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, a member of the Improvement Board and a member of the Council’s task and finish group in relation to Agenda 4 Community Pharmacies Scrutiny Report (Minute No 61 refers).

Councillor Chris Jones declared a personal interest by virtue of her employment with the Cheshire and Wirral Partnership NHS Foundation Trust.

Councillor Tony Smith declared a non-pecuniary interest by virtue of being a member of the Improvement Board.

Dr Sue Wells declared a non-pecuniary interest by virtue of being a partner in a medical practice.

Apologies were received from Councillor Phil Davies, Councillor Jeff Green, Ms Sheena Cumiskey, Cheshire and Wirral NHS Partnership Trust, Jon Develing, Accountable Officer, Wirral CCG, David Allison, CEO Wirral University Hospital Trust, Annette Roberts, Community Action Wirral, Phil Davies, Healthwatch Wirral, Chief Superintendent Ian Hassall, Merseyside Police and Clare Fish, Strategic Director Families and Wellbeing.

To approve the accuracy of the Minutes of the Health and Wellbeing Formal Board held on 16 November, 2016 and 23 January, 2017.

That subject to the amendment of Suzanne Edward’s title to Service Director, CWP Wirral that the accuracy of the Minutes of the Health and Wellbeing Formal Board held on 16 November 2016 and 25 January 2017 be approved as a correct record.

Members of the Board gave consideration to the Chair and members of the People Overview & Scrutiny Committee’s Community Pharmacies Report January 2017.  The Director of Health and Wellbeing introduced the item and outlined the background to the report.  Members were informed that the Government had set out initial proposals for community pharmacy in 2016/17 and beyond in an open letter to the Pharmaceutical Services Negotiating Committee (PSNC) and other stakeholders on 17th December 2015. The proposals had included revised contractual and funding arrangements. A period of formal consultation had ended on 24th May 2016, although confidential discussions had continued beyond that date.

Following a Notice of Motion to Council in July 2016, this issue had been referred to the People Overview & Scrutiny Committee for further consideration. On the advice of NHS England, it was not practical to commence a detailed scrutiny review immediately as the Government had not, at that time, made a formal response to the consultation nor provided detailed proposals regarding the future contractual and financial arrangements for community pharmacies. 

Once the Government’s final proposals had been made public in October 2016, a task & finish group had met in November to consider the potential impact of the changes to Wirral. The group had agreed that the objectives of the review were:

•  To understand the rationale behind the current provision of community pharmacies in Wirral. 

•  To review the implications for Wirral of the Government proposals for changes to the contractual framework and funding of community pharmacies.

•  To ascertain whether action or intervention by the various partners would be necessary to mitigate the impact on services. The report attached as Appendix 1 documented the findings of the members and the conclusions which had been drawn. On 1st February 2017, this report had been approved by the People Overview & Scrutiny Committee and had been referred to the Health & Wellbeing Board for further consideration.

Councillor Moira McLaughlin, Chair of the People Overview & Scrutiny Committee being unable to attend the meeting of the Health & Wellbeing Board Councillor Angela Davies, who had been a member of the task and finish group, attended the meeting and outlined the report and the recommendations to the Board.

Councillor Phil Gilchrist commented that the task and finish group had been a learning experience for members and the intention was to flag up an early warning system in case any pharmacies were to close and further to ensure that no communities were left without pharmacies. In relation to recommendation 6 – Repeat prescription pilot scheme of the report Dr Sue Wells commented that that there was always a 2 month delay receiving the outcome of the pilot scheme and an update from the CCG regarding the outcomes with particular reference to the patient experience of this pilot would be brought to People O & S and the HWB as appropriate. In relation to paragraph 6.3 of the report she commented that GP’s guidance encouraged self-care for minor conditions - for minor coughs, colds for example GP’s would  ...  view the full minutes text for item 61.

Nicola Allen, NHS England, attended the meeting and gave an update to Wirral Health and Wellbeing Board regarding the activities and responsibilities of NHS England. The report outlined the national and regional context together with specific updates on priorities that the Local NHS England Teams were responsible for progressing.

The report provided details of the new GP contract that had been agreed. Along with the Government, and the British Medical Association’s General Practitioners Committee, NHS England had agreed a new general practice contract for 2017/18.

The new agreement included an increased focus on some of the most vulnerable, with tailored annual reviews offered to frail pensioners, and an increase in the number of health checks for people with learning disabilities. The new contract also included provisions to encourage practices to be more accessible to patients.

The report also provided members with information on the NHS GP Induction and Refresher (I&R) Scheme that provided a safe, supported and direct route for qualified GPs to join or return to NHS general practice.  This was designed for GPs who had previously been on the GMC Register and NHS England’s Medical Performers List (MPL) and would like to return to general practice after a career break, raising a family or time spent working abroad.  The Portfolio Route gave the option for doctors, who had worked in NHS general practice in the previous five years, and had been working abroad in an equivalent primary care setting to apply from overseas. The scheme also supported the safe introduction of overseas GPs who had qualified outside the UK and had no previous NHS experience. The scheme included a range of assessments including placements and simulated surgeries to support appropriately skilled GPs into NHS general practice.

The Board was also informed that NHS England had launched a public consultation on how it would put in place new standards for hospitals providing congenital heart disease services in England. The consultation, which was running for 16 weeks from 9 February to 5 June 2017, aimed to gather as many views as possible from patients, families and clinical experts and would include face to face meetings around the country, webinars and an online survey. This followed the publication in 2015 of a new set of quality standards for all hospitals providing congenital heart disease. NHS England was currently seeking views and input on how the standards could be put into practice. All of the documents relating to the consultation could be found at: www.engage.england.nhs.uk .

Ms Allen updated the Board with the changes to NHS local leadership and noted that to ensure continued progress was made on the delivery and implementation of the Five Year Forward View Richard Barker (North Regional Director) had appointed Clare Duggan as Regional Director of Transformation. Clare was currently Director of Commissioning Operations for Cheshire and Merseyside.  Clare would be working closely with Regional Management Team colleagues and other stakeholders to make sure that continued progress was made in a range of areas and health  ...  view the full minutes text for item 62.

Verbal presentation - Martin Earl & Hayley Sherwen

Members of the Board were provided with a presentation by DCI Martin Earl, Constable Hayley Sherwen (Mental Health Liaison Officer), Merseyside Police and supported by Mike Berry, Mental Health Lead for Police & Crime Commissioner that outlined the implementation of a Street Triage Pilot. The presentation provided details of the objectives of the pilot, the Triage Car remit and an outline of the Triage Car Action Plan. The triage car could be requested to assist with any policing incident with a mental health component e.g. alcohol or self-harm. This could be any piece of information that led an officer or member of police staff to suspect that an individual may have an issue with their mental health.  The health practitioner was there to support Merseyside Police by responding to any mental health concerns identified and to support officers in making decisions about people with vulnerabilities and who had mental health components. Police did not have the expertise and the Place of Safety in Wirral was Accident and Emergency at Arrowe Park Hospital – so as well as reducing overall numbers of people detained on a S 136 a key objective of the triage Pilot was to reduce footfall at A & E departments as well as introducing a better quality of intervention for an individual in acute MH crisis. In response to a question it was reported that there had been a 29% reduction in AED attendance in the first 12 months of the scheme.

The Chair and members of the Board welcomed the report and looked forward to supporting and taking the initiative forward. With this purpose DCI Martin Earl offered to contact partners and set up a meeting. Suzanne Edwards, CWP suggested that this could be enabled through a Crisis Care Concordat meeting.

Resolved – That;

1.  DCI Martin Earl, Constable Hayley Sherwen (Mental Health Liaison Officer) and Mike Berry, Mental Health Lead for Police & Crime Commissioner be thanked for their attendance and presentation to the Health and Wellbeing Board.

2.  the Health and Wellbeing Board endorse the Triage Benefits and the TCAP process.

Report and Presentation – Brian Simpson/Nick Atkin.

The Director of Health & Wellbeing introduced Mr Brian Simpson, Chair, Strategic Housing Partnership who would be attending future meetings of the Board as Housing representative. Mr Simpson requested that the Board consider the proposal from the Liverpool City Region (LCR) housing associations to support the Health and Wellbeing Board in tackling health inequalities in the borough. The offer from housing associations proposed they would adopt the following responsibilities where available in each local authority area and where appropriate, across the Combined Authority:

1.  To act as a single housing representative on the Health and Wellbeing Board.

2.  Be the primary housing link to the other housing associations working across the Local Authority area and act as a conduit back into key contacts within the CCG and Public Health Teams.

3.  Coordination of integrated wellbeing programmes within the housing sector on behalf of NHS England, CCGs and Public Health Teams. This would ensure closer working with wider statutory partners including the voluntary sector, emergency services, NHS Foundation Trusts, Community Services and Mental Health Trusts.

4.  Coordinate the Housing & Environmental aspects of NHS, CCG and Public Health’s Health and Wellbeing Strategies.

5.  To explore the options to truly integrated role(s) between the lead housing association in each Local Authority area and the CGG.

Members were also asked to consider any specific areas where joint working or specific projects could be developed from the priorities outlined in the report;

1.  Loneliness/ isolation

2.  Falls prevention

3.  Dementia

4.  COPD/ CVD – linked to heating levels and also flu immunisation

5.  Poverty – including debt, welfare reform, fuel poverty

6.  Healthy lifestyles

7.  Mental health – including linkages to homelessness, alcohol and substance misuse

A summary of the wider impact and contribution housing associations had across the LCR was included as Appendix 1 of the report.

The presentation could be accessed with the following link: -

2017\LCR HAs Health Wellbeing Board Template Offer 2 May 16.pptx

Resolved – That;

1.  Mr Simpson be thanked for his attendance and informative presentation to the Board.

2.  the Director of Health and Wellbeing liaise with Board members with a view to arranging a future workshop to enable partners to discuss the Housing Association offer in greater depth.

Presentation – Julia Hassall, Director for Children.

Julia Hassell, Director for Children attended the meeting and provided the Board with an update on Transforming Children’s Services in Wirral. The presentation could be accessed via the following link: -

HWB 15 Mar 2017\Transformation 15 3 17.pptx

Gary Oakford, Mersey Fire and Rescue informed the Board that the Fire and Rescue service would undertake to offer a Fire Safety Check for young carers. Julia Hassall agreed to liaise with Gary Oakford on this matter and on behalf of the Health and Wellbeing Board the Chair gave thanks for this offer.

Resolved – That the Director for Children be thanked for the presentation and the contents be noted.

Report to be tabled.

Graham Hodkinson, Director of Health & Care gave the Board a short verbal update which advised members of the requirements and considerations which had taken place so far in preparation for the 17/18 BCF submission. This provided an overview of achievements in 16/17 (at month 10) and summarised proposed priorities for investment in 17/18.

The update could be accessed on the following links : -

HWB 15 Mar 2017\HWBB 15 3 17.pub

HWB 15 Mar 2017\Copy of BCF 17-18 Schemes V9 Basic Summary 16 3 17.xlsx

Resolved – That: -

1.  the draft proposals and ongoing engagement be noted.

2.  the final guidance awaited with indicative timescales be noted.

3.  the final report be circulated to members for virtual sign off, anticipated end April 2017, subject to guidance received.

Verbal report – Fiona Johnstone, Director for Health and Wellbeing.

Fiona Johnstone, Director of Health and Wellbeing informed members that she was planning to bring a refresh of the Healthy Wirral Framework to the Board. Work was currently being undertaken with colleagues across the partners and this would provide the framework for discussions for the next 12 months. It was proposed that more Health and Wellbeing Development Sessions be arranged to enable discussion amongst the partners at a greater depth. Nicola Allen welcomed this and suggested that a session with the focus on Mental Health would be helpful to members.

The provisional date set for the next formal meeting of the Board is Wednesday 19 July, 2017 in Committee Room 2.

The date of the next formal Board meeting would be Wednesday 19 July, 2017 Committee Room 1, Town Hall, Wallasey.