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

Apologies for absence were received from:

David Bradburn, Director of Public Health, Wirral Council

Janelle Holmes Wirral University Teaching Hospital

Karen Howell, Wirral Community Health and Care NHS Foundation Trust

Karen Prior, Healthwatch Wirral

Simone White, Director of Children’s Services, Wirral Council

Tim Welch, Cheshire and Wirral Partnership NHS Foundation Trust

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.

Resolved –

That the minutes of the meeting held on 10 November 2022 be approved as a correct record.

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

The Director of Quality and Safety at NHS Cheshire and Merseyside presented this report which identified key issues identified relating to Quality and Safety through the Wirral Quality and Performance Group and other relevant sources. The report included: Issues of concern, issues of a general update, and issues for assurance. The report also highlighted where appropriate the actions that have taken place and the timescale of completion.

Members highlighted the issue of the increase in mental health problems and provision of care, including an increase in patients being placed in beds out of the area due to problems in community provision locally. The issue of the spread of C Difficile was also highlighted, which was to be investigated in trials in January 2023.

Resolved – That the areas of concern contained within the report, and the actions that are being taken be noted.

The Assistant Director – Communications & Corporate from NHS Cheshire and Merseyside presented this report which summarised the action taken by the Place Governance Group to progress points raised at the first formal meeting of the Wirral Place Based Partnership Board on 13 October 2022. The report presented revised Terms of Reference.

Several points of clarification were requested including:

·  A wish to see reports from all of the reporting groups

·  Specified representatives or level of representation from the constituent bodies

·  The specific quorums for Council officers and Members and voting rights

The Chair suggested that the recommendations be amended in the light of the discussion:

Councillor Mary Jordan moved new recommendations: That the Wirral Place Based Partnership Board

1. note the work to progress the actions detailed in the report and note that further work will be undertaken, with the terms of reference being draft;

2. ask the Place Governance Advisory Group to address the issues raised by the Place Based Partnership Board at its meeting on 8 December 2022 and

3. The Place Director remains as chair for the remainder of the Municipal Year and until a system is agreed regarding frequency and change of Chair and Vice Chair.

This was seconded by Councillor Yvonne Nolan.

Resolved – That

(1)  the work to progress the actions detailed in the report be noted and further work be undertaken, with the terms of reference being draft;

(2)  the Place Governance Advisory Group be asked to address the issues raised by the Place Based Partnership Board at its meeting on 8 December 2022; and

(3)  the Place Director remain as chair for the remainder of the Municipal Year and until a system is agreed regarding frequency and change of Chair and Vice Chair.

The Assistant Director – Communications & Corporate from NHS Cheshire and Merseyside presented this report which set out the four key governance and assurance groups that NHS Cheshire and Merseyside had established with partners in Wirral to support the Wirral Place Based Partnership Board and prepare for additional responsibilities through delegation. The report set out progress to date and draft terms of reference. It was noted that the groups were replicated in each of the nine Places in the Cheshire and Merseyside Integrated Care System.

Members pointed out consistency errors and made wording suggestions.

The Chair suggested amended recommendations in the light of the discission. These were proposed by Carol Johnson-Eyre and seconded by Alison Hughes.

Resolved – That

(1)  the work to establish the supporting governance and assurance mechanisms to support the work of NHS Cheshire and Merseyside and the WPBPB in the Borough be noted;

(2)   the establishment of the four supporting groups be endorsed;

(3)   amended terms of reference be brought back to the February Board meeting for approval.

The Chief Finance Officer of NHS Cheshire and Merseyside presented this report which provided a description of the arrangements that had been put in place to support effective integrated commissioning. It set out the key issues in respect of: a) budget and variations to the expenditure areas for agreement and inclusion within the 2022/23 shared (“pooled”) fund; and b) risk and gain share arrangements. The report also provides an update on the preparation of the framework partnership agreement under section 75 of the National Health Services Act 2006 relating to the commissioning of health and social care services, which will be subject to approval and final sign off by Cheshire and Merseyside Integrated Care Board (ICB).

The pooled finances were on target for a balanced position, and there was one major risk which was around the continuation of discharge and assessed beds. There had been an overspend but a financial recovery plan was in place.

Resolved – That

(1)   the forecast position for the Pool at Month 6 be noted as a £5.3m overspend position due to the Clinical Commissioning Group (CCG) / 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 the shared risk arrangements are limited to the Better Care Fund only, which is reporting a break-even position.

Decision making on this item is reserved for the Joint Strategic Commissioning Board Sub-Committee.

The Head of Legal Services introduced this item, which was to elect a Chair from amongst the three Councillors who were members of Wirral Council’s Adults, Social Care and Public Health Committee who sat on the Wirral Place Based Partnership Board. This was because a decision was required on the following agenda item and the decision had to be made by the Joint Strategic Commissioning Board Sub-Committee, which was a Sub-Committee of the Adults, Social Care and Public Health Committee and which sat in common with the Wirral Place Based Partnership Board but with only the three Councillors having voting rights.

Nominations were invited for the role of Chair.

Councillor Jason Walsh nominated Councillor Yvonne Nolan. This was seconded by Councillor Mary Jordan.

There were no other nominations so Councillor Yvonne Nolan sat as Chair.

Decision making on this item is reserved for the Joint Strategic Commissioning Board.

The Place Director introduced this report which set out the purpose of the Adult Social Care Discharge Fund, how the resources have been allocated, the conditions attached to the funding and how this impacted on Wirral as a Place. The Adult Social Care Discharge Fund was a national allocation of resources to local authorities and the NHS from His Majesty’s Government. The deadline for submission of the Wirral plans for the Adult Social Care Discharge Fund was 16th December 2022.

The funding was being released in two tranches in December 2022 and January 2023 and there were are some specific conditions set by the Department of Health and Social Care (DHSC). The NHS allocation was to allow movement from hospital, supporting discharge using a home first policy, with metrics to track performance. There is a share of £2.1 M with schemes funded at actual rather than planned cost so funds can be reinvested if schemes were not effective.

The Director for Care Health and Strategic Commissioning explained that the local authority allocation was £1.5 M, with the same deadline of 16 December and the same chief officers from the NHS and Council working on it, but the focus was different. The Council’s allocation was focussed on the care market, sustainability and capacity and also on the domiciliary care market, looking at admissions and discharges with a proportion to support ‘charge to assess’, where assessment is carried out at home to avoid hospital admissions. 

Members discussed the schemes and plans involved.

The three elected Members sitting as the Joint Strategic Commissioning Board Sub-Committee Resolved – That

(1)  the approval of the Wirral plan for the Adult Social Care Discharge Fund be delegated to the Director of Adult Social Care and Health, Wirral Council in consultation with the Place Director, NHS Cheshire and Merseyside.

(2)  a further update report on the submission be brought to the next meeting of the Joint Strategic Commissioning Board and Wirral Place Based Partnership Board.

The Place Director resumed the Chairing of the Wirral Place Based Partnership meeting.

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.

Changes to the work programme were made and noted by officers.

Resolved – That the work programme be noted.