Agenda and minutes

            The Minutes of the meeting held on 24 November 2020 having been circulated were signed as a correct record.

The minutes from the Health and Wellbeing Board meeting held on 7 October 2020 provided for the information of the Board.

RESOLVED:  That the minutes be noted.

The Board considered a report, which advised Members on the proposed reforms regarding integration of health and social care.  The Chair welcomed Jackie Bene (Chief Executive) and Alan Yates (Chair) from the Cheshire and Merseyside Health and Care Partnership (C&MHCP), who presented the item.

The guests advised the Board of the national development of the integrated framework and the local application of this framework across Cheshire and Merseyside, and how these two matters were linked. 

Members were referred to Appendix one which highlighted some consultation responses to the proposals from the Liverpool City Region (LCR) and Appendix two, which gave some examples of points for consideration at the meeting today.

In response to Board Member’s queries and concerns on the proposals, the following information was provided:

·         The framework would allow local authorities to make their own arrangements at a local level.  The main body pulling together plans for Halton would be the Health and Wellbeing Board (HWBB), in partnership with other agencies, who would represent the health needs of the local population;

·         Each local authority would have a representative on the overarching Board, eg the Chair of the HWBB;

·         There will be opportunity at a local level for challenging the arrangements alongside  partners;

·         It was noted that there were omissions in the Paper and lack of detail around social care and care homes, but this could be developed at a local level with flexibility to suit need;

·         The ‘Discharge and Assess’ model was seen as preferable to assessing then discharge, which was highlighted during the Pandemic;

·         ‘One Halton’ would remain the driving force for Health reforms in Halton;

·         A reliable IT system that worked for all was imperative to the success of the integration as so many users will be involved;

·         It was recognised that strong relationships between communities, agencies and the local authority was important to develop deep knowledge of local people and this ethos would be supported under the new framework;

·         It was hoped that in 3 years time the integrated programme would result in better partnership working, improved health of the local population, reduced inequalities and an overall improved service for the benefit of the population of Halton.

RESOLVED:  That the report, appendices and comments made be noted.

The Board received a report and supporting presentation from the Public Health Department, on the most recent data on COVID-19, including an update on Halton outbreak support team activity and the most recent information on testing and vaccination for the people in Halton.

Following Members questions the following was noted:

·         The Public Health Team had been working alongside the Environmental Health Team in relation to work place safety for employees and support and guidance had been provided to them.  A paper had been sent from Halton to the Department of Health with recommendations which may help with reducing outbreaks in work places;

·         Daresbury Ward showed a higher infection rate which could be attributable to the high number of work places situated there on sites such as Daresbury Sci-Tech and Manor Park; and

·         Testing in schools had begun in readiness for 8 March.  Although Covid-19 infection rates amongst children in schools were low, all the required safety measures would be in place to protect children and staff.

On behalf of the Board the Chair thanked the Public Health team for their hard work for the people of Halton, at this unprecedented time.

RESOLVED:  That the presentation be noted.

The Board received a report from the Strategic Director – People, which provided an update regarding population mental health prevention work that had been taking place during the Covid-19 Pandemic, including suicide prevention.

It was reported that mental health population involved an upstream approach targeting the majority of the population to keep people well.  It used a whole systems approach to improving mental health and wellbeing and involved working in partnership with both statutory and voluntary organisations.  The Health Improvement Team led on this area of work which fell into the following categories:

·         Developing the workforce and communities;

·         Tackling stigma and increasing awareness of support available;

·         Supporting organisations to make positive changes in how they operate; and

·         Suicide prevention.

The report provided detailed commentary and data on the work and activity carried out within each of these categories since April 2020. 

RESOLVED:  That the report be noted.

The Board considered a report from the Strategic Director – People, which provided an update on Halton’s Intermediate Care (IC) Services Review and progress towards the development of a new model for Intermediate Care in the Borough.

It was reported that in 2019, Halton commissioned a review of IC Services which included: an independent review via the Local Government Association (LGA) (this was attached at appendix 1); a North West Association of Directors of Adult Social Services (NWADASS) Peer Review (attached at appendix 2); and an ‘Organisational Raid’ to Rochdale, to view the service pathways and models operating in the Borough.

The Board received a summary of the recommendations/issues in relation to IC services in Halton resulting from the review.  Members were advised that following this an action plan was developed with a system wide oversight group and various work streams had commenced, including work on reviewing the IC criteria and associated pathways and a case for change in respect to a future model for the delivery of IC services in Halton.  It was noted that this work was paused in March 2020 due to the coronavirus pandemic; the report outlined the impact of this on the action plan.   The new IC model was also discussed, particularly with reference to the benefits of the Single Point of Access (SPA) and its Rapid Response Function (RRF). 

One member provided positive feedback on the Frailty Team and commented that it was hoped to make this service long term.  With regards to the training of Domiciliary Care staff at Warrington and Halton hospitals, this had ceased due to the progress of the new model.  Comments made at the peer review with regards to the availability of information for the general public was picked up and a communications plan would be included on the action plan.

RESOLVED:  That the report and appendices be noted.

The Board considered a report which highlighted the key issues with respect to the impact of Covid-19 on safeguarding in care homes.

It was noted that the current global Covid-19 Pandemic was unprecedented and the impact for individuals, families, communities and wider society was significant and long lasting.  It had touched every part of people’s lives and had required individuals and organisations to adapt to new daily interactions, social distancing, shielding, undertaking assessments by phone or using digital solutions to continue essential business.  Further, many of the existing protective factors in the lives of adults at risk of abuse and harm had been temporarily absent or limited. 

Members received information on the significant and sustained impact Covid-19 had had on the care home and domiciliary care sectors, for both residents and staff.  It was noted that a Care Home Resilience Group had been established, chaired by the Director for Adult Social Care, which oversees work undertaken by all partners within the Borough in relation to care homes.

It was commented that nationally there was concern over the number of vacancies in care homes and the viability of some because of this. The situation was being monitored in the Borough.

RESOLVED: That the report be noted.

The Board considered a draft Topic Brief for the 2021-22 Scrutiny Review, looking at local implementation of the recommendations from the North West Association of Directors of Adult Social Services (NWADASS) Elected Member Commission report into ‘The impact of Covid-19 on People with Care and Support needs, their Families, Carers and Communities’.

The Board agreed the Scrutiny Review topic and all Members were invited to participate.  The meetings would commence in March 2021 and a schedule would be sent to the Board following the meeting.

RESOLVED:  That

1)    the Scrutiny Review topic is approved; and

2)    all Members of the Board are invited to participate in the review.

The Board received the Performance Management Reports for quarter 3 of 2020-21.

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 2020-21.  This included a description of factors, which were affecting the service.  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. 

It was noted that some areas within the report were not being collected at this time as some metrics were in the process of being changed by central Government.  Adult Social Services saw no significant changes from last year and were on currently on target.

RESOLVED:  That the quarter 3 performance management reports be received.

Members made statements on the hard work and dedication of Council staff, Public Health staff and Council Partnership staff and many others working in Halton’s communities during the Pandemic.  Members had been approached in the community and received positive feedback many times, with the public expressing their thanks and appreciation for the help they have received. 

The Board wished to congratulate and thank everybody involved for their dedication to their jobs and the communities of Halton.  They stated that they were very proud of the work carried out over the past year, in these extremely challenging times.