Members of the Board are asked whether they have any personal or prejudicial interests in connection with any application on the agenda and, if so, to declare them and state the nature of the interest.

Councillor C Jones declared a personal interest by virtue of her employment with the Cheshire and Wirral Partnership NHS Foundation Trust.

 Councillor Phil Gilchrist declared a personal interest in general by virtue of being Cheshire and Wirral NHS Partnership Trust Appointed Governor.

Apologies were received from Councillor J Green, Mr G Hodkinson, Director of Adult Social Services, Councillor T Smith, Cabinet Member Children and Family Services, Andrew Cannell, CEO Clatterbridge Cancer Centre, Andrew Crawshaw, NHS England and Paul Murphy, Mersey Fire and Rescue.

To approve the accuracy of the Minutes of the meeting of the Health and Wellbeing Formal Board held on 12 November, 2014.

Resolved – That subject to the removal of the comment attributed to Dr Pete Naylor in the second paragraph of Minute 66 Update on response to Better Care Fund that the accuracy of the Minutes of the Health and Wellbeing Formal Board held on 12 November, 2014 be approved as a correct record.

The Board considered a report of the Director of Public Health that outlined  Wirral Health and Wellbeing Boards participation in a Peer Challenge process during 26-29 January, 2015.  The Peer Challenge was the Local Government Association’s health and wellbeing system improvement programme, co-created with a number of national organisations (e.g. Department of Health, NHS Confederation, Public Health England).

During the four days of the visit the Peer Challenge team had run 42 sessions and met with 84 people to support their understanding of five headline questions.  The membership of the Peer Challenge team, and the key questions were provided in Appendix 1 of the report. While feedback had been given through a presentation shortly after the visit, Wirral Health and Wellbeing Board had received the letter from the Peer Challenge team included in Appendix 1 of the report, which detailed the main findings from the review and the key recommendations.  The Board was now required to receive this letter and consider its next steps in response to the recommendations made.

The report noted that the Wirral Health and Wellbeing Board had identified the need for a clear vision, with a narrative for Wirral, together with effective programme management and communication with wider stakeholders as crucially important.  The Peer Challengers had recommended that the partnership structure on Wirral be reviewed and the place of the Wirral Health and Wellbeing Board be clarified along with other partnerships and working groups that existed.

The report also noted a significant component of the peer review feedback focussed on the need for a clear narrative and strategic direction for the Board. It was reported that a piece of work had recently been undertaken to identify the key themes within the vision statements of key partner organisations. From this work, a number of draft strategic aims were listed in the report which could accompany the overarching vision statement.

Fiona Johnstone, Director of Public Health, commented that the Board was being asked to reflect on the Peer Review feedback. There was a general view that Board members were concerned that the Board did not have measurable outcomes. Councillor Phil Davies suggested that a smaller group could look at the broad strategic aims for the Board and report back to a Health and Wellbeing Board Development Session.  Fiona Johnstone stated that this would be welcomed and asked for the nomination of a representative from each partnership for this group to be set up.  It was agreed that this group could take another look at Wirral’s Joint Strategic Needs Assessment, how the Board could carry out effective communication and engagement and give consideration to examples from other Health and Wellbeing Boards for reference. Its recommendations would be brought back to the Health and Wellbeing Board Development Session.

Resolved – That;

1.  The feedback letter from the Peer Challenge Team dated 7 February, 2015 be noted.

2.  The Director of Public Health be requested to set up a smaller group with the purpose of looking at a single vision, strategic  ...  view the full minutes text for item 79.

Members gave consideration to a report of Wirral Partners that informed the Board that Wirral had recently been successful in bidding to be a Vanguard site for the national Five Year Forward View programme developed by NHS England.  The intention of the programme was to test the models of care described in the NHSE December planning guidance - The Forward View into Action.

It was reported that initially, NHSE had invited interest in four models:

•  multi-specialty community providers (MCPs);

•  integrated primary and acute care systems (PACS);

•  additional approaches to creating smaller viable hospitals; and

•  models of enhanced health in care homes.

It was reported that the Wirral bid had been submitted in partnership with three other organisations: Cerner UK Ltd (cornerstone partner in the delivery of informatics solutions and promotion population health management), Advocate Physician Partners ACO, (USA)(cornerstone partner in the delivery of modelled Accountable Care Organisation deployment and learning) and the King’s Fund (cornerstone partner in the delivery of research, learning, evaluation and dissemination).  A copy of the submitted application was attached to this report.

Wirral Health and Wellbeing Board partners were committed to developing a Vision for future health and social care services on Wirral since 2014.  A significant amount of activity had been taking place to develop programmes and work-streams that would deliver positive services for our local population, while at the same time promoting prevention, and enabling effective demand management.  The Vanguard programme provided an opportunity to integrate the ideas outlined in the Five Year Forward View with the existing approaches being developed through Vision 2018.  The bid that was submitted was attached as Appendix 1 to the report.

Anthony Hassall Executive Director of Strategic & Organisational Development attended the meeting and gave members a presentation on ‘New Models of Care for the Wirral’.

Resolved – That;

1.  the successful outcome of Wirral’s application to be a Vanguard site for the Five Year Forward View be noted.

2.  the Health and Wellbeing Board receive regular feedback on progress with this initiative.

A report of the Director of Adult Social Services provided an overview of the latest position of the Better Care Fund (BCF). The BCF had been signed off with assurance from NHS England in September 2014. The BCF represented partnership working between the Clinical Commissioning Group (CCG), Local Authority and key providers.

Jacqui Evans, Head of Transformation, Adult Social Services attended the meeting to provide an overview of the report and responded to Members questions.

It was reported that there has been a recent review of the original schemes to ensure that they remained aligned with Vision 2018, the CCG 5-year plan and in line with the considerable financial challenges the Health and Social Care economy faced.

The economy would be performance measured against its ability to reduce emergency admissions through BCF investment.  This figure was originally set at a reduction of 5%, against 2014/15 baseline by 31 March 2016.  However, in light of A&E performance over the winter period and the challenging admissions trajectory, Wirral had revised its position to a target of 3.5%.  This remained a significant challenge, equal to a reduction of approximately 6 admissions a day.

It was also reported that there was a national requirement for the BCF to be managed via a pooled budget by April 2015.  Resources would be pooled through a Section 75 agreement, which set out governance arrangements including how risks such as under performance or overspend against individual schemes would be managed.  It had been agreed that the pooled budget would be hosted by the local Authority.  The CCG Director of Finance had jointly written the Section 75 request.  The Director of Adult Social Services and the CCG Director of Finance would directly oversee the governance of the pooled budget.

Members raised concern about the areas of the Specialist Alcohol Unit and the Alcohol Triage Service savings.  Superintendent John Martin highlighted the serious impact on services due to the abuse of alcohol and questioned what would be in place.  Jacqui Evans gave an explanation of alcohol services and Members expressed the view that there needed to be further consideration as to how appropriate care would meet needs.

The new PNA could be accessed at the following link:

www.info.wirral.nhs.uk/pna

Appendices to the report provided details of the Revised Scheme Summary and a Summary of key changes.

Resolved – That;

1.   the revised priorities be approved

2.  the progress and monitoring arrangements with regard to the section 75 pooled budget agreement be noted.

Members gave consideration to a report prepared by Andrew Crawshaw, NHS. England. Richard Freeman, NHS England attended the meeting and provided an overview of the report. NHS England provided a quarterly Accountability report to each Health and Wellbeing Board.  The report outlined the national and regional context together with specific update on priorities that the Area Teams were responsible for delivering and how these priorities were progressing.

Members were provided with an update on NHS England and informed of the progress on the Two Year Operational Plans as well as the development of the Cheshire and Merseyside Business Plan for 2015/16.

The report included details of New Care Models – Vanguard sites – Minute 80 refers. NHS England had announced the first 29 ‘vanguard’ sites that would transform care for five million patients across England.  The sites, supported by the New Care Models Programme, had been chosen from 269 applications to trail blaze new ways of providing more joined-up, personal care for patients and increase efficiency. 

Groups of nurses, doctors and other health staff from across the country had  put forward their ideas for how they want to redesign care in their areas, and now the NHS would be backing 29 of the most innovative plans, with the aim of bringing home care, community nursing, GP services and hospitals together for the first time since 1948.

Drawing on bespoke packages of national support and a £200 million transformation fund, from April the vanguards would develop local health and care services to keep people well, reduce demand and improve productivity.

The vanguards would take the national lead on the development of game-changing care models:

•  multispecialty community providers (MCPs) – moving specialist care out of hospitals into the community;

•  integrated primary and acute care systems (PACS) – joining up GP, hospital, community and mental health services, and;

•  models of enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services.

For patients, this could mean fewer trips to hospitals as cancer and dementia specialists hold clinics local surgeries, one point of call for family doctors, community nurses, social and mental health services, or access to blood tests, dialysis or even chemotherapy closer to home.

Locally there were the following vanguard sites: Wirral University Teaching Hospital NHS Foundation Trust and Primary Care Cheshire.  Further information was available on the following link:-

http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/

Resolved – That the report be noted.

Verbal report – Jayne Marshall, Department of Adult Social Services (DASS).

Paul Wormald, Commissioning Support Manager (Partnerships), Norma Currie, Commissioning Manager (Partnerships) and Annamarie Jones, Commissioning Lead, Department of Adult Social Services attended the meeting and provided the Board with a presentation on Learning Disabilities  Self-Assessment Framework Assessment. The Joint Health and Social Care Learning Disabilities Self-Assessment Framework helped to provide a single, consistent way of identifying the challenges and caring for the needs of people with learning disabilities and documenting the extent to which the shared goals of providing care are met. The presentation outlined the type of information collected, Comparision between 2012-2013 and 2013-2014 (Rag Rated), the key successes in the last 12 months, examples of good practice and an Action Plan for 2015 - 2016.

Resolved - That the officers be thanked for a useful report.

·  Pharmaceutical needs assessment

A report of the Director of Public Health informed the Board that the formal consultation for Wirral’s new Pharmaceutical Needs Assessment (PNA) was now complete. To meet the deadline for publication of the 1st April 2015 the Chair had approved the document in March, the Board was therefore asked to ratify the Chair’s action.

Resolved – That the decision to approve the Wirral’s Pharmaceutical Needs (PNA) by the Chair of the Health and Wellbeing Board be ratified.

The date of the next formal Board meeting is Wednesday 8 July, 2015 at 4:00pm in Committee Room 1, Town Hall, Wallasey.

The date of the next Formal Board was to be held on Wednesday, 8 July, 2015.