Ms Jacqui Evans, Assistant Director: Integrated Commissioning, Health and Care introduced her report that set out progress on the Avoiding Admissions scrutiny report approved by the People Overview & Scrutiny Committee in September 2016. The scrutiny review assessed the actions being taken to strengthen community based services that were intended to reduce the demand for acute services and thereby reduce hospital admissions. In September 2016, the report was referred to Cabinet and members also requested a report to provide a six monthly update regarding the implementation of the recommendations made in the original scrutiny report. An update on each recommendation was provided in the appendix.

The Assistant Director drew Members attention to a number of key areas in the summary of actions undertaken subsequent to the publication of the original report, namely:

Governance and funding. Wirral is to move to be an Accountable Care System by 2020 in line with national requirements. Wirral Clinical Commissioning Group, in conjunction with all partners were encouraged to continue to strengthen the culture of collaboration and partnership. AQUA had been engaged to support the Wirral system, particularly from a provider perspective – the focus is upon integrated care delivery moving from an integrated care system to an accountable care organisation. The AQUA programme was using Older People’s services to test out a future integrated model that builds up from local communities to develop 8 localities, feeding in to 4 hubs (constituency boundaries) and 1 district (Wirral). The approach will be tested through the development of 2 locality areas within the Birkenhead constituency built around 2 groups of GP practices

Service quality and a person-centred approach for community services. The Director of Adult Social Services and Wirral Clinical Commissioning Group, as commissioners of community services, are requested to ensure that adequate system capacity, service quality and a person-centred approach are embedded within all such contracts. Recent developments, in line with national best practise evidence, such as discharge to assess /home first models are currently piloted. A multidisciplinary team is supporting and overseeing these pilots and a fortnightly governance meeting is in place to review & evaluate. This is supported by commissioners & providers across the Wirral Health & Social Care economy. Winter pressures have been significant & unprecedented. Evaluation & work on future capacity modelling is underway. ECIP (Emergency Care Improvement Team) have been supporting the direction of transformational change. Wirral CCG & WBC are investing in 2017/18 funding in ‘home first’ provision. Pressures have been felt across certain sectors of the market during 2016/17, i.e. domiciliary care. Significant support has gone into stabilising the market and as such whole economy discussions are underway to explore future models of delivery which are sustainable

Members asked if there were challenges in achieving the targets for reducing admissions. The Assistant Director: Integrated Commissioning, Health and Care informed that the Better Care Fund continued to invest in preventative services, to support the prevention of admissions to hospital & long stay care and that overall this had currently achieved a 4.2% reduction in admissions with a target for 2017/18 of 5%.

The Chair thanked Ms Evans for her report and the summary of actions undertaken to date.

Resolved – That the report be noted.