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.

Members were asked if they had any pecuniary or non-pecuniary interests in connection with any application on the agenda and, if so, to declare them and state the nature of the interest.

Councillor Phil Gilchrist declared a non-pecuniary interest by virtue of being the Appointed Governor: Cheshire and Wirral NHS Partnership Trust.

Councillor Phil Davies declared a non-pecuniary interest in Item 4 Sustainability and Transformation Plan (STP) and the Healthy Wirral Local Delivery Services Plan (LDSP) by virtue of his wife’s employment as a Community Pharmacist.

Apologies were received from Phil Byrne, Mersey Fire and Rescue, Andrew Cannell, CEO, Clatterbridge Cancer Centre, Sheena Cumiskey, Cheshire and Wirral NHS Partnership Trust, Councillor Jeff Green and Julia Hassall, Director of Children’s Services.

To approve the accuracy of the Minutes of the Health and Wellbeing Formal Board on 9 March 2016.

Resolved - That the accuracy of the Minutes of the Health and Wellbeing Formal Board held on 9 March, 2016 be approved as a correct record.

Jon Develing, Chief Officer, Wirral CCG presented the report to brief members of the Health and Well Being Board on sustainability and transformation plans for Cheshire and Mersey and how this would be informed by a local delivery services plans for Wirral. The report explained how the Wirral Local Delivery Service Plan (LDSP) provided a foundation for the Healthy Wirral element of the plan, and how future governance arrangements to oversee implementation of the plan would  be developed.

It was reported that NHS Planning Guidance ‘Delivering the Forward View 2016/17 – 2020/12’ had been published on 22 December 2015. This had set out the requirement for local health systems to work together to produce Sustainability and Transformation Plans, which described how systems would achieve sustainability over the five year period.

The STPs required local leaders to come together to describe

• A shared vision for the health economy

• The programme of activities which will take the system into sustainability

• The governance for how this will be delivered

• The resources required, with up to £8.4bn set aside over the period to enable transformation to secure sustainability

• The STP would therefore be the future mechanism by which systems across the country gained access to transformational monies.

Members welcomed the report and agreed it would be a good framework and focus for the Health and Wellbeing Board with helpful ties to the Wirral 20:20 Plan.

(Councillor Phil Davies left the room during discussion of the area of the report concerning Community Pharmacies).

Resolved – That the development of the Healthy Wirral Local Delivery System Plan and the mechanism by which this will feed into the wider development of the Cheshire and Mersey STP be noted and endorsed.

This will be a  Verbal Report.

Nicola Allen, NHS England, attended the meeting and presented a verbal report to the Health and Wellbeing Board on the following areas:-

Strategy & Planning

STP: There was a national deadline of 30th June 2016 for STP submissions which Cheshire & Merseyside had met. 1:1 feedback would be given to local leaders regarding the submission by a panel including Simon Stevens (NHS England), Jim Mackie (NHS Improvement) and Mark Lloyd (LGA) on 20th July 2016.

The NHS England local office had worked with Regional colleagues and the NHS Improvement to perform a high level review of the financial submission which underpinned the STP. The broad themes to be fed back on this early submission were consistent with many other STP footprints, and these related to the maturity/robustness of governance arrangements and the reasonableness of the proportion of targeted efficiencies expected to arise from business as usual work streams.

In addition, the number of the financially challenged organisations operating within the footprint, and the risk for this to lead to inward focus on recovery solutions was recognised as a potential concern. 

GP Forward View: The GP Forward View had been developed and published in April 2016. This was a 5 year plan to stabilise, develop and transform Primary Medical Care which would benefit from a £2.4bn investment in Primary Medical Care between 2016/17 and 2020/21. Across the GP Forward View there were in excess of 80 commitments to deliver with 56 having significant elements of regional or local delivery. The main themes of the document in meeting the five year forward view challenge were:

•  Workforce

•  Estate & digital technology

•  Quality

•  Innovation & Transformation at scale

Joint Commissioning of primary medical services with Wirral CCG had commenced on 1st April, with the first meeting of the Joint Primary Care Commissioning Committee being held in Quarter 1.

Assurance

Financial Recovery: The Cheshire & Merseyside STP footprint had one of the highest proliferations of financially challenged CCGs. Financial plans for 2016/17 indicated a considerable level of financial risk is seeking to be managed. The picture was similarly challenging across the local provider system. As a consequence, there was a significant level of financial recovery effort being undertaken (under the oversight of the NHS England local office) to support the sustainability and transformation of services as set out in the STP. Inability to achieve this may impact on the overall ability of NHS England to remain within its formal resources envelope for 2016/17.

Health Outcomes

The Cheshire & Merseyside Strategic Clinical Network & Senate has merged with Lancashire (following the split of Lancashire & Greater Manchester Strategic Clinical Network as a consequence of Greater Manchester devolution). The new North West Coast Strategic Clinical Network was now co-terminus with the Academic Health Science Network and was ideally placed to support service improvement in the priority areas of Cancer, Mental Health & Dementia, Maternity Children & Young People, CVD, Palliative and End of Life care.

Councillor Phil Davies commented that it would be useful to look at the devolution area around health and  ...  view the full minutes text for item 37.

Members of the Board gave consideration to the Wirral Health Protection group: Annual Report 2015/16. Rachel Musgrave, Public Health, attended the meeting, provided members with an overview of the report and responded to members questions. This was the first Annual Report of the Wirral Health Protection Group, a forum of local partners working collaboratively to tackle key threats to the health of local people. The Wirral Health Protection Group had responsibility to ensure that Wirral had a robust health protection system which effectively controlled and prevented population level health issues.

Rachel Musgrave reported that the first section of the JSNA dedicated to Health Protection had recently been developed and was available at http://info.wirral.nhs.uk/default.aspx. She reported that the key health protection priorities were identified in the report and provided a targeted focus for the whole partnership in areas where improvement was required or needs were greatest. The report also included ‘Delivering Wirral’s Health Protection Priorities in 2016/2017’, set out information on how these priorities would be achieved over the next twelve months and identified the Accountable Lead/Group for each area.

Resolved – That the report be endorsed and the programme of action be supported.

The Health & Wellbeing Board gave consideration to the annual report of the Director of Public Health.

The production of an annual report was a statutory requirement of the Director of Public Health and helped to identify key issues, flag up problems, report progress and inform local inter-agency action. The 2015/16 annual report ‘Domestic Abuse, Let’s Make a Difference’ focussed on domestic abuse and supported the Wirral Plan 2020 pledge of zero tolerance to domestic abuse.

The annual report aimed to raise awareness and prompt discussion of domestic abuse. It called for individuals and organisations to play their part in preventing domestic abuse and, where it is happening, to help people access the support that is right for them. 

The year’s report was accompanied with a short film. This shared first-hand accounts of domestic abuse and its effect and how, with the right support, safe solutions could be found. The annual report and film had been developed with the support of Tomorrow’s Women Wirral and Involve Northwest. These organisations worked closely with Wirral individuals and families who had been affected by domestic abuse.

The report highlighted that domestic abuse was a significant issue for Wirral. The Borough had higher than the national average rates of police recorded incidents of domestic abuse. There remained a strong perception that domestic abuse was mainly physical male on female violence. The Director of Public Health’s annual report outlined that this was only part of the picture. The report described how domestic abuse could manifest in many different ways and how it could affect any age, any race, any class and any gender and could occur in all types of relationships.

The report shared work that had been delivered locally to raise awareness of domestic abuse and the stories of individuals who had been supported to deal with domestic abuse. It included suggestions for individuals and organisations and recommendations to tackle domestic abuse supporting the Council’s pledge of zero tolerance. Local and national sources of further help and information were also provided at the end of the report. 

Fiona Johnstone, Director of Public Health also reported that there was a communication plan to share the report and film with a wide range of stakeholders to increase awareness and encourage people to take action. This included, for example, Wirral Domestic Abuse Alliance, Wirral Clinical Commissioning Group, police, schools, workplaces and local residents. 

Resolved – That the communication of the annual report and film report be supported.

The date of the next formal Board meeting is Wednesday 13 July, 2016 at 4:00pm in Committee Room 1 Town Hall, Wallasey.

The date of the next formal Board meeting would be Wednesday 16 November, 2016 at 4:00pm in Committee Room 1 Town Hall, Wallasey.