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

Apologies were received from:

• Julian Eyre, Wirral Improvement Team, substituted by James Barclay.
• Janelle Holmes, CEO Wirral University Teaching Hospital NHS Foundation.
• Karen Howell, Wirral Community Health and Care NHS Trust, substituted by Paula Simpson
• Karen Prior, CEO, Healthwatch Wirral.
• Lorna Quigley, Associate Director of Quality and Safety Improvement,
• NHS Cheshire and Merseyside.
• Tim Welch, Chief Executive, Cheshire and Wirral Partnership.
• NHS Foundation Trust, substituted by Dr Faouzi Alam.

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 27 March 2024.

Resolved – That the minutes of the meeting held on 27 March 2024 be agreed.

There were no items on the Action Log.

The Associate Director of Finance (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 February 2024. It was reported that Wirral Place overspend was forecast to be over £16 million. Wirral Community Health & Care NHS Foundation Trust was forecast to deliver a £1 million surplus. Wirral University Teaching Hospital (WUTH) had a forecast variant of £5.2 million. In relation to Place, it was reported that increases in packages of care was a factor behind the variance, whilst it was noted that the forecast variance for WUTH was predominantly linked into industrial action costs. In relation to the Better Care Fund, the Board were informed that due to pressures in Wirral Independence Service, an overspend of approximately £150k was anticipated.

Members asked for clarity on how community groups and organisations were involved in community wealth building. In response, Members were informed that planning sessions for investments had been taking place with representation from the Voluntary, Community, Faith and Social Enterprise Sector with a focus on maximising community assets alongside NHS services.

The Board also discussed the process for reducing the reported deficit. It was reported that as part of the Integrated Care Board would highlight key priority areas including increasing productivity, focus on improving urgent care and discharge processes alongside improvements in packages of care.

Resolved – That

1. Wirral Place System forecast reported position at Month 11 2023/24 be noted.
2. the forecast reported position for the Pool and the discharge fund as at Month 11 2023/24 be noted.
3. the shared risk arrangements are limited to the Better Care Fund only, which is reporting a forecast breakeven position, be noted.

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 Place Director (Wirral) introduced 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 key areas of improvement including, Healthcare Associated Infections (HCAI) and Special Educational Needs and Disabilities (SEND). It was reported that Wirral continued to perform well across all aspects of planned care. In relation to Mental Health, it was reported that Super Multi Agency Discharge events (MADE) were continuing to be held with a focus to recognise and unblock delays, whilst Healthcare-associated infections (HCAIs) remained a priority for Wirral Place.

Providing an update on the programmes, the Place Director noted that SEND continued to be a priority for the partnership and had been included within

the 2024/25 planning round. It was further reported that Wirral system partners were working together to ensure that there is robust planning in regard to containment and incident management in relation to measles.

The Board discussed the SEND improvement work in greater detail. The Director of Children Family and Education confirmed that a new governance board was in place which would meet on a monthly basis.

Resolved – That

1. work underway across the system to monitor quality and performance, identifying areas for improvement be noted.
2. The work underway across the system to monitor quality and performance, identifying areas for improvement be noted and endorsed.
3. 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 Simon.Banks@cheshireandmerseyside.nhs.uk  if you would like this document in an accessible format.

The Place Director (Wirral) introduced the report which set out the latest position on NHS Planning Guidance 2024/25 alongside the approach taken in Wirral by NHS Cheshire and Merseyside with Place partners to refresh the Wirral Health and Care Plan 2023/24 for 2024/25. It was reported that a series of workshops had taken place to refresh the Wirral Health and Care Plan with the final session scheduled to take place in May 2024 to finalise the plans in line with the national timetable.

Members asked for clarification on the involvement of those with disabilities and long-term health conditions in developing the refreshed plan. In response, the Place Director confirmed representatives of these groups were included through the routine involvement of the Voluntary, Community Faith and Social Enterprise sector in the plan development. It was also noted that any changes to the plan would need to be supported by an Equalities Impact Assessment. In addition, Members highlighted that leadership and work to tackle Anti-Microbial Resistance needed to be a key part of the plan. Assurances were given to the Board of its inclusion.

Resolved – That

1. The update be noted.
2. The approach being taken to update the Wirral Health and Care Plan for the planning year 2024/25 be noted.
3. The Wirral Health and Care Plan 2024/25 be received at the June meeting for approval.

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 representative from the Wirral Improvement Team introduced the report of the Director of the Wirral Improvement Team which provided the performance dashboards for the programmes within the Wirral Place Health and Care Plan. The report provided information and assurance on the progress of the Programmes associated with the Wirral Health and Care Plan. It was reported that overall delivery Red Amber Green (RAG) rating for the Health and Care plan delivery in March/April was Green, with one programme in the portfolio reporting Red, three reporting Amber and the rest reporting Green. A number of highlights relating to the guiding programmes, delivery programmes and enabling programmes were detailed within the report. The Red RAG rating for use of resources related to overall financial deficit position, whereby review of expenditure and mitigation strategies continued to be sought and implemented.

The Board discussed the Performance dashboard in detail, highlighting the need for the workforce strategy to include monitoring of productivity going forward, and noting the interdependencies between the mental health programme, unscheduled care programme and primary and community care. The Board also noted its disappointment that the mental health programme board was stood down twice in 3 months due to quoracy.

Resolved – That the report, providing assurance on the delivery and oversight of the Health and Care 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 james.barclay1@nhs.net if you would like this document in an accessible format.

The Programme Manager, Wirral Improvement Team, introduced the report of the Chief Executive of Wirral University Teaching Hospital, which provided the Board with information and assurance on the work of the Unscheduled Care Improvement Programme for Wirral. It was reported that the Unscheduled Care Programme continued to make good progress across its component workstreams. Since the previous report, a decrease in the number of hospital inpatients with NCTR (sentinel measure) had occurred from 135 in February 2024 to 132 on the 1st March 2024.

Members discussed the high levels of care package implementation and the challenges of managing associated costs. Members also sought clarification that alongside unscheduled care improvement work, there would also be a focus on including addressing A&E waiting times as part of improvement planning. The programme manager confirmed that admission avoidance would feature as a workstream in future planning.

Resolved – That the update be noted.

The Place Director introduced the report of the Head of Transformation and Partnerships, (Primary Care, Mental Health, Learning Disabilities and Autism) which provided the Board with an update on the work of the Primary Care Group (PCG). The report included details of the PCG group meeting held on 26 March 2024, highlights of which were changes agreed to the Group’s Terms of Reference, and updates on Primary Care Access Recovery Plan (PCARP), the GP Contract for 2024-25, and the Primary Care Quality Scheme 24-25.

Resolved – That work of the Primary Care Group be noted and that the Board continues to receive updates as a standing agenda item.

The Place Director introduced the report of the Associate Director of Quality and Safety Improvement which provided an update on the meeting of the Quality and Performance Group held on 21st March 2024. Highlights of the meeting included an update on the local review of SEND governance, improving access to psychological therapies an update on the prevalence of ADHD rates in Wirral.

Members discussed the level of ADHD rates further where it was noted that Wirral has the highest reported ADHD rates in the country. It was explained that the group were exploring the reasons behind this, and further insight and intelligence work would explore possible overidentification and whether Wirral was an outlier. The Board also discussed challenges relating to availability of ADHD medicines nationally and the impact of private diagnoses.

Resolved – That

1. the work underway across the system to monitor quality and performance, identifying areas for improvement, be noted.
2. Assurance around the robust plans in place to manage specific areas for improvement be received.
3. the effective use of data to understand population health need and improve equality and access to services be noted.

The Place Director introduced the report which provided the Wirral Place Based Partnership Board with an update on the work of the Strategy and Transformation Group (STG). The report detailed updates from the meeting of the group held on 22^nd March 2024.

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

The Assistant Director of Finance (Place) introduced the report which provided the Wirral Place Based Partnership Board with an update on the work of the Finance and Investment Group (FIG). The report detailed updates from the meeting of the group held on 27th March 2024.

Resolved – That the work of the Finance and Investment Group be noted and that the Board continues to receive updates as a standing agenda item.

No public questions, statements or petitions had been received.

The Head of Legal Services introduced the report which presented the future

work programme of the Board.

Additional items were suggested including:

• A SEND update for Children and Young People for June 2024, to become a standing item thereafter.
• A Wirral review of collaboration and integration opportunities for health and care across Wirral in June 2024.
• A report on the transforming care programme later in the municipal year.

Resolved – That the work programme and suggested additional items be noted.

There as no other business.

10am on 20 June 2024

10am on 25 July 2024

10am on 26 September 2024

10am on 17 October 2024

·  10am on 20 June 2024

·  10am on 25 July 2024

·  10am on 26 September 2024

·  10am on 17 October 2024