
highest
rates
of
childhood
obesity,
are
the
schools
that
take
from
the
poorest
areas
of
the
city,
so
I
think
we
can
accept
that.
The
trend
that
we
see
elsewhere
is
present
here
in
York
in
terms
of
the
the
GP
involvement
in
this
I
would
say
that
the
GPS
need
just
as
much
and
Nigel
speaking,
the
GPS
me
just
as
much
support
and
understanding
this
as
the
general
public.
G
What
we
understand
to
be
childhood
obesity
is
not
necessarily
what
people
imagine
when
they
look
at
pictures
of
kids
on
the
beach
so
obesity
when,
when
you
see
a
child
in
front
of
you,
you
won't
necessarily
know
that
child's
obese,
the
measurements
are
complex,
you
have
to
say
type
and
weight
and
yet
swim
into
a
city.
A
formula.
G
E
Just
following
up
really
that
what
I
always
think,
it's
obviously
very
that,
as
it
says,
the
reasons
are
very
complex
and
I
just
thought.
It
would
be
good
if
we
could
understand
how
much
of
the
increase
in
obesity
is.
Poverty
related,
which
is
kind
of
harder
to
impact
with
messaging,
really
it's
more
useful
to
have
more
income
really
and
how
much
of
it
is
a
growing
thing
that
affects
you,
know
much
wider
group
in
the
city,
but
obviously
so
it's
difficult
to
pin
down
those
statistics.
G
So
poverty
itself
isn't
the
course.
We
know
that
because
if
you
go
to
the
poorest
parts
of
India,
you
don't
see
overweight
children.
The
difficulty
is
that
in
in
an
affluent
western
country,
the
availability
of
food
is
based
on
the
price,
if
you're
comparatively
poor,
the
food
that
you'll
access
is
those
that
are
high
in
calories
and
low
in
cost.
And
so
what
we
have
is
our
poor
areas
of
places
where
the
food
accessed
by
families
is
that
which
allows
them
to
be
fed
and
not
hungry,
but
isn't
necessarily
the
most
healthy.
G
So
there's
a
moment
there,
where
we
can
change
behaviors
for
life,
where
we
can
help
people
that
to
understand
that
physical
exercise
is
part
of
life
and
something
that
we
need
to
do
more
of
that
stay
in
front
of
a
television
and
staying
in
a
car
and
staying
on
the
bus.
Isn't
necessarily
the
right
thing
to
do
that:
eating
healthily,
isn't
just
about
the
number
of
calories
and
not
feeling
hungry.
G
It's
about
the
mixed
food
that
you
have
all
these
things
are
things
that
are
lessons
for
life
and
if
you
look
at
the
longitudinal
studies
of
this,
when
you
look
at
people
who
were
born
in
the
1930s,
when
food
was
actually
quite
scarce,
they
started
a
habit
of
eating.
That
meant
that
we
don't
see
high
levels
of
beasty
in
them
even
into
their
60s
and
70s.
G
In
the
late
40s
early
50s
food
became
suddenly
available
at
the
end
of
rationing,
and
we
know
that
they
do
have
a
propensity
to
obesity,
so
so
there's
and
then
there's
more
complicated
things
to
do
with
the
experience
of
children
in
the
womb.
If
we
intervene
with
children,
we
impact
on
adults
and,
unfortunately,
the
adults
that
are
now
the
parents
have
been
impacted
previously.
So
it's
a
it's
a
whole
system
approach.
That's
needed
at
a
community
level
to
change
the
behavior
of
families,
because
it's
families
that
put
food
on
the
table.
G
I
You
sure
I
was
just
looking
at
the
table,
one
on
page
24
25.
We
didn't
discuss
system
quite
a
bit
yesterday,
you're,
okay,
so
I
won't
make
the
points.
I
did
then,
but
I
just
noticed.
Looking
at
the
statistics,
almost
all
wards
show
at
least
a
doubling
in
obesity
rates
between
reception
and
year,
six
apart
from
Fisher
Gate,
which
is
almost
exactly
the
same,
so
what's
happening
in
Chris
gates,
that's
different
than
everywhere
else
in
the
city
in
terms
of
the
change
in
arista
rates,.
F
Don't
know
the
answer
to
educators
either.
What
I
would
say
is
that
the
picture
we
see
in
New
York
is
similar
to
the
national
picture.
We
know
that
we
have
this
increase
in
obesity
levels
between
reception
and
vr6,
and
that's
been
the
case
for
some
time.
I,
don't
think
unless
colleague
is,
is
aware
of
any
specific
research.
That's
been
done
into
this
I.
F
Don't
think
anybody
completely
understands
why
this
is
a
very
complex
area
and
we
could
spend
all
evening
just
discussing
this
chair
and
we
wouldn't
necessarily
be
able
to
answer
all
of
the
questions
that
are
being
raised.
What
I'd
like
to
propose
is
if
we
look
at
paragraphs
23
in
24
in
the
report.
What's
suggested
is
that
we
asked
the
healthy
weight
steering
group
to
continue
with
the
work
that
it
that
it's
doing
and
and
I
think
some
of
the
discussion
that
we've
had
this
evening.
F
You
know
particularly
around
parents,
involvement,
etc
and
understanding
getting
underneath
some
of
the
data
and
understanding
the
story
underneath
it
has
been
really
helpful,
but
I
would
draw
people's
attention
as
well
to
paragraph
24.
So
myself
and
the
public
health
team
are
doing
some
work
with
public
health
England
at
the
moment
to
look
at
how
we
can
adopt
a
health
and
all
policies
approach
which
we
think
will
work
when
tackling
childhood
obesity,
because
it's
not
about
focusing
on
the
problem
of
a
child
being
overweight.
F
It
actually
takes
that
whole
system
approach
and
will
look
at
everything
that
all
partners
and
all
departments
across
the
council,
for
example,
are
doing.
That
is
helping
to
create
an
environment
which
results
in
children
being
overweight
and
so
I
think
by
asking
the
steering
group
to
carry
on
doing
its
work.
But
how
then
that
reports
back
through
to
the
euro
K
board
I,
don't
know
whether
that
was
agreed
at
the
Euro
to
a
board.
F
A
J
Thank
You,
chair
I'm,
just
wondering
and
regarding
the
healthy
weight
steering
group,
is
there
an
opportunity
to
involve
and
engage
with
people
like
energize
that
are
delivering
exercise
regimes
around
the
area
and
there's
the
new
burn
home
and
various
other
areas.
I
think,
certainly
for
a
calm
world.
We're
looking
at
actually
putting
some
money
into
energized
to
assisters
in
ascertaining
what
we
can
do
for
our
residents
and
children
of
metacenter.
Well,
I
think
it
would
be
worthwhile
to
engage
with
any
journalism.
A
Any
more
questions
or
comments
Oh.
So
if
we
look
at
the
recommendations
on
page
22
to
agree
the
direction
they
wish
to
take,
I
think
the
direction
is
particularly
the
health
and
all
policies
that
that's
very
much
the
direction
and
I.
Think
from
what
I'm
hearing
people
would
like
the
healthy
weight
steering
group
to
bring
some
proposals
because
I
think
those
community
interventions
are
actually
what
it's
all
about,
and
we
certainly
can't
work
those
out
here,
but
hopefully
they'll
Fiona's
nodding.
That's
very
encouraging.
A
Thank
you
very
much
that
and
bring
back
some
proposals
to
us
and
then
I
will
discuss
with
Tracy
where
it
can
go
on
the
agenda.
So
we've
given
enough
time
for
you
to
do
something
and
enough
time
for
the
board
to
consider
it
is
everybody
content
with
that
right?
Thank
you
very
much,
right,
John.
Your
second
report
is
the
progress
report
on
page
37.
C
No,
thank
you
sure,
I
just
to
say
that
it
is
I.
Think
the
second
update
on
this
theme
of
the
health
and
well-being
strategy,
so
I
was
going
to
say
that
I'm
sure
people
are
familiar
with
the
format
the
information
presented
to
them.
I'm
sure
people
have
read
it,
so
it's
it's
I
think
perhaps
open
to
a
discussion.
Basically,
it
follows
the
the
priority
areas
within
this
section
of
the
health
and
well-being
strategy
and
reports
against
those,
and
you
have
a
narrative
report
at
annex
a
and
a
statistical,
KPI
performance,
monitor
dynamics.
Big
thank.
A
C
E
Yeah
again,
I
know
we
have
a
set
of
indicators
that
you're
reporting
against
in
here,
but
it
just
seemed
and
they
were
very
valid
and
useful
and
we'll
build
on
those.
It
just
seems
to
me
that
it
strangely
this
statistic
came
off
of
a
up
about
the
number
of
children
living
in
poverty
and
in
York,
and
it
all
seems
a
bit
strange
to
me
that
that
isn't
an
indicator
that
we're
measuring.
You
know
that
seems
to
me
quite
a
good
measure
of
success.
E
C
It
is
a
really
good
question
and,
and
to
a
certain
extent,
there's
there's
a
bit
of
a
management
speak
response
to
it
in
a
way,
and
it's
about
which
particular
strategy
it
takes
primacy
in
there.
So
we
do
have,
as
as
annex
a
of
the
previous
report
made
reference
to
with
the
York
childhood
poverty
strategy,
2011
to
2020,
to
a
certain
extent
the
health
and
well-being
strategy,
as
in
some
ways
a
superseded
it
because
in
in
the
first
paragraph
it
makes
reference
to.
C
The
strategy
has
the
following
priorities:
the
gap
in
education
outcomes
for
young
people,
the
skills
necessary
for
young
adult
life,
including
employment
skills,
access
to
the
right
financial
support,
financially,
inclusive
fuel
poverty,
legend
facilities,
transport,
youth,
almost
mistook,
not
all
of
those
areas
are
picked
up
either
through
the
health
and
well-being
strategy
or
through
the
children's
plan.
So
we
are
cut
as
as
a
as
a
partnership
as
a
city
we're
covering
those
areas.
C
F
We
maintain
an
overview
of
all
of
the
national
indicators
that
are
published
either
as
part
of
the
public
health
outcomes
framework
or
any
other
works.
So
you
know
John
and
I,
and
and
Martin
in
in
our
roles,
will
will
always
have
a
watching
brief
over
those,
so
that
and
when
certainly
for
the
public
health
outcomes
framework,
which
also
looks
at
child
poverty.
If
we
were
when
looking
at
the
annual
data
release
could
see
that
a
particular
indicator
was
heading
in
the
wrong
direction.
F
We
we
would
notice
that
we
would
pick
that
up
and
then
we
would
want
to
do
further
work
to
interrogate
that.
So
there
is
that
kind
of
watching
brief.
We
have
all
of
the
time,
even
though
not
every
indicator
might
find
its
way
into
a
specific
report,
because
there
are
hundreds
of
indicators
and
we
couldn't
look
at
all
of
them
in
in
those
reports.
So
and
then
there
is
the
local
soft
intelligence
that
we
pick
up
through
the
euro,
k
board
and
other
and
other
partnerships.
F
A
A
F
You're
right,
it
does
look
odd.
There
is
a
glyph,
that's
looking
at
that,
so
we
have
established
an
oral
health
action
group
for
York,
which
does
have
membership
on
that
group
from
the
local
dental
committee
and
a
dental
public
health
consultant
from
public
health
England
as
well.
I
think
our
thoughts
and
Kev
may
want
to
add
something
to
this
is
that
we
might
be
looking
at
over
treatment.
F
So
we
know
from
the
dental
survey
data
that
we
haven't
got
very
high
levels
of
tooth
decay
in
our
children
across
the
city,
and
we
we
know
from
the
HealthWatch
report
that
was
done
in
two
access
to
dentistry,
that
there
are
can
be
some
issues
around
access,
but
generally
children
are
able
to
access
dental
treatment
when
they
need
it,
so
it
could
be
custom
and
practice
locally.
So
that's
one
of
the
theories
we're
working
to
at
the
moment.
Okay,
this
is
not
angel.
G
So
this
is
an
exam
question.
I
think
I
said
that
the
workshop.
This
is
an
exam
question
of
the
Faculty
of
Public
Health.
They
could
give
you
these
exact
graphs
and
poor
registrar's
to
pass
the
exam
have
to
ask
you
get
B
that
question
that
you
just
asked,
and
we
even
present
it
as
a
counselor,
is
asking
you
that
question,
because
this
is
seen
elsewhere.
The
problem
is
that
we're
comparing
areas
that
have
different
levels
of
dental
offer.
G
So
if
you've
got
an
area
that
doesn't
have
dentists
for
kids,
you
have
to
see
a
dentist
before
you
can
be
referred
to
a
spittle
for
an
extraction
and
so
areas
that
have
less
dentists
have
less
extractions
areas
where
there's
more
tooth
decay.
The
dentists
in
some
places
will
tend
to
do
their
own
extractions,
which
don't
get
counted
on
this
data,
because
this
is
hospitals
and
areas
where
children
have
very
poor
dental
health.
Our
last
letters
go
to
a
dentist,
even
if
there
are
entus
so
there's
a
combination
of
all
those
factors.
G
What
do
we
know
exactly?
Sharon
says:
we've
got
good
access
to
dentists.
We
have
good
tooth
health
and
we've
got
a
large
number
of
people
having
extractions
the
usual
rational
explanation
of
that
will
be
that
we're
over
cautious
on
child
extractions
and
shavonne,
and
the
other
dentists
in
the
team
have
looked
at
this
over
many
years
and
it's
been
a
an
ongoing
pattern.
G
Prevents
child
extractions
from
being
done
in
dental
practices?
There's
a
there's,
a
sense
that
dentists,
who
used
to
be
able
to
maintain
children's
teeth,
it's
much
easier
to
refer
an
extract,
so
it's
not
all
because
of
dentists
being
overcautious
or
sending
in
and
the
dentist's
refer
to
somebody
else.
It's
not
a
benefit
to
them.
To
send
me
a
child
in
and
bizarrely
this
is
the
largest
proportion
of
surgery
and
children
right
across
your
chain.
A
That's
a
fascinating
bit
of
information,
you're
full
of
fascinating
facts,
really
aren't
you
and
we
haven't,
got
my
Proctor
here
to
comment,
unfortunately,
but
it
that
is
very
interesting.
It's
puzzled
me
for
a
long
time.
I
couldn't
understand
why
the
decay
is
low
and
the
extractions
are
high
are
still
not
sure.
I
completely
understand
it.
Yes
and.
F
That's
obviously
costing
the
system
a
lot
of
money
having
all
these
children
admitted
to
hospital.
That
I've
just
been
passed.
A
note
that
says
that
part
of
the
work
that
they
you
oral
health
actually
be
looking
at
is
doing
a
survey
of
all
dentists
over
the
summer.
So
the
work
with
the
local
dental
network
has
supported
that.
So
there
will
be
a
survey
done
of
all
dentists
over
the
summer
to
understand
referral
practices.
A
K
There
is
an
action
plan
which
was
included
in
the
annex,
which
addresses
the
recommendations
that
were
made
on
the
report,
and
the
report
highlights
some
of
the
examples
of
work
that's
being
picked
up
mostly
within
the
institutions,
to
better
support
the
health
and
well-being
of
students.
We
had
a
meeting
this
morning
of
the
network
so
in
terms
of
kind
of
further
updates.
K
You
know
there
was
nothing
particular
over
and
above
what's
in
the
reports,
you
had
other
than
that
some
of
the
waiting
times
being
reduced
on
I
apt,
so
there's
a
kind
of
an
anticipation
that
maybe
some
of
the
demand
back
into
counseling
services,
where
we've
seen
students
being
referred
back
to
university
counseling
services,
because
there
hasn't
been.
That's
luck
in
the
system
to
pick
them
up
so
hoping
that
some
of
that
will
start
feeding
through
and
helping
to
manage
some
of
that
demand,
but
really
have
a
team
for
questions
and.
L
Not
really
any
more
than
that's
in
the
report,
but
I
suppose
just
the
one
thing
to
say
is
that
you
know
having
come
here
about
last
year:
I
think
it
was
with
the
results
of
the
student
health
needs
assessment,
I
think
it's
been
really
positive.
There
were
that
has
been
done
over
the
last
year
and
I
think
there
are
areas
where
we're
actually
sort
of
starting
to
see
some
progress.
Now
so
I
think
you
know
that's
really
positive,
and
we
should
acknowledge
that.
A
M
Sorry
so
just
thinking
about
holy
to
previous
meeting
me
I
was
reading
a
minute
so
that
the
you've
got
a
high
proportion
of
being
me,
students
within
our
higher
education
department.
So
the
mental
health
assessment
and
the
mental
health
needs
in
relation
to
those
services.
Does
it
take
account
of
the
father?
We've
got
varying
BM
e
students
and
obviously
mental
health
impact
on
them
is
different.
K
I
think
there
are
being
students,
but
also
international
students,
which
are
identified
as
students
where
actually
some
of
the
cultural
factors,
particularly
affecting
mental
health,
are
significant
within
the
higher
education
systems
themselves
and
their
services.
They
are
looking
at
how
to
provide
more
dedicated,
supports.
I
think
one
of
the
big
challenges,
culturally
is
getting
people
to
disclose.
K
There
are
sort
of
there's
the
the
action
plan
that
you've
been
given
has
been
the
one
that
has
been
developed
for
the
network
sort
of
as
a
whole,
but
within
the
universities
themselves
and
the
colleges
they
also
have
their
own
sort
of
action
plans
as
well,
which
are
more
detailed,
and
that
is
definitely
something
that
they're
aware
of
and
working
towards.
I'm,
not
sure
I
could
give
you
a
definite
answer
as
to
how
that
impacts
in
the
practice.
K
K
I
think
that
was
mostly
just
to
say
that
actually
on
the
network,
we
haven't,
got
CCG
representation,
so
really
a
question
to
the
board
of
whether
whether
that
does
need
to
be
someone
from
the
commissioning
group
who
attends
those
network
meetings
and
who
the
who
the
most
appropriate
person.
That
would
be
so,
maybe
if,
if
an
action
off
the
back
of
this,
the
thing
to
pick
that
up.
That
would
be
great.
K
K
But
then
also
the
GP
representation
as
well,
so
there
are,
we
do
have
from
quite
a
big
distribution
list
on
that
network,
but
it
does
tend
to
be
us.
You
know
often
happens
with
these
things,
but
it
does
tend
to
be
there
actually,
some
of
the
primary
care
involvement
that
there
was
at
this
stage
when
the
network
was
initially
set
up.
Some
of
that
attendance
has
dropped
off
actually
so
so
we're
not
getting
gp's
represented
around
that
group
as
well.
So
again,.
A
D
A
What
quite
happy!
Well!
Thank
you!
A
million
Fiona,
it's
a
good
report.
It's
very
interesting
and
I
hope
that
people
come
back
to
us
at
some
point.
If
we
look
at
the
recommendations
on
page
70,
we've
considered
the
content
and
the
work
of
the
network,
and
we
approve
the
receipt
of
the
progress
updated
in
one
year.
Yes,
we
all
happy
with
that.
That's
brilliant
thanks!
Very
much
I
think
all
the
work
I've
been
doing
with
Andy
Chapman
about
suicide.
Safer
community
becomes
extremely
important.
A
That
is
not
the
only
health
issue
of
the
student
population
and
it
is
not
only
a
population
where
this
happens,
but,
on
the
other
hand,
I
think
there's
been
significant
progress
by
the
further
and
higher
education
community
in
addressing
both
the
mental
and
physical
health
of
their
students
that
that's
what
I
see
and
I
hope.
You
see
that
yes,.
K
Thank
You,
chair
and
just
also
to
say,
I,
think
there
was
a
query
raised
when
the
papers
went
went
round
about
how
this
work
linked
in
with
cameras,
provision
and
other
kind
of
the
mental
health
work.
So
just
say
that
you
know
those
links
are
being
made
either
through
myself,
but
we
also
have
active
members
of
the
student
support
teams,
who
are
very
much
involved
in
working
groups
around
transitions,
suicide
prevention
on
the
mental
health
partnership
as
well
good.
A
Know:
okay:
now
we
go
on
now
we're
doing
frightfully
well
today
and
we've
got
item
H,
all
the
numberings,
although
we
haven't
got
paper
here
at
the
moment,
so
I
think
Fiona.
Would
you
mind
doing
your
health
protection
assurance
until
she
appears
from
upstairs,
as
you
happen
to
be
here,
if
she
isn't
we're
very
grateful
to,
if
you
would
so
I,
don't
know
what
number
paid
you've
got
it
I've
got
to
just
page
77.
So
thank
you.
Fiona
I
appreciate
that.
L
And
so
we
brought
a
report
to
the
half-a-mile
being
board
last
year
on
health
protection
and
there
are
a
number
of
areas
in
there
where
we
identified
we
needed
to
make
improvements.
So
this
report
is
really
a
one
year
on
update
on
where
we
sit
around
health
protection
and
what
progress
we've
made
and
so
I
mean
I'm.
Happy
to
you
know.
L
If
people
have
read
it,
if
there
are
questions
that
they
want
to
ask
I
think
the
main
point
to
raise,
and
is
that
you
know
in
those
areas
last
year
where
we
said
we
needed
to
do
better
in
the
majority
of
them.
We
can
see
that
we
we
have
made
good
progress.
There
is.
There
are
obviously
still
improvements
that
we
can
make,
but
largely
things
are
going
in
the
right
direction.
But
on
happy
to
to
answer
any
specific
questions
that
anybody
has.
F
F
Given
that
some
of
the
data
is
on
a
veil
of
york
basis,
but
if
we
take
some
of
the
work
that's
happening
at
the
moment
around
infection
prevention
and
control,
TB
control,
where
we
we
we
know
we
need
to
review
those
arrangements
at
the
moment.
It
would
make
sense
to
look
at
some
of
that
on
available
basis.
So
that's
work
that
I'm
intending
to
take
forward.
A
N
F
I'm
not
entirely
sure
when
I
took
sighs
appointed
a
stretch
of
Public
Health,
but
just
over
two
years
ago
now
at
that
point,
York
weren't,
formal
members
of
that
committee,
and
it
was
something
that
I
put
in
place
after
being
appointed
and
and
said
that
you
know
there
needed
to
be
a
York
focus
as
well,
so
that
arrangement
has
been
in
place
for
about
two
years.
I
would
say
an
elements
of
that
Oh
as
are
working
quite
well.
F
A
I
Specific
about
that,
and
just
on
page
28
and
progress,
five
you're,
just
looking
at
the
improvements
and
things
and
just
I'm
just
kind
of
tying
together,
something
that
came
up
with
the
Euro,
cable,
yes
and
I.
Think
is
within
this
report
about
the
contact
rates
for
two-year-olds
with
health
visitors,
and
it
just
seems
to
me
that
some
of
these
things,
like
improving
uptake
of
seasonal
flu
vaccines
and
improving
the
uptake
of
maternal
vaccinations
and
second
dose
of
MMR.
L
Yes,
so
absolutely
you'll
know
that
those
contact
rates
for
two-year-olds
have
been
improving
over
the
last
year,
and
you
know
some
of
our
rates
of
uptake
of
immunizations
have
likewise
been
improving.
So
absolutely
those
you
know
that
is
one
of
the
chemo
methods
of
getting
that
message
out
there
to
parents.
So
we
work
very
closely
with
the
naught
219
service
around
those
messages
and
making
sure
that
you
know
every
opportunity
where
we
come
into
contact
with
parents.
We're
all
saying
the
same
thing
that
it's
really
important
about
immunizations,
so
yeah
and.
A
A
Helps
me
and
just
the
word
vaccine
in
there,
it
does
look
slightly
odd,
if
not
right,
so
the
recommendations.
Now
on
page
83,
we're
asked
to
receive
a
report
from
note
the
content
which
we
have.
We
asked
to
the
to
establish
the
or
to
continue
to
establish
the
local
Health
Protection
Committee,
as
the
committee
content
with
that.
Yes,
okay,.
A
N
Thank
you.
So
my
name
is
Pippa
corner
I'm,
the
assistant
director
for
and
commissioning
for,
Vale
of
York,
CCG
and
City
of
York
Council,
and
in
that
role,
I
am
the
York
health
and
well-being
board
better
care
from
bleed.
So
this
report,
just
fairly
briefly,
gives
some
headlines
about
the
progress
that
we've
made
on
the
better
care
fund.
Since
it
was
last
here
which
actually
is
a
few
months
ago,
I
think
now
I
think.
The
overall
message
of
the
report
is
that
we
are
making
progress.
N
We
understand
the
targets
have
been
eased
slightly,
but
we
would
still
be
very
challenged
to
actually
meet
them
in
this
year,
and
that
is
the
reason
why
I've
also
drawn
attention
to
the
that,
as
as
we
understand
it,
we
will
have
conditions
placed
on
our
use
of
the
improve
better
care
fund.
The
IBC
F
by
government
and
although
I
don't
think,
we've
had
the
official
letter
yet
to
to
say
that
this
is
now
in
place.
N
We've
kind
of
had
the
letter
that
says
if
we
will
get
the
letter,
that's
interesting
as
that
sounds,
and,
however,
the
national
conditions
that
are
being
placed
on
areas
with
poorer
performance.
Around
delayed
transfers
relate
to
using
the
fund
to
ease
pressure
on
UNH
s,
to
reduce
the
bays,
and
actually
that
is
what
we
are
using
our
fund
to
do.
So
until
we
see
the
detail,
I
think
it's
reasonable
to
assume
that
actually
we
will
comply
with
those
conditions
and,
and
that
shouldn't
be
a
problem.
N
I
think,
alongside
all
of
that
aspect,
which
might
seem
more
technical
and
certainly
runs
to
the
restaurants
process.
The
other
part
I
wanted
to
be
able
to
share
with
partners
is
actually
we've
had
some
really
good
events
during
May
to
relaunch
the
better
care
fund
for
York
and
to
think
of
it
much
more
as
a
lever
for
change
and
transformation,
developing
integration
and
trying
to
define
what
integration
might
mean
for
York,
rather
than
it
simply
being
another
spreadsheet.
N
The
conclusion
certainly
seems
to
be
that
people
are
really
comfortable
with
the
version
of
integration,
which
is
about
partnership,
collaboration,
working
together
and
certainly
prevention,
a
real
strong
focus
on
prevention,
and
that's
where
better
care
fund
needs
to
find
its
niche,
so
I
hope
the
report
and
can
I
give
that
overview.
That
people
need
to
see
and
I.
Think
we've
talked
about
possibly
bringing
some
of
those
case,
studies
back
to
a
future
meeting
where
we
could
get
down
to
the
nitty-gritty
of
what
it
means
for
local
people.
A
E
Okay,
I've
got
two
questions,
I
think.
First,
one
is
you've
you've
given
us
quite
a
number
of
pages
of
the
documents
about
the
high
impact
change
model
and
I
may
just
be
not
reading
this
correctly,
but
have
we
actually
got
anything
that
tells
us
where
we
are
on
that?
So
we
plans
in
place?
Are
we
established
or
are
we
I.
N
N
So
we
have
provided
a
return
which
says
that
we
have
an
established
approach
to
early
discharge
planning,
which
was
progress
on
the
previous
quarter.
Lieutenant
said
we
have
plans
in
place
for
most
of
the
other
areas,
we're
still
at
the
stage
of
plans
in
place
but
expecting
to
have
established
arrangements
in
the
next
month
or
two.
Now
we
have
white
cautious
about
the
claims
we're
making
about
the
progress
we've
made.
N
There
are
some
of
the
other
areas
that
perhaps
were
older
about
their
claims
didn't
get
that
opportunity
to
bid.
So
the
other
part
of
the
return
says
well,
what
are
your
challenges
and
even
where
we
said,
we've
got
early
discharge
planning
established.
We're
saying
we've
still
got
some
real
cultural
challenges
to
achieve
the
change,
that's
necessary
across
the
patient
journey.
So,
although
we're
implementing
the
safe,
bundling,
Foundation
Trust,
actually
not
in
every
ward,
is
it
delivered
in
the
way
that
the
scheme
would
suggest
that
you'd
want
that?
You
know
in
an
ideal
world.
N
So
we
certainly
can
provide
quite
a
lot
more
detail
on
that,
but
I
need
some
help
to
digest
the
data
into
a
format.
That's
helpful
for
the
support
and
we're
just
about
to
submit
another
return
for
Johnathan.
The
next
return
is
during
the
20th
of
July,
so
we'll
be
further
forward
again,
so
we
could
circulate
something
with
the
minutes.
If
that
would
be
helpful,
I
think.
O
I'll
get
with
it
sorry,
I
didn't
leave,
wasn't
able
to
leave
hold
till
about
quarter
past
Warsaw,
apologies
and
I.
Think
we've
made
significant
progress,
I
think
what
you've
talked
about
in
terms
of
the
discharge,
her
band
and
the
work
that
we're
still
in
underneath
the
the
the
guys
of
the
accented
emergency
delivery
board
and
all
those
types
of
things
has
made
a
big
difference.
O
You
know
in
overall
terms
the
length
of
stay
for
our
elderly
patients
has
dropped
from
about
eleven
days
to
about
seven
on
average,
I
mean
that's
just
just
a
massive
change,
actually,
there's
still
a
lot
to
do
and
I
think
and
there's
still
a
significant
number
of
patients
in
our
cube
beds.
That
actually
didn't
even
be
in
our
cube
pets,
and
that
would
make
a
big
difference
if
they,
if
they
were
moved
on
and
got
appropriate
services
elsewhere.
O
A
P
Speakers
John
mentioned
earlier
so
stranded.
Patients
I
think
there's
a
real
challenge
in
places
like
New
York
around
how
you
support
people
who
we
would
refer
to
in
local
government
languages,
self
funders
the
people
who
largely
funded
through
the
local
authority.
We
get
hold
of
an
assessor
move
on,
but
seventy-five
percent
of
the
population
are
not
people
that
we
fund
and
provide
support
to
and
there's
a
whole
range
of
just
because
you
have
a
little
bit
of
money.
We're
not
talking
about
people
who
are
extremely
well-off.
P
We're
talking
about
people
who
are
beyond
the
financial
care-
and
you
know
they
worry
about
the
impact
for
them.
They
don't
know
where
to
go
to
so
I
think
one
of
the
issues
for
us
is,
as
the
chair
is
mentioned-
I
think
the
stuff
around
better
information
and
advice
on.
How
do
we
do
that
consistently
across
the
system?
We're
certainly
engaging
with
primary
care
and
GPS
around
that,
because
they
could
keep
people
away
from
them.
P
We're
seeing
the
impact
of
local
area
coordination,
things
like
social
prescribing
earlier
intervention
and
prevention
around
mental
health
and
people
who
are
quite
lonely
and
isolated.
The
role
of
the
voluntary
and
community
sector
is
significant,
because
what
you
find
is
a
lot
of
older
people
because
of
a
deterioration,
physical
mobility,
often
a
lot
of
the
time
they
become
quite
isolated.
How
do
we
get
through
to
care
us
and
want
us
you're,
expendable
errors?
Carers
focus
that
we
have
so
I
think
there's
a
plethora
of
things.
P
What
we
haven't
been
good
at
the
hairshirt
moment
is
we're
not
systemic
across
the
system,
so
some
agencies
are
better
at
it
than
others
and
I.
Think
we've
been
too
focused
on
getting
people
out
of
hospital,
rather
preventing
as
many
going
to
both
primary
care
and
secondary
care.
It's
not
just
secondary
care.
The
pressure
put
on
primary
care
filters
through
the
system
and
we
start
at
the
wrong
place
to
get
the
solution.
P
If
you
like
I,
think
York
is
in
a
far
better
place
than
many
others,
but
we
need
to
capitalize
that
I
mean
as
despite
all
the
positive
progress
we've
made
I
it's
almost
like
you
could
do
a
prediction
of
where
we'd
be.
If
we
weren't
doing
those
things
because
we've
been,
we
would
be
the
worst
performing
in
the
country.
I
think,
but
I
do
think
that
we
do
need
to
recognize.
P
A
N
We
know
that
actually,
the
we
have
a
large
portion.
We
were
delayed
in
mental
health
services
because
there
are
older
people
with
very
complex
needs
and
we
don't
have
readily
available
placements
for
them
immediately
when
they
need
them.
Everybody
that's
waiting,
is
actually
waiting
for
a
type
of
care,
either
care
at
home
in
their
own
home
or
a
placement
that
isn't
available
just
yet,
but
people
I
think
are
waiting
fewer
days
and
people
aren't
generally
waiting
for
assessment.
N
O
O
But
it's
just
a
really
honest
conversation,
which
is
simply
I'm
afraid.
You
can't
stay
here.
Let's
work
on
what
the
alternatives
are
for,
where
we,
where
you
can
actually
go
and
and
they're
often
not
difficult
conversations,
but
some
of
the
people
on
the
front
line,
find
it
really
difficult
and
actually
to
find
the
time
to
have
those
conversations
where
they
can
sit
down
with
somebody
and
spend
half
an
hour,
45
minutes
with
an
individual.
O
That
explains
what
those,
what
those
options
are
and
I
think
by
understanding
that
sometimes
we've
asked
people
to
do
really
difficult
things
and
actually
taking
that
responsibility
away
from
them
and
giving
it
to
somebody
else.
Then
that's
been
a
success
too.
So
I
think
I
think
there's
still
something
to
do.
There's
still
work
to
be
done
on
on
fast
track
and
alive.
I
started
this
work
to
be
doing
an
assessment
you
know
to
mean
and
that
the
assessing
patients
about
what
their
future
needs
are.
O
A
Really
interesting
margin,
it's
very
profound,
I
think
this
business
of
time
is
absolutely
key,
because
if
you
just
dismiss
what
somebody
is
saying
never
get
to
the
what's
sitting
underneath
it,
then
you
don't
really
make
progress.
So
it's
really
good
I'm
glad
you
arrived
in
time
to
contribute
to
that
discussion.
A
Very
much
appreciate
it's
good
that
that
report
is
only
to
note-
and
we
have
noted
it
and
without
some
questions
about
it
and
we're
grateful
clipper
because
as
I
say
it's
something
that
has
exercised
the
cumulative
brains
of
the
health
and
well-being
board
for
some
considerable
time
right.
So
we
go
on
now
to
agenda
item
10
on
page
113,
and
this
is
the
report
from
the
place-based
improvement
panel,
which
I
think
Martin
is
speaking
to.
P
Reviewing
interesting
enough,
which
isn't
in
here
just
as
some
peculiar
information
is
that
CQC
and
the
Department
of
Health
are
holding
a
national
event
in
September
to
learn
from
the
first
now
20
sites
I
get
to
go
on
where
to
house
actually
but
to
represent
two
places.
But
there
is
a
I
think
it's
some
learning
that
that
some
of
these
things
have
not
been
as
systematic
as
they
should
have
been
and
to
maybe
get
the
ownership
greater.
The
expectation
I
had
when
it
came.
P
It
was
that
it
should
be
something
that's
rolled
out
and
I'm,
pretty
confident
to
say
that
the
outcome
of
September
will
be
that
low
and
behold.
Cqc
will
suggest
that
they
should
go
and
do
this
to
every
locality
and
that
they
will
then
be
employed
to
do
it.
The
key
things
anyway
for
tonight
are
just
that.
The
meetings
obviously
have
continued.
P
They
have,
as
you
would
expect,
develop
the
terms
of
reference
which
you've
got
there
as
an
appendix
and
I
think
it's
just
about
setting
out
about
the
ownership
and
the
engagements
and
the
one
of
the
key
things
that
they've
done
and
it's
one
of
our
failings
historically
is
sometimes
we
have
very
great
ambitions,
and
then
we
don't
resource
them.
And
then
we
have
do
I,
see
your
progress,
because,
fundamentally
it's
just
added
on
to
somebody
else.
We
have
got
a
commitment
across
the
key
agencies
for
them
all
to
contribute
to
resource
it.
P
I
think
that's
positive
in
several
ways.
One
is
that
it
spreads
the
burden.
Secondly,
it
I
think
gets
a
commitment
from
all
of
the
agents,
because
they've
all
then
got
some
skin
in
the
game.
And
thirdly,
as
I
said,
it
gets
the
capacity
that
you
need
so
I,
don't
see.
Personally,
that
was
a
contentious
thing.
A
E
Yeah
I
just
wanted
to
ask
about
the
relative
reference
to
the
terms
of
reference
and
engagements
with
the
wider
public
I
know.
The
intention
is
to
report
to
this
board
its
intervals,
I
believe,
but
it
doesn't
seem
entirely
clear
how
members
of
the
public
are
necessarily
going
to
know
what
ideas
are
being
developed
in
the
in
the
whatever
it's
called
P
being
a.
J
E
You
know
a
series
of
the
early
stage.
It
I
can't
think
how
many
of
us
before
if
the
minutes
will
be
published
and
I,
can't
remember
if
the
answer
was
yes
or
or
no,
you
know
the
paragraph
5.
It
does
talk
about
requiring
some
involvement
of
members
of
the
public
to
be
reported
to
the
place
based
partnership,
but
how?
How
will
we
go?
How
are
people
going
to
know
what's
going,
what's
really
being
decided,
there
are
sub
I
might
be
thinking
of
an
odd
choice
moment.
E
P
P
P
It's
an
opportunity.
So
we've
got
you
know.
Is
it
several
of
the
people
that
sit
on
a
partnership
in
the
room
for
them
to
take
things
gently
or
less
generally,
to
have
a
conversation
about
where
they're
feeling
that
people
aren't
living
up
to
what
they
said
they
were
going
to
do
or
that
they're
not
getting
the
support
that
they
need
or
ideally
and
I.
Think
we've
been
bad
at
this
in
Europe
to
go
and
say:
we've
got
a
real
problem.
Can
we
share
our
problem,
and
can
you
go
you?
P
Can
you
people
help
I
think
what
we
tend
to
do
is
find
a
way
of
explaining
away
the
problem
or
pretend
there
isn't
a
problem
until
it
comes
out
in
some
other
manifestation
and
I
know.
That's
difficult
and
I
know
that
some
of
my
political
colleagues
have
difference
of
opinion
in
terms
of
that
everything
might
need
to
be
more
transparent
in
everything
out
in
the
open.
P
Don't
say
this
in
a
disrespectful
way
to
the
CCG,
but
not
just
the
CCG,
as
the
Commissioner
they're
there,
as
practitioners
and
as
people
who
deal
with
the
public
we
and
they
have
got
a
collective
view
to
go
back
to
so.
In
this
case,
it's
Mike,
Holmes
I,
don't
think
is
any
issue
you
knowing
who's
on
that
representation.
P
I
can
assure
you,
and
certainly
when
we
had
our
peer
challenge,
the
police
should
get
a
big
head
for
this
I
mean
they
asked.
Could
we
take
your
police
force
with
us
because
you
know
they
hadn't
had
that
of
engagement
in
another
place
which
isn't
too
far
away
in
Yorkshire?
So
you
know,
that's
that's
a
good
thing.
It
is
maybe
not
it's
a
baby,
a
compromise,
but
you
know
we've
got
to
recognize
what
it
is
we're
trying
to
get
out
at
the
end
of
it.
P
A
Can
I
ask
the
hang
on
a
sec?
Can
I
ask
in
paragraph
20
when
one
way
I
lost
the
board,
knowing
at
whether
the
the
report
back
will
be
approved?
But
would
it
say
in
there
a
summary
of
what
has
been
decided?
What
has
been
suggested
to
give
because
I
think
the
health
more
people
do
want
a
flavor
of
what's
going
on.
P
I'm,
not
myself,
a
member
of
that
group,
it's
the
chief
officers,
but
we
obviously
do
a
lot
of
support
and
preparation,
very
both
shot,
sharing,
John
and
myself
and
I'm.
Sure
Kevin
will
do
the
same
with
with
his
boss,
and
Mike
would
have
done
the
same,
but
now
Mike
will
be
supporting
himself
because
he's
now
there
and
so
on.
P
One
of
the
key
things
that
was
stated
is
that
there
should
be
a
note
that
could
go
out
to
say
these
are
the
key
things
that
we
discuss,
but
it
was
not
expected
to
go
into
detail
and
it's
not
about
hiding
it.
It's
about
saying
that
the
meetings
aren't
minuted
in
that
way.
It's
a
partnership
where
people
get
together
to
say
are
we
doing
the
best
we
could
possibly
do.
Should
we
be
doing
more?
Should
we
do
be
doing
something
different?
P
O
E
Very
brief
comment:
cuz
that
you've
already
said
quite
a
lot
of
it,
but
I
do
think
it's
important
that
there
are
reports
on
a
regular
basis
of
it,
particularly
anything
that
is
a
significant
change.
That's
come
from
those
discussions
and
that's
that
of
the
least
and
I
take
it
minutes
are
not
public,
because
you're
saying
minutes
are
not
done
in
that
way.
I.
P
Think
the
intention,
given
the
time
frames,
would
be
to
make
sure
there's
a
report
back
to
each
health
and
well-being
board.
So
this
stage
I
shouldn't
I,
think
you
should
have
as
a
standing
item,
but
we
need
to
make
sure
that
the
health
and
well-being
more
members
see
the
communication
that's
drafted
following
the
meeting
I,
don't
know
if
it
has
to
do
with
other
significant
events
that
may
be
happening
us
sometime
very
soon,
but
there
unfortunately
they're
meeting
that
was
due
for
today.
I
think
it
was
more
that
dis
actually
they're.
O
O
A
A
F
You,
chair
I'm
not
intending
to
go
through
the
report
and
then
at
all
it's
it's
really
just
to
update
the
board
on
the
activities
that
the
health
and
well-being
board
stew
and
group
have
been
undertaking.
So
I
think
the
report
is
fairly
self-explanatory,
so
I'm
happy
to
take
any
questions,
and
otherwise
the
report
is
really
for
noting
by
the
by
the
board.
A
Are
there
any
particular
questions
on
the
report
on
the
steering
group?
No,
that's
great.
Thank
you
shine
model
of
clarity.
Thank
you
right
now.
You
will
notice
in
that
report
on
page
129,
it
talks
about
changes
in
membership
and
there
will
be
changes
in
membership
and,
as
a
result
of
that,
I
want
to
say
under
any
other
business.
A
So
I
would
like
to
record
those
things
and
I've
agreed
with
Tracy
that,
as
those
positions
are
changed,
that
people
are
appointed,
we
will
let
everybody
know
by
email,
and
then
it
will
come
formally
to
the
board
on
the
next
occasion.
Just
so
you
know
who
to
expect
so
I
think
I
don't
have
any
other
business
unless
anybody
wants
to
raise
something
very
urgent
which
I
sincerely
hope
they
don't,
because
we're
they
are
going
to
be
five
minutes
early,
which
is
a
miracle.