Neighbourhoods are 9 geographical areas of Wirral with a population between 30,000 to 50,000 people living in them.  This presentation describes the neighbourhoods, and new ways of working across Health and Care in order to support the population living in those areas in more effective ways.  The model shows how closer working at this level, will enable communities and the voluntary sector to work together, with citizens and the Health and Care sector to deliver improved outcomes and responses, with a focus on what is important to local people.  This forms a core part of the Healthy Wirral Programme.

The Board received a presentation introduced by the Joint Director for Care and Health, Graham Hodkinson, providing an update of work in Wirral’s nine neighbourhoods that formed a core part of the Healthy Wirral Programme. The presentation described the neighbourhoods, each of which had a resident population of between 30,000 to 50,000 people, and the new ways of working across Health and Care to better and more effectively support those local populations.  The neighbourhood model showed how closer working at this level would enable communities and the voluntary sector to work together with the Health and Care sector to deliver improved outcomes and responses, with a focus on what is important to local people. 

Neighbourhoods are about people and the ‘place’ they live, and ‘place based care’ was concerned with using a defined set of resources to provide the best possible quality of care and health outcomes for a neighbourhood’s population.  The principles upon which place based care was based were advised as –

• a partnership approach, engaging stakeholders across all sectors in collaborative decision-making;
• a move from central control to being led by the people who live and work locally;
• community engagement – the encouraging of collaborative working, critical thinking and problem solving;
• local flexibility, providing a robust foundation for decision-making; and
• a long-term commitment, ensuring there is adequate time and resources to commit to this work.

The presentation further considered the features of an integrated care system and of place-based care in practice; the linkage of the approach to Healthy Wirral’s agreed Mission Statement and Vision; and the features of Healthy Wirral Neighbourhood provision, considering the benefits for both local people and staff.  Identified key achievements in the Neighbourhoods approach to date included the defining of the neighbourhoods, appointment of GP Co-ordinators and establishment of Leadership Teams; the establishment of a multi-disciplinary team approach; the alignment of resources and improved linkage to community resources; and the strengthening of third sector links and provision.  The Neighbourhood Programme structure and the Neighbourhood Governance arrangements led by the Healthy Wirral Executive Delivery Group were outlined, while the impacts achieved by a pilot project in one neighbourhood comprising a Frailty Personal Independence Co-ordinator working with Age UK were further advised.

Going forward, the Board was advised of the immediate priorities for the neighbourhoods approach as it progressed –

• the development of a future operating model;
• embedding the digital Wirral Care Record;
• co-designing care models with a neighbourhood focus;
• continuing the improvements in integration and engagement with the third sector;
• accelerating a Population Health Management approach;
• co-producing primary care networks on the Neighbourhoods’ footprints; and
• greater alignment with the Wirral Together capacity building approach.

The Chair noted that the neighbourhoods agenda was one that the Board should be rightly proud of, noting that Wirral was ahead of others across Merseyside and Cheshire and that the approach was now contained in the NHS Plan.  Going forward there was a need to consider the allocation of GP practices against the primary care networks now forming to see how these linked up, but Wirral was leading with an approach that focused on people and communities, rather than on organisations.

The views of the Chair were supported, with comment made that it had been a slow and often challenging process to get agreements.  With reference to the work of Personal Independence Co-ordinators and the reported reduction in referrals to GPs, it was also advised that a reduction in non-elective admissions to hospitals was also being observed.  A concern was expressed that certain announcements in recent weeks might have impacts on this area of work, but this was tempered by a consideration of what had been achieved and what work underlies it.  It was noted that the neighbourhoods structure presented a real opportunity for Children’s Services in their improvement journey.  As a short term measure services had been brought together, but the neighbourhoods as described here provided a possible model for locality delivery. 

RESOLVED – That the presentation updating the Board on neighbourhood working be noted.