The Chair welcomed everyone and read the webcast notice.

PRESENT:

Councillor Jean Robinson   Chair

Abel Adegoke   Primary Care

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

Sayyed Osman  Director of Adults, Health and Strategic Commissioning, Wirral Council

Dave Bradburn   Director of Public Health, Wirral Council

Councillor Phil Gilchrist   Wirral Council

Councillor Jeff Green  Wirral Council

Councillor Kieran Murphy  Wirral Council

Elizabeth Hartley   Director of Children’s Services, Wirral Council

Matthew Swanborough   Wirral University Teaching Hospital

Rebecca Barker  Department for Work and Pensions

Tony Bennett  Wirral Community Health and Care

John O’Boyle  Merseyside Fire and Rescue Service

Michael Brown  Chair of Wirral Community Health and Care NHS Foundation Trust

Matthew Moscrop  Merseyside Police 

Also present:

Dave Higgins  Department for Work and Pensions

Libby Eastley  Magenta

Tracy Flute  Wirral Council

Julie Graham  Wirral Council

Jo Simpson  Wirral Council

Bridget Hollingsworth  Wirral Council

• Janelle Holmes, CEO, Wirral University Teaching Hospital was substituted by Matthew Swanborough, Chief Strategy Officer;
• Sir David Henshaw, Chair of Wirral University Teaching Hospital
• Mark Greatrex, Chief Executive was substituted by Tony Bennett, Chief Strategy Officer;
• Julie Gray, Wirral Council;
• Gill Banks, Principal, Wirral Met College;
• Louise Healey, DWP was substituted by Rebecca Barker, Disability Employment Adviser Lead, DWP;
• Mark Thomas, Merseyside Fire and Rescue Service (MFRS) was substituted by John O’Boyle, Group Manager MFRS;
• Isla Wilson, CEO, Cheshire & Wirral Partnership NHS Foundation Trust
• Paul Satoor, CEO, Wirral Council
• Simon Banks, Place Director (Wirral), NHS Cheshire and Merseyside
• Cllr Julie McManus, Wirral Council
• Cllr Sue Powell-Wilde, Wirral Council

Members of the Board are asked whether they have any personal or prejudicial interests in connection with any application on the agenda and, if so, to declare them and state the nature of the interest.

There were no declarations of interests.

To approve the accuracy of the minutes of the meeting held on 14 March 2024.

Resolved:

That the minutes of the meeting of the Health and Wellbeing Board on 14 March 2024 be agreed as a correct record subject to the agreed amendments as follows:

Instead of the Director of Public Health:

Minute 43 should read the report of “the Place Director (Wirral), NHS Cheshire and Merseyside”.

Minute 44 should read the report of “the Director of Adult Care and Health”.

minute 45 should read the report of “the Chief Executive Officer of Healthwatch”.

Minute 46 should read the report of “the Place Director (Wirral), NHS Cheshire and Merseyside”.

Minute 47 should read the report of “the Place Director (Wirral), NHS Cheshire and Merseyside”.

No questions, statements or petitions were received.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact juliegraham2@wirral.gov.uk if you would like this document in an accessible format.

The Early Childhood Team Operation Manager and the Public Health Principal presented the report of the Director of Public Health which was the third report in the rolling quarterly ‘deep dive’ session for each of the priority areas.  Priority 3 focussed on ensuring the best start in life for all children and young people through the priority’s game changers ‘Best Start/Early Help and Family Help’. The priorities of the Health and Wellbeing Strategy were aligned to the ambitions of the Wirral Plan, particularly, working for brighter futures for children, young people and their families by breaking the cycle of poor outcomes and raising the aspirations of every child in Wirral, as well as working for safe and pleasant communities where our residents feel safe, and where they want to live and raise their families. 

It was acknowledged that this was a dynamic and evolving programme and some of the work required further development across the system. It was highlighted that working as a multiagency team, 12 family hubs across Wirral have been created including locations in schools third sector buildings and Local Authority activity centres. The Best Start for Life programme was offered at all the family hubs and provided help for families in a child’s first 1001 days. In addition, the Family Tool Box provided a digital enhanced offer. It was reported that Wiral has been selected as one of the five Pathfinder areas in the country. This delivery of the 12 month Pathfinder programme was scheduled to commence in September 2024. This was to include reshaping the multidisciplinary work on Wirral and testing what worked and this was an excellent opportunity. It was reported that there were two new offers for children and young people. The first was around emotional health and wellbeing and was a digital portal called Branch which would provide services, information and support. Branch would be able to generate real time data. It was explained that a new Mental Health in schools team was due to go live in September 2024 and targeted at secondary schools. The second offer was the risk and resilience approach which would bring together many services in one place, such as substance misuse and sexual health services, to offer a holistic approach and to gather intelligence to add insight to the offer. It was key to link across all the game changers to have the maximum impact and the employment and worklessness game changer was explained.  Audits were to be undertaken around attendances at A&E for substance misuse and mental health and attendance at A&E. The mental health data had been collected last week. This was to give a clear baseline of what the picture was when the two new initiatives for children and young people commenced.

It was clarified to members that the report covers children and young people with SEND up to the age of 25. Members asked about the definition of school readiness, the location of the satellite sites and Core 20+5. The Core  ...  view the full minutes text for item 6.

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. It was explained that a report would be brought to each future meeting of the Health and Wellbeing Board and progress would be tracked on a monthly basis. It was explained that progress would be monitored on each of the 10 areas identified in the SEND Improvement Plan and these actions are expected to be delivered by October 2025. It was highlighted that a recovery plan for EHCP’s had been approved and a plan to increase the capacity of the educational psychologists and the statutory SEND assessment team had already been agreed.  A recovery plan for SALT in the neurodevelopmental pathway had also been put in place.

Members suggested including a range of providers and representation of children and young people on the Board

Members asked about LIFE school. It was explained that a rapid review had been completed and a recommendation had been made to the national panel that Wirral Council would undertake a child safeguarding practise review and this was expected to be supported. An independent reviewer would then be appointed to complete that review which would be published.

Members discussed early interventions which would mean that less children would need EHCP needs assessments and statutory plans.

The Chair proposed an addition to the recommendation to state that: It is recommended that the Health and Wellbeing Board notes the SEND improvement delivered though the Local Area SEND Partnership Board and requests that the SEND Partnership Board reviews its membership with a view to include representation of Primary Care and NHS partners on the board.

This was seconded by Dr Abel Adegoke and agreed by assent.

Resolved: That

1. The Health and Wellbeing Board notes the SEND improvement delivered though the Local Area SEND Partnership Board and requests that the SEND Partnership Board reviews its membership with a view to include representation of Primary Care and NHS partners on the board.

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The Director of Public Health presented the report with support from the Assistant Director, Consultant in Public Health which provided an overview of the work undertaken on the Joint Strategic Needs Assessment “JSNA” programme over the past year and outlined some of the work prioritised as part of the 2024/2025 programme. Findings from an overarching annual assessment of key population health metrics were presented along with plans describing how this annual statistical summary will be enhanced. It was explained that the JSNA has been in place in Wirral for a number of years and it consisted of in depth strategic needs assessments and community research and a suite of interactive tools on the website so that the end user could interrogate the data systems and self-serve. It was highlighted that the website had been improved in response to feedback and the governance of the JSNA process had been improved through the Health and Wellbeing Strategy Implementation Group. Work had been done to expand the capacity for community research to develop a qualitative research toolkit to make the most of all the engagement with local residents and to provide a repository to capture that information. It was explained that the Marmot All Together Fairer Plan had been used to look at how to best address the social determinants of health and work had been done across Cheshire and Merseyside to develop some metrics to track progress. The report contained a comparative position for Wirral on the All Together Fairer beacon indicators and proposals for enhancing that with some locally defined indicators.

Members discussed the variation on the Wirral of male and female life expectancies and the ability to pull out information for different sectors of the population including people with disabilities. Members asked about barriers to active travel.

Members asked about the decrease in life expectancy and the reasons for this were discussed and scrutiny of the reasons for this was planned.

Resolved: That

1. the report be endorsed.
2. the ongoing JSNA programme as a collaborative, cross-system endeavour which provides the strategic intelligence to inform system-wide priority-setting and action to improve health and reduce inequalities be supported.

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The Director of Adults, Health and Strategic Commissioning presented the report of the Place Director (Wirral), NHS Cheshire and Merseyside which outlined the delivery dashboard for the programmes within the Wirral Place Health and Care Plan which provided an oversight of the whole programme portfolio, provided a monthly narrative update and Red Amber Green rating of overall programme delivery, benefits, risks and issues.  It was highlighted that population health was largely centred around prevention and to engage communities to improve their health. It was noted that there continued to be significant demand on the Wirral Place system and resources continued to be challenged so it was important to ensure that best value continued to be delivered by transforming and improving services. It was highlighted that workforce was critical to delivery across the social care system to ensure sufficiency to deliver against the programmes and challenges that Wirral had. There was an emphasis on work in the digital space which was about enabling more innovation and efficiency whilst making sure people were not excluded. It was recognised that under the medical optimisation programme medication was not always the best form of treatment or support.

It was clarified to members that the EHCP plans were rated as green as this rating referred to the RAG rating of the programme and the work that had been done around improvement and implementation of transformation and this was discussed. It was suggested that there could be a section added regarding what the current situation was in Wirral and what improvement was planned in terms of the programme itself to give clarity around what was to be improved and what progress had been made.

Resolved: That the overview of the delivery and oversight of the Health and Care Plan programmes to the Wirral Place Based Partnership Board as set out in this report be noted.

The Head of Integrated Services presented the report of the Director of Adults, Health and Strategic Commissioning which provided a summary of the proposed content of the Better Care Fund (BCF) Plan for 2024/25 and asked for approval of the plan. It set out the detail of the budget areas to be pooled in 2024/25 as part of the mandatory Section 75 agreement with the Integrated Care Board. It was reported that there were no material changes for Wirral and the capacity and demand assumptions were correct. It was noted that Wirral has a much improved NCTR of less than 10 percent of beds occupied by people with NCTR compared to 2023 when the NCTR figure was 34 percent. The ambition was to have only 5 percent of people in beds who could be at home. It was reported that a delirium pathway was being developed. It was explained that the Health and Wellbeing board had sovereignty to approve the plan and the Section 75 agreement was then scheduled to go to the Adult Social Care and Public Health committee that evening. The levels of funding were predetermined and it was noted that the Council had no influence over those. There was an ambition to work with far more people with lived experience and carers.

Members asked about the quality of life after discharge from hospital and this was discussed. It was explained that statutorily a person who went home with a package of support would have to be reassessed by a social worker.

Members asked about who shaped the BCF plan and a workshop was to be held to enable members to influence the deployment of the BCF services. 

Resolved: That

1. the content of the mandatory BCF Plan for 2024/25 be approved.

2. Continued compliance with the requirements of the BCF fund be noted and that (NHSE) outcomes for 2023/25 continued to be met.

3. That there were no changes to the capacity and demand assumptions included in the 2023/25 BCF plan be noted.

4. The information provided that will enable the Health and Wellbeing Board to influence the deployment of BCF services within the lifespan of this plan (2023/25) and plans be noted.

5. That the current position does not pose a risk to the Section 75 Agreement be noted.

6. The detail of the budget areas to be pooled in 2023/24 as part of the mandatory Section 75 agreement with the Integrated Care Board be noted.

The Chair presented the report which gave the proposed work programme for the following Municipal Year.

It was agreed that the Director of Adults, Health and Strategic Commissioning was to prepare a briefing note about the issues in the whole system.

Resolved: That subject to the above additional item the proposed Health and Wellbeing Board work programme for the remainder of the 2024/25 municipal year be noted.