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

Apologies were received from David Allison, CEO Wirral University Teaching Hospital NHS Foundation Trust, Simon Banks, Chief Officer, Wirral CCG, Nesta Hawker, Director of Commissioning Wirral CCG and Dr Sue Wells, Chair, Wirral CCG.

To approve the accuracy of the minutes of the meeting held on 19 July, 2017.

Resolved – That the accuracy of the Minutes of the Health and Wellbeing Formal Board held on 19 July, 2017 be approved as a correct record.

Councillor Ian Lewis commented that at the last meeting of the Health and Wellbeing it had been agreed that STP be a standard item on the agenda however this had not been included in this meeting.  The Director of Health and Care informed the Board that this would be covered during the meeting and the Chair indicated that he would be happy to include discussion at this meeting.

Presentation.

Members of the Board were provided with a presentation by David Robbins, Wirral Safeguarding Board. 

The presentation set out the objectives of LSCBs and informed that the WSCB operated as an independent multi-agency body under the direction of the independent chair (Prof Maggie Atkinson) and was not subordinate to any other body. It was explained that under the Children and Social Work Act (2017) LSCB’s would be replaced by other local arrangements by April 2019.

Members of the Board were provided an outline of the service which included the structure of WSCB, the priorities for safeguarding areas, training undertaken and provided the Annual Report which could be found on the following link;

http://www.wirralsafeguarding.co.uk/wp-content/uploads/2016/02/WSCB-Annual-Report-2016-17-3.pdf

Members’ attention was drawn to the Boards website and Mr Robbins urged professionals to utilise this link on their website as it would provide a useful tool.  He stressed that there needed to be a strong understanding between the HWH and the WSCB.  The website could be found on the following link;

www.wirralsafeguarding.co.uk

Mr Robbins responded to questions from the Board. The Chair thanked him for the presentation and commented on the need for joint priorities for the Boards.  The Chair endorsed the need for further discussion around what practical measures the HWB Board could do to help and it was agreed that WSCB be an item on the Health and Wellbeing Board’s next agenda.

Resolved – That;

1  the report be noted.

2  that WSCB be included as an item on the agenda for the next meeting of the Health and Health and Wellbeing Board to be held on 14 Mar 2017.

Presentation and report.

Members of the Board were provided with a presentation form Julie Webster, Director for Health and Wellbeing on the Public Health Annual Report 2017 -

Expect Better.

The key messages of the report were that life expectancy at birth had improved in Wirral over several decades. Despite this, gaps persisted between the east and west of the borough and between men and women.

People living in more deprived areas tended to live shorter lives with a greater proportion of their lives spent in poor health. The early onset of illnesses or disability could place a greater burden on the health and social care system than when people live longer in good health.

The report also provided detailed avoidable deaths in the Borough and included a number of graphs detailing the reasons for early deaths and a range of recommendations were also set out for health and social care organisations some of which focussed on Wirral partners.

Members discussed the report and made suggestions for the means to set up targets over the variation and uptake throughout the Borough.  Julie Webster thanked partners for their contributions and shared a short film 'Expect Better' that supported this year’s annual report Wirral 2016/17 and aimed to highlight the differences in life expectancy and avoidable deaths across the borough and could be found on the following link:

https://youtu.be/kEC2W41ZtlE

Resolved – That;

1  the report be noted.

2  an action plan outlining the key targets be set up and circulated to relevant agencies who could support the initiative and that this be brought back to the next meeting of the Health and Wellbeing Board.

Verbal report - Graham Hodkinson (Director for Health & Care).

Members of the Health and Wellbeing Board were provided with a presentation ‘Healthy Wirral Update’ by Graham Hodkinson, Director for Care and Health.

With reference to the STP the Director commented that place-based services were local building blocks and the NHS Cheshire and Merseyside were taking the lead and would commission special services and local needs such as hospital walk-in centres.

Graham Hodkinson indicated that Simon Banks, Chief Officer, Wirral CCG would be the most appropriate person officer to give an update to future meetings of the Board.

The Chair welcomed the move away from a nationally imposed STP to a more locally based plan that could be shaped locally

In relation to Healthy Wirral the Director commented that it was a cohesive plan that sat under the 2020 plan.  It provided more detail in relation to care health and wellbeing priorities and offered a platform for an Integrated System

Shared Governance arrangements were developing the Healthy Wirral Partnership, Healthy Wirral Executive Delivery Group and the Emerging Programme Office and Performance Reporting.  The presentation also outlined the drivers for change.

Fiona Johnstone indicated that the Plan would be turned into a dashboard that would come back to a future meeting of the Health and Wellbeing Board.

The Chair welcomed the move away from a nationally imposed STP to a more locally based plan that could be shaped locally.

Resolved – That the report be noted.

Jacqui Evans, Assistant Director for Unplanned Care & Community Care (CCG/WBC), presented the Board with update on the progress and developments across the unplanned care system, overseen by A&E Delivery Board.

The report provided the Wirral Health and Wellbeing Board with an update on progress and developments across the unplanned care system, overseen by A&E Delivery Board.

Members were informed that Wirral had faced a challenging period during the winter of 2016, continuing to date. The acute hospital and A&E had seen unprecedented pressure during winter 16/17. There had been little let up on that pressure throughout the summer months.  From a community perspective, domiciliary care had been challenging, key providers were leaving the market at a time of increased demand for services. Recruitment & retention of key professionals, especially therapists, nurses and care staff had also had an impact.

It was reported that the system had also recognised the need to deliver transformational change, across all organisations, including the need for a real shift in behaviours and culture to be able to respond resiliently to demand and ensure positive patient outcomes and experiences.  These challenges had resulted in consistent non-achievement of the 4 hour standard.  As such the acute had been in the bottom quartile nationally for performance during the first two quarters of the year. This was a situation owned and recognised as a whole system challenge, requiring collaborate solutions and significant transformational change at pace.  The urgent care challenges for Wirral were therefore a priority, acknowledging all organisations had a part to play and that there were opportunities to improve connections between planned and unplanned care.

The report also provided details of Transformational Priorities going forward for 17/19 and outlined priorities the system had agreed, based on a combination of national best practice guidance, mandated practice and assessment and understanding of the local situation.

The Board was informed that the key issue for Wirral partners was to turnaround urgent care delivery in Wirral and ensure performance was significantly improved over the coming winter months. .  Members were informed of the key areas to address the current Wirral situation and improve performance and were informed that the system had improved significantly over the past couple of months. Due to the combined efforts to deliver the priorities described in the report, improvement against the 4 hour standard had improved and maintained and would be further improved. The system leaders were fully committed to deliver the standards required and ensure patient safety.

Members were informed that there was a detailed single unplanned care system plan, incorporating winter planning and the Better care fund priorities. This had been commended as an approach by NHSE and held as national best practice.

There was now a system dashboard in place with progress monitored and reported by exception to A&E delivery board on a monthly basis.

The Chair thanked Jacqui Evans for a very comprehensive report and it was;

Resolved – That;

1  the progress on priorities overseen by A&E delivery  ...  view the full minutes text for item 19.

Jacqui Evans, Assistant Director for Unplanned Care & Community Care Market (CCG/WBC), presented a report to the Health and Wellbeing Board regarding submission of the Better Care Fund. Plans had been circulated, signatures for approval from all CEO’s received and the final submission had been made on 11 September 2017. Formal notification had been received on 30 October 2017 The appendix to the report contained a copy of the letter received from Simon Weldon, Director of NHS operations and delivery, NHSE, confirming Wirral’s submission, and following regional and national assurance, was ‘Approved’.

Jacqui Evans reported that this was excellent news, with Wirral being one of a small number of systems nationally approved with no conditions. Feedback from the regional team had been received acknowledging the single integrated whole system plan, incorporating BCF, unplanned care & winter priorities and recommending as national best practise.

It was now requested to transfer agreed funds into a pooled budget under a section 75 agreement. This was to be agreed locally and submitted by 30 November 2017 to NHSE.

The Board was requested to note the 2 conditions specified namely that:

1.  the CCG will meet the performance objectives specified in its BCF plan; and

2.  the CCG will meet any additional performance objectives specified by NHS England from time to time.

It was reported that the system was aware of the performance requirements and priorities and working hard to deliver.  The report also provided an outline of the Current Performance.

Resolved – That;

1  the progress & outcome of submission of the Better Care Fund be noted.

2  the S75 requirements & timescales be noted.

3  a further update on progress be brought to the next Health & Wellbeing Board

4  a special meeting of the Health and Wellbeing Board regarding the Urgent Care Review be arranged at a date to be circulated by the Acting Director of Strategy & Partnerships.

5  the Sustainability and Transformation Plan be a standing item on future agendas of the Health and Wellbeing Board.

Verbal report – Nicola Allen (NHS England).

Nicola Allen, Head of Medical Directorate, NHS England presented the Health and Wellbeing Board with the NHSE Quarterly Update.  The report provided members with an update regarding the activities and responsibilities of NHS England and outlined the national and regional position together with specific updates on priorities that the Local NHS England Teams were responsible for progressing.  The report covered Strategy and planning -Better Care Fund and Primary care: Community Pharmacists, Mental health: Children and Young Peoples Local Transformation Plans, National Directors, Delivery and Assurance, Operational Delivery & Resilience, Winter Preparedness, Flu vaccination and Quality and safety.

Nicola Allen also noted that NHS England had launched an 8 week consultation on radiotherapy services. The consultation was seeking feedback on a new specification for adult radiotherapy services.  Through the consultation, NHS England would like to get more views on the proposals from patients, carers, members of the public, clinicians and anyone else who might have an interest in radiotherapy services. The consultation period would run from 18 October to 18 December 2017 and could be viewed on the following link;

https://www.engage.england.nhs.uk/consultation/radiotherapy-service-specification-consultation/

Resolved – That;

1  Nicola Allen be thanked for the report.

2  the report be noted.

Verbal report – Phil Davies, Chair, Healthwatch.

Phil Davies, Chair, Healthwatch presented the Health and Wellbeing Board with an update for October/November 2017. This provided the Board with an update of the activities, outcomes and outputs of Healthwatch Wirral (HWW).  It was noted that HWW had set its workplan in line with the Five Year Forward View.  However, it was noted that it was important that it reacted to the public’s views and opinions.  HWW’s remit was to signpost, Influence service design and carry out Enter & View Visits.  Some examples to demonstrate this activity were highlighted in the report. The report covered Information Bank at WUTHFT, Signposting, Resource Library, 1, 2, 3 Campaigns, Enter & View Visits, a list of Meetings regularly attended by Healthwatch Staff and Volunteers, a list of current projects and it was also noted that HW distributes a monthly e-bulletin.  Healthwatch aimed to work with all partners and stakeholders and to proactively seek and disseminate information to the public, including public consultations.

Resolved – That;

1  Phil Davies, Healthwatch be thanked for the report.

2  the report be noted.

Wirral Plan Performance Report Quarter 1

https://www.wirral.gov.uk/about-council/council-performance

Members’ attention was drawn to the Wirral Plan Performance Report Quarter 1 that was available to view on the following link;

https://www.wirral.gov.uk/about-council/council-performance

The date of the next formal Board meeting is Wednesday 14 March, 2018 at 4:00 pm in Committee Room 1 Town Hall, Wallasey.

The date of the next formal Board meeting would be Wednesday 14 March, 2018 at 4:00 pm in Committee Room 1 Town Hall, Wallasey.  A further special meeting regarding the Urgent Care Review would be timetabled in due course.