Agenda and minutes

Venue: Council Chamber - Birkenhead Town Hall. View directions

Contact: Shirley Hudspeth  Committee and Civic Services Manager


No. Item


Apologies for Absence

Additional documents:


Apologies for absence were received from Michael Treharne, Lorna Quigley and Councillor Stuart Whittingham.


Decision Making Arrangements

Additional documents:


It was reported that Wirral Council’s Cabinet had delegated authority to make decisions to its Cabinet Committee. However, the NHS Wirral Clinical Commissioning Group (CCG) had not delegated authority to its Committee to make decisions. Therefore, the CCG’s Committee would agree recommendations at this meeting to report to the next meeting of the CCG scheduled for 11 September 2018, for decision.




That the decision making arrangements be noted.


Members' Code of Conduct - Declarations of Interest

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.

Additional documents:


Councillor Chris Jones declared a personal interest in Item No. 5 on the agenda – All Age Disability and Mental Health by virtue of her employment with the Cheshire and Wirral Partnership NHS Foundation Trust.



To approve the accuracy of the minutes of the meetings held on 19 June 2018.

Additional documents:


Subject to Paula Cowan being referred to as Dr Paula Cowan, the Minutes of the meeting of the Joint Strategic Commissioning Board held on 19 June 2018 be confirmed as a correct record.


Commissioning and Transformation Strategy pdf icon PDF 56 KB

Report of the Director of Commissioning and Transformation.

Additional documents:


Nesta Hawker introduced a report informing Members that the Commissioning and Transformation Strategy shared the high level plans and commissioning priorities of Wirral Health and Care Commissioning (WHaCC) up to 2021. WHaCC would lead on the development of place based care on Wirral. This model was that local people who accessed care would have seamless care pathways and that there would be more focus on enabling people to remain well, without the need of help from traditional formal services.


Members noted that the focus would be on people and place, not on organisations. The transformation of service delivery was expected to reduce the need for high cost acute care and improve health and wellbeing, reducing the need for long term care. The aim was to improve the outcomes for the people of Wirral and also to deliver sustainable services, both clinically and financially. It was reported that placed based care was being developed in response to the challenges that the Wirral health and care system faced. These included constrained funding, increasing demand, fragmentation of services and the need to deliver better health, better care and better value for the people of Wirral.


The ambition to provide services at the most appropriate local level had led to the development of the 51 – 9 – 4 – 1 model. This footprint had been developed on population needs and the nine neighbourhoods as outlined in the Strategy would be the focal delivery point for care which would be ‘wrapped around’ the person. Therefore, the neighbourhood’s development was the priority for 2018/19. These neighbourhood teams would have an integrated workforce spanning primary, secondary, mental health and social care and importantly community and voluntary groups.


To achieve this ambition for WHaCC to commission on a place based care basis a gradual approach to this new way of commissioning would be adopted with the phasing in based upon segments of the population. Due to the demographic of Wirral the first priority would be older people with a focus on frailty. Members were made aware that the aim was to develop a prospectus which would outline the outcomes expected for the frailty population on Wirral. This would be co-produced with both the public and stakeholders.


The Strategy was appended to the report and was intended to share the plans for the development of place based commissioning.  It outlined the vision of how it would move to commission on popular based health and care outcomes.


Members were informed that the single commissioning strategy had been developed in partnership with stakeholders from across the health and care system. A key intention of bringing together the Local Authority and CCG Commissioning was to have a single approach to commissioning health and care services, therefore, separate strategies were not in line with the key aims and no other options had been considered.


Councillor Bernie Mooney declared a personal interest in this item of business by virtue of her employment with Age UK.



Members considered the documentation in detail, noted it  ...  view the full minutes text for item 13.


All Age Disability and Mental Health pdf icon PDF 172 KB

Report of the Assistant Director, Health and Care Outcomes.

Additional documents:


Jason Oxley, the Assistant Director Health and Care Outcomes introduced a report that informed that integrated assessment, case management and support planning processes for children and adults with disabilities and adults with mental health needs, with Cheshire and Wirral Partnership NHS Trust (CWP) would improve support for the most vulnerable people in Wirral.  Those who had a disability or a mental health need.


Appended to the report were the following appendices:





All Age Disability and Mental Health Service Full Business Case


Merseyside Pension Fund Actuarial Evaluation


All Age Disability and Mental Health Service Contract (Draft)


All Age Disability and Mental Health Service Specification


All Age Disability and Mental health Service Due Diligence Report


All Age Disability and Mental Health Strategy


Survey results


Members noted that Social Care Services played an important role in enabling vulnerable people to maximise their independence, to take an active part in their communities and to keep well in Wirral.  The inter-dependency between health and care systems had become increasingly clear over recent years. Nationally, Councils were being faced with increasing demand on Social Care Services which presented as a challenge to meet within the available resources.  Local Authorities and NHS providers were increasingly working to integrate social care and health services locally to provide both sustainability and a better experience for people who used these services.


People with disabilities and their families had informed that they had experienced difficulty in navigating between different services and between health and care organisations, had found it difficult to maintain communication with all the different people involved in their support and had not always had joined up planning for adulthood.


Members were informed that this service was in line with the All Age Disability Strategy and feedback received from people that needed support from services. A Wirral resident had informed that


  “The main issue is to break down the barriers between organisations and ensure that everyone in each of the organisations understands what the others do” (ref Survey Results Appendix F).


The service aimed to ensure that the Council and NHS partners used the collective resources to provide better and more joined up support to people with disabilities or a mental health need. This followed the successful implementation of a fully integrated service for older people which was now provided by Wirral Community NHS Foundation Trust on behalf of the Council and under a similar agreement.


It was reported that the following key features of the all age service were essential to success:


·  Bringing health and social care staff together to provide integrated, coordinated support to people.

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

·  Supporting young people with complex needs into adulthood.

·  Clear accountability and governance arrangements.

·  Resilience and flexibility to emerging issues in service delivery.


The Council’s Cabinet (March 2016) had approved the establishment of a Transformation Programme with the development of an All Age Disability and Mental Health service. On 6 November 2017,  ...  view the full minutes text for item 14.


Care and Support at Home Commission pdf icon PDF 118 KB

Report of the Lead Commissioner Community Care Market and the Assistant Director Primary Care.

Additional documents:


Jacqueline Evans, Assistant Director – Integrated Commissioning Programme and Iain Stuart, Assistant Director, Primary Care introduced a report that set out plans related to improving the sustainability of the care market in Wirral via a joint commission for care at home services led by Wirral Health and Care Commissioning (WHCC).


Appended to the report were the following appendices:





Lessons Learned Log


Risk Register (co-produced with providers)


Stradia Workshops


Procurement Timetable


It was proposed to jointly commission and enable existing providers to keep their existing caseload post-award. Successful providers would be able to keep existing caseload and take up new cases going forward and Members were told that this would ensure minimum disruption for people who used services and would also reduce the impact of a review of the 1,400 cases.


Members were informed that this approach aimed to ensure that services were delivered in the right place and at the right time and that individual personal outcomes could be improved for vulnerable people that required personal care and support.


It was noted that the commission would support the continuation of the downward trend in long term residential and nursing placements by growing the community offer to the increasing population of older people, allowing them to receive care whilst at home.


Domiciliary Care Services provided personal care for people living in their own homes and were currently independently regulated by the Care Quality Commission (CQC) under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009. All of the current service provisions were commissions provided through the independent sector.


Members noted that the service would go out to open tender in September 2018 and would be open for all providers to formally tender and apply for the work, with an intention for the new service to commence in April 2019.  The commission would include:


·  Reablement

·  Domiciliary Care Services

·  Complex/Continuing Health Care

·  End of Life Care


Members also noted that these services would form part of a newly designed integrated pathway for care at home with ‘home first’ also included. There would be an enhanced focus on hospital admission avoidance, an improved hospital discharge offer, behaviour change and self-care. The service specification outlined the vision for the delivery of these services, the key features of the service and the outcomes it was expected to achieve.


The new model would incorporate:


·  An Outcomes focused approach

·  A ‘top to bottom’ service (complex to community involvement)

·  Electronic care monitoring

·  Electronic care planning

·  Social Value (the evaluation criteria will be based on 20%)

·  Wirral based – providers to demonstrate a previous history of working in Wirral using a locally sourced workforce and keeping the Wirral £ in Wirral

·  Trusted Assessor model

·  Open Book Accounting – better value for money and a clearer understanding of Provider costs to enable us to have a dynamic financial approach

·  Payment delivery against ‘actuals’

·  Community / Third sector engagement

·  Deliver a balanced and equitable care market  ...  view the full minutes text for item 15.


Date of Next Meeting

To note that the next meeting of the Joint Strategic Commissioning Board will be held at 2pm on Tuesday, 16 October 2018 in the Council Chamber of Birkenhead Town Hall.


Additional documents:




That it be noted that the next meeting of the Joint Strategic Commissioning Board is scheduled for 2pm on Tuesday, 16 October 2018 in the Council Chamber of Birkenhead Town Hall.