There were no apologies for absence.

There were no declarations of interests.

To approve the minutes of the meeting of the Joint Strategic Commissioning Board held on 28 May 2019.

RESOLVED:

That the minutes of the meeting of the Joint Strategic Commissioning Board held on 28 May 2019 be agreed as a correct record and signed by the Chair.

Verbal report.

The Officer from Wirral Health and Care Commissioning told the Board about the experience of a young person with a learning disability and autism which illustrated the partnership working and successful outcomes of new jointly commissioned services.

The case involved a young man who had been provided with a new home in a purpose-built supported accommodation which comprised six self-contained apartments, with three communal areas. Staff there completed a bespoke training package which included information about individual residents and techniques to use in supporting their individual needs. The man had a learning disability and autism and could present with behaviour that can challenge when his needs were not anticipated or met in the appropriate way. Following a placement breakdown and an incident in the community, he was detained under the Mental Health Act and had been treated in hospital for about a year. He moved into the new accommodation in spring 2019, settled in very well and made progress in many areas, including allowing staff into his personal space for extended lengths of time, eating with company, being in control of his daily activities, going out in the car and shopping, enjoying park equipment which helped him lose weight, having a balanced healthy diet, having his hair cut and having dental work. He even helped staff at the setting by cutting the grass. His parents have visited him often as have his relatives, and his social worker said it had been a positive experience for him. His family are very complimentary about the care staff and see a real positive change in him.

RESOLVED: That the story be noted.

The Chairman allowed three members of the public to address the Committee with their opinions about the recommendations in the report. One agreed that streamlining was necessary and supported NHS Wirral Clinical Commissioning Group’s proposals, particularly as they had ensured that substantive services would be kept open and they would be open to all age groups. The second urged the CCG to reconsider because of the effects on the deprived areas of Birkenhead and Wallasey of taking away their local access. The third speaker also urged the CCG to rethink and noted that with a reduction in bus services people felt isolated.

The Chairman introduced the report and stressed that it was an NHS decision which fell outside of the pooled fund arrangements, so approval would be by the CCG Governing Body.

The Director of Commissioning for NHS Wirral CCG explained that the transformation of urgent care had been a priority since 2009. The overall need was to ensure that constitutional standards around Urgent Care were met, and patients received excellent quality from a sustainable service. An extensive consultation had taken place in 2018 on the initial options and, in addition to the consultation responses, 45,000 signatures had been received via a number of petitions.  There had been a detailed independent analysis of the consultation feedback, together with detailed work on usage reasons and age profiles. It was emphasised that the recommendations here represented an endeavour to recognise that the CCG had listened to the findings of the feedback and these proposals would be an enhanced service,  with the retention of three walk-in facilities and the extended provision of the Urgent Treatment Centre at Arrowe Park helping to reduce pressure on A&E.

The Members thanked the CCG for listening and being responsive to the opinions given in the consultation but expressed concern at transport access from deprived communities.  It was acknowledged that there needed to be a joined-up approach between the NHS and the Council using the established mechanisms to ensure transport issues were addressed, recognising the commissioning roles of each organisation. Concern was also expressed in relation to the management of ‘peaks and troughs’ at Gladstone and Moreton Minor Injury/Illness Units given the proposed change to bookable urgent appointments.

The next stage would be scrutiny of the decision by the relevant Overview and Scrutiny Committee(s) and implementation would not commence until that process had concluded and a clear implementation plan had been developed.

The Chairman thanked the public for the responses and petitions and reassured residents that services would be monitored to understand the impact of the changes, and that the priority was commissioning high quality services. Transport issues would be explored at other meetings with Councillors and operators.

RESOLVED:

That as a result of the public consultation, all of the following be approved by the NHS Wirral Clinical Commissioning Group (CCG) Governing Body:

A)  Implementation of a 24-hour Urgent Treatment Centre (UTC) at the Arrowe Park Hospital Site

B)  All-age walk in access in each community hub:  ...  view the full minutes text for item 17.

The Liverpool City Region (LCR) Programme Manager introduced this report, which provided an overview of collaborative work, led by the Directors of Adult Social Services across LCR. The key driver was demand management, to prevent, delay or reduce demand across the health and social care system and to share best practice.  Work had focused effort on the areas of the greatest spend and highest risk, being Home Care; Residential and Nursing Care; and Complex Care (Younger Adults).  Discussions had been underway to determine the focus of the work for the following two years, and younger adults with more complex needs was likely to be the chosen topic.

RESOLVED:

That the content of this report be noted.

The Chief Finance Officer from Wirral CCG introduced the report which described the arrangements that had been put in place to support effective integrated commissioning.  It setoutthekey issues in respectof the expenditure areas that were included in the 2018/19 shared (“pooled”) fund and the risk and gain share arrangements.

The fund was £131.9 million in 2018/2019. There had been a gross deficit of £1.0m on the pool at 31^st March 2019, £0.8m of which was mitigated by underspend on the Better Care Fund, which left a net deficit of £0.2m, which had been shared with £0.1m for NHS Wirral CCG and £0.1m for Wirral Council.

RESOLVED: That the final financial position of the pooled fund, as at 31^st March 2019, be noted.

The Chief Officer of the Wirral Health and Care Commissioning and NHS Wirral Clinical Commissioning Groupsummarised the report whichdetailed his work since the last meeting including:

·  North West regional meeting of NHS Trust Chief Executives and CCG Chief Officers, which discussed long term plan implementation, against a background of EU exit uncertainty and demographic challenges  

·  Delivering Healthy Wirral

·  Visit of the Chief Executive NHS England and NHS Improvement who emphasised where focus should be

·  Collaboration for Leadership in Applied Health Research and Care (CLARHC) North West Coast Event

·  Public Question Time event which was focussed on urgent care

·  Meeting with Margaret Greenwood MP

·  Adult Care and Health Overview and Scrutiny Committee

·  Meeting with Frank Field MP

RECOMMENDATIONS

The contents of the report be noted.