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 Anita Leech declared a personal interest in agenda item 10 SEND - Update by virtue of two grandchildren having an Educational Health Care Plan (EHCP).

To approve the accuracy of the minutes of the meeting held on 13 Nov 2019.

Resolved – That the accuracy of the Minutes of the Health & Wellbeing Formal Board held on 13 November, 2019 be approved as a correct record.

The Director of Public Health provided an update on the Coronavirus pandemic and the current situation nationally and in Wirral.  The situation was clearly a new and evolving situation from that first notified by WHO at the end of January.  Wirral had successfully dealt with the isolation of those quarantined at the unit at Arrowe Park Hospital and the second group of guests had now left the borough and returned to their homes.  This had demonstrated a good high-quality level of service in Wirral.  The Director outlined strategies that were being undertaken and work being undertaken to communicate to local people.  The Chief Executive would be Chairing meetings across the Health and Social Care Sector.  Communications to the public were providing advice for people to protect themselves including hand washing and the use of tissues.  It was clear there was a high level of anxiety amongst people and the plan locally was to provide advice and assurance to the public.  A cross-party group, Chaired by Councillor Chris Jones, would be meeting.  It was an unprecedented, evolving situation and the authority would be open as messages changed.

Resolved – That the Director of Public Health be thanked for the update and the contents be noted.

Simon Banks, Chief Officer, NHS Wirral CCG and Wirral Health & Care Commissioning, provided the Board with an update from the NHS.  He reported that the situation was currently at a Level 4 incident and was a command and control situation with the NHS being responsible to Cobra.  Mr Banks outlined an explanation of the business management that was in place including the hospital isolation pod, the role of supporting practices and the instant response structure.  Mr Banks would be taking part in a meeting the following day with the Chief Executive and provided assurance that although it was clearly an evolving situation Wirral was in a very good place. David Hammond, Assistant Director for Partnerships, Wirral Community NHS Foundation Trust, provided an update on operational detail including ways in service could continue to be provided and the National approach and direction.  Mr Banks responded to questions from members regarding current guidance and noted that at the at the moment the situation was business as usual and was entirely National driven with local Public Health guidance.  Management of the local care and health group would ensure the vulnerable were communicated with appropriately.  Julie Webster informed that the pandemic was at the time of the meeting in the containment phase.  Social distancing was being employed and the borough was following National policies and considering how this would be carried through locally.

Resolved – That Simon Banks and David Hammond be thanked for the update and the contents be noted.

Verbal report – Julie Webster.

Julie Webster, Director of Public Health, provided the Board with an update on Health and Wellbeing Board’s development review.  It was reported that three development sessions had been carried out with the support of the Local Government Association.  Health inequalities was the single-issue focus and there was a need for conversation on where the Health and Wellbeing Board sits in this.  The next workshop was scheduled for 1 April 2020 to consider how the Health and Wellbeing Board strategy would be developed.  The 2020 Annual Report would support this and help shape priorities and this would be published in June.

Councillor Chris Jones commented that the sessions had been very useful.  Paul Boyce, Director for Children’s Services commented that the sessions had been very well facilitated and had set challenges that members could take away as actions.

Resolved – That Julie Webster be thanked for the verbal report and the contents be noted.

The Director of Public Health provided a report on the proposal to work with the Marriot team.  In common with Wirral’s Health and Wellbeing Board the Cheshire and Merseyside Health and Care Partnership (C&M HCP) had identified reducing health inequalities as its core purpose.  A new Health and Wellbeing Strategy was currently being developed to set out how locally this aim would be achieved. Inequalities in health persisted both between C&M and within C&M. Despite improvements in life expectancy within most local authorities in C&M, the region remained below the England average. In addition, within C&M, as with the rest of England, there was a social gradient in health – the lower a person’s social position, the worse his or her health. This meant most people in C&M were not living as long as the best off in society and were spending longer in ill-health.  C&M becoming a Marmot Community would enhance and enable the local approach and the report set out the key benefits to Wirral that included:

-  Access to international expertise and evidence on reducing health inequalities

-  Developing leadership across system partners

-  Strengthening joint working

-  Maximising impact and evaluating outcomes

-  National and international recognition of local work to reduce health inequalities.

Resolved – That;

1.  the proposal to work together as a Cheshire and Merseyside Marmot Community be endorsed.

2.  the C&M Health and Care Partnership be supported in overseeing and assuring this initiative.

Simon Banks, Chief Officer, NHS Wirral CCG and Wirral Health and Care Commissioning, provided the Board with the Healthy Wirral 5 Year Strategy. The strategy supported the delivery of wider Wirral strategic planning including the Wirral 2025 Plan and the development of the Wirral Local Plan.

It was reported that in common with all health and care systems across Cheshire and Merseyside, Wirral was expected to establish and implement its plans to achieve the best possible health and wellbeing outcomes for its population within the funding available to the system. The 5 Year Strategy described the ambitions and key strategic priorities to achieve the Healthy Wirral vision of enabling all people in Wirral to live longer and healthier lives.  The ‘Healthy Wirral’ partnership and the associated programme was seen as the prime system-wide approach to delivering sustainable and affordable long-term changes to the way that the health and wellbeing of the Wirral Population was supported. The appendices to the report contained the Draft Healthy Wirral 5 Year Strategy, the Draft Healthy Wirral 5 Year Delivery Plan and the Healthy Wirral System Operating Plan 2019/20.

Resolved – That the approach in the draft strategy be endorsed and its progress to completion and publication be supported.

The Board gave consideration to a report of the Director of Public Health that set out that making alcohol less affordable was the most effective way of reducing alcohol-related harm. It was reported that many health groups had been campaigning for the introduction of a minimum unit price (MUP) for alcohol in England to reduce the harm caused by cheap, strong alcohol e.g. white cider. 

The report detailed work taking place across the North of England to consider the introduction of a minimum unit price for alcohol.  Alcohol consumption had an impact on social, economic and cultural life. In recent years alcohol consumption had increased dramatically and it was now estimated that 85% of adults drink alcohol.

It was reported that alcohol misuse was now the third biggest risk factor to health behind tobacco and high blood pressure. The Wirral Alcohol Strategy had been published in 2015 with the aim for Wirral to be a place that promoted a responsible attitude towards alcohol and minimised the risks, harms and costs of alcohol misuse to allow individuals, families and communities to lead healthier and safer lives. The ambition set out in the strategy was to support Wirral to have a healthier relationship with alcohol by intervening as early as possible.

MUP was linked to the strength of the product and worked by setting a floor price below which a product cannot be sold. In that way, it increased the price of the cheapest drinks which were most typically consumed by increasing and higher risk drinkers.

Research from Sheffield University indicated that significant benefits would be seen from the introduction of a 50p MUP in England.  The same research clearly showed that MUP impacted on those people drinking at high risk levels, while leaving the average moderate drinker virtually untouched. The report also noted that most of the harm prevented would be found in more deprived groups. Despite not drinking more than high income groups, they suffered the greatest harm.

A member questioned whether the policy of Local Action Areas implemented 7 years ago gain anything and the Director informed that this had not been taken forward and was no longer in existence. A lot of work however had been put in and was still in place and the situation remained hopeful that this could be continued under the new Committee structure.

The Director of Public Health also highlighted that previous research had shown that less than 1% of products sold in pubs would be affected by a 50P MUP.  In light of the harms caused in Wirral by the widespread availability of cheap alcohol and the improvements in alcohol related health and crime promised by the research it was;

Resolved - That

•  lobbying activity in collaboration with councils across the North of England for the introduction of MUP in England be supported.

•  work with neighbouring areas to consult on making a bid to introduce MUP at a regional/sub-regional/local level by making a bid using the Sustainable Communities Act be  ...  view the full minutes text for item 93.

The Director of Public Health introduced a report that informed the Health and Wellbeing Board of the process for producing a new Pharmaceutical Needs Assessment (PNA) for Wirral for the period 2021-2024.

Members were informed that there was a legal requirement for the Wirral Health and Wellbeing Board to publish an updated PNA before the 31st March 2021 and the Director gave assurance that this timeline would be achieved.

Wirral’s current PNA had been produced in 2018 and concluded that the borough was well served in terms of spread of community pharmacies. There was one pharmacy for every 3,402 residents, which compared favourably to the national average of one pharmacy for every 5,000 residents.

A further report would be brought to the Board when the draft Pharmaceutical Needs Assessment (PNA) for 2021 – 2024 was ready for public consultation and ahead of signing off the final publication of a new PNA for Wirral on or before 1st April 2021.

Resolved – That the Health and Wellbeing Board note;

1.  the process has begun to produce a new Wirral Pharmaceutical Needs Assessment (PNA) for the period 2021 to 2024.

2.  the final PNA would be published on or before 31st March 2021.

Report for noting.

The Director of Public Health introduced a report that provided the Health and Wellbeing Board with an update on progress achieved to date 2019/20 and considered next steps and priorities for 2020/21. The report focussed on current performance with a progress update provided against the system priority areas. 

Resolved – That;

1  the update and ongoing priorities overseen by A&E Delivery Board be noted.

2  the interdependencies of all partners to the resilient delivery of the 4-hour standard and wider key performance requirements be recognised.

3  the improving position, challenges and priorities for 2020/21 be noted.

The Health and Wellbeing Board gave consideration to a report of the Director of Children’s Services that informed that the local authority with Local Area partners in Health and Social Care were conducting extensive consultation around the new Special Educational Needs and Disabilities (SEND) Strategy. The report served to provide a brief update. The appendices to the report contained the Special Educational Needs (SEND) Strategy 2020-2024, Consultation Questionnaire and the Special Educational Needs and Disability Strategy, 2020-2024 Consultation.  It was reported that, to date, headteachers and representatives of the Local Area had contributed to producing the proposed strategic priorities. The Local Area was keen to know the views of all stakeholders as these views were important in shaping the strategy.  All responses were to be completed online or returned by March 13, 2020 and a questionnaire issued for young people to gain their views.

Tarun Ghosh, Head of SEND and Inclusion, informed the Board that a great deal of work had already been done and emphasised the importance that the people of Wirral, children and young people participate in the consultation as the authority was keen to gain people’s views.  There had been a positive start to the consultation as Wirral had a strong Youth Voice and the deadline had now been extended until the ‘Your future Your Voice’ event at the Floral Pavilion had taken place in order that those views not already given might be captured. The deadline had therefore been extended to 2 April 2020.

The report highlighted that all children and young people with Special Educational Needs and Disabilities (SEND) were entitled to an education that enabled them to achieve the best possible educational and other outcomes. The new Special Educational Needs and Disabilities (SEND) Strategy brought a sharp focus on early identification of need(s), assessment of need(s) and provision to meet need(s).  The combination of the three approaches would lead to better outcomes for children/young people (CYP).  The report also set out the main overarching priority – to improve the quality of provision and outcomes for young people with Special Educational Needs and Disabilities (SEND) and the three subsidiary priorities - to ensure early identification of special education needs and high quality intervention particularly for children and young people exhibiting social, emotional and mental health issues, further develop effective transition from one education phase/setting including preparing for adulthood pathway and to further develop participation, engagement and coproduction with children, young people, parents and carers.

Members of the Board welcomed the consultation.  The Director for Health and Care commended and supported its aims in preparing the pathway to adulthood and in raising the aspiration and equal opportunities for young people with Special Educational Needs and Disabilities (SEND).  The Director for Children’s Services also commented that this was a plan for life for young people – up to the age of 25 years.

On behalf of the Board the Chair thanked Tarun Ghosh for his update and it was;

Resolved: - That;

1  the report be noted.  ...  view the full minutes text for item 96.

1  Healthwatch – Karen Prior, Chief Officer Healthwatch (Verbal).

2  NHS – Update - Nicola Allen, Head of Medical Directorate, NHS (Report).

a)  Healthwatch

An update was submitted by Karen Prior, Chief Officer, Healthwatch, on the work and projects of Healthwatch, Wirral.

b)  NHS England

An update was submitted by Nicola Allen, Head of Medical Directorate, NHS England.  The aim of the report was to update Wirral Health and Wellbeing Board regarding the activities and responsibilities of NHS England and NHS Improvement, together with specific updates on priorities of NHS North West.

Resolved – That the reports be noted.

Link for information: -

https://www.cheshireandmerseysidepartnership.co.uk/

The following link was provided for the Board’s information;

https://www.cheshireandmerseysidepartnership.co.uk/