The Chair welcomed everyone and read the webcast notice.

PRESENT:

Councillor Jean Robinson   Chair

Simon Banks    Director of Place (Wirral) NHS Cheshire and Merseyside

Sayyed Osman  Director of Adults, Health and Strategic Commissioning, Wirral Council

Dave Bradburn Director of Public Health, Wirral Council

Marcus Shaw  Director of Regeneration and Place, Wirral Council

Adrian Leach  Assistant Director SEND and Inclusion, Wirral Council

Councillor Stephen Bennett   Wirral Council

Councillor Jeff Green  Wirral Council

Councillor Kieran Murphy   Wirral Council

Dr Abel Adegoke  Chair of the Primary Care Council

Adrian Jones  Department for Work and Pensions

Tony Bennett  Wirral Community Health and Care NHS Foundation Trust/Wirral University Teaching Hospital

Chris Lynch  CWP

Matthew Moscrop  Merseyside Police

Kirsteen Sheppard  Healthwatch Wirral

Mark Thomas  Merseyside Fire and Rescue Service

Tim Welch  CWP

Also present:

Gareth Prytherch  Chief Executive, Wirral CVS

Julian Eyre  Programme Director, Wirral Improvement Team

Nikki Jones  Wirral Council

Jane Harvey  Wirral Council

Vicki Shaw  Wirral Council

Christine Morley  Wirral Council

• Isla Wilson, Chair, CWP will be represented by Chris Lynch, NED;
• Natalie Pereshine, Chief Superintendent, Local Policing;
• Paul Satoor, Chief Executive Wirral Council;
• Libby Eastleigh, Interim Growth & Business Development Specialist, Magenta Living;
• Gill Banks, Principal and CEO, Wirral Metropolitan College;
• Karen Prior, Chief Executive Officer, Healthwatch Wirral;
• Cllr Julie McManus, Wirral Council;
• Elizabeth Hartley, Director of Children’s Services, Wirral Council was represented by Adrian Leach, Assistant Director, SEND and Inclusion.

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.

There were no declarations of interests.

To approve the accuracy of the minutes of the meeting held on 19 September 2024.

Resolved that the minutes of the meeting of the Health and Wellbeing Board on 19 September 2024 be agreed as a correct record.

No questions, or petitions were received.

The following statement from COSMOS was read out on their behalf by Kevin Sutton as follows:

This statement is by COSMOS, Wirral - the Community of Send Mothers Obtaining Solutions.

At the last Health and Wellbeing Board on 18^th September 2024 a full SEND report was given to the Board by the Director of Children’s Services (DOCS). At that time COSMOS Wirral was coming together and since that time considerable progress has been made.

The purpose of this statement is to inform the Board that at the first Health and Wellbeing Board meeting in 2025 COSMOS, Wirral would welcome and appreciate the opportunity to bring forward a detailed report informing the Board of COSMOS’s draft Aims and Objectives, draft Terms of Reference, the considerable progress that is being made and continues to be made ‘working in partnership’ and its outline plans for the rest of 2025.

If agreed, the detailed report will be presented through the CVF-Reference Group with whom COSMOS are working in full partnership.

COSMOS is aware that it already enjoys support from members of the Board. The detailed report will be seeking the full support of all members of the Board in its mission through a broadly based partnership.

At this early opportunity it is appropriate to advise the meeting and the Board members that discussions at the request of local Members of Parliament, because of the relevance to discussions elsewhere, have and will be taking place during 2025 at an appropriate frequency.

It is appropriate to mention that COSMOS Wirral are working closely with the DOCS and SENDLO and aim to work together with Parent Carer Participation Wirral (PCPW) when necessary. COSMOS Wirral are also working closely with the family hubs teams whose premises and resources will be crucial in taking the initiative forward

Any member of this Board wishing to ‘meet and discuss further’ will be warmly welcomed.

With best wishes and thank you for your time.

The Chair welcomed the new group. It was agreed that the Health and Wellbeing Board would look at the Terms of Reference and objectives of COSMOS and advise on which meeting any future report should come to. The Chair explained that there was a Participation and Engagement subgroup of the Local Area SEND Partnership Board which may be better placed to receive any future reports and this would need to be considered.

The PDF file below may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices.?Please contact janeharvey2@wirral.gov.uk if you would like this document in an accessible format. 

The Assistant Director of Public Health presented the report of the Director of Public Health which provided an overview of the progress and impact of the Health and Wellbeing Strategy over the past 12 months, with a focus on tangible outcomes for local residents. It was highlighted that the main focus was on evidence based areas that would make the biggest impact on population health and reducing health inequalities. The game changer strategy was focused on the right things and strongly mirrored the Marmot recommendations for Cheshire and Merseyside/All Together Fairer. It was noted that there had been a lot of external validation connected to the approach that had been taken as a system to deliver the strategy. It was highlighted that the strategy was dynamic and was changing and examples were given in each of the four game changer areas.  The six elements of the evaluation framework took in a range of methods to enable the impact upon residents to be properly judged. One of the elements was the Marmot Altogether Fairer beacon indicators which allowed the comparison of Wirral to England as a national data set and allowed the monitoring of the longer term progress of the strategy.  There was an ongoing programme of qualitative insight work that had helped to guide the strategy which had won an award particularly around the ethnographic research on those experiencing fuel poverty.

The model of the systems health leads and the public health leads had contributed to the additionality of the strategy. It was acknowledged that there were challenges around the strategy with a push pull effect to achieve short term gains against the commitment to long term impact. Both were crucial. Sometimes the earlier health and prevention initiatives are at more risk at times of extreme pressure. The lack of funding for employment programmes was highlighted and there was a lack of entry level posts due to an environment of recruitment freezes. It was crucial to continue with the focus around the key evidence based areas to reduce health inequalities and maximise the potential of the game changers and continue to grow the connections and maximise the opportunities to enhance cross cutting themes such as prevention at scale, child family poverty and housing.

Members asked about how the Council was working with people in the development and implementation of the strategy and the determination of the objectives and there had been a culture of co-development such as with the All Age Disability strategy.

Members queried the decrease in male life expectancy and the range of factors impacting on this was discussed. There was a national decline in male life expectancy and Wirral were below average although last week the ONS had updated the figures and there had been a very small uptick in the latest figures for Wirral. It was clarified to Members that ethnographic research involved going to see people in their own environment.

The Chair asked about the development of the Universal Population Health and Wellbeing survey  ...  view the full minutes text for item 28.

The Chief Executive of Wirral CVS and the Public Health Principal presented the report which provided an update on the Community Voluntary and Faith Sector (Wirral CVS) commissioned by Public Health to deliver a programme of activity to support collaboration between key system partners and the Community, Voluntary and Faith sector. Wirral CVS was commissioned in May 2023 by Wirral Council to undertake a one year pilot to help deliver the Coming Together Plan and support the development of the Health and Wellbeing Board Strategy and following the success of the pilot Wirral CVS were awarded a three-year grant from 1 May 2024 to 31 April 2027.

It was highlighted that free membership of Wirral CVS was open to any Voluntary, Community, Faith and Social Enterprise (VCFSE) that was based or delivered services in Wirral.  The CVF Forum had been reestablished and was co-chaired by Wirral Council and Wirral CVS.  It was important that Wirral CVS now had membership of the Voluntary Sector 6 (VS6) Partnership across Liverpool City Region which had allowed funding to be drawn down to support the sector and had also allowed the progression of the Single Front Door for Volunteering.

CVS’s usually operate under 4 pillars, capacity building Wirral, leadership and advocacy, partnership and collaborations and volunteering. It was explained that Wirral CVS operates in a different way to many other CVS’s. Capacity building was about supporting organisations on the front line with a range of things and over the last 12 months 112 groups had been directly supported with developing policy and strategy and funding. It was reported that organisations had been supported to develop 28 funding applications valued at around £208,000. Wirral CVS had distributed just over £400,000 in grants to 46 organisations this year. It was noted that the organisations were from a range of sizes up to organisations with a £100million turnover. Quarterly briefings were being held with local MP’s.

Under the second pillar of Leadership and Advocacy, Wirral had a Representation Model which was unique to Wirral where any member could put themselves forward. It was highlighted that there were 18 representation opportunities for leaders to represent the sector and work would be done in 2025 to fill those vacancies.

A key collaboration this year was around the Step Up Fund which had been delivered with 20 organisations receiving £15,000 of funding of which £10,000 was to focus on the game changers in the Health and Wellbeing Strategy and the remaining £5,000 was to focus on the organisations development and sustainability. The development funds were to be spent by March 2025 and the feedback, once available, would be provided on the Wirral CVS website.

It was reported that One Wirral were delivering cancer services on behalf of Wirral CVS with funding from Cheshire and Merseyside Funding Alliance.

It was clarified that there were 612 registered volunteers with 120 provider organisations registered on the Volunteer Wirral portal with 225 live opportunities. The volunteer front door would be kept running for the  ...  view the full minutes text for item 29.

The Head of Legal presented the report of the Director of Law and Corporate Services which recommended the co-option to the Board of an officer of Magenta Living to represent the Registered Providers.  The Health and Social Care Act 2012 provided that Local Authorities must establish a Health and Wellbeing Board and prescribed a number of people who must be members of the Board. However, the Board did have the ability to co-opt other non-voting members and in the refreshed Health and Wellbeing Strategy for 2022 there was a section that specifically referred to the importance of housing and wellbeing and set out a number of deliverables. The recommendation in the report was that the Board would benefit from representation from a Housing Sector Provider and this would be best achieved through co-opting a registered housing provider. Magenta Living were Wirral’s largest housing provider with houses, bungalows and apartments across Wirral and Cheshire and were a not for profit organisation and owned or managed just under 13,000 properties whilst employing around 500 staff.

Members queried whether there was a mechanism for Magenta to work with the other registered providers and it was clarified that Magenta Chaired the Wirral Strategic Partnership Board which had just had its first meeting and would bring housing providers together

Resolved – That a representative of Magenta Living to represent Registered Providers be Co-opted onto the Health and Wellbeing Board as a non-voting member.

The PDF file below may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices.?Please contact elizabethhartley@wirral.gov.uk if you would like this document in an accessible format. 

The Assistant Director of SEND and Inclusion presented the report of the Director for Children, Families and Education which provided an update on the improvement programme for Special Educational Needs and Disabilities (SEND) for the Local Area in Wirral. The Local Authority, Cheshire and Merseyside Integrated Care Board, education settings, parent carer forum, and other relevant stakeholders were considered members of the Local Area. The report included the Written Statement of Action Impact Group Tracker which monitored progress against the areas identified for improvement in the Local Area SEND Inspection and Improvement Notice.

The Send Partnership Board continued to meet monthly and continued to comply with the requirements of the Improvement Notice. Of the 29 metrics in the SEND improvement plan 24 had been achieved or exceeded which is 83 percent and 5 metrics had not been achieved. It was reported that in 8 out of 10 of the Written Statement of Action (WSoA) areas, all targets had been achieved. The two WSoA areas that had not met the targets were related to EHCP’s and the embedding of the Graduated Approach and it was important to recognise that those were the two areas that had the most significant material impact on children and families in the borough and these were areas for significant focus moving forward.

It was reported that three areas had been moved to business as usual and those were around the local offer, strategic oversight and the use of performance information.

It was highlighted that the Local Authority had invested significant extra money into supporting, restructuring and expanding the teams around EHCP’s and the newly recruited staff were to commence work in January 2025. 

Progress had been made with meaningful co-production at strategic level as shown by the work around the implementation of the All Age Disability Strategy and the way in which speech and language therapy services were delivered. With regard to parental satisfaction with provision, access to speech and language therapy in educational settings and perceived suitability of education places and access to neurodevelopmental assessments remained constraints.

A communications officer had been put in place to look at communications with parents with newsletters with regular information points for families. A Strategic Commissioning Officer had also been appointed to oversee joint commissioning which included speech and language therapy services, the All Age Disability team and the newly launched emotional health and wellbeing service BRANCH.

Work continued to embed the graduated response consistently across all schools and settings and there had been training and development of ambassadors to develop a peer lead system of support for increasing inclusion in schools. Moving forward, the incorporation of health services into the graduated approach included the implementation of a neurodevelopmental profiling tool which would give earlier and better sight of the needs of children and young people.

Members asked whether an Equalities Impact Assessment on the reduction in funding for the SALT for the jointly commissioned speech and language therapies had been completed. The Assistant Director of SEND  ...  view the full minutes text for item 31.

The PDF file may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact jaynemarshall@wirral.gov.uk if you would like this document in an accessible format.

The Director of Adults, Health and Strategic Commissioning presented the report which demonstrated continued compliance with the requirements of the Better Care Fund (BCF) and that the NHS England (NHSE) outcomes for 2023/25 had been met. The report recommended several approaches that would promote greater understanding for elected members on the Health and Wellbeing Board and the Adult Social Care and Public Health Committee of the schemes the BCF supports and  ensured that members had oversight and were involved in the development of Wirral’s integrated BCF annual plans. The BCF Bi-Annual Plan had to come to the Health and Wellbeing Board and the Adults Social Care and Public Health committee and was a mandated report for NHS England. It was reported that the Better Care Fund was a £62million programme which was a joint fund between the Local Authority and the NHS which was governed by a S75 Agreement which allowed resources to be pooled. It was highlighted that the report focussed on right care, right place, right time and was also about managing demand and reducing the cost of care to the system. It was also focussed on making sure that joint governance was in place to ensure proper oversight of the use and development of the funds. Work had been undertaken to give members more opportunities to have oversight in the use of the funds.  More details on the different elements of the fund had been provided to members to offer them more influence and opportunities to challenge in relation to the development of the pooled fund and ensure that real value was delivered. Members would be able to influence and develop the programme in future.

Resolved - That

1. The continued compliance with the requirements of the BCF fund be noted and it be noted that (NHSE) outcomes for 2023/25 have been met.

2. The current position does not pose a risk to the Section 75 Agreement be noted.

3. Progress against the annual plan be approved.

4. The recommended approaches to promote greater understanding of and enable more effective scrutiny by elected members of the schemes the BCF funds be approved.

5. The recommended approaches to ensure elected members have oversight and are involved in the development of the integrated BCF annual plans in the future be approved.

The PDF file below may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices.?Please contact julian.eyre@nhs.netif you would like this document in an accessible format. 

The Programme Director of the Wirral Improvement Team presented the report of the Place Director (Wirral), NHS Cheshire and Merseyside which outlined the delivery dashboard for the programmes within the Wirral Place Health and Care Plan which provided an oversight of the whole programme portfolio, provided a monthly narrative update and Red Amber Green rating of overall programme delivery, benefits, risks and issues.  The report also looked at the impact on the Health and Wellbeing of Wirral residents.

It was highlighted that the Place Partnership had agreed that tackling health inequalities has become implicit in the plan. A key element was the work around Core20+5 and ensuring that met Wirral’s Needs. There were three key elements, the first of which was empowering communities so that they had a say in shaping the services and had the knowledge and ‘know how’ to access services and maximise their own personal wellbeing. The second element was to take a holistic approach to health and wellbeing and better integrating health, care and community services to address broader determinants of health.  The third element was to work well together using research and intelligence to identify disparities and guide and deliver tailored interventions.

It was reported that the Primary and Community Care Programme stage one of the Integrated Frailty Teams Pilot had been completed and had shown an improved experience of health services of those who were moderately or severely frail. Work had started on the development of a Falls Management Prevention Strategy to support people at risk of falling. A Winter wellness event had been held in the hospital and it was noted that future events would be brought out into the community.

A key piece of work was a pilot with Magenta housing to change the way that continuing care following discharge can be received in a place that they feel safe in.

The scope of the Unscheduled Care Programme had broadened to focus on the front door of the hospital and those services that prevented people from being admitted to hospital. This in turn reduced the risk of deconditioning as an inpatient. 

The Estates and Sustainability Programme was developing a centralised platform for

documenting planning and developing solutions for a longer term approach to estates

facilities. The work of the digital programme for people with hyper tension was also highlighted.

Members discussed future Winter Wellness events and suggested community locations, the use of the wellbeing bus, free vaccinations and the possibility of twice yearly events. Members asked about the amount of people clinically ready for discharge and were keen to find out why Wirral was an outlier for people not already known to health care and where the first health care is an admission into hospital. The Programme Director of the Wirral Improvement Team agreed to add that into the programme.

Members asked about the overspend of £6.5million and the impact of spending ICB monies ringfenced for Primary Care and these questions were to be taken back to the ICB Director of Finance.  ...  view the full minutes text for item 33.

The PDF file may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact Kirsteen.Sheppard@healthwatchwirral.co.uk if you would like this document in an accessible format.

The Business Development & Volunteer Manager, Healthwatch Wirral introduced the report of the Chief Executive Officer, Healthwatch which outlined the key achievements of Healthwatch Wirral for the year 2023/2024. The report highlighted the impact of Healthwatch based on phone calls, the Healthwatch Feedback Centre and direct engagement activities.

It was reported that the Healthwatch evaluation on the pressures in emergency care was available on the Healthwatch website. The GP Survey was scheduled to finish in January 2025 and would be a comprehensive evaluation of the Primary Care Access Recovery Plan and the implementation of modern General Practice. The report  would be completed in the summer of 2025.

Resolved – That the report be noted.

The Chair presented the report of the Director of Law and Corporate Services which gave the proposed work programme for the following Municipal Year.

It was agreed that the following items would be added to the work programme:

 • Workshop on the Performance Framework of the ICB

 • Step Up Funding report from Gareth Prytherch when the projects are completed.

 • The twenty beacon indicators of the All Together Fairer item were to be included  within the JSNA Annual report.

Resolved - That subject to the above additional items, the proposed Health and Wellbeing Board work programme for the remainder of the 2024/25 municipal year be noted.