The Chair welcomed members, officers and members of the public viewing the webcast to the first meeting of the Partnerships Committee of the 2021/22 Municipal Year.

There were no apologies for absence.

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 consider whether they had 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 what they were.

Councillor Ivan Camphor declared a personal interest by virtue of being a General Practitioner at Heatherlands Medical Centre, Medical Secretary for Mid-Mersey Local Medical Committee, General Practitioner Committee Representative for Cheshire and Mid Mersey, British Medical Association Chair of the Committee on Community Care and Executive Trustee of Age UK Mid Mersey.

To approve the accuracy of the minutes of the meeting held on 13 January 2021.

Resolved – That the accuracy of the minutes of the meeting held on 13 January 2021 be agreed.

There were no questions, statements or petitions from the public or Members.

Jo Watts, Associate Director of Operations for Specialist Mental Health at Cheshire and Wirral Partnership NHS Foundation Trust introduced the report, which provided the Partnerships Committee with an overview of the quality of services provided by the Trust and afforded the Committee the opportunity to comment on the accounts, a record of which would be incorporated into the final accounts.

A presentation was delivered to the Committee providing a high-level overview of what had been achieved in the previous year, and it was advised that the full quality accounts would be circulated to members once they had been approved by the Cheshire and Wirral Partnership (CWP) Board. The presentation detailed CWP’s activity during the Covid-19 pandemic, with 87% of planned appointments being delivered and those requiring rearrangement being done so collaboratively where necessary. The Trust had  delivered the vaccination programme in Wirral whilst also working to support people with mental health issues, including launching a crisis line in April 2020 and working with partners to support acute services to deal with the additional demand in these services.

Beyond the Covid-19 response, it was reported that the trust had also developed a number of successful pilots including enhancing veteran awareness, whilst also retaining the outstanding rating for care and developing an internal book of best practice which would be shared with members. The Committee was advised that quality improvement priorities would continue to focus on patient safety, using outcome measures and transformation programmes.

Members welcomed the presentation and presented several questions, including around support to adults and children requiring mental health and ADHD services. It was noted that the crisis line had been used 93,000 times and the Committee was advised a recruitment drive was underway for psychologists and further work was ongoing to develop a peer support network and forge greater links with local universities. CWP were encouraged to link in with Primary Care Networks.

Resolved – That the report be noted.

Paul Edwards, Director of Primary Care and Corporate Affairs at NHS Wirral Clinical Commissioning Group introduced the report of the Chief Officer, which set out the proposed changes to the NHS in legislation and guidance for the introduction of an Integrated Care System. The report set out the background to the proposed changes, detailing the publication of the White Paper by the Department of Health and Social Care in 11^th February 2021, with the intention of the Government to bring forward a Health and Care Bill to implement the proposals in that White Paper being confirmed in the Queen’s Speech in May 2021, and more recently an Integrated Care System design framework having been published.

The Committee was advised on the implications of the proposals for Wirral residents and Wirral Council itself. It was reported that the intention of central Government was to develop a model to promote partnership working reduce bureaucracy, which would involve there being a single Integrated Care System for the Cheshire and Merseyside footprint, replacing all Clinical Commissioning Groups. There would be 9 ‘places’ within the Cheshire and Merseyside Integrated Care System based on Council boundaries of which Wirral would be one, and the guidance was consistent in that the majority of decision making would take place at a ‘place’ level, unless it made sense for decisions to be taken holistically at Integrated Care System level. Members were further advised that the Health and Wellbeing Board would play a key role in the governance of the Integrated Care Partnership at Wirral ‘place’ level, and that the proposals were subject to the passing of the Health and Care Bill.

The Committee sought further clarification and assurance on where decision would take place at a regional and place level, and discussed which services that would be dealt with at Integrated Care System level such as the ambulance service and those that would be dealt with at a place level such as mental health services. It was also highlighted that Cheshire and Merseyside was the largest proposed Integrated Care System and Members queried the implications of this.

It was proposed by Councillor Jean Robinson, seconded by Councillor Joe Walsh, that a separate one-item agenda meeting be scheduled to further consider the development of an Integrated Care System with different evidence and expertise to be presented at the meeting. The motion was put and agreed by assent. It was therefore –

Resolved – That

1)  a separate one-item agenda meeting be scheduled to further consider the development of an Integrated Care System with different evidence and expertise to be presented at the meeting.

2)  the report be noted.

Sue Borrington, Head of Planned Care at NHS Wirral Clinical Commissioning Group introduced the report which provided an overview of the proposal for reconfiguration of Spinal Services for Cheshire and Merseyside. It was reported that the service was commissioned by NHS England, who had led the review following concerns from within the four sites currently operating the service, which found that there were unexplained variations across the providers and opportunities for greater financial efficiencies and sustainability.

The proposal was to reduce the four locations to just one location being the Walton Centre, which would offer a single referral pathway for emergency spinal surgery, access to 24/7 MRI scans, co-location with a major trauma centre and concentration of specialist expertise. The Committee was advised that various engagement had taken place at service level as advised by NHS England, and that the proposals had been led by a clinical committee who had ensured the recommendations were in line with the findings of the review and National Institute for Health and Care Excellence guidance. It was further reported that it would be limited in terms of how Wirral patients would perceive the change, but that they would benefit from the reduction in variations and the concentration of specialists.

The Committee queried the reduction in the number of beds as part of the proposals, where assurances were provided that the reduction was due to not needing as many surgical beds and that there would be no reduction in services. A number of further questions were asked by members including around how the services would be commissioned in the future and the level of engagement including which organisations were consulted such as general practices and the ambulance service.

Resolved – That

1)  the report and the proposal for reconfiguration to a Single Service be noted.

2)  that due to the minimal impact on Wirral patients, it be agreed that the proposal does not represent a substantial variation in the way the service is delivered and that the proposal development process, including the approach to patient engagement, is commensurate with the scale of the proposed change.

Mark Cambourne, Assistant Director for Neighbourhoods, Safety & Transport introduced the report of the Director of Law and Governance, which provided the background to the presentation that the Royal National Lifeboat Institute (RNLI) had been invited to give to the Partnerships Committee. It was reported that workshops had been undertaken with Councillors regarding the forthcoming Community Safety Strategy, where it was fed back that coastal and inland water safety should be more prominent within the strategy. The Council currently commissioned RNLI to provide the Coastal and Inland Water Safety services, but the RNLI also had a national role as a volunteer organisation.

Peter Rooney, Area Life Saving Manager at RNLI then introduced his presentation to Committee. The presentation detailed the RNLI’s purpose, vision and values, as well as its staffing arrangements which were predominantly volunteers with lifeguard services operating from six locations across Wirral in the Summer with three lifeboat stations. The presentation further detailed the national water safety statistics, with 621 people drowning in the UK in 2020, 43% of which were when people did not intent to enter the water. Locally, in Merseyside around half of drownings involved drink or drugs which was much higher than the national average. The Committee was advised that it was anticipated that Summer 2021 would be exceptionally busy due to more people holidaying at home, therefore there was a Summer engagement campaign underway to tackle this.

The Committee discussed the dangers locally including Leasowe Bay and access to Hillbre Island from Hoylake and West Kirby. The Coast Review process was queried where it was reported that an interim review had taken place two years previous and had resulted in a hovercraft being located in Hoylake. Members were advised that the performance of this would be tracked and measured through the Community Safety Partnership.

It was proposed by Councillor Jenny Johnson and seconded by Councillor Jean Robinson, that RNLI be invited to report back to the Partnerships Committee at the end of the season to present their ideas and recommendations. The motion was put and agreed by assent. It was therefore –

Resolved – That

1)  RNLI be invited to report back to the Partnerships Committee at the end of the season to present their ideas and recommendations.

2)  The report and presentation be noted.

The Chair introduced the report of the Director of Law and Governance which provided outcomes from a Better Care Fund Workshop that had taken place in the 2020/21 Municipal Year and sought the views of those members who were members of the Committee in the previous year.

It was felt that the report encompassed all of the comments made by members in the workshop, and that the Committee would be well placed to scrutinise the priorities identified and review them at some point during the municipal year. The Chair queried why Children’s services were not included, where it was confirmed that the workshop was on the Better Care Fund solely and that Children’s Services formed part of the wider pooled fund.

It was proposed by Councillor Jean Robinson, seconded by Councillor Dave Mitchell as an alternative to the recommendations within the report, that the report be noted and a report be presented back to the Committee at a future date on the outcomes referred to within the report, including a review of the priorities of the pooled fund. The motion was put and agreed by assent. It was therefore –

Resolved – That the report be noted and a report be presented back to the Committee at a future date on the outcomes referred to within the report, including a review of the priorities of the pooled fund.

Vicki Shaw, Head of Legal Services introduced the report of the Director of Law and Governance which sought appointments to the Joint Health Scrutiny Committee, in accordance with the protocol established as the framework for the operation of joint health scrutiny arrangements across the local authorities of Cheshire and Merseyside.

It was proposed by Councillor Jean Robinson, seconded by Councillor Jenny Johnson, that Councillor Jean Robinson and Councillor Ivan Camphor be appointed to the Joint Health Scrutiny Committee, and that a further Labour Member be appointed at a future date. The motion was put and agreed by assent, it was therefore –

Resolved – That

1)  Councillor Jean Robinson and Councillor Ivan Camphor be appointed to the Joint Health Scrutiny Committee in accordance with political balance requirements to allow participation in joint health scrutiny of any developments or variation to health services which the authority decides represents a substantial development or variation.

2)  the Monitoring Officer as proper officer be authorised to carry out the wishes of the Labour Group Leader in allocating a further Labour member to the Joint Health Scrutiny with effect from the date at which the proper officer is advised of the names of such Members.

The Chair of the Committee introduced the report which provided the committee with an opportunity to plan and review its work across the municipal year. The Chair informed the Committee that the existing work programme had been inherited from the previous municipal year and following discussions with the Group Spokespersons, it was felt that the Committee would be best placed focusing on items covered by the legislation within its Terms of Reference.

It was proposed by Councillor Jean Robinson, seconded by Councillor Jenny Johnson, that the items on the existing work programme be removed with the exception of the Better Care Fund and Voluntary/Third Sector.

Members suggested further items for consideration including potential Voluntary/Third Sector organisations to invite which would be discussed at agenda setting meetings. Other suggestions included a further update on the Integrated Care System developments including inviting independent attendees such as the Wirral local medical secretary, as well as a further update from the Clinical Commissioning Group on the services they commission, and an update from the Police and Crime Commissioner and Merseyside Police.

The motion to remove the existing items from the work programme except for the Better Care Fund and Voluntary/Third Sector, and to include updates from the Clinical Commissioning Group, Police and Crime Commissioner and Merseyside Police and a further standalone update on the Integrated Care System was put and agreed unanimously. It was therefore –

Resolved – That

1)  the items on the existing work programme be removed with the exception of the Voluntary/Third Sector and the Better Care Fund.

2)  updates from the Clinical Commissioning Group, Police and Crime Commissioner and Merseyside Police and a further standalone update on the Integrated Care System be added to the work programme.