The Chair welcomed the members of the Board, officers and those watching the webcast to the meeting.

PRESENT:

Carol Johnson-Eyre  Voluntary, Community, Faith and Social Enterprise representative (Chair)

Simon Banks  Place Director (Wirral), NHS Cheshire and Merseyside

Councillor Simon Mountney  Wirral Council

Councillor Kieran Murphy  Wirral Council

Councillor Tony Murphy  Wirral Council

Dr David Jones  Primary Care

Dr Stephen Wright  Primary Care

Jacqueline Davidson  Assistant Director Public Health, Wirral Council

Mark Greatrex  Interim Chief Executive, Wirral Community Health and Care Trust

Elizabeth Hartley  Director of Children’s Services, Wirral Council

Janelle Holmes  Chief Executive, Wirral University Teaching Hospital NHS Foundation Trust

Karen Prior  Chief Executive, Healthwatch Wirral

Tim Welch  Chief Executive, Cheshire and Wirral Partnership NHS Foundation Trust

ALSO PRESENT:

Julian Eyre  Wirral Improvement Team

Jayne Marshall  Wirral Council

Martin McDowell  NHS Cheshire and Merseyside

Gareth Prytherch  Voluntary, Community, Faith and Social Enterprise

Iain Stewart  Head of Transformation and Partnerships, NHS Cheshire and Merseyside (Wirral)

Vicki Shaw  Head of Legal Service, Wirral Council

Christine Morley  Secretary

Members are asked to consider whether they have any relevant interest in connection with any item(s) on this agenda and, if so, to declare them and state the nature of the interest.

The Chair asked for members to declare any interests in any items on the agenda. No interests were declared.

To approve the accuracy on the minutes of the meeting held on 7 May 2024.

Resolved – That the minutes of the meeting held on 7 May 2024 be agreed.

There were no items on the action log.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact julian.eyre@nhs.net if you would like this document in an accessible format.

The Programme Director, Wirral Improvement Team presented this report which provided an update on the Workforce Enabling Programme within the Wirral Place Health and Care Plan 2023-24 and 2024-25. The report aimed to provide the Board with information and assurance on the progress of this programme. There were two key pieces of work, the first of which was the Wirral Workforce Dashboard which looked to synthesise key data from all of the Wirral anchor institutions, to understand the workforce profile and to support future talent, such as the need to support those aged 18 – 24 into the workforce and a programme had been launched to support a cohort comprising of care leavers to provide a real support programme tailored to their aspirations and matched to real job opportunities. 

Members asked how this was linked to the Supported Employment Strategy and asked for clarification of the academic institutions involved, whether there was any evidence that young people who had been in care were attracted to health and care work and asked about the involvement of people with disability and long term health conditions in the Wirral People Plan.

The Chair noted that it was great that the primary sector and voluntary service were involved. It was reported that Children’s Services welcomed the support for young people.

Resolved – That this report which provides assurance on the delivery and oversight of the workforce programmes be noted.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact simon.banks@cheshireandmerseyside.nhs.uk if you would like this document in an accessible format.

The Place Director (Wirral), NHS Cheshire and Merseyside presented this report which provided update on the system management of key strategic risks as identified in the Place Delivery Assurance Framework. There was no change around the service delivery risk. The quarterly risk review was to return to the Board in September.

Members asked for clarification around the identification of key strategic risks and the formulation of risk scores which was given. Members asked about community wealth building and were given examples of the NHS and Wirral Council working together on the delivery of that such as through employment and utilisation of social value through contracts and procurement. Members requested that poverty and the cost of living be addressed in relation to the risk to children and young people in future reports.

Resolved – That

· the work to apply NHS Cheshire and Merseyside’s Risk Management Framework to the Wirral Place Partnership governance arrangements be noted.

· the updated Place Delivery Assurance Framework be approved.

· it be noted that an updated PDAF will be presented at the Board meeting scheduled for 26th September 2024.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact lorna.quigley@cheshireandmerseyside.nhs.uk  if you would like this document in an accessible format.

The Associate Director of Finance (Place) presented the report of the Associate Director of Quality and Safety Improvement which provided oversight of the Quality and Performance across Wirral Place since the last reporting period. The report focussed on some key areas of improvement including Healthcare Associated Infections (HCAI) and Special Educational Needs and Disabilities (SEND) and All Age Continuing Care (AACC). It was noted that there had been one confirmed case of measles in Wirral. The AACC was highlighted as the national standard was being maintained at 81 percent and decisions were being made within 28 days of referral where the national average was 80.

Members asked about key risks and collaboration. Members felt that AACC needed to be kept as a priority and further data would be included in the next report.

Resolved – That

· the work underway across the system to monitor quality and performance, identifying areas for improvement be noted.

· the further work underway to strengthen the governance around quality and safety across Health and Social Care be noted and endorsed.

· assurance around the robust improvement plans in place to manage specific areas for improvement be received.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact julian.eyre@nhs.net if you would like this document in an accessible format.

The Programme Director, Wirral Improvement Team presented this report which provided the performance dashboard for the programmes within the Wirral Place Health and Care Plan. The report aimed to provide the Board with information and assurance on the progress of the Programmes associated with the Wirral Health and Care Plan 2023-24 and 2024-25. The overall delivery RAG rating in June was green, one programme was rated red and two were amber.

Members asked whether the medicines optimisation included medication reviews for patients. Members also asked about the neuro divergent pathways and there was to be a graduated offer within schools.

Resolved – That this report which provides assurance on the delivery and oversight of the Health and Care Plan programmes be noted.

The Assistant Director of Integrated Services and Commissioning presented the report of the Director of Adults Care and Health, Wirral Council and the Place Director (Wirral), NHS Cheshire and Merseyside which provided a progress update on the capacity and demand modelling that has been completed across Wirral Place to date and proposed the key next steps to complete the work to increase capacity across the system and reduce those with no criteria to reside (NCTR). There had been a significant and sustained reduction in those with NCTR and there were further plans to reduce that further in the lead up to winter. It was acknowledged that advice and previous intervention had been received from the Better Care Fund via Professor John Bolton who had supported with the capacity and demand modelling. It was highlighted that the Transfer of Care Hub had had a very positive impact, particularly with the Home First Service and the increase in care market sufficiency specifically in relation to domiciliary care. It was reported that the aim was to reduce the NCTR number to 70 by March 2025 and sustain that.

Members asked about the reason for the increase in the NCTR numbers in June 2024. Members queried whether the reduction in NCTR numbers had created a bulge elsewhere in the system. Workshops were planned to review the NCTR figures and the frailty schemes and the virtual wards.

The Chair noted that it would be useful to raise awareness of the Able Me programme within the CVFS sector and find out more about the link into Primary Care.

Resolved - That

1) the workstream and other UEC funded scheme evaluations, inclusive of performance to-date, quality and outcomes and future benefits and focus be accepted.

2) the capacity proposal figures to progress with the Wirral Health and Care system for implementation in 2024/25 be accepted.

3) the current progress made in relation to reduction in people meeting the NCTR and agree future NCTR target be noted.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact james.barclay1@nhs.net if you would like this document in an accessible format.

The Chief Executive, Wirral University Teaching Hospital NHS Foundation Trust presented the report which provided the Board with information and assurance on the work of the Unscheduled Care Improvement Programme for Wirral. It was clarified that the capacity and demand work formed part of the overall unscheduled care work to ensure that the right services were in the right place. It was highlighted that from an ICB perspective emergency care remained one of the NHS’s highest priorities and remained significantly under pressure across the whole country. The Trust had moved from one of the worst performing in relation to an NCTR of between 250-270 to the best in Cheshire and Merseyside with a range between 100-110 with an ambitious target of 70. It was highlighted that for Home First patients assessed and managed at home their long-term care requirements were reduced by about 50 percent. Home First had become business as usual for Place and would not be reported any further in this programme. The focus for 2024 – 2025 was on pre hospital and there was significant work that needed to be done around attendance and admission avoidance. There was a push to standardise the delivery of some of those offers across Cheshire and Merseyside. Virtual wards where patients were managed in the community with support would be standardised across Cheshire and Merseyside to maximise the number of beds available.

Members asked about the assessments for virtual wards and this was discussed.

Resolved – That this update be noted.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact simon.banks@cheshireandmerseyside.nhs.uk if you would like this document in an accessible format.

The Place Director (Wirral), NHS Cheshire and Merseyside presented the report which provided an overview of the process undertaken to refresh the Wirral Health and Care Plan 2023/24 for 2024/25, in consideration of national guidance and local priorities. The Wirral Health and Care Plan 20254/25 had been refreshed and came with a recommendation from the STG for approval.

Members asked about the workshops which had taken place between December and April 2024 around planning guidance, priorities and a narrative plan and this was discussed.

Members asked about the smoking cessation programme and targeted lung health checks.

Members discussed the maternity service and it was acknowledged that under the Cheshire and Merseyside maternity programme Wirral was doing really well and had received a good rating from CQC. The importance of access to a GP for early diagnosis of cancer was also discussed by Members.

Clarification was given to members of the oversight that was in place to ensure that co-production was done properly. Members noted the Gold Award which the Public Health Department and NHS Partners had received from the infection control society for their work on hydration and urinary tract infections for a twenty percent reduction in antibiotics and hospitalisation.

Members asked for clarification around the backlog of memory assessments and this was reported to be at consultant level as waiting times had increased.

Resolved – That the Wirral Health and Care Plan 2024/25 be approved.

The Director for Children, Families and Education presented the report which introduced the improvement programme for Special Educational Needs and Disabilities (SEND) for the Local Area in Wirral. The report explained the rationale for establishing the Local Area SEND Partnership Board in April 2024, its purpose, how that was delivered, and provided an update on activity and progress to date. The Local Area SEND Partnership Board was accountable to the Health and Wellbeing Board for delivery of the Written Statement of Action (WSoA) and SEND Improvement Plan as agreed following the Improvement Notice for SEND, which was issued to Wirral Council by the Minister for Children, Families and Wellbeing on 15th May 2024. The improvement notice which was issued by the Minister for Children, Families and Wellbeing outlined the expectations and required improvement to be delivered by October 2025. As there were several interdependencies with the work and priorities of the Wirral Place Based Partnership Board (WPBPB) it was important that WPBPB had sight of the reports and the progress in the report which was brought for information.

Members passed on positive feedback from organisations across Wirral and asked about representation in the sector. Members asked whether the Council was in a position to increase visits to SEND schools given the improvement notice. Assurance was given that commissioners did undertake visits and if there was any learning from reviews that visits needed to be increased they would be increased in accordance with the recommendations. It was clarified to Members that scrutiny sat with the SEND Improvement Board. 

Resolved – That this report to the Health and Wellbeing Board be noted.

The Place Director (Wirral), NHS Cheshire and Merseyside presented the report which provided an update on the progress of a review of collaboration and integration opportunities across health and care in Wirral (“the Review”). The Review had been commissioned by NHS Cheshire and Merseyside and was being delivered in partnership with the NHS trusts working on Wirral.

It was reported that Stage 1 of the Review had concluded and there was now a need to focus on the front door in terms of unscheduled care and improve delivery in terms of neighbourhood health and care services. Stage 2 had already commenced and would continue to report to the steering group and report to the board in September 2024.

Members asked how people with disabilities or long term conditions were engaged in the Review. It was explained that this Review was not engaging people directly utilising the service but rather it was looking at how the providers and commissioners of the service can work better together to improve service delivery in terms of moving the key metrics and also improving the quality of service.

Resolved – That the progress of the Review be noted.

The purpose of this report was to provide an update on the work of the Finance and Investment Group (FIG).

Resolved – That the work of the Finance and Investment Group be noted and updates continue to be received as a standing agenda item.

The Head of Transformation and Partnerships, NHS Cheshire and Merseyside ICB presented the report which provided an update on the work of the Primary Care Group (PCG). The access figures for patients were good across Wirral. There had been a dip in patient satisfaction around making an appointment and speed of getting through to practices. Insight and patient experience work had been done last year with Healthwatch Wirral around enhanced access which included additional access on top of core hours. It was highlighted that patient insight into access to Primary Care would continue to be gathered throughout the year so that this could be fed back to practices to inform improvement.

A request for a new PCN drawn from the Birkenhead PCN had been approved. Five or six practices would form a new PCN from 1 August 2024. It was noted that two practices were up for procurement of a new APMS contract for a 10 year period.

It was reported that Pharmacy First had been live since January 2024 and across Cheshire and Merseyside there had been 28,000 referrals. It was acknowledged that the number of referrals for Wirral was a little bit low at around 6 percent.

Members noted that there was a mismatch between the introduction of modern general practice access and total triage models and patient satisfaction. It was acknowledged that when practices moved to the modern general practice access model patient satisfaction had temporarily reduced.

Members asked to see overall performance measures, comparisons and KPI’s in future.

Members discussed the placement of PCN’s in Neighbourhoods in relation to community services and Neighbourhood development and this had been picked up as part of the agreement. It was noted that in light of earlier information around increased attendance at urgent care due to proximity, an early conversation should be had with the new PCN’s around admission avoidance and the Moreton and Meols PCN approach.

The Chair noted that a new PCN map would be helpful.

Resolved – That the work of the Primary Care Group be noted.

The purpose of this report was to provide an update on the discussion and outcomes of the meeting of the Quality and Performance Group held on 16 May 2024.

Resolved – That

· the work underway across the system to monitor quality and performance, identifying areas for improvement be noted.

· assurance around the robust plans in place to manage specific areas for improvement be received.

· the effective use of data to understand population health need and improve equality and access to services be noted.

The purpose of the report was to provide an update on the work of the Strategy and Transformation Group (STG).

Resolved - That the work of the Strategy and Transformation Group be noted.

There were no questions from the public or members and no petitions or statements.

Notice of question to be given in writing or by email by 12 noon, Monday 22 July 2024  to the Council’s Monitoring Officer (via the online form here: Public Question Form) and to be dealt with in accordance with Standing Order 10.

Please telephone the Committee Services Officer if you have not received an acknowledgement of your question by the deadline for submission.

Statements

Notice of representations to be given in writing or by email by 12 noon, 22 July 2024 to the Council’s Monitoring Officer (committeeservices@wirral.gov.uk) and to be dealt with in accordance with Standing Order 11.1.

Petitions

Petitions may be presented to the Committee if provided to Democratic and Member Services no later than 12 noon, 22 July 2024, at the discretion of the Chair. The person presenting the petition will be allowed to address the meeting briefly (not exceeding three minutes) to outline the aims of the petition. The Chair will refer the matter to another appropriate body of the Council within whose terms of reference it falls without discussion, unless a relevant item appears elsewhere on the Agenda. If a petition contains more than 5,000 signatures, it will be debated at a subsequent meeting of Council for up to 15 minutes, at the discretion of the Mayor.

Please telephone the Committee Services Officer if you have not received an acknowledgement of your statement/petition by the deadline for submission.

The Chair of Wirral Place Based Partnership Board introduced this report which presented the future work programme of the Board.

It was noted that the winter plans were to be brought to the Board in October in the Unscheduled Care report and Iain Stuart was to note the Primary Care Report for October.

Resolved – That the work programme for the Wirral Place Based Partnership Board for the remainder of the 2024/2025 municipal year be noted.

There was no other business.

10am on 26 September 2024

10am on 17 October 2024

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