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

Apologies had been received from Councillor Paul Martin who was substituted by Councillor Angie Davies.

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.

Councillor Angie Davies disclosed a pecuniary interest in item 10 by virtue of her employment with CWP and a prejudicial interest in item 11 because she had close relatives who were coeliac, one of whom was in receipt of a prescription for gluten free bread. Councillor Angie Davies left the committee room for both of those items.

The Chair informed members that in order to assist in the order of business, agenda item 9 and 14 be considered last to allow the Committee to move into exempt session, if required.  The minutes are in the order of the agenda.

To approve the accuracy of the minutes of the meeting held on 26 November 2024.

Resolved – That the minutes of the meeting held on 26 November 2024 be agreed by assent.

No questions, statements or petitions had been received.

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The Assistant Director, Integrated Services and Commissioning introduced the report of the Director of Adults, Health and Strategic Commissioning which sought approval for the re-commissioning of the care and support services within eight general extra care schemes which were due to expire between March and June 2026.  The new services, once procured, would commence on either 1 April 2026 or 1 July 2026. Furthermore, the tender would include an invite to Providers to bid for a contract to deliver care and support within a new general Extra Care scheme on Pasture Road, Moreton which was currently in development with an intended completion date in late 2026.  It was reported that the intention was to co-produce the model with those that live within the schemes and work within the community care market.  Extra care was delivered as an alternative to residential and nursing and helped to maintain people in their own homes.

It was reported that the Council would look to procure the service from the Liverpool Flexible Purchasing Service which was an established framework across Liverpool City Region.

Members asked whether, given the Council’s budgetary concerns, there was any scope for lowering the age restrictions on people in extra care provision, given this is one of the most cost-effective ways of delivering support.

It was clarified that this scheme was for people aged 55 or over and the Council was able to draw down capital from Homes England to support the development.

Resolved – That

1. The commencement of a procurement process pursuant to the Liverpool City Region Flexible Purchasing System for Extra Care for the provision of suppliers to deliver Care and Support within nine general Extra Care schemes, eight of which were due to expire in 2026 as outlined in section 3.5 of the report and one new scheme in Pasture Road, Moreton as referred to in paragraph 3.6 of the report be approved.  Each of which to be of a contract term of 3 years with the option to extend for a further 2 years. 
2. The Director of Adults, Health and Strategic Commissioning be authorised to award the tenders to the respective successful tenders following the tender process. 

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The Assistant Director, Integrated Services and Commissioning introduced the report of the Director of Adults, Health and Strategic Commissioning which sought authorisation to issue a temporary contract for the current Care and Support at Home Mobile Nights service contract, which was due to expire on 31 March 2025. The temporary contract would be for a period of 5 months from 1 April to 31 August 2025. This temporary arrangement would give the Council sufficient time to undertake a full procurement exercise for a new service to start on 1 September 2025. It was reported that the Mobile Night Service delivered both planned and unplanned domiciliary care to support people in their own homes. There were 199 service users of this service which equated to approximately 245 visits per night. The service provided same day (within 2 hours) pick up of new mobile night packages over 7 days. The two-hour window was to support hospital discharges. The value of the contract was £646,000 up until end of September 2025 and a full procurement exercise would be undertaken from September onwards.

Members asked why there had been an 11% decrease in 2024 in those using the Mobile Night service. There had been a decrease in numbers using the service alongside an increase in the complexity of people using the service with less people needing care for more hours.

Members noted the provider was paying the real living wage.

Resolved – That

1.  The current contract with Professional Carers Wirral Ltd be continued for a period of 5 months.

2.  A formal tender exercise for a new Mobile Night Service for a period of 3 years with the option to extend for a further 2 years be commenced.

3.   The Director of Adults, Health and Strategic Commissioning be given authority to award the contract to the highest performing tenderer following the evaluation of the tender process.

The Assistant Director, Integrated Services and Commissioning introduced the report of the Director of Adults, Health and Strategic Commissioning which detailed the review of charges for Adult Social Care services and proposed increasing them to ensure that the Council recovered the costs incurred in providing them. In addition, the report proposed applying two new charges for Appointeeships and Public Health Funerals where the Council had not recouped the cost of administration which it was entitled to do under the Care Act 2014 and the Public Health (Control of Disease) Act 1984. An increase in self-funder charges was proposed from £60 to £90 and the proposed cost increases were as set out in the recommendations.

A policy change was proposed to allow Public Health funeral charges to be charged against the deceased’s estate at a rate of £350. A policy change was also proposed to charge a fee of £10 per week when the Council took on the responsibilities of an Appointee and these changes would be incorporated within the Annual Budget Report to Policy and Resources Committee.

Members asked whether the switch from prepayment cards to cash payments for carers would be extended to direct payments but were informed there were no plans to phase out prepayment cards for direct payments recipients. 

Members requested the benchmarking figures for the costs of funerals and for self-funders within the Liverpool Citty Region and it was agreed to circulate the benchmarking figures to committee.

Resolved – That

1.  An increase in the administration charge for arranging care for self-funders, those who pay the full cost of care, from £60 to £90 be approved in principle.

2.  The increased administration charge for setting up and putting in place a deferred payment agreement, enabling a person to defer or delay paying the costs of their care and support until a later date from £500 to £800 be approved in principle.

3.  Carers’ payments which were presently facilitated via pre-paid cards instead be paid directly into the Carers bank account thereby eliminating set up and monthly administration related charges.

A policy change be agreed to allow:

4.  That expenses related to providing Public Health funerals be charged against the deceased’s estate at a rate of £350.  These charges will be incorporated within the Annual Budget Report to Policy and Resources Committee.

5.  That a charge be made when the Council takes on the responsibilities of an Appointee at a rate of £10 a week.  These changes will be incorporated within the Annual Budget Report to Policy and Resources Committee.

6.  A further report on the Minimum Income Guarantee and the Disability Related Expenditure in 2025/26 be accepted.

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The Head of Finance – People introduced the report of the Director of Finance

which provided an update on the budgets within the remit of the Adult Social Care and Public Health Committee in respect of forthcoming pressures and proposed savings that were being considered within the Medium-Term Financial Plan.

It was also for the Committee to consider feedback and outcomes from the Budget Oversight Panels (BOPs) which had been held in recent months.  The Panels enabled officer and member liaison on proposed budget options, to facilitate discussion and allow direction to be obtained on further analysis required.  The Panels also provided an opportunity for alternative proposals to be considered.

The Policy and Service Committees were responsible for those services being delivered under their operational headings within their annual budget envelope. The Policy and Resources Committee, in consultation with the respective Policy and Service Committees, had been charged by Council to formulate a draft Medium Term Financial Plan (MTFP) and budget to recommend to the Council.

The Council was required to set a balanced budget each year and set a Medium-Term Financial Plan which considered the future pressures and savings reforms that would be taken forward to result in a balanced budget position. 

It was reported that the Council was facing a severe budget challenge to identify savings required to set a balanced budget for the next financial year, largely due to increased demand and costs for social care services, compounded by the previous significant reductions in Government funding and uncertainty around the future financial settlements. 

Unless significant, deliverable cost reductions were identified and approved, the Council would not meet its statutory obligation to set a legal and balanced budget without a significant increase in funding.

The Chair noted that Members wished to discuss the content of the exempt appendices relating to the report. Therefore, on a motion by the Chair, seconded by Councillor Mary Jordan, it was –

Resolved - That under section 100 (A) (4) of the Local Government Act 1972, the public be excluded from the meeting during consideration of the following items of business on the grounds that they involve the likely disclosure of exempt information as defined by paragraphs 3 and 4 of Part I of Schedule 12A (as amended) to that Act. The Public Interest test had been applied and favoured exclusion.

Members considered the exempt Appendix 3 and agreed the outcomes as detailed in Appendix 3.

Resolved – That

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

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

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The Director of Nursing, Therapies and Patient Partnerships and the Assistant Director for Specialist Mental Health presented the Cheshire and Wirral Partnership NHS Foundation Trust’s (CWP’s) Quality Account which was an annual report that focused on the quality of the services provided. The report highlighted CWP’s achievements during 2023/4, the drive to improve the quality of care and treatment that was delivered and also included ambitions for 2024/2025.

It was outlined that CWP provided Adult Mental Health Services on the Wirral both community and in-patient, Children and Young Peoples Mental Health Services predominantly in the community and any inpatient services would be assessed and accessed by the Lead Provider Collaborative for tier 4 CAMHS. Learning Disability Community Services were also provided as well as All Age Disability and Continued Care services. These were the four care groups provided by CWP.

It was reported that during 2023-2024 nearly 4500 referrals were made for children and young people which was an average of over 350 per month with an average active caseload of around 1700 at any one time.  There were over 15,000 referrals made for adults in 2023-2024 with an average referral rate of nearly 1300 people per month and an average caseload of just over 5,000. During the year from 2023-2024, there were almost 1000 referrals per year for Learning Disability which equated to 77referrals per month and a caseload of 3000.

It was highlighted that in terms of clinical effectiveness the ambition had been to improve the clinical networks across all the care groups. A core framework for each of the networks had been developed and progressed. A key focus had been the development of a revised and refreshed automated friends and family test to ensure that people can provide feedback on services that had been received. The priorities for 2024-2025 were improving outcome measures as a mechanism for quality improvement.

It was highlighted that the Big Book of Best Practice which showcased the work of CWP was available on the website. For the Wirral this included projects around the 0-18 services and ethnicity and a Skills for Me project which enabled people to be supported and improved annual health checks for people with serious mental illness and the utilisation of virtual reality to alleviate concerns around the environment that patients will access. The Wirral Mental Health in Schools Team continued to be developed. The complex care pathway had been developed to bring services together.

An increase in demand for mental health services was reported and a service for 18 to 25 year olds had been developed to support a smooth transition from Children to Adults.

Members asked about Skills for Me and support for Adults into employment and this was discussed. Early help and early language skills development were also discussed and Children’s waiting lists. 

The Chair noted the fact that adult autism assessments had been temporarily put on hold and requested an update from CWP on where they were at and how this was progressing. The update  ...  view the full minutes text for item 58.

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The ICB Place Director (Wirral) stated that the purpose of the report was to inform the Committee that the Board of NHS Cheshire and Merseyside Integrated Care Board (ICB), at its meeting on 28 November 2024, approved the recommendation that the ICB commenced a period of public consultation regarding the proposal to cease NHS funded gluten-free prescribing (bread and bread mixes) across Cheshire and Merseyside. 

The ICB had a duty to engage with Local Authority Health and Overview Scrutiny Committees (HOSC) to seek confirmation as to whether the HOSC believed the proposal was a substantial change to NHS services.  If this was confirmed by HOSC then this would trigger the requirement for the ICB to formally consult with the HOSC, in line with the s.244 Regulations of the NHS Act 2006 (as amended by the Health and Care Act 2022).  The Committee was asked to consider and determine whether the proposal represented a substantial development or variation. It was reported that the aim was to harmonise the arrangements for the whole of Cheshire and Merseyside.

The committee requested further details regarding who was engaged in the work to develop these proposals around Gluten Free products and this information would be circulated to members.

Members determined that the proposals around Gluten Free products represented a substantial development or variation that required scrutiny through a Joint Overview and Scrutiny Committee.

Resolved – That the Adult Social Care and Public Health Committee believes that the proposals to cease NHS funded gluten free prescriptions (bread and bread mix), across Cheshire and Merseyside represents a substantial development or variation to NHS Services.

The Chair of the Adult Social Care and Public Health Committee introduced this report which detailed the annual work programme of items for consideration by the Adult Social Care and Public Health Committee.

Resolved – That the Adult Social Care and Public Health Committee work programme for the remainder of the 2024/25 municipal year be noted.

Resolved – That Adult Social Care and Public Health Committee noted the exempt appendices to the report.