Agenda and minutes

Venue: Committee Room 1 - Wallasey Town Hall. View directions

Contact: Daniel Sharples 


No. Item


Welcome and Introduction

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



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Apologies for absence were received from Dave Bradburn, Janelle Holmes, Karen Howell, Carol Johnson-Eyre, Justine Molyneux, Karen Prior and Councillor Jason Walsh.


Declarations of Interest

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.


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The Chair invited members to declare any disclosable pecuniary and any other interests in connection with any item(s) on the agenda and to state the nature of the interest.


Simon Banks declared a personal interest in item 9 ‘Transforming Care for People who have a Learning Disability and or Autism’ as the senior responsible officer for Transforming Care across Cheshire and Merseyside.


Councillor Mary Jordan decalred a personal interest in item 10 ‘Wirral Winter Plan 2022-2023’ as her son was a GP.


Minutes pdf icon PDF 232 KB

To approve the accuracy on the minutes of the meeting held on 13 October 22.


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Resolved – That the minutes of the meeting held on Thursday, 13 October 2022 be approved as a correct record.


Public and Member Questions

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The Chair reported no public questions, statements or petitions had been received.


Health and Care Partnership Strategy pdf icon PDF 403 KB

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The Place Director (Wirral) NHS Cheshire and Merseyside introduced the report which provided an update on the development of the Cheshire and Merseyside Health and Care Partnership Strategy and how Wirral as a “place” would contribute to this Strategy. It was reported that statutory guidance required each ICP (Integrated Care Partnership) to produce and publish an ICP Strategy by December 2022 and there would also be a requirement to publish a “five-year joint forward plan” by April 2023. This meant that the Cheshire and Merseyside Health and Care Partnership would need to sign off the strategy in December 2022 and the five-year joint forward plan in February 2023.


The Cheshire and Merseyside Health and Care Partnership had agreed that the strategy should be developed from existing documents and that each Place should contribute to it with their local plans. The Wirral submission would be based upon the information contained in the Health and Wellbeing Strategy 2022-2027 and Outcomes Framework, as well as drawing upon the information on the Wirral Intelligence Service website.


Following a discussion on measuring public health outcomes, it was confirmed that the Health and Care Partnership would be collating the public health performance indicators on a Cheshire and Merseyside footprint, but that these would still be considered at Place to ensure Wirral’s specific outcomes were considered.


Resolved – That


(1)  the proposal that the Wirral submission for the Cheshire and Merseyside Health and Care Partnership Strategy is based upon the information contained in the Wirral Health and Wellbeing Strategy 2022-2027 and Outcomes Framework be supported, and that the Place Director coordinates the submission with the Director of Public Health.

(2)  a copy of the Cheshire and Merseyside Health and Care Partnership Strategy be received at a future meeting.


Wirral Dementia Strategy 2022-2025 pdf icon PDF 431 KB

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The Head of Mental Health Commissioning (Wirral Place) introduced the report which provided detail on the Wirral Dementia Strategy 2022-2025, which had been produced to review the ambitions outlined in the previous 2019-2022 strategy, which were not achieved due to the impact of Covid-19, and defined the priority areas, actions, and outcomes over the next four years to meet the vision for how dementia care and support would be delivered across all wards within the borough. The focus of this strategy was structured around NHS England’s Well Pathway for Dementia and focused on recovery from Covid-19, and better integration across health and care services to deliver the best outcomes for the population who may have dementia, as well as those who care for them. Greater alignment of services and more creative responses to people’s needs and aspirations would lead to individuals being diagnosed with dementia earlier and having more community-based support in place to enable them to live independently for longer.


It was reported that currently there were over 3,000 people aged 65+ with a dementia diagnosis and projections estimated that the total numbers of people living with dementia in Wirral would more than double to over 7,000 by 2035. The Board discussed the diagnosis rate in detail, where it was noted that the national diagnosis rate target was 66.7% and it was felt that locally there should be ambitions to improve this. Further discussions took place in relation to the close links between dementia and regeneration and housing, and the role of Primary Care in supporting the strategy.


On a motion by Councillor Mary Jordan, seconded by Dr Abel Adegoke, it was –


Resolved – That


(1)  the Wirral Place Dementia Strategy 2022-2025 be approved.

(2)  quarterly updates on progress be provided to the Place Based Partnership Board.


Social Care Reform pdf icon PDF 183 KB

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The Assistant Director for Care and Health, and Commissioning for People (Wirral Council) introduced the report of the Director of Care and Health which detailed the Social Care Charging Reforms and the implications for people who access care and support services and the considerations that were required for the Council’s Adult Social Care services. The report set out the key elements of the proposed changes to social care, which included:


·  a lifetime cap on the amount anyone in England will need to spend on their personal care

·  a more generous means-test for Local Authority financial support

·  the ability for self-funders to ask their council to arrange their care

·  moving towards a fair rate of care in respect of councils’ fees to providers


The plan announced the creation of a new Health and Social Care Levy to fund the changes and provided for a 1.25 percentage point increase to National Insurance contributions for the 2022 to 2023 tax year, however this had since been reversed and officers were awaiting further guidance about the support arrangements. The reforms were still due to come into effect in October 2023.


It was reported that in Wirral, there were approximately a further 900 people who were self-funding their own care who would come forward for assessment under the reforms, with an approximate further 1400 people receiving chargeable domiciliary care or other care in their own home who would be impacted by the changes. The full financial impact of the changes were still not fully understood, but an estimated cost of £1m was estimated to implement the changes including IT system changes and staffing.


It was reported that the report was being considered by the Place Based Partnership Board as the reforms would have an impact on the whole of the health and care system. The ongoing issues with retention and recruitment in social care were outlined, as well as the importance of engagement with the social care workforce at an early stage to assist with the implementation of the changes. The need for engagement with the third sector was also highlighted. The Assistant Director outlined that the use of online self-assessment would be encouraged and staff and the third sector would be engaged in this process as early as possible.


On a motion by Councillor Yvonne Nolan, seconded by Simone White, it was –


Resolved – That


(1)  the approach to the Council’s implementation of the charging reforms be endorsed.

(2)  the significant impact of the social care charging reforms, including on the Adult Care and Health budget and resources as well as the wider health and care system be recognised.


Transforming Care for People who have a Learning Disability and or Autism - Update report pdf icon PDF 527 KB

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The Associate Director of Transformation and Partnerships (NHS Cheshire and Merseyside) introduced the report which detailed the Transforming Care Programme, which was a national programme led by NHS England aimed at improving health and care services so that more people with learning disabilities and/or autism can live in the community, with the right support, close to home and have the same opportunities as anyone else.


The report provided an update on the delivery of the programme, including the number of inpatients which was reported as 4 adults and over the target of 2 adult inpatients, but that 3 of these patients had discharge destinations planned. It also updated on the number of inpatients for Children and Young People, with 1 young person remaining in specialist placement and work ongoing to prepare for discharge into the community with the necessary and appropriate levels of support. It was reported that care treatment reviews had successfully prevented two admissions from taking place which was welcomed by the Board.


The Board discussed the complex needs of residents with learning disabilities or autism and issues they faced around hospital discharge and choice of care. It was argued that the local target for Annual Health Checks should exceed the 70% national target.


Resolved – That the report be noted.


Wirral Winter Plan 2022-2023 pdf icon PDF 486 KB

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The Associate Director of Transformation and Partnerships (NHS Cheshire and Merseyside) introduced the report which provided a summary of Wirral Health and Care System’s preparations for winter 2022/23. It was reported that Wirral like other places across Cheshire and Merseyside was facing ongoing significant challenges within Urgent and Emergency and Care (UEC) pathways and that winter may be more challenging than most in respect of the cost-of-living crisis. In response, Wirral’s plan included initiatives within hospital such as new Virtual Wards to support people with Frailty and Respiratory conditions as well as out of hospital investment being made into securing more GP appointments, community beds and domiciliary care capacity.


Joint work between the NHS and Wirral Council was underway to support people affected by the cost-of-living crisis such as introducing Warm Hub locations. The plan had been developed across Health and Care Partners within Wirral such as the local hospital, community trust, primary care, social care and voluntary sectors. Wirral’s plan was still to be submitted for evaluation to NHS Cheshire and Merseyside Integrated Care Board (ICB) and NHS England.


Following updates from provider representatives, a discussion ensued on the capacity of emergency care in hospitals, which was reported at 99.2% capacity with the capacity protocol having been implemented twice in the week leading up to the meeting. The Board considered the system approach to dealing with hospital capacity including a focus on preventative measures and communications to the public about what other services were available and often more appropriate than emergency hospital care. It was noted that the winter plan for 2022/23 had notable differences to previous winter plans with an emphasis on the home first approach.


Resolved – That the preparations being made by Wirral’s Health and Care System partners for Winter 2022/23 be noted.


2022/23 Pooled Fund Finance Report to Month 5 August 2022 pdf icon PDF 529 KB

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The Associate Director of Finance (Cheshire and Merseyside) introduced the report which set out the arrangements in place to support effective integrated commissioning, including the budget and variations to the expenditure areas for agreement and inclusion within the 2022/23 pooled fund and the risk and gain share agreement.


It was reported that there was an overspend of £8.2m which was due to the CCG/ICB Wirral place pool commissioned services. This element of financial risk lay with the ICB and was predominantly due to Continuing Health Care and Mental Health packages of care (activity and price) operational pressures, which was being investigated, and therefore the ICB would meet the costs of this overspend. A deep dive into the main areas and a financial recovery plan had been requested and was now in the process of being developed. Mitigations had been identified and the Board was advised that a reduced figure was expected to be reported at the next meeting.


The Board discussed the mitigations that had been identified and it was outlined that further details on these could be shared with members. The financial recovery plan was being reviewed and it was proposed that the detail should be shared with the Board.


On a motion by Tim Welch, seconded by Dr David Jones, it was –


Resolved – That


(1)  it be noted that the forecast position for the Pool at Month 5 as currently a £8.2m overspend position due to the Clinical Commissioning Group / Integrated Care Board (ICB) Wirral Place pool commissioned services and that the ICB Wirral Place holds the financial risks on this overspend.

(2)  it be noted that due to the overspend financial position an urgent financial recovery plan was now being developed and in progress identifying responsible leads, actions and next steps, and that an update be provided to the January 2023 meeting of the Place Based Partnership Board.

(3)  it be noted that the shared risk arrangements were limited to the Better Care Fund only, which was reporting a break-even position.


Work Programme pdf icon PDF 370 KB

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The Head of Legal Services introduced the report which detailed the annual work programme of items for consideration by the Wirral Place Based Partnership Board. The Board was comprised of members from multiple organisations and the report enabled all partners to contribute items for consideration at future meetings.


It was noted that it had been agreed that the financial recovery plan would be reported back to the January 2023 meeting.


Resolved – That the work programme be noted.