Agenda and minutes

Venue: NHS Wirral Nightingale Room, Old Market House, Hamilton Street

Contact: Fiona Johnstone 

No. Item


Welcome and Apologies


Cllr Phil Davies welcomed the members to the meeting and took the opportunity to formally record his thanks to Cllr J. Green, who had previously held the position of Chair during his time as Leader of the Council.


Cllr Davies also wished to record his thanks for members’ contributions to date and looked forward to working with the group to make even greater strides around health and wellbeing for the population of Wirral.


Declarations of Interest


Members were asked to consider whether they had any personal or prejudicial interest in any matters to be considered at the meeting. No declarations of interest were recorded. 


However, it was agreed that a register of each member’s interests be established in line with Council policy.


It was resolved that:

Fiona Johnstone to establish the register of interests.


Minutes pdf icon PDF 132 KB

The minutes of the last Board Meeting (14 March 2012) are attached.


These were accepted as a true record of the proceedings.


Actions arising from the meeting of 14 March 2012:


Item 4: Alcohol presentation by Cheshire & Wirral Partnership in January 2012

Fiona Johnstone proposed that arrangements be made for an in-depth study to be undertaken on Alcohol as part of the Health & Wellbeing Strategy. This would be put on the Forward Plan. Details of the session would be advised and invitations sent to all interested parties.


Action: Fiona Johnstone to advise members of the details regarding this session.


Item 7.1 JSNA icon to be made available to the members – action closed

Fiona Johnstone thanked all members for agreeing to the installation of the JSNA icon on all PC desktops within their organisations.


Item 7.3 Public Health: Integrated Wellbeing model

Copies of the workshop report were requested.

Action: Fiona Johnstone to circulate the report to members.


Item 9: Relationship between the Health & Wellbeing Board and Overview & Scrutiny

Cllr Davies requested further clarity on this issue. Fiona Johnstone advised that she had had preliminary discussions with Cllr Mountney and will be meeting again with a view to proposing that a development session be arranged in order to understand the mutual relationship between the two committees. 


Action: Fiona Johnstone to arrange the joint meeting.


Health & Wellbeing Board Strategy pdf icon PDF 106 KB

Additional documents:


The members received the above report.


In order to meet one of the criteria of the Health & Wellbeing Board, there is a requirement to produce a Health & Wellbeing Strategy for Wirral. This strategy should be based on the needs of the population and then translate into actions that collectively address the underlying problems and lead to improving the health and wellbeing of the people of Wirral. It should also provide the members of the Health & Wellbeing Board with the opportunity to


·  explore local issues that previously may only have been addressed in isolation

·  develop a consensus on priorities to be addressed across the system and how to make use of collective resources in order to achieve them

·  formulate local decisions that drive service change (e.g. investment/disinvestment) according to local needs and to ensure local engagement with local communities.


The Board was advised that the results from the initial survey show that there were clear issues around alcohol and older people.


The draft strategy will be completed at the end of January 2013 and in line with the results of the initial work will focus on the areas of dementia and alcohol.


In considering the report, Cllr Phil Davies suggested that the link to the action plan is key and was interested to hear members’ views on the suggested framework.


Graham Hodkinson said that he would be interested in the relationship between the JSNA and the Status Review, which is due to take place, which could be an opportunity to bring in good practice.


Cllr Tom Harney referred the members to table 1 of the JSNA report “Responses to priorities any key issues identified”. He considered that in terms of producing a list of categories there was a danger that the said categories would be covering symptoms of other issues that needed to be addressed. He further considered that there is perhaps the need to look at other evidence and to conduct a reality check on what is happening and to go and actively talk to the people of the Borough.


Tony Kinsella responded by saying that any decisions made would have a strong evidence base to support any actions that were approved. Fiona Johnstone endorsed this by saying that the strategy would be outcome based with a prioritisation process based on what partners and the public were saying. Pragmatic decisions would be taken and there would be quite a number of steps to be followed before the first draft would be ready in January.


Dr Mantgani asked members to be mindful that real health issues need to be dealt with as well as the need to understand what impact poverty has on health for instance, which may be beyond the scope of the Board. However, he went on to say that there is a good track record in Wirral of all partners working together, as so often people with employment issues will pass through the primary care system at some stage. Julia Hassall also requested that the family as a  ...  view the full minutes text for item 4a


Extending Public Engagement pdf icon PDF 81 KB


The members received the above report.


This report states that the need to engage with Wirral residents in a comprehensive and effective way was acknowledged by the Shadow H&WB Board at its first meeting. The workstream was established with Voluntary Community Action Wirral (VCAW) taking the lead. The report advised that there are currently mechanisms in place but in order to achieve maximum reach and encourage feedback, more systems and mechanisms need to be developed and put in place. 


The Health & Wellbeing Board has acknowledged that the public need to understand how and why their opinions and ideas are being sought and how that information will be used. Full and participatory engagement will achieve this and will give the people of Wirral the opportunity to influence the priorities as well as perhaps taking an interest in their own and their community’s health and wellbeing.


It was acknowledge by the Board that existing and new methods of engagement should be explored and where possible utilised. Therefore the need to ‘map’ all existing engagement arrangements to identify any gaps or overlaps was agreed. 


Graham Burgess stated that the concept of joint working in the area of engagement would help with finances and also avoids any duplication of information and is worth exploring across the public sector. Di Hill asked the group to be mindful that in any engagement strategy there needs to be a clear form of words that can be easily understood and related to, and also to be aware that too many questionnaires and surveys may have the opposite effect.


Emma Degg advised the Board that a cross partnership group of communications staff had been established. Following liaison with VCAW and other partners, Emma Degg would produce a paper on a joint way forward for engagement.


It was resolved that:


·  Emma Degg to submit a proposal at the next meeting on a joint way forward for engagement.


Communications and Engagement Strategy pdf icon PDF 147 KB


The members received the above report.


Emma Degg stated that this report provides the Health & Wellbeing Board with a draft communications strategy, which will drive the promotion and engagement work required to assist in the delivery of the Board’s priorities. A wide range of stakeholders will be involved in or interested in the work of the Board and good communications will be at the heart of ensuring that they remain engaged and able to help shape the future. 


As stated during the discussions on engagement, a cross-agency communications and engagement group has been established across the patch to ensure that the work of the Board is promoted and communicated to all stakeholders in an effective, timely, consistent and appropriate manner. 


It was resolved that:


·  The report was noted and clearly linked with earlier discussions around the work of the JSNA and the Engagement workstreams.


Joint Commissioning and Integrated Delivery Update pdf icon PDF 110 KB


The members received the above report.


Graham Hodkinson advised the members that the Health & Wellbeing Board had previously identified that the area of joint commissioning was an important workstream.


The report provides an update on the situation following the NHS reform and the way the respective commissioners have embraced the challenges and opportunities that have become available. The document also provides a clear statement of intent in terms of delivery across the organisations, which are backed up by recommendations of the Wirral Integrated Commissioning Group.


Graham Burgess requested that a list of proposed jointly commissioned services together with a progress report be made available for the next meeting. He would also like to see reference to housing and leisure, areas where public health can influence outcomes. It was also recognised that this approach was the opportunity to co-ordinate the provision of services and would provide the opportunity to learn from each other.


Karen Prior advised that a Procurement Strategy had been submitted to Cabinet some time ago and she would make arrangements to distribute a copy to members. Julia Hassall also requested that reference to children and families be made and Graham Hodkinson in acknowledging this request would amend the Statement of Intent.


Cllr Phil Davies acknowledged that there was a clear appetite to explore this principle. Dr Abhi Mantgani also expressed his full support for the Integrated Commissioning Group and hopes it will build on the excellent joint working arrangements in Wirral.


It was resolved that:


·  The Board supports the establishment of the Wirral Integrated Commissioning Group.

·  Graham Hodkinson to amend the Statement of Intent to include reference to children and families.

·  A follow up report to be produced for the next meeting to include the list of proposed jointly commissioned services.

·  Karen Prior to circulate a copy of the Cabinet paper on Procurement Strategy.


Wirral Children's Trust delivery of children's services partnership activity through the Children & Young People's Plan pdf icon PDF 75 KB


The members received the above report.


Julia Hassall stated that the report details the Children & Young People’s (C&YP) arrangements via the Children’s Trust Board and invites the Health & Wellbeing Board to consider how the Trust’s planning arrangements can link with the work of the Health & Wellbeing Board and the Joint Health & Wellbeing Strategy.


The background sets out that there is a C&YP overarching strategic plan, which is reviewed annually. Currently there is no statutory requirement to produce an annual plan. The plan was carried out by the partner stakeholders and linked to five outcome areas:


  1. Being healthy
  2. Staying safe
  3. Enjoy and achieve
  4. Positive contribution
  5. Social and economic wellbeing


These priorities were informed through needs analysis including the Joint Strategic Needs Assessment (JSNA) and consultation with young people.


It was further stated that the Trust has a well-defined structure, including a joint commissioning group, which ensures involvement of all parties. In 2011 the Office for Standards in Education Children’s Services and Skills (OFSTED) rated Wirral Children’s Services as ‘performing excellently’ with a 4 on a 4-point scale. There is also strong representation from all agencies.


Julia Hassall continued by saying that as the Plan is published for the children, there is a children and young people’s version published on the teenWirral website. The Board was also assured that clear performance information is produced and returned on a quarterly basis.


In conclusion, Julia Hassall asked that the Board note the content and development of the C&YP Plan and to consider how it can be taken forward in view of any implications for the Joint Health & Wellbeing Strategy and the work of the Board.


Cllr Phil Davies asked the members to give consideration as to how the priorities in the C&YP Plan can be taken into consideration. This report also reconfirmed the need for the Wirral Integrated Joint Commissioning Group to include children’s services in any discussions.


Fiona Johnstone advised that she was a member of the C&YP Trust Board and took the opportunity to acknowledge the excellent work that is carried out on behalf of the younger population. She went on to say that this work is recognised as a key strand and will contribute to the health and wellbeing outcomes of the local population. As such it should be integrated as a key area of work in the overarching Health & Wellbeing Strategy.


It was resolved that:


·  The paper was noted

·  The key issues of the Children & Young People’s Plan be taken into consideration when drafting the Health & Wellbeing Strategy

·  C&YP services to be acknowledged as part of the Integrated Joint Commissioning Group.


Transition from LINk to Wirral Health Watch pdf icon PDF 65 KB

Additional documents:


Before discussing the paper, Fiona Johnstone tabled copies of an updated paper.


Graham Hodkinson advised that the updated report sets out the progress to date regarding the establishment of Wirral HealthWatch. This will be a local corporate body with links to HealthWatch England, being a statutory committee of the Care Quality Commission. 


The group was further advised that under Section 183 of the Health & Social Care Act 2012, the Local Authority was charged with a duty to make arrangements with a local body corporate to be known as Wirral HealthWatch; this being the replacement to the local LINks organisation. It was further reported that the local LINk Board and LINk members have been fully updated throughout the transition process. It is hoped that the HealthWatch Board will be in shadow form by the end of the year.


The group was further advised of the timeline moving forward to April 2013 as follows:-


August  write up consultation plan for future delivery of Wirral HealthWatch

September  begin consultation of delivery model of Wirral HealthWatch

October  begin recruitment of Wirral HealthWatch Chief Executive/Manager

December  community interest company (CIC) will be set up

January  employ Wirral HealthWatch Chief Executive/Manager

February/March  prepare the CIC for Wirral HealthWatch delivery

April  launch Wirral HealthWatch


Fiona Johnstone suggested that time be allocated at a future meeting to receive a further progress paper from the transition group.


Di Hill advised that further guidance on the transition was due out in October.  She also hoped that throughout the transformation into HealthWatch that the essence of the work of the LINk organisation will not be lost.


It was resolved that:


·  The Board continues to support the formation of Wirral HealthWatch and notes the progress to date.

·  An update paper from the Transition Group be received and agenda time set aside to discuss progress.


Wirral Clinical Commissioning Group


The Committee received an update from Dr Abhi Mantgani on the latest position regarding the Wirral Clinical Commissioning Group.


Following on from the agreement to establish a federation of the 3 commissioning consortia, the group was advised that the following appointments have now been made:


·  Chief Financial officer

·  Chief Clinical Officer

·  Two non-executive lay members – Audit and Governance

Patient Champion (clinical)


Other appointments will follow to include secondary care doctor and registered nurse. 


The group was further advised that the federation is also moving forward with the authorisation process, the outcome of which should be known in December. Authorisation can be granted with or without conditions.


In terms of development, work is progressing on updating IT equipment in surgeries and other premises in order to remove some of the paper-based systems and replace with electronic systems.


Areas of clinical development are also proceeding, including the opening of the breast-screening programme at the new St Catherine’s site and work has also been ongoing around the areas of dementia and alcohol awareness.


Dr Mantgani proceeded to advise that as the CCG moves closer to authorisation, members of the Board would be approached to complete a 360° survey. This will take place over the next few weeks and will feed into the authorisation process.


The group was also advised that the CCG recently held a board development day at which their vision/mission statement was discussed and some members of the H&WB Board were part of the group. 


Lorna Quigley proceeded to advise some of the words/suggestions that were captured at the development session and advised that the following strapline was eventually put forward as a suggestion.


“Your partner in a healthier future for all”


However, before the CCG mission statement is finalised, the views of the H&WB Board members and other stakeholders would be welcome. Arrangements would be made for a copy of the work captured at the development day to be sent to the members for their comment and feedback.


It was resolved that:


Lorna Quigley to pass the relevant papers to members with a request that any comments or suggestions be returned by the end of September.


Place Based Leadership Development Activity (Board Behaviours) pdf icon PDF 37 KB

This item will allow the Board to define the behaviour it wishes to adopt and to receive feedback from the telephone interviews that have been undertaken recently in order that the Board can develop a clear Memorandum of Understanding for future operation.


Professor Laurie McMahon presented a summary of output from interviews with Wirral Health & Wellbeing Board members that took place during July and August 2012.


By way of background Professor McMahon stated that one of the priorities that was selected for further work as part of the NHS Leadership Academy’s Place Based Leadership initiative, concerned appropriate member behaviour both within and beyond the meetings of the Health & Wellbeing Board.


A project design was agreed by which Board members would be interviewed about what behaviour they thought would help bring about the success of the Board. The analysis of the interviews would then be used to work within the Board to ascertain if a Memorandum of Understanding could be developed.


Professor McMahon proceeded to present the outcome of the analysis, which had resulted in 6 key ideas on which to build and develop the work of the Board and also its members.


  1. Role of the Health & Wellbeing Board
  2. Formal Processes
  3. Coping with Members; multiple roles
  4. Recording and reporting
  5. Decision-making
  6. Member behaviour


Professor McMahon stated that a report would be prepared following his observations of the members at the formal meeting and also the results of the interview process.


Cllr Phil Davies, on behalf of the members, thanked Professor McMahon for his comprehensive presentation. 


Fiona Johnstone also thanked Professor McMahon and said the presentation helped to crystallise the key feelings of the members and feedback would be welcome.


Dr Shyamal Mukerjee stated that although members may discuss and deliberate topics in a robust way, and may occasionally disagree on issues, it should be the role of the members to relay a consistent message and to be honest about what can be delivered.


It was resolved that:


·  Professor McMahon is thanked for his presentation and verbal report.

·  Professor McMahon to forward a copy of the output report.

·  Fiona Johnstone to work with Professor McMahon to develop a draft Memorandum of Understanding.

·  Emma Degg to draft a key message document.

·  Professor McMahon was thanked for his work with the Board over the prior 12 months.


Forward Plan pdf icon PDF 58 KB


Fiona Johnstone reported that the concept of the Forward Plan would support a proactive approach to the work of the Health & Wellbeing Board. This would be published with the Board papers and will provide transparency in relation to the intended work programme.


All members were requested to notify Fiona Johnstone of any areas for discussion/debate.


It was resolved that:


·  All members to forward topics for the Forward Plan to Fiona Johnstone


Review of Terms of Reference and Membership pdf icon PDF 57 KB

Additional documents:


Fiona Johnstone advised that the Terms of Reference for the Health & Wellbeing Board were agreed in December 2011 with a review to take place after 12 months.


Membership: all members were asked to comment on the existing membership. In discussion Graham Burgess suggested that if possible the membership should be limited to 20 in number. It was further suggested that perhaps the group organise a yearly conference for the purposes of reflection and forward planning.


The frequency of meetings was also discussed and it was suggested that the group meet every 6 weeks, alternating between formal board and development sessions.


David Allison voiced his concern regarding the role of the GPs on the Board.  He was advised that the GPs were representatives of their respective areas and do not attend in any ‘GP’ commissioning capacity. Fiona Johnstone reminded the group that as of 1st October Moira Dumma will be taking up the position of Local Area Director for the Cluster and she will be invited to take up a position on the Board. As Local Area Director she will be responsible for commissioning GP services. Again the members were reminded that the Health & Wellbeing Board was not a commissioning body.


All members were asked to consider the current membership and the group was reminded that a case to include representation from Housing had been made earlier.


The final membership will be advised at the next Formal Board meeting.


In conclusion, the members were asked to review the current membership and advise any obvious omissions. Any proposals for additional membership must be accompanied by a rationale for inclusion.



It was resolved that:


·  All members review the current membership and advise any changes or omissions to Fiona Johnstone.

·  An invitation to join the H&WB Board will be sent to Moira Dumma.

·  The frequency of meetings will be every 6 weeks.


Date of next Formal Board Meeting

  Suggested date Wednesday 12 December at 5.00 pm


It was agreed that this be held at 4.00 pm on 12 December 2012, Committee Room 2, Wallasey Town Hall.


There being no further business to discuss the meeting closed at 7.45 pm.