Agenda and minutes

          The Minutes of the meeting held on 26 November 2019 having been circulated were signed as a correct record.

          The following public question had been received in advance of the meeting:

Why has a voluntary organisation Age UK – Mid Mersey, at present on contract to HBC, given the same opportunity and time to discuss my health and welfare, as the principle drivers, Cheshire and Merseyside Health and Care Partnership and NHS Halton CCG.  Is Halton Council unsure that the Cheshire and Merseyside Health and Care Partnership and NHS Halton CCG can deliver my health and welfare requirements?

The following response was provided:

The primary responsibility of the Health Policy and Performance Board is to scrutinise Health and Social Care Services provided to the residents of the Borough, to ensure that the services being delivered are of the necessary quality and are delivering on required outcomes for residents.  These services include those that are contracted by Halton Borough Council and NHS Halton Clinical Commissioning Group from external organisations, both statutory and non-statutory.

As such, from time to time, organisations such as Age UK – Mid Mersey and other voluntary sector organisations e.g. British Red Cross etc. are requested to present information to the Board for consideration on the services provided and outcomes attained.

RESOLVED:  That the public question be received and response noted.

The minutes from the Health and Wellbeing Board meeting held on 2 October 2019 were provided for the information of the Board.

RESOLVED:  That the minutes be noted.

The Board welcomed Mark Lunney, Chief Executive of Age UK – Mid Mersey (Age UKMM) who presented a report and accompanying presentation on the work the Organisation undertook by them in the Borough.

Members were advised that Age UKMM had operated across Halton for over 30 years and was highly respected and recognised as the leading voice for older people.  They delivered a range of services under contract agreements with the Local Authority (LA) and Clinical Commissioning Group (CCG) alongside delivery of a range of ageing well services via external grant funding work, advice, campaigning and lobbying for the interests of older people in the areas of Halton, St Helens, Knowsley and Warrington. 

The report and presentation explained how the services were delivered using dedicated and highly experienced staff and volunteers.  They also outlined the contracted services offered and the range of community based work carried out recently.  

Members were also provided with information on the Respect Campaign  #DoYouSeeMe?  It was hoped the Campaign would create a movement across the whole Merseyside area.  Promotion leaflets about this were circulated to Members.

Appended to the report for Members information were the following documents:

·         Information for Older People in Halton (Age UK Mid Mersey Engagement June 2019;

·         Client satisfaction survey results;

·         A practical guide to healthy ageing; and

·         An example of a case study.

The following comments were made by Members and additional information provided following the presentation:

·         It was important to know who was and where people were accessing these services, so the Council could follow on with any further services that were needed;

·         One of the main challenges was reaching people who were not aware of the service;

·         The isolation of older people was a concern in some Wards in the Borough;

·         Age UK MM used intelligence sharing and a ‘heat map’ to identify people who may be in need;

·         Schools were being targeted with the #DoYouSeeMe? Campaign as it was important to raise awareness and educate at a young age; and

·         Despite the good work of Age UKMM, the importance of community organisations at the core of communities was crucial to older people and this was recognised.

Mr Lunney was thanked for his attendance.

RESOLVED:  That the report and presentation be noted.

The Board was introduced to Simon Constable, the new Chief Executive of Warrington and Halton Hospitals NHS Foundation Trust.

Members received a presentation which outlined the Trust’s key priorities under his leadership.  It also provided data on the Accident and Emergency Department in Warrington Hospital and provided information on plans for both Hospitals in relation to the use of the estate and equipment.

Members welcomed the presentation and noted the challenges that may be faced in the future with the suggested key priories.  The following information was provided in response to Members questions:

·         Although in the past some specialist services had been difficult to recruit to, this had improved and as of today, all specialist areas were staffed with consultants with the exception of one;

·         The success of neighbouring hospitals was recognised and the Trust hoped to learn from them;

·         The improvement of waiting times at A&E was a priority – there were variations of patient numbers and waiting times during the week and at weekends; and

·         Plans for diverting non-emergencies away from A&E would be improved using triage and educating the public.

On behalf of the Board, the Chair thanked Mr Constable for his attendance and invited him to return to a future meeting.

RESOLVED:  That the Board notes the report and presentation.

The Board was presented with an update on the Cheshire and Merseyside Health and Care Partnership, from the Implementation Lead, Dave Sweeney.

It was reported that the Cheshire and Merseyside Health and Care Partnership successfully submitted its first 5-year Health and Care Strategy into NHS England / Improvement on 15 November 2019.  This would be a rolling 5- year Strategy, updated annually.

The report discussed the NHS long term plan; communication and engagement; the journey to becoming an integrated care system (ICS) and developing the integrated care partnerships (ICPs); the System Leadership Development Programme; and the collaboration at scale programmes.

The Board noted that a draft Partnership Memorandum of Understanding (MOU) was being worked through by the ICS Steering Group and it was important that Halton was a part of this.  This would help clarify the purpose of the partnership, how decisions would be made and the composition of the Partnership Board – recognising the primacy of ‘Place’.

The Chair thanked Mr Sweeney and it was agreed that a report on the progress of the MOU would return to the Board at a future meeting.

RESOLVED:  That the Board notes the information and promotes and supports the Partnership and delivery of the 5-year Strategy for Cheshire and Merseyside.

The Board received a report and accompanying presentation from Dr Andrew Davies – Clinical Chief Officer, that gave an update on the NHS Halton Clinical Commissioning Group’s (CCG) Commissioning at Scale Programme.

Dr Davies outlined for the Board proposed future commissioning arrangements and the associated relationships between Primary Care Networks (PCNs), Place Based Integrated Commissioning and commissioning at Scale.  He also outlined the principles that would need to be in place to ensure that integrated commissioning and PCNs would be supported by the CCG.  These included Primacy of Place, sovereignty, listening to the patient voice, engagement of Member practice and minimising costs of conformity.

The Board was advised that there would be an extraordinary meeting of the NHS Halton CCG’s Governing Body on 11 March 2020, on proposals to develop a Mid-Mersey CCG which would cover Halton, Warrington and St Helens.  A further update would be presented at the next meeting.

RESOLVED:  That the Board notes the presentation and update.

The Board received a report from the Chief Commissioner for Halton, NHS Halton CCG, which updated Members of the progress to date of the Widnes and Runcorn Urgent Care Centres since the decision not to re-procure the service.

The Urgent Care Centre Progress Report and Service Development and Improvement Plan (SDIP) were attached to the report together with the Service Specification for the Halton Urgent Treatment Centres (previously known as Urgent Care Centres) which included Appendices 1 and 2.

 The Board was informed that since the publication of the agenda, the introduction of bookable appointments for GPs and advanced nurse practitioners were now available and clinicians at the Treatment Centres were able to ring the acute hospitals for advice and refer directly into the appropriate setting rather than go through A&E.  It was noted that data relating to the performance of the Centres would be available in 6 months’ time.

The following was noted in response to questions:

·         Despite the UTC service, pressure on A&E had not reduced as much as it was hoped;

·         Educating the public on the UTC service was important and there was further work planned around this;

·         The GP extra service was praised, however it was not promoted in some surgeries so some people did not know about it;

·         Some difficulties remained with the ICT services, however these were being worked through; and

·         Transport was provided for patients if for example they were being transferred to hospital after clinical assessments at the Centres.  It was not available to take people home after being discharged from the Centre. 

RESOLVED:  That the Board notes the update.

The Board received a report from the Strategic Director – People, which introduced the conclusion to the scrutiny review of the Deprivation of Liberty Safeguards.

The findings of the scrutiny review were presented in a report – Health Policy and Performance Board Scrutiny Review of Deprivation of Liberty Safeguards (DoLS) Report January 2020, which was attached as appendix 1 to the report.  Within this report were the meeting minutes and presentations that took place over the scrutiny review for the information of all Board Members.

The overall conclusions and recommendations of the review were presented to the Board and Members were requested to endorse these for referral to the Executive Board.

Members considered the suggested topics that had been identified for consideration for scrutiny during the next Municipal year.  After a vote, it was agreed that ‘The GP Hub – Integration of Adult Social Care with GP practices (One Halton)’ would be the topic group for next year.

RESOLVED:   That the Board

1)    endorses the recommendations of the scrutiny review and agrees that these be referred to the Executive Board; and

2)    agrees that the scrutiny topic for the next Municipal Year be ‘The GP Hub – Integration of Adult Social Care with GP practices (One Halton).’

The Board received the Performance Management Reports for quarter 3 of 2019-20. 

Members were advised that the report introduced, through the submission of a structured thematic performance report, the progress of key performance indicators, milestones and targets relating to Health in quarter 3 of 2019-20.  This included a description of factors, which were affecting the services.

The Board was requested to consider the progress and performance information and raise any questions or points for clarification; and highlight any areas of interest or concern for reporting at future meetings of the Board. 

One Member queried the gaps in the homelessness statistics on page 273; these would be available April/May time so would be forwarded to the Board then.  Under Key Performance Indicators for older people, ASC05b, a query relating to the drop in quarter 3 would be looked into by officers and reported back to Members.

RESOLVED:  That the Performance Management Reports for quarter 3 be received.