PRESENT:

BOARD MEMBERS:

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

Simon Banks  Place Director (Wirral), NHS Cheshire and

Merseyside

Jayne Marshall  Assistant Director Wirral Council

Jacqueline Davidson  Assistant Director Wirral Council

Councillor Simon Mountney   Wirral Council

Councillor Kieran Murphy  Wirral Council

Matthew Swanborough  Wirral University Teaching Hospital NHS Foundation Trust

Tim Welch  Chief Executive, Cheshire and Wirral

Partnership NHS Foundation Trust

Dr Abel Adegoke  Primary Care

Dr Ian Cubbin  Primary Care

Dr David Jones  Primary Care

Dr Stephen Wright  Primary Care

ALSO PRESENT:

James Barclay  Wirral Improvement Team.

Julian Eyre  Programme Director, Wirral Improvement

Team

Elizabeth Hartley  Director for Children, Families and Education

Anthony Kirk  Assistant Director Early Help, Prevention and Effectiveness Children’s Services

Tom Knight  Associate Director of Primary Care

(Dental and Community Pharmacy)

Martin McDowell  Associate Director of Finance & Performance, NHS Cheshire and Merseyside

Vicki Shaw  Head of Legal Services, Wirral Council.

Christine Morley  Secretary

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

Apologies for absence were received from:

• Janelle Holmes, Chief Executive, Wirral University Teaching Hospital NHS Foundation Trust was substituted by Matthew Swanborough Chief Strategy Officer
• Sayyed Osman, Director of Adults, Health and Strategic Commissioning, Wirral Council
• Dave Bradburn, Director of Public Health, Wirral Health
• Councillor Julie McManus, Wirral Council
• Paul Satoor, Chief Executive, Wirral Council
• Karen Livesey, One Wirral, VCSFE
• Karen Prior, CEO Healthwatch Wirral

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. Dr Stephen Wright declared an interest in the Dentistry report at item 5 as he is an NHS dentist.

To approve the accuracy on the minutes of the meeting held on 20 February 2025.

Resolved – That the minutes of the meeting held on 20 February 2025 be agreed.

There were no items on the action log.

The Chair proposed that the two public questions be heard first.

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

The NHS Cheshire and Merseyside Associate Director of Primary Care (Dental and Community Pharmacy) provided an update on dental services in Wirral, local dental improvement plan progress and the publication of the national dental recovery plan. The report provided assurance to the Board around commissioning of dental services within Primary Care and access to dentistry. Under the National Dental Recovery Plan 20 practices signed up for the new patient premium which would finish on 1 April 2025. It was reported that across Cheshire and Merseyside 40,000 plus patients accessed dental services through the new patient premium and Arrow Park Dental Practice had signed up to the Dental Recruitment Scheme. Between April and December 2024, 2250 patients had accessed Pathway 1 urgent care and 542 Adults and Children accessed urgent care and completed their care under Pathway 2 where a patient was treated finished by the same dentist who provided previous urgent care. During the same period, under the Routine Access scheme 6175 patients accessed services on the Wirral and this figure will be slightly higher once all the figures are added.

The 2025-26 plan had been signed off on 20 February 2025 and there was an additional £8m so the total investment from NHS Cheshire and Merseyside was circa £23m.  Urgent care, urgent care plus and routine access would be continued and there was a pilot scheme to look at access for vulnerable groups and the workforce issue which would involve a multidisciplinary team. The environment remained difficult as it was still limited by the national contract, cost of living increases and additional laboratory costs.

Members asked about the percentage of Wirral Residents that were registered for routine care. It was clarified that there was no registered list of patients in private practice so it was not possible to give a percentage.

Members asked about access to dentistry for vulnerable patients and what could be done as a Place to support dentistry around the national contract and this was discussed.  It was noted that an average list size for a full time NHS dentist was around 2600 patients.

An addition to recommendation 1 was proposed by the Chair as follows: “Note the update on dental services in Wirral, Local Dental Improvement Plan Progress and the publication of a National Dental Recovery Plan”.

An additional recommendation was proposed by the Chair as follows:

“2. Requests that NHS Cheshire and Merseyside and the Local Dental Committee produce an action plan specific to Wirral to propose solutions for the local population.”

Resolved – That

1.  The report, the Local Dental Improvement Plan Progress and the publication of a National Dental Recovery Plan be noted.

2.  NHS Cheshire and Merseyside and the Local Dental Committee be requested to produce an action plan specific to Wirral to propose solutions for the local population.

The PDF file 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 Place Director (Wirral), NHS Cheshire and Merseyside introduced the report of Associate Director of Quality and Safety Improvement, NHS Cheshire and Merseyside which provided oversight of the Quality and Performance across Wirral Place since the last reporting period. The report focussed on the key areas of improvement including Healthcare Associated Infections (HCAI), but also noted a slight decline in diagnostic testing and cancer targets which was largely due to the cyber incident at Wirral hospitals. Recovery plans were in place and good progress was being made to recover that position. The dementia diagnosis rate was at 67percent and although this target had been removed from the NHS planning metrics for 2025-2026 it would remain a local priority to improve access to services for people with dementia. In future, this would be included in the Mental Health work programme.

Members queried how many people were on the waiting list for an autism diagnosis in Wirral and the Place Director (Wirral), NHS Cheshire and Merseyside would request this information from the providers.

Resolved – That

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

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

 3.  Assurance around the robust improvement plans in place to manage specific areas for improvement be received.

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

The Associate Director of Finance, NHS Cheshire and Merseyside (Wirral) presented this report which provided an update on the financial position for the Wirral Place health and care system partners as at the end of January 2025, Month 10 in the financial year 2024/25. The system had an actual reported deficit of £39.2m compared with a planned year-to-date deficit of £20.5m, which represented an adverse variance of £18.7m. This was an improvement on month 9 reporting of £1.6m. The Adult social care budgets were reporting an adverse variance due to increased activity and costs in social care services as well as the cyber-attack on Wirral hospitals and were predicted to be £7.8m overspent unless further mitigating actions could be identified. A final report would be brought for month 12 for the outturn position. The Better Care Fund had a £270,000 overspend which would be shared between the two partners.

Members queried where Wirral Place lay in comparison to the other places on Cheshire and Merseyside and the position of Cheshire and Merseyside ICB in relation to other ICB’s around the country. It was clarified that the predicted variance in Wirral was likely to be the third highest out of the 9 Places. On a cost per head basis in terms of overspend Wirral was likely to be in third or fourth place on Cheshire and Merseyside. It was explained that approximately half of the country were in a cohort that required enhanced financial scrutiny and Cheshire and Merseyside ICB was in the top quartile from a national perspective.

Members also queried the financial implications for Wirral Place following the government announcement regarding NHS England. No further information had been received from government or NHS England other than a target to make fifty percent cuts by the end of the year.

Resolved – That

1.  The report and the specific recommendations in relation to the Pooled Budget, listed below be noted

2.  The forecast reported position for the System, Pooled Fund and the Discharge Fund as at Month 10 2024/25 be noted.

 3.  The shared risk arrangements are limited to the Better Care Fund  only, which is reporting an overspend position of £270k be noted.

The PDF file 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 Programme Manager – Wirral Improvement Team presented the report of the Chief Executive of Wirral University Teaching Hospital NHS Foundation Trust which provided information and assurance on the work of the Unscheduled Care Improvement Programme for Wirral. The four workstreams were explained.

It was highlighted that Wirral continued to perform well against other places in Cheshire and Merseyside for No Criteria to Reside performance where it had been in first place out of 7 places since 19 January 2025. It was noted that the February Unscheduled Care Board had agreed that the Wirral System planning meeting would be held in May 2025 to discuss the Unscheduled Care needs of the Wirral population.

Members noted that there was a significant uptick in same day GP appointments in December and a corresponding drop in visits to the urgent treatment centre drop in. This could be related to the work of both GP’s and the Acute Respiratory Hub that was put in place at that time and appeared to be a success.

Resolved – That the report be noted.

The PDF file 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, introduced this report which provided an update on the system management of key strategic risks as identified in the Place Delivery Assurance Framework. There were no changes to the risk scores apart from the one for collaboration. It was reported that, as part of a review, both the collaboration risk score and the Community Wealth Building risk score were recommended to be closed and would no longer feature as a risk going forward.

At the next meeting, the PDAF report would focus on service delivery, children and young people, workforce, finance and unscheduled care and some of the risks would be redefined.

Resolved – That

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

2.  The updated Place Delivery Assurance Framework be approved.

A full review of the Place Delivery Assurance Framework will be needed for the Wirral Place Based Partnership Board meeting in June 2025 be noted.

The PDF file 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 for the Wirral Improvement Team introduced this report which provided an update on the Workforce Enabling Programme within the Wirral Place Health and Care Plan 2024-25. The report provided information and assurance on the progress of this programme. The key aim was to work on the development of a key people strategy to address the workforce challenges across Wirral Place and four specific priorities were identified. A workforce dashboard had been developed which synthesised workforce data across the whole of the system which allowed significant insight into the workforce to support operational delivery as well as the planning pipeline.

It was highlighted that the provider collaborative was an initiative to support the employment of a cohort of Wirral Care Leavers. The key point of this piece of work was to bring together various organisations across the Wirral to work collaboratively and look at how to work better as a system. Feedback from stakeholders was being synthesised to bring to a future meeting.

440 people attended the Place level Health and Care Jobs Fair was held on 21 January 2025 with over 20 employers, 5 training providers and other careers support organisations. It was reported that a quarter of the people who attended were able to have an interview at the event and over 9 percent were then offered employment as a result.

Given the review of governance and the health and care portfolio, whilst significant changes in strategic direction of the workforce programme and the priorities were not envisaged, the SRO had recommended a number of actions pending the changes outlined in the governance manual and the changes across the system. The formal programme steering group would be paused until the new governance structures were established and further work on building the Wirral Workforce Strategy would be paused until the Steering Group was re-established within the new governance arrangements and there was clarity on the wider health and care work plan that the workforce programme supported. The work on identified priorities for 2024 to 2025 continued to conclusion.

Members asked about the recruitment of more people with learning disabilities and/or autism to support the Council’s agenda to employ more people with disabilities in general. It was clarified that the All Age Disability programme was developing a strategy around employment and training opportunities for people with disabilities.

Resolved – That this report which provides assurance on the delivery and oversight of the workforce programmes to date, and supports the recommendations for the programme delivery in light of the current governance changes be noted, namely:

• The formal programme steering group be paused until the new governance structures are established.

• Further work on building the Wirral Workforce Strategy be paused until the Steering Group is re-established within the new governance arrangements and there is clarity on the wider health and care work plan that the workforce programme supports.

• Whilst work be continued to ensure that the Wirral Place workforce dashboard is established, consolidation of the current work  ...  view the full minutes text for item 130.

The PDF file below 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 for the Wirral Improvement Team introduced this report which provided information and assurance on the progress of the programmes associated with the Wirral Health and Care Plan 2024-25. The live dashboard was reviewed by the Strategy and Transformation Group monthly, where programme Senior Responsible Officers (SRO’s) attended.

There had been a number of notable achievements which included the work of the guiding programmes to improve health and wellbeing outcomes, tackle health inequalities and tackle financial challenges within the health and care system. The report highlighted key developments and successes in the delivery programmes which included supporting some of the most frail and vulnerable people and the launch of the Branch system to look at a pathway for neurodivergence. Work had been done to enhance mental health discharge pathways and housing was looked at as an element to support people on that journey.

The cyber incident had a significant impact on the timeliness and scope of the programmes and the recommendation of the Wirral Review sought to understand that. This had lead to a number of the programmes within the portfolio being paused. The prioritisation of ICB programme delivery had also impacted programme delivery.

The Programme Director for the Wirral Improvement Team was standing down the following day, as were a number of other staff members, and it was highlighted to the Board that capacity issues within the Team constituted a risk to the support that could be given to programme delivery going forward. The Chair and members thanked the Programme Director for his support of the Board.

Members asked about a housing strategy for All Age Disability. Members also queried the impact of a 50percent reduction in staff on the ability of Place to deliver programmes and whether delivery would have to be scaled back and this was discussed.

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

The PDF file may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact alison.hughes29@nhs.net if you would like this document in an accessible format.

The Place Director (Wirral), NHS Cheshire and Merseyside, introduced this report which provided an updated Wirral Place Governance Manual which reflected proposed changes following the Wirral Review in 2024. The changes included a revised governance structure featuring the Wirral Provider Collaborative, proposed changes to meeting frequency of the Wirral Place Based Partnership Board and the arrangements for Chair, removal of the Strategy and Transformation Group and the transfer of some of the responsibilities of this Group to the Wirral Provider Collaborative and the removal of the Place Director and Wirral System Chief Executives meeting.

It was noted that the Governance Manual was being presented in a period of significant flux and uncertainty and may need to be brought back to the Board again, depending on the operating model for NHS Cheshire and Merseyside going forward. The proposal was for the future Chair to be a member of the Community, Voluntary, Faith sector with no rotation and there would be a reduction to six meetings per year commencing in July 2025.

Members were supportive of the amendments and optimistic that they would make a difference through the Provider Collaborative which would get underway quickly.

Resolved – That the Wirral Place Governance Manual V3 be approved, recognising that by nature it remained a dynamic document. The document would return to the Board in July 2025, with the inclusion of the Wirral Provider Collaborative Terms of Reference.

The Head of Transformation and Partnerships, (Primary Care, Mental Health, Learning Disabilities and Autism), NHS Cheshire and Merseyside (Wirral) provided this report which gave an update on the work of the Primary Care Group.

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

The Associate Director of Quality and Safety Improvement (Wirral), NHS Cheshire and Merseyside provided this report which gave an update of the discussion and outcomes of the meeting of the Quality and Performance Group held on 20th February 2025.

Resolved – That

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

2.  Assurance be received around the robust plans in place to manage specific areas for improvement.

The Place Director provided this report which gave an update on the work of the Strategy and Transformation Group (STG). 

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

The PDF file may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact elizabethhartley@wirral.gov.uk if you would like this document in an accessible format.

The Director for Children, Families and Education spoke to this report which provided a copy of the SEND Improvement update report to the Health and Wellbeing Board on 13 March 2025. 

Members questioned the potential reduction of waiting times for children awaiting diagnosis of ADHD through the LEAP clinics and this was discussed.

Resolved - That the SEND Improvement update report be noted.

Two public questions had been received. The first question was from John Taylor-Brace regarding access to NHS dentistry as demand seemed far greater than supply.

The Chair provided the following response:

The NHS has never commissioned dentistry to cover the whole population, as there is the assumption that some people won’t access dental care and others will choose to access private dentistry. This compounded with recruitment difficulties and challenges with the dental contract itself, has put increased capacity issues on access to NHS dentistry.

For patients trying to access routine care, they should visit the NHS website - Find a dentist - NHS to search for practices in their local area. Patients can ask to be placed on as many practice waiting lists as they like, if the practice holds one. We have 10 practices in the Wirral area who have signed up to the Access & Quality scheme for 25/26, which should help improve access, particularly for more vulnerable groups, which these practices are asked to prioritise. We do not advertise which practice are signed up to the scheme, as capacity is limited and we would not want the practices to be overwhelmed.

Similarly, we have 15 practices in the Wirral area delivering additional urgent care appointments for 25/26, which can be accessed by calling the Dental Helpline (0161 476 9651), or the practices can accept some patients who call directly. Again, capacity is limited and the Dental Helpline should always be the first point of contact if urgent care is needed. In some cases, we can also assist patients who have had difficulties accessing urgent care via the Helpline.

The second question was asked by John Taylor-Brace on behalf of Level 80 regarding the progress that had been made by the NHS over the last year to reduce waiting lists locally. The Chair gave the following answer:

We address waiting lists in the Performance Report at each Place Based Partnership Board, covering a range of services. If the questioner would like information about a specific waiting list which is not covered in the Performance Report the Place Director would be happy to consider whether that information can be provided separately to the questioner and members of the Board or could be added to the report going forward.

John Taylor-Brace would contact the Place Director separately with a supplementary question regarding recruitment problems within the NHS.

Statements and Petitions

There were no statements or petitions received.

Notice of question to be given in writing or by email by 12 noon, Monday 24 March 2025 to the Council’s Monitoring Officer via this link: Public Question Form and to be dealt with in accordance with Standing Order 10. The question to be put at the meeting shall not exceed 100 words in length.

For more information on how your personal information will be used, please see this link: Document Data Protection Protocol for Public Speakers at Committees | Wirral Council

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

Statements and Petitions

Notice of representations (statements) and petitions are to be given in writing by 12 noon, Monday 24 March 2025 to the Council’s Monitoring Officer.

To register your intention to give a statement please do so via this link: Public Statement Notification, and this will be dealt with in accordance with Standing Order 11.1.

Petitions may be presented to the Committee. The person presenting the petition will be allowed to address the meeting briefly (not exceeding one minute) 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. Please give notice of petitions to committeeservices@wirral.gov.uk in advance of the meeting.

There were no statements or petitions received.

The Chair of the Wirral Place Based Partnership Board introduced this report, which detailed the annual work programme of items for consideration by the Wirral Place Based Partnership Board. The June 2025 meeting had been cancelled and a meeting would be set up to design the work programme for the next meeting in July 2025.

It was agreed that the following items would be added to the work programme

   ·  Dentistry

·  All Age Disability

·  A revised Place Delivery Assurance Framework

·  Transforming Care as a standing item, once or twice a year.

Resolved – That subject to the above additional items, the proposed Wirral Place Based Partnership Board work programme for the remainder of the 2025/26 municipal year be noted.

The Chair announced that this was her final meeting as a member of the Board. Karen Livesey would become the new Chair and Jane Wilson, CEO of the Hive would represent the Community, Voluntary, Faith sector. The Place Director thanked the Chair and wished Julian Eyre and Lorna Quigley all the best as they would be stepping down.

10am on 19 June 2025

10am on 24 July 2025

10am on 25 September 2025

The next four scheduled meetings were noted as:

10am on 24 July 2025

10am on 25 September 2025

10am 20 November 2025

10am 22 January 2025