The Chair welcomed everyone to the meeting as well as those watching the webcast. 

Apologies for absence were received from:

Councillor Julie McManus

Councillor Brenda Hall

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.

Members were asked to declare any disclosable pecuniary interests and any other relevant interest and to state the nature of the interest. There were no interests declared.

To approve the accuracy of the minutes of the meeting held on 19 September 2023.

Resolved – That the minutes of the meetings held on 19 September 2023 be approved as a correct record.

No public questions, statements or petitions have been received.

The Head of Integrated Services presented the report of the Director of Care and Health which set out the detail of the budget areas to be pooled in 2023/24 as part of the mandatory agreement under Section 75 of the National Health Service 2006 Act, between the Council and NHS Cheshire and Merseyside Integrated Care Board (ICB), Wirral Place.

Members received reassurance that any overspend on the NHS portion of the budget would not affect the Council’s financial position.

Resolved - That 

1.   the continuation and value of the pooled fund arrangement between the Council and NHS   Cheshire and Merseyside ICB as outlined in section 4.1 of this report be approved;

2.   the Director of Law and Governance in consultation with the Director of Care and Health be authorised to enter a Section 75 agreement with NHS Cheshire and Merseyside ICB for 2023/24. Note that the shared risk arrangements are limited to the Better Care   Fund (BCF) only, which is currently reporting a break-even position; and

3.   that the increase in the Section 75 pooled fund in April 2023 as a result of the Adult Social Care Discharge Fund as outlined in Section 4.2 of this   report be noted.

The Head of Integrated Services presented the report of the Director of Care and Health which proposed to extend the contract with Cheshire and Wirral Partnership NHS Foundation Trust (CWP) until 30 September 2025, on substantially the same terms, to enable a full analysis of the benefits and detriments of returning the service to the Council’s delivery arm. The issue was brought to the last meeting of this Committee but further information was requested which had now been included.

Members were informed that the extension of a year was a reasonable period to gather sufficient date to appraise the delivery of the contract.

The Chair, Councillor Janette Williamson, proposed an alternative resolution which detailed the decision required.

This was seconded by Councillor Gail Jenkinson.

Resolved: That

1.   the contract with CWP be extended for a further year until 30 September 2025, on substantially the same terms to enable further analysis, in partnership with CWP and other systems partners, of the benefits and detriments of a continuation of current service arrangements or of returning the services to the Council’s direct delivery.

2.   the Director of Care and Health be requested to provide a further report to the Adult Social Care and Public Health Committee by September 2024 to update on the outcome of this exercise and to make recommendations as to the future delivery of the services.

The Director of Public Health and the Senior Public Health Manager presented the Report of the Director of Care and Health which sought authorisation to tender for the development of a new offer to support children and young people in relation to health and risk-related behaviours. It was intended that the new offer would be commissioned from September 2024 and would transform support for children and young people by providing a more effective and co-ordinated approach to improve outcomes for them. It would e a more holistic approach with a five-year contract to help children and young people cope with the challenges in their life, through universal and targeted support.

Members queried the support for particular circumstances, and confirmed that there was monitoring across the borough to identify particular issues in specific areas.

Resolved – That

1.   the Director of Public Health be authorised to commence the commissioning of risk taking/health related behaviours offer for children and young people. This will be for a contract period of five years (1st September 2024 – 31st August 2029) with the option of two one-year extensions in accordance with the spend profile in paragraph 4.5 of this report.

2.   delegated authority be given to the Director of Public Health to award the tender to the successful bidder following the tender process.

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

The Assistant Director of Operational Delivery & Professional Standards presented the report of the Director of Care and Health which detailed a new duty for the Care Quality Commission (CQC) to assess how Local Authorities were meeting their Adult Social Care duties in relation to the Part 1 of the Care Act 2014, and a new power for the Secretary of State to intervene where CQC considers a Local Authority to be failing to meet these duties. The report set out the development of Wirral’s Self-Assessment of how it provided Adult Social Care services, and followed on from a workshop held on 9 August 2023.

Resolved – That the report be noted.

The Director of Public Health and the Head of Health Protection presented the report of the Director of Care and Health which provided an update on the partnership work undertaken to deliver Wirral’s Health Protection Strategy. This had been approved at Committee on 23rd January 2023 and set out the collective approach for ensuring a resilient health protection system and response in Wirral. It was emphasised that a partnership approach was vital as no single agency could deliver all that was required.

Members questioned whether particular issues were being considered including Hepatitis C, cold and hot weather, Urinary Tract Infections, shingles, and air quality.

Resolved - That

1.   the progress made to date in the implementation of the Wirral Health Protection Strategy be noted;

2.   annual updates on progress against delivery of the Health Protection Strategy be received from the Director of Public Health.

Appendix 1 may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact tom.knight1@nhs.net if you would like this document in an accessible format.

The Head of Primary Care for NHS Cheshire and Merseyside presented the report of the NHS Cheshire and Merseyside Integrated Care Board (ICB) which provided an update on the commissioning of primary care dental services, and gave details of the Dental Improvement Plan 2023/25 which was to ensure that access is improved for both routine, urgent, and dental care for our most vulnerable populations and communities impacted by the COVID pandemic. The aims of the Plan included developing access sessions for new patients across 60 practices in the ICB and

add an additional 30,000 appointments across Cheshire and Merseyside. It was noted that:

·  lack of access to dental services was a national issue primarily connected with an NHS contract that was considered no longer fit for purpose.

·  patients had a general misunderstanding that they registered with a dentist in the same way as registering with a GP, but the dental contract allows for their removal.

·  Oral health had deteriorated since the Covid-19 pandemic, especially in vulnerable patients, and dealing with those takes longer which exacerbates the time pressures.

·  The NHS contract was not attractive to the workforce so recruitment and retention was difficult although this was covered in the workforce plans of the NHS and ICB.

·  Urgent Dental Care Centres within existing practices had been set up during the pandemic and had continued since.

Members questioned the approaches and about reaching particular groups such as schoolchildren, care home residents and children in care. They also requested additional information for particular issues.

Resolved - That the report be noted.

The Assistant Director Strategic Commissioning and Integrated Services presented the report of the Director of Care and Health which detailed the results from a Task and Finish Session held in May 2023 on Mental Health Transformation. This had followed a report by the Cheshire and Wirral Partnership to the 14 June 2022 Adult Social Care and Public Health Committee which provided a background and summary of the activity undertaken within Cheshire and Wirral in respect of delivering the NHS Long Term Plan ambitious targets for community mental health.

It was suggested that a detailed report on the progress since the workshop be presented with the Cheshire and Wirral Partnership. 

Councillor Phil Gilchrist was thanked for his work in Chairing the Workshop and then helping to prepare and present the report.

Resolved – That the contents to the report be noted and a further update report come to a future committee.

The Chair presented the report of the Director of Law and Governance.

Additional items were suggested, which were:

• End of Life care
• Maternity Services

Resolved – That, subject to the addition of End of Life care and Maternity Services, the work programme be noted.