Members of the Board are asked whether they have any personal or prejudicial interests in connection with any application on the agenda and, if so, to declare them and state the nature of the interest.

Members were asked if they had any pecuniary or non-pecuniary interests in connection with any application on the agenda and, if so, to declare them and state the nature of the interest.

Councillor Phil Gilchrist declared a non-pecuniary interest by virtue of being the Appointed Governor: Cheshire and Wirral NHS Partnership Trust

Councillor Chris Jones declared a personal interest by virtue of her employment with the Cheshire and Wirral Partnership NHS Foundation Trust.

Dr Sue Wells declared a non-pecuniary interest by virtue of being a partner in a medical practice.

Apologies for absence were received from Nicola Allen, Head of Medical Directorate, NHS England, Sheena Cumiskey, CEO Cheshire and Wirral Partnership NHS Foundation Trust, Councillor Phil Davies, Chief Superintendent Ian Hassall, Merseyside Police, Graham Hodkinson, Director for Health & Care, Janelle Holmes, CEO Wirral University Teaching Hospital NHS Foundation Trust, Karen Howell, CEO Wirral Community NHS Foundation Trust, Councillor Ian Lewis and Karen Livesey, Head of Service, Community Action, Wirral.

To approve the accuracy of the minutes of the meeting held on 14 Mar 2018.

Resolved – That with the amendment of the apologies recorded for Mr B Simpson, Chair, Strategic Housing Partnership, that the accuracy of the Minutes of the Health & Wellbeing Formal Board held on 14 March, 2018 be approved as a correct record.

The Board gave consideration to a report of Simon Banks Chief Officer, Wirral Health and Care Commissioning and Senior Responsible Officer, Healthy Wirral.  Mr Banks outlined the report which provided an update on the work of the Healthy Wirral Programme and introduced Mr David Eva the Independent Chair who would oversee Healthy Wirral Partners Board.

The Board gave consideration to a report of Simon Banks Chief Officer, Wirral Health and Care Commissioning and Senior Responsible Officer, Healthy Wirral.  Mr Banks outlined the report which provided an update on the work of the Healthy Wirral Programme and introduced Mr David Eva the Independent Chair who would oversee Healthy Wirral Partners Board.

Members were informed that the Healthy Wirral programme was the system-wide programme to deliver sustainable and affordable health and wellbeing services to the population of Wirral.  The programme brought together all of the resources and expertise of NHS and Care organisations into one single programme that was aimed at improving Health and Wellbeing outcomes for the people of Wirral. 

It was reported that in line with other areas across Cheshire and Merseyside Wirral was now establishing and implementing plans to achieve the best possible health and wellbeing outcomes for the population within the funding available to the system.  The Healthy Wirral Programme had identified a mission of ‘Better health and wellbeing in Wirral by working together’ with the clearly stated aim to enable all people in Wirral to live longer and healthier lives by taking simple steps to improve their own health and wellbeing. By achieving this together the aim was to provide the very best health and social care services when people really need them, as close to home as possible. Delivering this aim required the Wirral partners to rise to four key challenges; Acting As One, Clinical sustainability, Improving population health and Financial sustainability.

The report included the areas of Healthy Wirral Governance, Integrated Commissioning, Wirral Integrated Provider Partnership, Place Based Care and Individual Work Stream Progress.

The appendices to the report covered Healthy Wirral Governance, Healthy Wirral Work Streams and Wirral Integrated Provider Partnership Board Terms of Reference.

Resolved – That;

1  Simon Banks be thanked for the update.

2  the report be noted.

Jacqui Evans, AD for Unplanned Care & Community Care submitted a report that provided Members with an update on progress and developments across the unplanned care system, overseen by A&E Delivery Board.

It was reported that Wirral had maintained a strong “System Focus” over the past 12 months, in order to improve and deliver resilient unplanned care services for Wirral residents.  The position going into winter 17/18 had not been strong, seeing Wirral in the bottom quantile nationally for performance against the 4 hour standard.

During the past year, the system had moved forward with integration particularly between commissioning (CCG & WBC) and the embedding of the transfer of social care to Wirral Community Trust and impending transfer of social care specialist teams to CWPT. An urgent care executive had been established to improve governance and grip and utilised the work completed with Venn on whole system capacity and demand modelling.

It was reported that as a result of the focus, Wirral had seen a 5% improvement in system performance (4 hour standard) over the winter period, and had seen a 10% improvement since last summer. This had been achieved by a strong whole system transformation plan and improved system leadership and accountability. There was recognition however that more needed to be done to improve system performance.

Wirral had concluded a review of winter, to ensure learning had informed plans for 18/19 (appendix 1 embedded in the system plan appendix 1 document referred) and details of what worked well last winter was included in the report.  The Key Challenges, Wirral’s approach for 18/19, a summary of performance, Governance approach and management of risk, key risks and next steps were also provided in the report.  The appendices to the report included the Wirral Winter and Unplanned Care System Sustainability Plan 2018-2109 and the 4 hour standard performance summary.

Resolved – That;

1.  Jacqui Evans be thanked for the report.

2.  the update and ongoing priorities overseen by A&E delivery board be noted.

3.  the interdependencies of all partners to the resilient delivery of the 4 hour standard be recognised.

4.  the improving position be noted.

Jacqui Evans, AD for Unplanned Care & Community Care submitted a report that provided Members with an update on progress and developments with regard to BCF.

The report provided feedback from the regional team regarding the Wirral plan that summarised; “BCF 2017/19 plan stood out to assurers for its integrated governance and approach, demonstrating that all programmes and plans influencing urgent / out of hospital care aligned and that BCF was not a stand-alone initiative. Performance monitoring of the BCF is fully embedded in the Winter and System Sustainability Plan. The area have several new schemes and approaches including a whole system capacity demand model which has recently been featured at a regional event and will be rolled out with some North HWBs via regional support funds. They have recently redesigned 3 pathways under transfer to assess principles which they feel is impacting positively. Further details and case studies being captured.”

The 2 year BCF plan was attached in appendix 1 to the report and outlined the 17/19 priorities and funding allocation changes for 18/19.  Appendices to the report were also provided for the Performance Overview 17/18, Month 2 18/19 performance summary, Month 2 18/19 performance summary, DTOC targets, 18/19 revised scheme funding, Proposed winter funding allocation,

High impact change model, Capacity and demand model and the Unplanned system plan.

With reference to the financial summary Jacqui Evans highlighted that the total funds contributed to the BCF pool in 17/18 amounted to £52.2 million.  The underspend projection of £850,604 was shared on a 50/50 basis as per the risk share agreement within the S75 document.

Jacqui Evans also outlined the next steps which covered the aim to revise plans in accordance with awaited guidance, Monitor performance and deliver against action plan and to continue to report quarterly against progress to NHSE.

Resolved – That;

1.  Jacqui Evans be thanked for the BCF update.

2.  the progress and next steps be noted.

3.  further updates on progress be included in future meetings of the Health and Wellbeing Board.

Members gave consideration to a report of the Director of Health and Care which presented the draft Commissioning and Transformation Strategy attached as an appendix to the report.  Nesta Hawker, Director of Commissioning & Transformation, WHaCC, attended the meeting and outlined the key points to the Board. The draft Commissioning and Transformation Strategy shared the high level plans and commissioning priorities of Wirral Health and Care Commissioning up to 2021.  The Strategy was intended to share the outcomes that would provide the focus for commissioning the framework for the development of place based commissioning and outlined the vision of how the move to commission on population based health and care outcomes would be achieved.

Fiona Johnstone, Director of Strategy and Partnerships indicated that the strategy aligned to the key functions and purpose of the Health and Wellbeing Board in identifying the needs of the community.

Dr Sue Wells welcomed the draft report and commented that the strategy worked towards tackling inequality in Wirral.

Resolved – That;

1.  Nesta Hawker be thanked for the report.

2.  as the final version of the Strategy would be presented to the Joint Strategic Commissioning Board in August Members of the Board email any comments on the draft Commissioning Strategy to Nesta Hawker, Director of Commissioning, without delay

Carol Jones, Commissioning Lead, Wirral Health and Care Commissioning submitted a report that informed members of the Memorandum of Understanding – Supporting an integrated approach to identifying and assessing Carers health and wellbeing.

Carol Jones described Carers as ‘the golden thread’ and defined Carer as anyone who cares, unpaid, for a friend, partner or family member who needs help due to illness, disability, a mental health problem or an addiction who would not manage without their support.

The report outlined the Memorandum of Understanding – Supporting an integrated approach to identifying and assessing Carers health and wellbeing needs.  This provided the basis for organisations to show their commitment to support, identify and assess Carers in Wirral.  It provided the opportunity for organisations to adopt the approach that ‘Carers are everybody’s business’.  The MOU had been developed by NHS England, ADASS and others.  It had been supported locally by key partners represented at the Carers Partnership Board, who were committed to working together for adult Carers and Young Carers. 

It was reported that in 2014, a mandate from the Department of Health to NHS England had included the objectives ‘to ensure that the NHS becomes drastically better at involving patients and their Carers, and empowering them to manage and make decisions about their own care and treatment’.  In response, NHS England and the Royal College of General Practitioners had launched their Commitment to Carers report which set out 8 priorities and 37 commitments and the Commissioning for Carers guidance;

https://www.england.nhs.uk/wp-content/uploads/2014/05/commitment-to-carers-may14.pdf

Carol Jones encouraged Board Members to adopt the Memorandum of Understanding.  Councillor Angela Davies addressed the meeting and commented that the Memorandum of Understanding provided an excellent framework.

Resolved – That;

1.  the need to improve the identification, recognition and support of Carers in Wirral be agreed.

2.  the NHSE Memorandum of Understanding – Supporting an integrated approach to the identification and assessment of Carers health and wellbeing be endorsed.

3  the Carers Partnership Board report back on progress on developments to future meetings of the Health and Wellbeing Board.

Simon Banks, Chief Officer, Wirral Health & Care Commissioning, introduced a report from the Cheshire and Merseyside Transforming Care Partnership Update - Quarter 4, 2017/18.

The report provided an overview of the performance of the Cheshire and Merseyside Transforming Care Partnership during Quarter 4, 2017/18 and highlighted key points for the attention of Partnership organisations across Cheshire and Merseyside.  It was reported that during this quarter the Partnership had undertaken a range of actions to make progress against the seven workstream areas within its Workplan which aimed to:

·  help people live in homes and not hospitals

·   improve people’s health, quality of care and quality of life

Resolved – That;

1.  the report be noted.

2.  that any comments be forwarded to the Director of Health and Care.

Simon Banks, Chief Officer, Wirral Health & Care Commissioning, introduced a report on behalf of Karen Howell, CEO/SRO for the Cheshire & Merseyside Strategic Workforce Programme (Chair).  The report provided an overview of the Strategic Workforce Programme as one of four enabling programmes to support the delivery of the place based care systems and the clinical and transformational programmes across Cheshire and Merseyside and gave details of the agreed aims of the programme.  The report provided details of the Governance of the programme, the Key work programmes, the risk register, the ToR – Strategic Workforce Programme Board, the ToR – Local workforce Action Board, the draft ToR – Social Partnership Forum and the Page on a Page

Resolved – That;

1.  the report be noted.

2.  any comments be forwarded to the Karen Howell, CEO/SRO for the Cheshire & Merseyside Strategic Workforce Programme (Chair).

Simon Banks, Chief Officer, Wirral Health & Care Commissioning, introduced a report on the Cheshire and Merseyside Women’s and Children’s Partnership Strategic Highlight Report that had been prepared by Catherine McClennan and covered the period November 2017 - January 2018.

Resolved - That;

1.  the report be noted.

2.  that a link to the website be circulated to Members of the Board.

Fiona Johnstone, Director of Strategic and Partnerships, introduced a report that provided the Health and Wellbeing Board with the annual report of the Director of Public Health.  The Board were informed that the purpose of the Public Health Annual Report was to draw attention to local issues of importance which had an impact on population health. Since the Council had taken back responsibility for Public Health in 2013 five reports had been published on the topics of social isolation, healthy schools and children, domestic violence and the roles of the Council and the NHS in promoting health and wellbeing. These reports had led to action in the reduction of the number of people smoking in the borough, to levels below the national average; increased support for people who felt socially isolated plus significant activity across a range of partners that highlighted and reduced the damage caused to local communities from alcohol abuse e.g. Drink Less Enjoy More Campaign. 

The 2018 annual report reflected on the public’s concern about the impact of gambling on local people.  It supported the delivery of the Wirral 2020 Plan and the Pledge ‘Wirral Residents Live Healthier Lives’.  The annual report aimed to describe what harmful gambling was and served to illustrate the impact it had on local residents, their families and friends.

The report gave details a number of recommendations that had been developed in conjunction with local partners and key Council departments e.g. licensing and planning. The recommendations covered action on the following themes:

• Raising the profile of harmful gambling via a communications campaign to highlight the impact of harmful gambling; working with schools and promoting the help and support available to people who are struggling with their gambling habits
• Supporting people at risk of harmful gambling by raising the awareness of frontline staff of the support that is available
• Understanding and measuring harmful gambling in the borough to inform future licensing decisions
• Work with other Councils to identify action to reduce the risks that consumers, especially those that are vulnerable, face from gambling e.g. enhanced consumer protection for online gambling

In addition it was proposed that a working group be established with the Gambling Commission to consider how local powers could be used to support a reduction from harm relating to gambling.  The Health & Wellbeing Board was requested to support the recommendations outlined in the report.

Fiona Johnstone referred to the financial impact of gambling and the impact of the spiral of addiction on friends, family and mental health.  Members noted that the report had been taken to a meeting of the Cabinet and welcomed the report as being an excellent piece of work.

Resolved – That;

1.  the report be noted.

2.  Julie Webster be thanked for the preparation of the report.

3.  the Health & Wellbeing Board support the recommendations  in the report and feedback ideas to the Acting Director for Health & Wellbeing.

Members of the Board gave consideration to a progress update report on Wirral’s Healthier Lives Pledge – Wirral Residents live Healthier Lives that set out the target for Wirral residents to have a good quality of life and live healthy lifestyles in clean and safe environments.  The report gave details of the aims of the pledges, what had been achieved to date, what steps would follow next and provided relevant case studies.  Significant progress had been made in particular to the prevalence of smoking cessation.  Fiona Johnstone indicated that partners would be asked to engage further in working towards aims of the Wirral’s Healthier Lives Pledge.

Resolved - That the report be noted.

Verbal update.

Fiona Johnstone, Director of Strategy and Partnerships, provided a short verbal update to the Board on Wirral Together.  Over the next few months, the Healthy Wirral Partnership has agreed to develop a co-produced commitment on Health and Wellbeing that is intended to set out a ‘deal’ between those who support Health and Wellbeing, and our local communities.  All partners will be asked to contribute to its development and it will reflect insight from local communities on what they think their part of the deal should be.  The work is to begin on developing Wirral Together for Health & Wellbeing in September.

Resolved – That the verbal report be noted.

Wirral Together for Children : Presentation : Paul Boyce

Paul Boyce, Corporate Director for Children attended the meeting and provided a presentation on Wirral Together for Children and Young People.  The presentation included the context of what Wirral was like when he was appointed to the post, an update on what improvements had been made in children’s social care; an update on the creation of a “one children’s service”, the next steps to be taken and how partners could help.  Members discussed the presentation and suggested that this topic could be discussed in further detail at a further meeting or spotlight session.

Resolved – That;

1.  the Corporate Director for Children be thanked for the presentation.

2.  the presentation be circulated to Members of the Health & Wellbeing Board for information.

3.  the issues raised in the presentation Wirral Together for Children and Young People be brought back to a future meeting of the Health & Wellbeing Board.

Andy Thomas, Head of Assurance and Delivery, NHS England, submitted a report on behalf of Nicola Allen, Head of Medical, NHS England(Cheshire & Merseyside) & Lead for Service Change Assurance.

Resolved – That the report be noted.

Phil Davies, Chair, Healthwatch submitted the Annual Report 2017/18 to the Board that provided an update on the activities, outcomes and outputs of Healthwatch Wirral (HWW).

Resolved – That the report be noted.

The date of the next formal Board meeting is Wednesday, 14 November 2018 at 4pm in Committee Room 1 Town Hall, Wallasey.

The date of the next formal Board meeting would be Wednesday, 14 November, 2018 at 4 pm in Committee Room 1 Town Hall, Wallasey.