The Director of Adults, Health & Strategic Commissioning Services introduced the report of the Director of Finance which provided an update on the budgets within the remit of the Committee in respect of forthcoming pressures and proposed savings that are being considered within the Medium Term Financial Plan. The report also summarised the outcomes of the recent Budget Workshops between Members and senior officers, which had enabled officer and Member liaison on proposed budget options, facilitated discussion and allowed direction to be obtained on further analysis required and provided an opportunity for alternative proposals to be considered.

Members requested further detail on Shared Lives.

The Social Care precept was also discussed by Members and it was noted that this had been taken into account in the figures in the report. If the precept was not applied the money available for Adult Social Care would be reduced by in excess of £2million.

It was explained to Members that Local Authorities would be expected to absorb any Care Quality Commission (CQC) assessment costs within their settlements. No additional funding had been made available to cover assessment costs.

Resolved – That

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

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

The Director of Regeneration and Place agreed to enter into a contract extension with Involve Northwest for the delivery of the Worklessness Support Service for a period of 12 months from 1 April 2024 to 31 March 2025, to the value of £1,108,749.

The acquisition of the property listed in the attached exempt report is approved. 

The Divisional Director of Nursing and Midwifery, Women’s and Childrens division, Wirral University Teaching Hospitals NHS Foundation Trust (WUTH) presented the report which provided an update and oversight of the quality and safety of maternity services at WUTH. The report provided a specific update regarding Year 5 of the Maternity Incentive Scheme (MIS). There was also an update on progress on the Saving Babies Lives Care Bundle. The report also highlighted the outcome of the recent Care Quality Commission (CQC) inspection of the maternity services provided by WUTH.

Assurance was given that the three year delivery plan was on target to meet requirements.

It was noted that maternity was very much in the limelight due to Ockenden 1 and 2 following from the Shrewsbury and Telford enquiry.  It was stated that reports were consistently made to the Board of Directors and within the Trust full compliance on that was reviewed quarterly and all immediate actions were maintained to do that.

Members queried whether there were any areas for improvement and the CQC had identified three specific areas which were actioned whilst the CQC was either on site or within two weeks. These were around maternity triage and telephone services and baby abduction. There was an additional measure recommended to the full lockdown secure system which was added to some lockable doors and also a stable resus platform in the Seacombe Birth Centre.

Members queried the removal of the maternity shop from the precinct. It was explained that it had been difficult to meet the IPC infection control requirements. Alternative sites were being proactively sought across the Wirral and community hubs were being looked at. It was reported that a site had been secured in Birkenhead.

Members asked how many births had taken place in Seacombe Birthing Centre as opposed to home births. It was explained that the centre was pioneered in 2019 to deliver community home births of on average around a hundred per year within the team and 14-16 births were in the centre.

Members questioned how sure we could be that the neonatal services would remain on the Wirral. It was reported that neonatal services had been subject to an ongoing review by NHS England for at least five years and the outcome was still awaited.

Members queried recruitment and retention of midwives and it was reported that in 2021 there was funding for clinical recruitment and retention of midwives which included supporting newly qualified midwives to support retention. A six monthly report went to the Board and Members were reassured that the vacancy rate sat at 2 percent which had enabled WUTH to progress with continuity of care.

Members asked about the feedback mechanism and this was clarified as the national family and friends feed back tool, cards and user platforms which were taken very seriously and shared widely and goes to the Board. The CQC feedback had highlighted a couple of areas including knowing what a lady’s history was and the role out of continuity of care would support that. It was reported that negative feedback was very rarely received which was mainly around the post natal area and pain management.

Members were proud of the maternity services on Wirral and thanked WUTH.

Resolved – That the updates within the report and progress by Wirral University Teaching Hospital NHS Foundation Trust (WUTH) on the delivery of safe maternity services be noted.

The Independent Chair of the Wirral Safeguarding Adults Partnership Board presented the report of the Director of Care and Health which provided a further update on the work of the Wirral Safeguarding Adults Partnership Board (WSAPB) and presented the WSAPB 2021-2023 Annual report. The Care Act 2014 requires Local Authorities to establish a Safeguarding Adults Board in its area.

The Wirral Safeguarding Adults Board was comprised of senior leaders across health and social care who commission or deliver services for people in need of help and support who can make decisions about budgets and changes to policies and procedures. Senior leaders from the Hospital Trusts, the Mental Health Trusts, fire, police, probation as well as health and social care services, Healthwatch and Chief Executive of Age Concern who worked with the other voluntary sectors had come together on the Board.

Safeguarding spotlight sessions were offered by the Board and a session was offered.

Members asked how far the Board had got in terms of implementation of the plan. It was clarified that the report contained a table that showed a RAG rating of all the actions. A couple of actions were yellow and still in progress. One of the reds was about obtaining data from colleagues staff training and referrals and the Board were taking that forward. The Board were quite ahead with the forward plan and knew what needed to be done about the areas in yellow.

Members questioned what awareness raising was being done in terms of neglect and whether that included self neglect. It was highlighted that neglect was one of the biggest areas of abuse and the Board had completed a piece of work with Liverpool John Moores University on neglect, self neglect and hoarding behaviours and guidance has been sent to staff across the partnership.

In addition, Members questioned the target for the delivery of the knowledge and skills area which was one of the biggest areas to develop. The report was up to March 2022.

Members asked how the Board can bring an extra level of assurance that existing organisations could not supply. It was explained that the Board brought a multiagency approach and brought together composite reports in one place to see how they link in and work together.

It was agreed by Members that a spotlight session on a subject to be decided by Committee would add value and an update report from WSAPB was offered.

Resolved – That the update report in relation to the work of the Wirral Safeguarding Adults Partnership Board and the 2021 – 2023 Annual report spanning the first 18 months of the Board be noted.

The Head of Legal introduced the report which presented the future work programme of the Committee.

Additional items were suggested including:

•  A spotlight session from the Wirral Safeguarding Adults Board on a topic to be decided by Committee.

•  An item around Shared Lives.

•  Quality Accounts for WUTH and CCC as a scrutiny item.

•  An update report from CWP over the availability of community psychiatric nurses when the changes have bedded in after May.

•  An update report from WSAPB.

Resolved - That, subject to the changes noted above, the proposed Adult Social Care and Public Committee work programme for the remainder of the 2023/24 municipal year be noted.

The Associate Director for NHS Cheshire and Merseyside and the Assistant Director of Commissioning and Integrated Service presented the report of the Director of Care and Health which provided an update on Palliative and End of Life Care Services provided in Wirral. The report included services commissioned by NHS Cheshire and Merseyside Integrated Care Board (ICB), Wirral Place and also activities undertaken by commissioned Adult Social Care providers in Wirral.

Members discussed their experience of end of life care and that the key to end of life care was communication. Members asked about the provision made for people to have their end of life care in their own home and this was explained.

Members noted that the distinction between end of life care and palliative care needs to be made. It was explained that there is a difference between palliative care with symptom management which can take a year to 18 months or more and end of life care that can be 6 weeks or less.

It was reported that people eligible for the continuing health care fast track had been identified for end of life care within three months and of those, between fifty to sixty percent of people on that pathway died within three months.

Resolved – That the content of the report, and the Health and Care system work underway to support End of Life Care in Wirral be noted.

Resolved – That

1. The admission arrangements for community and voluntary controlled schools and the Wirral co-ordinated schemes for 2025-2026 as set out in Appendices 1 and 2 to the report be agreed.

2. The revised Wirral Fair Access Protocol as set out in Appendix 3 of this report be agreed.

The purpose of this report is to enable the Director of Regeneration and Place to consider and approve the ringfenced allocation of funding from the UK Shared Prosperity Fund (UKSPF) which has been received by way of grant funding from the Liverpool City Region Combined Authority (LCRCA) for the purpose of delivering the Wirral Ways to Work programme to the value of £1,461,216.

The Director of Regeneration and Place has agreed to approve the allocation of the UK Shared Prosperity Fund as set out in paragraph 4.1 of the attached report.