Agenda and minutes

Venue: Committee Room 1 - Wallasey Town Hall

Contact: Patrick Sebastian  0151 691 8424

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No. Item


Apologies for Absence

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Apologies for absence were received from Councillor Gerry Ellis and Karen Prior, Chief Officer Healthwatch Wirral.


Members' Code of Conduct - Declarations of Interest

Members are asked to consider whether they have any disclosable pecuniary or non-pecuniary interests in connection with any item(s) on the agenda and, if so, to declare them and state the nature of the interest.


Members are reminded that they should also declare whether they are subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.


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Members were asked to consider whether they had any disclosable pecuniary interests and/or any other relevant interest in connection with any item(s) on this agenda and, if so, to declare them and state the nature of the interest.


Members were reminded that they should also declare whether they were subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.


The following declarations were made.


Councillor Chris Meaden

Personal interest by virtue of her daughter’s employment within the NHS.

Councillor Christina Muspratt

Personal interest by virtue of her daughters’ employment within the NHS and as a GP.

Councillor Sharon Jones

Personal interest by virtue of her employment within the NHS.

Councillor Tony Norbury

Personal interest by virtue of his daughter’s employment within Adult Social Services.

Councillor Joe Walsh

Personal interest by virtue of his daughter’s employment within the NHS.

Councillor Tony Cottier

Personal interest by virtue of his daughters’ employment within the NHS.

Councillor Phil Gilchrist

Personal interest by virtue of his role as a Governor appointed to the Cheshire and Wirral NHS Partnership Trust, and as a member of the Health and Wellbeing Board.

Councillor Mary Jordan

Personal – by virtue of employment within the NHS; and involvement in Incubabies, a charity raising funds for the neonatal unit at Arrowe Park; and her son’s employment as a GP.



Minutes pdf icon PDF 135 KB

To approve the accuracy of the minutes of the meeting held on 12 September 2018 and the special meeting held on 12 November 2018.

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Reference Minute 28 (special meeting 12 November 2018) – Urgent Care Review – a Member requested that reference be included to the break in proceedings where consultation on legal advice was sought, and that after a short break, and having consulted with the Council’s Solicitor and the Director Adult Care and Health, the Chair reconvened the meeting and invited Members to continue their deliberations. 


Resolved – That, subject to the above amendment, minutes of the meeting of the Adult Care and Health Overview and Scrutiny Committee held on 12 September 2018, and the minutes of the special meeting held on 12 November 2018, be confirmed as a correct record.


Financial Monitoring Report Quarter 2 2018/19 pdf icon PDF 98 KB

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Peter Molyneux, Senior Manager Corporate Finance introduced the regular report of the Assistant Director: Finance and Section 151 Officer that provided Members with detail to scrutinise budget performance and updated the Overview and Scrutiny Committee on the financial position of the Council. The attached Cabinet reports set out the projected revenue and capital monitoring position for 2018/19 as at the close of quarter 2 (30 September 2018).


The Senior Manager Corporate Finance provided Members with a summary presentation that set out the budgetary figures for 2018/19 and information regarding key areas of relevance / note i.e.


  • The quarter 2 capital report recommended that Cabinet agree the 2018/19 Capital Programme of £60.9 million which takes into account re-profiling identified during 2018/19. Expenditure to date was £16.3 million.
  • The quarter 2 revenue report showed a balanced budget for Adult Care & Health. The quarter 2 capital report showed an expenditure of £381,000 on a programme of £3.5 million.
  • Savings being delivered ahead of schedule
  • New: Winter Pressures Grant (£1.8m)
  • Creation of All-Age Disability Service
  • Capital: £3.4m programme, £0.4m spend to date


The Senior Manager Corporate Finance’s presentation also provided members with a further breakdown of the key budget expenditure relating to 2018-19 Adult Social Care Budget & Pressures, a summary of the  All-Age Disability Service, Pooled Budget with Wirral Clinical Commissioning Group (CCG) and the Committee’s role in the 2019/20 Budget process and associated key dates, namely:


  • 26 November 2018 – Cabinet agree budget proposals.
  • 6 December 2018 - Adult and Health Overview and Scrutiny Workshop on budget options.
  • 18 February 2019 – Cabinet Approval budget and updated Medium Term Financial Strategy.
  • 4 March 2019 – Full Council consider budget and Council Tax.


In response to Member questions, the Director for (Adult) Care & Health informed that budget pressures on the service were carefully managed, being directly related to levels of demand and assessed need.


Resolved – That the report be noted.


Musculoskeletal (MSK) Integrated Triage Service - Update pdf icon PDF 1 MB

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Mr Simon Banks, Chief Operating Officer Wirral Clinical Commissioning Group (CCG) introduced a report of the Director of Commissioning and Transformation and the Chief Operating Officer Wirral University Teaching Hospital that provided an update on the Musculoskeletal (MSK) Integrated Triage Service.


The report informed that on 1 July 2018, NHS Wirral CCG had implemented a new Musculoskeletal Integrated Triage Service through a Prime Provider, NHS Wirral University Teaching Hospital (WUTH). This replaced a previously fragmented service and offered referrers and patients a streamlined process for referral and leaner diagnostic and treatment pathways.


Mr Banks informed the Overview and Scrutiny Committee that development of the model had commenced in 2015; commissioners had undertaken a broad range of research and engagement comprising workshops, site visits, information sharing/networking events and desktop research. This in turn had led to agreement for a fully integrated triage service with one point of entry and strong emphasis on the right treatment at the right time.  Members noted that the new service had been in operation for 4 months, and:


  • Provided a single point of access
  • Simplified the referral process for GPs
  • Provided a comprehensive and consistent referral and assessment process
  • Reduced duplication and service waste
  • Enhanced the quality of patient experience and patient pathways
  • Provided an appropriate mix of community and secondary based provision


Dr Sue Wells, Chair Wirral CCG provided a GP’s perspective of the new procedures and expressed her support to the new systems which enabled single referral for patients with complex needs, dramatically reducing waiting times if being transferred between different departments. Dr Wells added that the patient experience had dramatically improved as a result.


Resolved – That the report be noted.


Annual Social Care Complaints Report 2017/18 pdf icon PDF 384 KB

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David Jones, Complaints Manager introduced his report that informed that it was a statutory requirement to produce an annual report about complaints made by, or on behalf of people who receive support or services from Adult Social Care. His annual report also provided a mechanism by which the Council could monitor the quality and effectiveness of services and of its complaints procedure.


The report provided an overview and analysis of all complaints received during the reporting period 1 April 2017 to 31 March 2018; including a summary of identified issues, examples of service improvement and details of future objectives for 2018/19. Comparisons from the previous reporting period, i.e. from 1 April 2016 to 31 March 2017 had been included where available.


Members noted that the report was to be published on the Council’s website, and made available to managers and staff, elected members, residents and inspection bodies. During 2017/18, just over 11,144 service contacts had been received from new clients by Adult Social Care. At the beginning of April 2017, just over 4220 people had been provided with ongoing long term support.


The report provided information about complaints, compliments and other feedback received by Adult Social Services for the period 1 April 2017 until 31 March 2018.


Members were apprised that each Complaint is acknowledged within 3 days and complainants will be informed of the expected timescale at the outset. In all cases complaints should be dealt with expediently. In response to a Member question Mr Jones informed that some complaints, of a more complex nature, would require more time to investigate and resolve and that the maximum amount of time allowed for dealing with any complaint was six months. Investigations were conducted in an impartial, reasonable and proportionate manner.


Ensuring that complaints are managed effectively at all stages of the procedure by having clear and straightforward systems in place to capture complaints and that these processes are readily accessible to all users, and ensuring decisions are taken as quickly as possible and where fault is found, lessons are learnt which are then fed back into service improvements. Mr Jones explained that the Council also sought to use its intelligence and work with operational teams to reduce the level of dissatisfaction occurring.


Mr Jones informed how transfers of social workers had seen challenges for the NHS (timetable for dealing with complaints 45 days), but these issues were being monitored regularly and contractually.


Resolved – That the report be noted.


Learning Disability Commissioning (verbal update)

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In advance of a formal written report scheduled for the January meeting of this Committee, Jason Oxley, Assistant Director Health and Care Outcomes provided a verbal update on the commissioning of support for people with a disability which supports the pledges and priorities of the Wirral Plan and All Age Disability Strategy.


Mr Oxley informed of the commissioning plan for people with learning disabilities that sets out the Council’s commitment to protect the most vulnerable people and the need to commission a varied range of services to support them. He further informed of the national Transforming Care programme that aimed to support people closer to their homes, or in their own homes rather than outside of the Borough and in hospital settings. Mr Oxley apprised Members of the cost pressures being faced by the Council and the Clinical Commissioning Group (CCG) for people with increasingly complex needs.


Members were informed of the availability and location of new extra-care housing, supported living and residential care arrangements. Mr Oxley apprised Members that it was Council’s practice that payments to Supported Living service providers were now based on the services they had actually provided, and not the amount of services originally requested, with payments also based on outcomes. He added that re-commissioning was underway for respite care and retendering procedures were actively seeking to improve standards.


The Adult Care and Health Committee received an update on work underway in respect of Transforming Care that aimed to ensure timely, supported discharge from care and also focussed on avoiding admissions in the first instance. The primary aim being to provide a range of services / activities in a positive fashion, flexible with better outcomes and efficiencies.


Members requested that Mr Oxley’s notes be circulated to the Committee.


Resolved – That the verbal report be noted.



2018/19 Quarter 2 Wirral Plan and Health and Care Performance pdf icon PDF 113 KB

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Graham Hodkinson, Director for Health & Care (DASS) introduced his report that provided the 2018/19 Quarter 2 (July – September 2018) performance report for the Wirral Plan pledges under the remit of the Adult Care and Health Overview and Scrutiny Committee. The report provided an overview of the progress in Quarter 2 and available data in relation to a range of outcome indicators and supporting measures.


The report also included further performance information that had been requested by Members to enable effective scrutiny. The Adult Social Care and Health Performance Overview was included as Appendix 2 to the report and had been developed following Member feedback to include key performance data across the health and social care service.


Mr Hodkinson’s report informed of a number of key points, namely:


·  The employment rate for people over 50 had reached its highest rate since the plan began (40.6%). Work continued to explore ways to promote employment opportunities in later life.


·  The Heswall Door Knock had taken place in August resulting in 263 people signposted to an activity by a Community Connector.


·  The Employment rate aged 16-64 - Equality Act core or Work Limiting Disabled measure had increased again to 48.8% up from 47.5% last quarter. This was an increase from 37.5% at the start of the plan. Wirral was closing the gap on the North West (50.4%) and National average (53.7%) which both remained static this quarter.


·  The proportion of people who were feeling supported to manage their condition had reduced to 60.1% for the period January 2018 - March 2018 from 67.2% the previous year. This reduction reflected the pattern across the rest of the country. The All Age Disability Steering Group was further developing networks to enable third sector, supported housing and statutory organisations to feedback enabling the group to act on a wider range of service user inputs in the future.


·  Ensuring people with disabilities had stable and appropriate accommodation improved their safety, increases their independence and reduced their risk of social exclusion. The Q2 figure of 83.5% had increased from last quarter but was lower than the latest North West average. There had been an increase in Extra Care schemes throughout the borough, which aimed to increase the number of adults with a learning disability who live in stable and appropriate accommodation.


·  In Quarter 2 there had been a decrease in domestic abuse cases referred to the Family Safety Unit; 258 cases, compared to 276 in the previous Quarter. The percentage of referrals judged to have met the high-risk threshold had increased. The number of cases dealt with by the MARAC and repeat MARAC cases had increased, and Wirral MARAC case rates were higher than similar force and national benchmarks.


Mr Hodkinson responded to a number of questions from Members seeking clarity on information gathering methods and variance between the presentation of statistical evidence in regard to domestic violence occurrence. Mr Hodkinson informed that he would seek clarification on these matters for future reporting.


Resolved – That the report  ...  view the full minutes text for item 40.


Report of the Health and Care Peformance Panel pdf icon PDF 104 KB

Additional documents:


Councillor McManus introduced her report as of Chair of the Health and Care Performance Panel that provided an overview of the first Health and Care Performance Panel meeting of the municipal year, which was held on 8th October 2018. The report provided feedback to Members of the Adult Care and Health Overview and Scrutiny Committee around key discussions and areas of interest resulting from the meeting, namely:


  • Financial Monitoring Q1 2018/19
  • CQC Improvement Plan – Wirral University Teaching Hospital (WUTH)
  • CQC Improvement Plan – Wirral Community Trust


The report also included a summary of actions:


·  Members had requested further detail relating to the Wirral Health and Care Commissioning pooled budget. Specifically, a breakdown of contributions from Wirral Council and Wirral CCG so that they may be sure that there was no duplication of funding. Members also requested sight of the Better Care Fund monitoring report, so that they may be more aware of where the money goes and how it was spent. It was agreed that this would be brought to a future meeting of the Health and Care Performance Panel.

·  Members requested further information relating to the ownership of Pensby Wood.

·  The WUTH and WCT CQC improvement plans will be added to the work programme of the Health and Care Performance Panel so that Members can monitor the progress of both Trusts throughout the municipal year.

Resolved – That the report be noted.


Adult Care and Health Overview and Scrutiny Committee - Work Programme Update pdf icon PDF 78 KB

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The Chair introduced her report considering the work programme for the Adult Care and Health Overview and Scrutiny Committee that should align with the corporate priorities of the Council, in particular the delivery of the Wirral Plan pledges which are within the remit of the Committee, and reflect the health scrutiny functions delegated to the Committee.


The report provided an update regarding progress made since the last Committee meeting held on 12 September 2018. The current work programme was made up of a combination of scrutiny reviews, workshops, standing items and requested officer reports. The update report provided Members with an opportunity to review and evaluate the Committee’s work throughout the Municipal Year.


The Chair highlighted two specific areas of work to be addressed in the forthcoming months, namely:


  • Budget Scrutiny - In line with previous Municipal Years, it was anticipated that workshops would be held for Members of each of the Overview and Scrutiny Committees, in order for them to review budget proposals within their remit for the 2019/20 Municipal Year. It was expected that the Adult Care and Health Overview and Scrutiny budget workshop was to be held on Thursday 6 December 2018, with a full report presented to Committee in January 2019.


  • Reality Check Visits - At the last meeting of the Adult Care and Health OSC held on 12 September 2018, it had been suggested that Members may find value in visiting both Arrowe Park Hospital and the Seacombe Birthing Centre in order to view the facilities, and to observe the experiences of both patients and staff. These visits were to be co-ordinated by Healthwatch Wirral, and were expected to take place later in the Municipal Year.


A Member requested that the Clinical Senate report findings relating to the review of Urgent Care services on Wirral be brought before Members of the Committee at the earliest possibility.


Members were requested to forward their expressions of interest in attending the Reality Check Visits to the Committee’s Scrutiny Officer.


Resolved –


That the proposed Adult Care and Health Overview and Scrutiny Committee work programme for 2018/19, be noted.


Urgent Business Approved by the Chair - Winter Pressures

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The Chair informed that it had been brought to her attention that an extra Ward had been opened at Clatterbridge Hospital to deal with additional Winter pressures should it be needed. The Chair added that she had been advised that the hospital did not have sufficient staffing resources to manage this, and staffing had been outsourced. She believed that this should have brought to the attention of the Overview and Scrutiny Committee, and that if this was the case the matter should be reported to the Adult Care and Health Overview and Scrutiny Committee at its next meeting in January.


The Director for Health & Care (DASS) provided a brief update to Members on the matter, informing that Arrowe Park Hospital had directly commissioned additional beds at Clatterbridge for sub-acute patients with Four Seasons Healthcare, and a request made to Social Care for funding had been refused.


A Member provided first-hand experience of how Arrowe Park Hospital had provided additional Wards for sub-acute patients, and did not believe that a) the Ward would not exclude patients requiring quite high levels of care and that b) agency staff would not necessarily have the levels of skills required to provide the level of care needed.


Resolved –


That a report on the matter of Winter Care provision be presented to the next meeting of the Adult Care and Health Overview and Scrutiny Committee in January 2019.