Agenda and minutes

            The Minutes of the meeting held on 26 September 2023 having been circulated were signed as a correct record.

The minutes from the Health and Wellbeing Board’s meeting held on 5 July 2023 were submitted to the Board for information.

The Board received an update from the Director of Strategy and Partnerships, Warrington and Halton Teaching Hospitals NHS Foundation Trust, on the completion of the project to develop an out-of-hospital Hub to deliver clinical outpatient services from Runcorn Shopping City.

It was announced that Phase 1 of the project had been in operation for almost 12 months and delivered Audiology, MSKCATS, Optometry and Orthoptics services, as well as community health services such as vaccination clinics.  It was noted that in the first 10 months of opening, the Hub had provided services to more than 3000 patients across 3 providers.

Phase 2, the Community Diagnostic Centre, was planned to open in December 2023 and would include audiology, sleep studies, ultrasound, respiratory and phlebotomy services.  Phase 3 would include future opportunities as the Centre had the potential to accommodate additional services, these were outlined.

Members’ welcomed the opening of the Hub and that it had been well received by residents.  The following responses were given to questions:

·         The Active Travel Service pilot was now operating (by Wellbeing Enterprises) and was advertised using social media and distribution of leaflets in the Shopping City;

·         The Wellbeing Service provider was appointed by the Liverpool City Region (LCR) – further information on the process for selecting the provider would follow after the meeting as it was not to hand;

·         The location and accessibility of the Hub for residents was welcomed as it could be used by most patients using public transport;

·         The potential of including more services in the Hub was positive;

·         The Hub did not offer drop-in phlebotomy services (which had ceased in the Borough since Covid-19).  There was, however, a new online booking service currently being trialled at two GP’s surgeries.  Despite this it was felt that a drop-in service would be preferred by many residents – these comments would be fed back to the Trust; and

·         The Musculo-skeletal service at the Captain Sir Tom Moore Building was still available.

RESOLVED:  That the presentation be noted.

The Board received a report of the Chief Executive’s Delivery Unit, which provided an update on ‘The Big Conversation’.

The Big Conversation was about engaging with the public so that they understood the challenges that the Council was facing.  It was an approach between the Council and those who lived or worked in Halton to work together to create an improved Borough in all aspects of everyday life.  A stakeholder analysis and a Communications Plan was developed to generate and establish as many opportunities as possible to involve all stakeholders in many different ways.

Members were advised that to date, a total of 1012 responses had been received; a breakdown of these by source was provided.  The report outlined the promotion, consultation and engagement carried out in the community so far.  The themes emerging from the consultation were also presented and any gaps in responses were highlighted, as well as the actions required to fill these.

It was noted that the consultation ends on 30 November 2023, after which an analysis would be undertaken to identify the key priorities.  January and February 2024 would see final consultation with stakeholders via drop-in sessions and community engagement, prior to the Corporate Plan being finalised in March, ready for its launch in April 2024.

Further to Members questions, it was commented that the exact amount of engagement from the public would not be known until the analysis was carried out in December, after the closing date.  Members were reassured that public access to the survey was via many methods, so that all sections of the population were able to complete this in the format that suited them.

In order to address the low number of respondents from the 16-24 age group, staff had attended: Riverside, Carmel, Priestley and Sir John Deane Colleges; the Linnets and Vikings Clubs; and the Family Hubs in Windmill Hill and Kingsway to encourage people to complete the survey.  Also, social media advertising had targeted this age group and the team had liaised with social workers who encouraged residents they dealt with to complete the survey.  One Member commented that the Holiday Activities and Food (HAF) Programme staff could have been contacted, to encourage responses from residents they dealt with and this was a missed opportunity.

RESOLVED:  That the Board

1)    notes the report; and

2)    continues to endorse the approach to facilitate ‘The Big Conversation’.

The Board received a report and presentation from the NHS Director for Halton Place, which provided an update on Primary Care Access in Halton.

The presentation set out the current position within Halton and also highlighted the Primary Care Access Recovery Programme (PCARP) across Cheshire and Merseyside, including Halton.  Nationally, general practice was delivering more than 1m appointments every day and half a million more every week than pre-pandemic.  GP’s in Halton had delivered almost 705,000 appointments between April 2022 and March 2023 and the service had seen a range of developments which had grown the workforce to meet rising demand and the needs of an ageing population.

Members were advised however, that the pandemic had changed the landscape and the increase in practice capacity needed to keep pace with growing demand.  They were advised of The Fuller Stocktake Report, which built a broad consensus on the vision for integrating primary care with three essential elements: streamlining access to care and advice; providing more proactive, personalised care from a multidisciplinary team of professionals; and helping people stay well for longer.  This remained the intent and was part of the strategic objectives set out for integrated neighbourhood delivery and multi-disciplinary team working within Halton.

The report described the two central ambitions of the PCARP and four areas of focus identified that would support the recovery, in relation to the first element.  Progress would be monitored and reported over the next 12 months and beyond, to ensure that the improvements outlined were as effective as possible.

Following Members’ comments, the following was noted:

·         The percentage of appointments that were provided by GP’s from April 22 to March 23 was 51%.  It was explained that the other 49% of appointments were provided by other practitioners, such as Advanced Nurse Practitioners (ANPs) and other specialist staff, depending on the condition being experienced by the patient;

·         It was planned to have more multi-disciplinary teams at GP’s surgeries  going forward;

·         Certain administration tasks relating to patient appointments were part of a GP’s role due to patient confidentiality;

·         Healthwatch surveys indicated that patient satisfaction rates varied in Halton from poor performing to above average performance – information sharing between surgeries took place so that lessons could be learnt and practices were being encouraged to work together more; and

·         Healthwatch patient feedback received referred to some online systems being patchy – more specific details would be provided following the meeting.

RESOLVED:  That the presentation is received and noted.

The Board received updates and presentations from the Place Director – One Halton, on phlebotomy and musculo-skeletal Services in Halton.

The presentations outlined the latest position for both services for Halton’s patients and gave details of planned increases in service capacity in the future.

It was commented that the wait time for musculo-skeletal service appointments had increased for patients in Halton, this was due to increased demand for the service.

RESOLVED:  That the presentations are received and noted.

The Board considered a report of the Director – Halton Place, which presented an update on the One Halton Partnership.

The One Halton Partnership Board comprised a wide range of members including NHS bodies, local authority bodies (including children’s, adults, public health services) and non NHS/non statutory bodies.  The Partnership Board was the vehicle for delivery of national priorities and Halton’s Joint Health and Wellbeing Strategy.  Achieving One Halton’s ambitions was the responsibility of all partners working together to achieve a set of shared strategic objectives for Halton Place.

The presentation included a recap of the Integrated Care System (ICS) structure; the NHS Cheshire and Merseyside (C&M) Integrated Care Board (ICB); and the Place Based Partnerships.  The C&M ICB key priorities were outlined which included how these aligned to Halton Place priorities.  Officers’ also described the challenges being faced in Halton and gave examples of projects currently being worked on.

RESOLVED:  That the presentation is received and noted.

The Board was presented with the Halton Safeguarding Adults Board (HSAB) Annual Report 2022-23.

It was noted that under the Care Act 2014, Safeguarding Adults Boards (SAB) were responsible for producing an Annual Report, setting out achievements of the SAB and highlighting priorities for the following year.

The HSAB Annual Report had been developed in conjunction with partners, to ensure the report encompassed a multi-agency approach.  The Annual Report included performance data and comparisons between years; achievements in the year and highlighted areas of good practice regarding safeguarding in the Borough.

The Annual Report would be published after approval and shared with HSAB’s member organisations through the SAB Board meetings.

In response to a question, it was commented that there was a 6% increase in the numbers of DoLS applications received last year.  Out of 894 received, 518 of these there were from women.  The fact that there were more older women in the Borough than men could be the reason for this, as well as the fact that some people were just not aware of the Policy, so did not apply.

RESOLVED:  That the Board

1)    note the report; and

2)    approve the Annual Report for publication.

The Board received the Performance Management Reports for quarter two of 2023/24.

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 two of 2023-24.  This included a description of factors, which were affecting the service. 

The Board was requested to consider the progress and performance information; 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 overall the performance data was heading in the right direction with no particular areas that required highlighting.  One Member requested sight of the Suicide Strategy at a future meeting.

RESOLVED: That the Performance Management report for quarter two of 2023/24 be received.