The Chair welcomed everyone to the meeting as well as those watching the webcast. A minutes silence was held in memory of Carol Jones who was the Carers lead at Wirral Council for twenty four years.

No apologies for absence were received.

The Chair proposed moving Item 10 (Maternity) to be heard first and Item 12 (Wirral Safeguarding Adults Partnership Board Update Report) to be heard second. This was agreed. The minutes are in the order of the agenda.

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. Cllr Kieran Murphy declared a pecuniary interest in item 8.

To approve the accuracy of the minutes of the meeting held on 28 November 2023.

Resolved – That the minutes of the meeting held on 28 November 2023 be approved as a correct record.

There were no questions, statements or petitions to report.

The Senior Public Health Manager presented the report of the Director of Public Health which sought agreement from the Committee to progress proposed commissioning intentions for Community Connector Service, Connect Us, and set out the requirement for the current Community Connector service to be recommissioned from February 2025. The service was experiencing increased demand, and supported residents and communities with a wide range of complex issues which followed the pandemic and also in response to the ongoing cost of living crisis.

Members requested further information around outcomes and it was agreed that this would be provided.

Members discussed the work of the Community Connectors. It was agreed that information was to be given to Members about the future programme of work that the Community Connectors were working on. It was noted that the original programme of work was in East Wirral and not as much work had been done in West Wirral and this was to be looked at. Further work was agreed in rural areas around isolation as well as isolation in relation to mental health.

Resolved that:

1. The Director of Public Health be authorised to re-commission the Community Connector service totalling up to £4,308,654 (£718,109 per annum) or a four-year contract (1st February 2025 – 31st January 2029) with the option of a one year plus further one year extension.

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

The Head of Integrated Services presented the report of the Director of Care and Health which recommended and described a more ambitious and longer-term service model that would be better able to achieve the strategic aims of the Council, value for money targets and a more comprehensive offer for potential and current Direct Payment recipients to support the sustainability of the arrangements.

A procurement exercise was undertaken for a PA register which received a low response rate, possibly due to being a short-term one year pilot. It was proposed to undertake a further procurement exercise for a merged Direct Payment (DP) offer for a three year plus one contract to include a payroll and managed accounts service and information and guidance to support DP recipients.

Members asked whether any other options to DP being made by pre-payment cards had been considered as pre-payment cards may take choice away from people. No other options had been considered but it was something that could be considered as the specification was improved. If cash was used people were required to provide accounts and there was not any evidence that DP reduces what the money can be spent on so there should be no problem in terms of choice and control.

Members asked about age limits and were informed that there was no age limit to those in receipt of DP.

Members were informed that people would be given training and support with the financial side of DP if they wished or alternatively the financial side could be completed for them.

Resolved that:

(1) The proposed service model and outcomes as described in section 3.1 to 3.6 of this report be endorsed

(2) (a) The Director of Care and Health be authorised to commence a procurement process for the appointment of an accredited provider for a merged offer to include a payroll and managed accounts service, information advice and guidance for current and potential Direct Payment recipients and a Personal Assistant register for a three-year contract with an option for a further one-year extension; and

(b) Delegated authority be given to the Director of Care and Health to award the contract to the successful bidder following the tender process.

(3) The Director of Care and Health be requested to bring a further report to a future Committee to inform Members of the outcomes achieved once the new service model is established.

Cllr Kieran Murphy had a pecuniary interest in this item and left the meeting.

The Assistant Director, Integrated Services & Commissioning presented the report of the Director of Care and Health which requested approval to award a contract for the provision of the Wirral Independence Service (WIS), at an increased budget cost of £4.9m from £4.2M per year. The commencement of the procurement process at an original budget cost of £4.2M was approved by this Committee in June 2023. The current contract ends in June 2024 and there were no further contract extensions available. The WIS included the provision of community equipment, technology enabled care and response service, carers emergency card, falls pick-up / responder service, falls prevention service, provision of paediatric equipment and education equipment for schools.

Members were reassured that there was an amnesty in place for the return of equipment.

Resolved that:

The Adult Social Care and Public Health Committee approve the award of a 5-year contract (with options for a 3 year, plus a 2-year contract extension) for the provision of the Wirral Independence Service (Community Equipment and Telecare) with a total contract value of £4.9m annually, up to £51m over 10 years to Medequip Assistive Technology Ltd as the highest scoring tenderer in accordance with the Most Economically Advantageous Tender (MEAT) criteria.

The Director of Adults, Health & Strategic Commissioning Services introduced the report of the Director of Finance which provided an update on the budgets within the remit of the Committee in respect of forthcoming pressures and proposed savings that are being considered within the Medium Term Financial Plan. The report also summarised the outcomes of the recent Budget Workshops between Members and senior officers, which had enabled officer and Member liaison on proposed budget options, facilitated discussion and allowed direction to be obtained on further analysis required and provided an opportunity for alternative proposals to be considered.

Members requested further detail on Shared Lives.

The Social Care precept was also discussed by Members and it was noted that this had been taken into account in the figures in the report. If the precept was not applied the money available for Adult Social Care would be reduced by in excess of £2million.

It was explained to Members that Local Authorities would be expected to absorb any Care Quality Commission (CQC) assessment costs within their settlements. No additional funding had been made available to cover assessment costs.

Resolved – That

1. The indicative pressures and proposed savings detailed in Appendix 1 and 2 be noted.

2. The Budget Workshop feedback and outcomes, as detailed in Appendix 3 be agreed.

The Divisional Director of Nursing and Midwifery, Women’s and Childrens division, Wirral University Teaching Hospitals NHS Foundation Trust (WUTH) presented the report which provided an update and oversight of the quality and safety of maternity services at WUTH. The report provided a specific update regarding Year 5 of the Maternity Incentive Scheme (MIS). There was also an update on progress on the Saving Babies Lives Care Bundle. The report also highlighted the outcome of the recent Care Quality Commission (CQC) inspection of the maternity services provided by WUTH.

Assurance was given that the three year delivery plan was on target to meet requirements.

It was noted that maternity was very much in the limelight due to Ockenden 1 and 2 following from the Shrewsbury and Telford enquiry.  It was stated that reports were consistently made to the Board of Directors and within the Trust full compliance on that was reviewed quarterly and all immediate actions were maintained to do that.

Members queried whether there were any areas for improvement and the CQC had identified three specific areas which were actioned whilst the CQC was either on site or within two weeks. These were around maternity triage and telephone services and baby abduction. There was an additional measure recommended to the full lockdown secure system which was added to some lockable doors and also a stable resus platform in the Seacombe Birth Centre.

Members queried the removal of the maternity shop from the precinct. It was explained that it had been difficult to meet the IPC infection control requirements. Alternative sites were being proactively sought across the Wirral and community hubs were being looked at. It was reported that a site had been secured in Birkenhead.

Members asked how many births had taken place in Seacombe Birthing Centre as opposed to home births. It was explained that the centre was pioneered in 2019 to deliver community home births of on average around a hundred per year within the team and 14-16 births were in the centre.

Members questioned how sure we could be that the neonatal services would remain on the Wirral. It was reported that neonatal services had been subject to an ongoing review by NHS England for at least five years and the outcome was still awaited.

Members queried recruitment and retention of midwives and it was reported that in 2021 there was funding for clinical recruitment and retention of midwives which included supporting newly qualified midwives to support retention. A six monthly report went to the Board and Members were reassured that the vacancy rate sat at 2 percent which had enabled WUTH to progress with continuity of care.

Members asked about the feedback mechanism and this was clarified as the national family and friends feed back tool, cards and user platforms which were taken very seriously and shared widely and goes to the Board. The CQC feedback had highlighted a couple of areas including knowing what a lady’s history was and the role out of continuity of  ...  view the full minutes text for item 70.

The Associate Director for NHS Cheshire and Merseyside and the Assistant Director of Commissioning and Integrated Service presented the report of the Director of Care and Health which provided an update on Palliative and End of Life Care Services provided in Wirral. The report included services commissioned by NHS Cheshire and Merseyside Integrated Care Board (ICB), Wirral Place and also activities undertaken by commissioned Adult Social Care providers in Wirral.

Members discussed their experience of end of life care and that the key to end of life care was communication. Members asked about the provision made for people to have their end of life care in their own home and this was explained.

Members noted that the distinction between end of life care and palliative care needs to be made. It was explained that there is a difference between palliative care with symptom management which can take a year to 18 months or more and end of life care that can be 6 weeks or less.

It was reported that people eligible for the continuing health care fast track had been identified for end of life care within three months and of those, between fifty to sixty percent of people on that pathway died within three months.

Resolved – That the content of the report, and the Health and Care system work underway to support End of Life Care in Wirral be noted.

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

The Independent Chair of the Wirral Safeguarding Adults Partnership Board presented the report of the Director of Care and Health which provided a further update on the work of the Wirral Safeguarding Adults Partnership Board (WSAPB) and presented the WSAPB 2021-2023 Annual report. The Care Act 2014 requires Local Authorities to establish a Safeguarding Adults Board in its area.

The Wirral Safeguarding Adults Board was comprised of senior leaders across health and social care who commission or deliver services for people in need of help and support who can make decisions about budgets and changes to policies and procedures. Senior leaders from the Hospital Trusts, the Mental Health Trusts, fire, police, probation as well as health and social care services, Healthwatch and Chief Executive of Age Concern who worked with the other voluntary sectors had come together on the Board.

Safeguarding spotlight sessions were offered by the Board and a session was offered.

Members asked how far the Board had got in terms of implementation of the plan. It was clarified that the report contained a table that showed a RAG rating of all the actions. A couple of actions were yellow and still in progress. One of the reds was about obtaining data from colleagues staff training and referrals and the Board were taking that forward. The Board were quite ahead with the forward plan and knew what needed to be done about the areas in yellow.

Members questioned what awareness raising was being done in terms of neglect and whether that included self neglect. It was highlighted that neglect was one of the biggest areas of abuse and the Board had completed a piece of work with Liverpool John Moores University on neglect, self neglect and hoarding behaviours and guidance has been sent to staff across the partnership.

In addition, Members questioned the target for the delivery of the knowledge and skills area which was one of the biggest areas to develop. The report was up to March 2022.

Members asked how the Board can bring an extra level of assurance that existing organisations could not supply. It was explained that the Board brought a multiagency approach and brought together composite reports in one place to see how they link in and work together.

It was agreed by Members that a spotlight session on a subject to be decided by Committee would add value and an update report from WSAPB was offered.

Resolved – That the update report in relation to the work of the Wirral Safeguarding Adults Partnership Board and the 2021 – 2023 Annual report spanning the first 18 months of the Board be noted.

The Head of Legal introduced the report which presented the future work programme of the Committee.

Additional items were suggested including:

•  A spotlight session from the Wirral Safeguarding Adults Board on a topic to be decided by Committee.

•  An item around Shared Lives.

•  Quality Accounts for WUTH and CCC as a scrutiny item.

•  An update report from CWP over the availability of community psychiatric nurses when the changes have bedded in after May.

•  An update report from WSAPB.

Resolved - That, subject to the changes noted above, the proposed Adult Social Care and Public Committee work programme for the remainder of the 2023/24 municipal year be noted.