The Chair welcomed attendees and viewers to the meeting and reminded everyone that the meeting was webcast and retained on the Council’s website for two years.

Apologies for absence were received from Councillor Clare O’Hagan who was deputised by Councillor Helen Collinson and Councillor Ivan Camphor who was deputised by Councillor Alison Wright.

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.

The following declarations were made:

To approve the accuracy of the minutes of the meeting held on Tuesday 14^th June 2022.

Resolved – That the minutes of the meeting held on 14 June 2022 be approved and adopted as a correct record.

No public questions, statements or petitions had been received.

Councillor Angela Davies and Councillor Helen Collinson left the meeting during the consideration of the item.

The Medical Director for Cheshire and Wirral Partnership (CWP) introduced the report which was an annual report to the people served by CWP about the quality of services provided. The report highlighted achievements of the previous year and outlined ambitions for the coming year.

It was reported that the last Care Quality Commission report was in March 2020 and all areas were rated as good with Caring rated as outstanding. The quality improvement priorities for 2021-22 of clinical effectiveness, patient experience and patient safety had been achieved and the quality improvement priorities for 2022-23 which had been set based on feedback from service users were detailed.

A 20% surge in demand for adult specialist mental health care was highlighted. This had resulted in the launch of three services, the First Response Service, the Community Wellbeing Alliance and he Mental Health Intensive Support team in order to respond to the needs of the community.
In addition to this, an increase in demand for children and young people’s mental health support was reported with 1 in 6 now impacted by serious mental ill-health, previously this had been 1 in 9.

The report outlined a 49% reduction in inpatient day usage, following a query from Members it was clarified that this figure related to the complex needs services which provided intense psychological specialist support to recover or improve patients conditions and this has led to the reduction of the use of GP services, A&E services and ambulances as service users are getting the right response and support when they require it.

A query was raised regarding the readmission data, specifically, the rising number of young people who presented to mental health services and were readmitted presented in the draft quality account. The Medical Director explained that the readmission data in the draft account was incorrect, and the actual figures were lower than reported. It was highlighted that more young people are presenting in a crisis situation and that this could be a result of long waiting lists for appointments with CAMHS which were confirmed as a wait of 12 weeks coming in to treatment and 18 weeks to receive treatment. Members were given assurance that this waiting time had reduced from the previous year and that partnership work had been undertaken to provide wrap around support during the waiting period.

Resolved – That the content of the report be noted.

The Director of Public Health introduced the report which provided the Committee with an update on plans to develop a local Health Protection response for Wirral, evolving from the Local Outbreak Hub model, established in response to the COVID-19 pandemic during 2020.

Wirral’s Local Outbreak Hub was funded until 30th September 2022, by the Contain Outbreak Management Fund (COMF). It was outlined that the COMF grant would continue to fund the newly revised Health Protection Delivery Service for six months, from October 2022 until March 2023, when this funding stream concluded. The report sought approval for the Core Public Health Grant to be used to fund the Health Protection Delivery Service for twelve months from April 2023 to March 2024, to ensure local resilience and continuity.

Public Health teams had learned from the pandemic response and built on local requirements and health protection capabilities. The Director emphasised the importance of ensuring sufficient local resources to deal with periods of increased demands such as new waves of COVID as well as other respiratory diseases which often worsen in the winter months.

In response to a query on how this would support residents with the current outbreak of Monkeypox it was reported that the UK Health Security Agency (UKHSA) were managing this but the skillset of the team within the Local Outbreak Hub was something that could be utilised with any disease and the team were working on plans for if and when management of this needed to be undertaken locally.

Clarity was sought on the necessity of the Health Protection Delivery Service from April 2023 to March 2024 due to relatively low case numbers of COVID. It was outlined that the Health Protection Delivery Service would be equipped to deal with a number of clinical diseases and issues in the borough that needed a local response.

Resolved (10:1) – That the funding of Wirral’s Health Protection Delivery Service from April 2023 to March 2024 through the core Public Health Grant in the sum of £705,756 be approved.

The Lead Commissioner of Community Care Market introduced the report of the Director of Care and Health which updated Members on Carers Services and provided an update on the development of a new Wirral Adults Carers Strategy. The report gave an overview of changes nationally and locally that directly influenced the strategic review.

The 2011 Census reported that there were in excess of 40,000 carers who provided informal care in Wirral and contributed towards the local economy by reducing the demand on Wirral health and care services. There were 748 self-reported 0–15-year-olds and 2,840 16–24-year-olds with caring responsibilities in Wirral.

The current carers strategy was under review and through collaboration with colleagues across the North West, a new white paper that was made available in December 2021 was being utilised to develop a local strategy. Following a series of engagement events and the annual carers survey, 125 carers stated that they would like to be involved in the co-production of the strategy.

It was reported that a new Early Intervention and Prevention & Carers service had been commissioned and went live on 1^st March 2022. This had been awarded to Wirral Health and Wellbeing Community Interest Company with the remit to improve the number of carers identified and to increase the awareness of carers services across the borough.

A discussion ensued regarding the carers assessments, assurance was given that although they could be completed online, anyone who struggled with this format could still be offered face to face assessments. It was identified that as well as being able to self-refer for a care assessment, a GP could also make the referral.

Concerns were raised about the length of time co-production of strategy could take and the amount of consultation with young carers. Members felt that the strategy would need more time to be developed and co-produced before being brought to the Committee as final.

On a motion by Councillor Nolan, seconded by Councillor Jordan it was –

Resolved – That the progress to date in developing the Carers Services and the Wirral Adults Carers Strategy be endorsed, and a further report be brought to the Committee in November 2022.

The Place Director (Wirral) introduced the report which gave Members an update on the development of the Integrated Care System (ICS), the impact on Wirral as a place and the establishment of the Integrated Care Board (ICB) working arrangements in the borough.

The Adult Social Care and Public Health Committee approved the creation of the Place Based Partnership Board on 3 March 2022. There was an informal workshop with members of the board on 25 July 2022 to set out next steps around establishing the board and to look at the supporting groups to ensure robust governance and assurance.

It was outlined that work was being undertaken with the Voluntary, Community and Faith sector around their representation as well as representatives from primary care. Future meetings of the Place Based Partnership were likely to have four primary care representatives as it would have a responsibility for community pharmacy, dentistry and optometry as well as general practice.

Members highlighted the difficulty of finding local dentistry practices that would take on new NHS patients. It was clarified the of the 40,000 registered dentists, only 20,000 work in the NHS and this was largely due to the way contracts had been structured. It was recognised that dental access was a significant issue to be tackled.

Assurance was given to members that a coherent workforce strategy was an objective of the Place Based Partnership Board, the Place Director noted that areas of the borough have low rates of employment and high numbers of young people not in employment, education or training and there was an opportunity to align to the Wirral plan and create careers and apprenticeships in the NHS.

Resolved – That the content of the report be noted.

The Assistant Director of Care and Health introduced the report of the Director of Care and Health which updated members on the progress made with the transfer arrangements for Wirral Evolutions services into Wirral Borough Council direct delivery.

Following the decision made by the Adult Social Care and Public Health Committee on 3 March 2022, a project team was established to put in place the necessary governance arrangements and services were planned to be insourced within six months from the 1^st April 2022. The transfer was expected to be completed on 27 September 2022.

It was outlined that to ensure a smooth transition for the service users, the service would continue to operate from the same locations and have the same staff and management team. There were 151 staff members who took part in a consultation led by Wirral Evolutions and supported by the Assistant Director of Care and Health, HR and the trade unions. Wirral Evolutions staff who chose to transfer would be protected under protection of employment (TUPE) transfer on no less favourable terms. Fixed term contracts had been extended and was an opportunity to establish those staff to permanent positions which had received a positive response.

The Assistant Director of Care and Health brought the Committees attention to pension arrangements and reported that at the point of transfer all staff would be automatically enrolled to the Local Government Pension Scheme which was more favourable than current arrangements.

Members recognised that some Wirral Evolutions staff has expressed interest in taking Early Voluntary Retirement (EVR), under TUPE, a job would be available for all staff and so if staff members chose not to transfer it would be considered a resignation and EVR would not apply. It was anticipated that the majority of staff would transfer with positive feedback from 1-1s. Any current vacancies in Wirral Evolutions would also transfer across and be recruited to.

Resolved – That the content of the report be noted.

The Assistant Director of Care and Health introduced the report of the Director of Care and Health which provided a performance update in relation to Adult Social Care and Health. The report was designed based on discussions with Members through working group activity in 2020 and 2021.

Members attention was drawn to care home activity, there were 1681 people living in care homes. The highest category of care for people living in care homes was general residential care, the majority reason for moving into this area of care was dementia and a significant amount of support was offered to people with dementia although it was clarified not all people with dementia required the specialist Elderly Mentally Infirm (EMI) residential or nursing care. The report stated that there were 4 care homes closed due to COVID, since publication the figure had changed and there were now 15 care homes fully or partially closed to admissions as a result of COVID.

It was outlined that there were continued pressures on domiciliary care in terms of capacity, largely due to workforce recruitment and retention. This had impacted on packages of care for people waiting to be discharged from hospital or those in the community who required a new or changed package of care. The waiting list for a package of care was over 300 with an average of 70 packages picked up per week.

Members discussed the care homes with ratings of inadequate or requires improvement and felt a report should be brought to the committee to explore the work being done to reduce the number of care homes with these ratings.

On a motion by Councillor Nolan, seconded by Councillor Davies it was –

Resolved – That

(1)  the content of the report be noted.

(2)  a report on care home improvement be brought to a future Committee meeting.

Councillor Angela Davies and Councillor Helen Collinson left the meeting during the consideration of the item.

The Head of Legal Services introduced the report of the Director of Law and Governance which sought agreement to terms of reference to the Working Group and appointment of members to it.

On the 14^th June 2022, Cheshire and Wirral Partnership (CWP) brought a report to the Adult Social Care and Public Health Committee on the Community Mental Health Transformation Programme, upon consideration of the report the committee resolved to set up a task and finish group to scrutinise and provide feedback into the consultation phase of the transformation programme.

It was outlined that whilst the task and finish group could be based on political proportionality, there was no requirement.

On a motion by Councillor Walsh, seconded by Councillor Jordan it was –

Resolved – That

(1)   the Cheshire and Wirral Partnership (CWP) Community Mental Health Transformation Working Group be appointed for 2022/23 with terms of reference set out in Appendix 1.

(2)  the working group be comprised of four members with each political party nominating one member.

(3)  the Monitoring Officer as proper officer be authorised to carry out the wishes of the Group Leaders in allocating Members and named deputies to the Cheshire and Wirral Partnership Community Mental Health Transformation Working Group and to appoint those Members with effect from the date at which the proper officer is advised of the names of such Members.

The Head of Legal Services introduced the report of the Director of Law and Governance which provided the Committee with an opportunity to plan and review its work across the municipal year.

Members requested a report on Sexual Health Services in Wirral, within that looking at the provision around Monkeypox, and an update in February 2023 on the Addiction, Diversion, Disruption, Enforcement and Recovery (ADDER) programme.

On a motion by Councillor Nolan, seconded by Councillor Davies it was –

Resolved – That

(1)  the Adult Social Care and Public Health Committee work programme for the remainder of the 2022/23 municipal year be noted.

(2)  a report on Sexual Health Services in Wirral be added to the work programme.

(3)  an update on the ADDER programme be brought to committee in February 2023.