Dr Sue Wells apologised that the meeting had been moved from Birkenhead Town Hall to Wallasey Town Hall.  She informed that this had been necessary as it was very cold in Birkenhead Town Hall as the central heating was not working.

Apologies for absence were received from Councillor B Mooney.

Members are asked to consider whether they have 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.

No declarations of interest were received.

To confirm the minutes of the meeting of the Joint Strategic Commissioning Board held on 16 October 2018 as a correct record. (Copy attached.)

Subject to the following amendments, the Minutes of the meeting of the Joint Strategic Commissioning Board held on 4 December 2018 were confirmed as a correct record:

Julie Webster be added to the list of members in attendance; and

Sylvia Cheater and Alan Whittle be added to the list of members who had sent their apologies for absence.

A report of the Chief Finance Officer, NHS Wirral CCG and Wirral Health & Care Commissioning is attached.

Michael Treharne introduced a report that described the arrangements that had been put in place to support effective integrated commissioning.  The report set out the key issues in respect of:

·  the expenditure areas that are included in the 2018/19 shared pooled fund (live) and those expenditure areas in shadow form for 2018/19; and

·  the current and future risk and gain share arrangements.

Members noted that the approach to integrated commissioning, the business case and the proposed integrated arrangements for Wirral Health and Care Commissioning (WHaCC) had been well documented via Wirral NHS CCG Governing Body Board meetings on 2 May 2017 and 5 December 2017, and via Wirral Council’s Cabinet meetings on 27 March 2017 and 27 November 2017.

The following key features of integration were outlined as essential to success:

·  Pooling resources, intelligence and planning capacity.

·  Delivering the Right Care in the Right Place at the Right Time.

·  Managing demand and reducing the cost of care.

·  Clear accountability and governance arrangements.

·  Resilience and flexibility to emerging issues in service delivery.

Mr Treharne reported that Healthy Wirral had been established as the core programme for delivery of key transformational programmes of health and care.  WHaCC was the system lead for the delivery of this programme through the Healthy Wirral Partners Board. The financial challenge for the CCG and Council would continue, regardless of integration. The key for Wirral would be to ensure that integration of commissioning was seen as an opportunity to help to improve outcomes for people to make more effective use of the resources available (making the most of the “Wirral pound”,) rather than the financial challenges being seen as a barrier to integration. The risks and mitigations associated with integration would continue to be monitored and updated in the months to come.

The total fund contributed to the commissioning pool in 2018/19 amount to £130.4m, as per the table below:

The total funds making up to the shadow pool in 2018/19 amounted to £531.2m as per the table below:

The budgets illustrated within the shadow pool comprised all other budgets within the Adult Social Care and CCG areas which were not formally pooled in 2018/19.

Mr Treharne informed that a proposal regarding the arrangements for the 2019/2020 Financial Year would be presented to the Joint Strategic Commissioning Board in due course.

Over time, services which were currently out of scope for WHaCC could potentially be included within the pooled funding arrangements (e.g. further Children’s Services).  The risks of adding these services to the pooled fund arrangement would need to be assessed and mitigated, prior to any decision to expand the pool further.

A full breakdown of the pool’s composition was set out in the report along with the current forecast.

Members noted that at 31 October 2018, the CCG had a developing year-end pressure of £1.1m spread  ...  view the full minutes text for item 29.

A report by the Healthy Wirral Programme Manager is attached.

Simon Banks introduced a report that informed the Joint Strategic Commissioning Board 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 ‘Healthy Wirral’ Programme was seen as the prime system-wide programme to deliver sustainable and affordable long-term changes to the way that the health and wellbeing of the Wirral population was supported.  Appended to the report was a summary of the Healthy Wirral Programme Work Streams.

Members noted that the Healthy Wirral Programme had identified a mission of ‘Better Health and Wellbeing in Wirral by working together’ with the clearly stated aim to enable all people in Wirral to live longer and healthier lives by taking simple steps to improve their own health and wellbeing. Mr Banks informed that by achieving this, the very best health and social care services could be provided when people really needed them, as close to home as possible and delivering this aim required the Wirral partners to rise to four key challenges:

·  Acting as One.

·  Clinical Sustainability.

·  Improving Population Health.

·  Financial Sustainability.

Mr Banks outlined the key actions that had been undertaken to date and set out the proposed next steps to progress the Healthy Wirral Programme.

The Joint Strategic Commissioning Board noted that the Healthy Wirral Programme continued to make good progress in the following priority areas:

·  Work Stream Composition and Leadership.

·  Programme Requirements.

·  Programme Support.

·  Workforce Support.

·  Leadership Development.

·  Mersey Internal Audit Authority Support to the Programme.

·  Primary Care Network Development.

·  Working with Cheshire and Merseyside Health and Care Partnership.

Mr Banks answered Members questions on his report as appropriate and informed that delivering the right care at the right time meant the Clinical Commissioning Group and the local authority had a statutory duty to do this in a managed and strategic way. He informed that the Joint Strategic Commissioning Board would continue to receive Healthy Wirral updates.

RESOLVED:

That the content of the report be noted.

Report of the Assistant Director of Health and Care Outcomes is attached.

The Assistant Director of Health and Care Outcomes presented a report that described the approach that was being taken by Wirral Health and Care Commissioning, to the commissioning of care and support services for people with a learning disability and/or autism in Wirral. He informed that a similar report had been provided for consideration at a meeting of the Health and Wellbeing Board.

The Joint Strategic Commissioning Board noted that Wirral had put in place a programme of work to achieve a greater range of support options for people with a learning disability. This would increase choice and control and would improve wellbeing and independence for people.

It was reported that the national Transforming Care Programme had been developed to ensure that people were not inappropriately supported in specialist hospital placements for people with a learning disability or autism, when they could effectively be supported in a non-clinical environment such as their own homes, natural communities, specialist residential care and closer to home.

Members noted that both the Council and NHS Wirral Clinical Commissioning Group (CCG) had budget pressures and recognised that services could be more effectively commissioned to enable independence. A broader range of support options were required in order to provide the right type of services to meet a broader set of support needs within the budget available.

The report described the commissioning approach that would provide a broader range of support services to meet the needs of people with a learning disability and that would contribute towards the delivery of the Wirral Plan pledges.

Members commented on the report and this included the following:

·  The Council was working closely with NHS providers to ensure people had the right level of support in place and that discharges were monitored and progressed.

·  An immense amount of work had gone into the Transforming Care Programme.

·  The work that had been carried out was positive and forward thinking.

·  Pooled funding was very important and helped the two organisations to work properly in partnership providing the right service for the right people.

·  A whole range of excellent projects were ongoing.

·  There was further work to do in respect of people with complex needs this involved identifying and planning the services needed.

·  The transition between children’s services and adult services was a key area for consideration.

·  This excellent work was a good illustration of why the two organisations were working together as commissioners.

RESOLVED:

That the content of the report be noted.

A report by the Acting Director of Health and Wellbeing is attached.

The Acting Director for Health and Wellbeing presented a report seeking the Joint Strategic Commissioning Board’s agreement to progress the proposed commissioning intentions for public health services for the period 2019-2010. The proposal set out in the report linked to the delivery of the Wirral 2020 Plan and the statutory responsibilities of the Council in respect of its public health functions. The Joint Strategic Commissioning Board noted that the proposed actions affected all wards within the borough and the decisions requested were key decisions. Appended to the report at Appendix 1 were the Public Health Contracts by Provider 2019/20 (including Commissioning Intentions).

The proposed commissioning intentions for public health services in 2019/20 were summarised in a Table in the report as follows:

  Summary of Commissioning Plans 2019/20

The Joint Strategic Commissioning Board noted that there were sixteen contracts (with a value of £5,100,833) which would not be subject to any change during 2019/20. This was because the contracts were in term or were being extended for a further year. All extensions complied with the Council’s Contract Procedure Rules and were allowed as part of the contractual terms and conditions. The service specification for these contracts would be reviewed and renegotiated with providers as part of the 2019/20 contract negotiations and any changes to the specifications e.g. performance metrics, were designed to ensure that contracts reflected the Board’s commissioning intentions and maximised performance in terms of outcomes and value for money.

It was reported that several contracts would be retendered during the 2019/2020 financial year and it was anticipated that the new contracts would be operational by April 2020. Contracts would also need to deliver social value outcomes.  Current contracts for these services would continue during the re-commissioning process so that there was no loss of service to local people. Services to be recommissioned during 2019/2020 were as follows:

·  Integrated Drug and Alcohol Treatment Services

·  The Healthy Child Programme 0-19

·  The Community Connectors Programme

·  Weight Management Services

It was noted that it was necessary to recommission these services to comply with the Public Contract Regulations and the Council’s Contract Procedure Rules. The value of the proposed contracts would be above the relevant European Union threshold and the supplier selection process would be conducted in accordance with The Public Contract Regulations 2015 and the Council’s Contract Procedure Rules.

The Joint Strategic Commissioning Board noted that services to be retendered, the proposed contract length and the maximum budget allocation were as follows:

Services to be retendered in 2019/20

A report by the Lead Commissioner, All Age Independence is attached.

Simon Garner presented a report that informed that Extra Care Housing meant that older people and people with Learning Disabilities had choice and control to live as independently as possible as part of the community. Extra Care was not simply about providing a home with the right support and care. Extra Care Housing provided a lifestyle and a place that was integrated in its community.

The Joint Strategic Commissioning Board noted that Extra Care Housing brought with it an improved quality of life for individuals compared to living in residential care.  Along with improved benefits for residents, Extra Care Housing may deliver a financial benefit to local partners in the long run as it maximised the value people could get from housing benefit. The report set out what Extra Care Housing was, what the key national policy drivers were, what the needs of the population look like in Wirral and how the challenge was being approached in order to meet these needs.

The three strategies within the 2020 Plan that Extra Care Housing impacted on were: Ageing Well, All Age Disability and Good Quality Housing.

This matter affected all Wards within the Borough.

It was reported that there were alternatives to Extra Care such as community services, sheltered housing and residential care. However Extra Care provided an important alternative form of housing that enabled people to live independently.

The Joint Strategic Board agreed that this was a fantastic report.  This was just the beginning and it would need to look beyond 2030 in terms of planning.

RESOLVED:

That the report be noted.

The report is attached.

Lorna Quigley presented the Wirral Safeguarding Children Board’s (WCSB) Annual Report 2017-18.  It set out how WSCB had responded to the need continually to improve safeguarding in the borough. It was noted that 2016-17 had seen the start of that improvement and 2017-18 had built on it. The report captured how the Board and each partner agency on it, had undertaken safeguarding that placed children and young people’s wellbeing at its core.

The Joint Strategic Commissioning Board noted that the Annual Report included reports on the Board’s crucial work in independent challenge and scrutiny, both key roles expressing the Board’s statutory responsibilities. WSCB’s core purpose was to ensure, and where necessary to require improvement in, the effectiveness of Wirral-wide, all-agency safeguarding for children, young people and their families. The report focused on WSCB’s delivery of its priorities, capturing and reporting organisations’ activities and ensuring they made positive differences in children’s lives.

The Annual Report recorded continued improvement of practice through the use of Wirral’s new intervention, child protection and family support model, Supporting Families Enhancing Futures (SFEF), which had been co-designed by all Wirral partner bodies and was intended for use across the board in their work with children and young people. Its use sought to ensure the families with whom SFEF was used could be true partners with, as well as often vulnerable recipients of services. 

It was reported that this was an opportunity to celebrate some of the work that had been carried out.  It was the second year of the improvement journey and it was pleasing to see a number of initiatives in place. Teams had worked in a multi-agency way to ensure the additional work necessary had been completed in year 2.  Children were now at the centre of decision-making and joint working had ensured that the WSCB was compliant with its statutory responsibilities in respect of safeguarding arrangements.

Reference was made to the poor communication around safeguarding which was frustrating.  The different agencies had not been communicating well.  The Joint Strategic Commissioning Board wanted this to be fixed as a priority. The Corporate Director for Children’s Services informed that the structure and processes were now in place and it was expected; now there was stability, that there would be an improvement in communications.

The Joint Strategic Commissioning Boards attention was drawn to the Chair of the WSCB, Dr Maggie Atkinson’s foreword where she had warned that the ongoing challenge of “doing still more with still less” was now a matter for grave concern to all who worked with children and young people. She had said that it was not alarmist to state that the borough may find that in the worst circumstances, there were now palpable and recorded threats to the safety and wellbeing of some children. Dr Atkinson had made no excuses for stating this, as an independent Chair who was charged with saying what must be said no matter how hard it was to hear. It was not the partner agencies at the  ...  view the full minutes text for item 34.

To note that the next meeting of the Joint Strategic Commissioning Board will be held at 2pm on Tuesday, 5 February 2019 in the Council Chamber of Birkenhead Town Hall.

RESOLVED:

That it be noted that the next meeting of the Joint Strategic Commissioning Board is scheduled to be held at 2pm on Tuesday, 5 February 2019 in the Council Chamber of Birkenhead Town Hall.