Report of the Assistant Director, Health and Care Outcomes.

Jason Oxley, the Assistant Director Health and Care Outcomes introduced a report that informed that integrated assessment, case management and support planning processes for children and adults with disabilities and adults with mental health needs, with Cheshire and Wirral Partnership NHS Trust (CWP) would improve support for the most vulnerable people in Wirral.  Those who had a disability or a mental health need.

Appended to the report were the following appendices:

Members noted that Social Care Services played an important role in enabling vulnerable people to maximise their independence, to take an active part in their communities and to keep well in Wirral.  The inter-dependency between health and care systems had become increasingly clear over recent years. Nationally, Councils were being faced with increasing demand on Social Care Services which presented as a challenge to meet within the available resources.  Local Authorities and NHS providers were increasingly working to integrate social care and health services locally to provide both sustainability and a better experience for people who used these services.

People with disabilities and their families had informed that they had experienced difficulty in navigating between different services and between health and care organisations, had found it difficult to maintain communication with all the different people involved in their support and had not always had joined up planning for adulthood.

Members were informed that this service was in line with the All Age Disability Strategy and feedback received from people that needed support from services. A Wirral resident had informed that

  “The main issue is to break down the barriers between organisations and ensure that everyone in each of the organisations understands what the others do” (ref Survey Results Appendix F).

The service aimed to ensure that the Council and NHS partners used the collective resources to provide better and more joined up support to people with disabilities or a mental health need. This followed the successful implementation of a fully integrated service for older people which was now provided by Wirral Community NHS Foundation Trust on behalf of the Council and under a similar agreement.

It was reported that the following key features of the all age service were essential to success:

·  Bringing health and social care staff together to provide integrated, coordinated support to people.

·  Delivering the Right Care in the Right Place at the Right Time.

·  Supporting young people with complex needs into adulthood.

·  Clear accountability and governance arrangements.

·  Resilience and flexibility to emerging issues in service delivery.

The Council’s Cabinet (March 2016) had approved the establishment of a Transformation Programme with the development of an All Age Disability and Mental Health service. On 6 November 2017, the Cabinet approved the Full Business Case (Appendix A) and the development of an integrated All Age Disability and Mental Health service by a formal partnership arrangement with CWP. The Cabinet also approved estimated one off set up costs and for the final arrangements to be presented for sign off in spring 2018.

Further development of the service specification was required in relation to the delegated functions for children and young people and, therefore, the final arrangements were being presented for sign off in summer 2018.

The CWP approved the business case and final arrangements on 25 July 2018.

Governance arrangements had changed with the development of Wirral Health and Care Commissioning as a Strategic Partnership. Therefore, a Leader Decision on the final arrangements had been sought to approve the final arrangements and for a report to be submitted to the Joint Strategic Commissioning Board to endorse this decision.

It was reported that careful consideration had been given to a range of other alternative delivery models. These had included retaining and developing the services within the Council, the setting up of a community interest company to provide the services and developing an informal partnership with a public sector provider to provide the services differently.

These options were also detailed within the Full Business Case (Appendix A to the report). However, the agreed service model provided the opportunity for achieving the benefits required and to develop Place Based Care.

Members considered the documentation in detail and made comments and asked questions on the following:

·  This initiative was in the best interests of families and children.

·  Not all of the Council’s statutory duties had been transferred over.  It was complicated to transfer children to the adult services and both Directors retained their statutory duties. This was clarified and it was noted that decision making remained firmly within the Council.

·  Consultation had begun with the Trade Unions in December 2017 and all staff involved in the transfer had been consulted.  The Trade Unions were supportive of the principles and the reasons it was being done.  Some changes had been made as a direct result of the consultation exercise.

·  Wirral was now in a unique place.  Services were now more person-centred to ensure no one ‘fell through the cracks’.

·  This was primarily the Council’s statutory duty but CCG Members could make comment but endorsement was a matter for the Cabinet Committee.

The NHS Wirral CCG Members RECOMMENDED (to their Council colleagues):

That

(1)  the decision to approve the final arrangements be endorsed;

(2)  the final arrangements for creating an All Age Disability and Mental Health Service be noted;

(3)  the staff transfer on 19 August 2018 be noted; and

(4)  the delegation of Wirral Borough Council’s statutory duties to CWP, as detailed in the contract and service specification be noted.

Wirral Borough Council’s three Cabinet Members, sitting as a Committee of the Cabinet subsequently

RESOLVED:  That

(1)  the decision to approve the final arrangements be endorsed;

(2)  the final arrangements for creating an All Age Disability and Mental Health Service be noted;

(3)  the staff transfer on 19 August 2018 be noted; and

(4)  the delegation of Wirral Borough Council’s statutory duties to CWP, as detailed in the contract and service specification be noted.