Agenda and minutes

          Subject to noting that David Wilson was in attendance, the Minutes of the meeting held on 25 June 2024 having been circulated were signed as a correct record.

The minutes from the Health and Wellbeing Board’s meeting held on 20 March 2024, were submitted to the Board for information.

Members welcomed Mr Tom Knight from NHS Cheshire and Merseyside, who presented to the Board a report which updated them on dental services in Halton; the local dental improvement plan progress; and the publication of the national dental recovery plan. 

It was reported that access to dental care remained one of NHS Cheshire and Merseyside’s key priorities.  However, access to NHS dental services was impacting negatively on patients on a local, regional and national level.  Many performers on NHS contracts had switched from providing NHS care to private care, resulting in national workforce challenges.  This was due to the NHS contract no longer being an attractive option both professionally and financially.

The report described how the NHS Cheshire and Merseyside Dental Improvement Plan 2023-34 facilitated an increase in access from 2023-24 and led to a number of providers offering urgent care and urgent care plus.  Additionally, a pathway was created for looked after children and vulnerable patients such as those receiving cancer treatment.

The Cheshire and Merseyside Dental Improvement Plan 2024-26 was presented to the Board.  The local plan would focus on five key pathways which focussed on routine access for all; these were explained in detail.  It was reported that under the New Patient Premium and Golden Hello incentives within the National Dental Recovery Plan, Halton had 4 practices and one practice respectively, opting into the schemes.

Member’s questions were taken and the following additional information was provided:

·       Under the New Patient Premium scheme patients would be seen as they usually were, so based on their individual health needs.  Some patients attended every 6 months, some every 12 months;

·       One Member shared the experience of one of her constituents with a  child who was turned away from a dentist in an emergency – further information would be provided to Mr Knight following the meeting;

·       The NHS had no jurisdiction over private practice;

·       The dentists in Halton who were included in the above schemes must advertise on their websites when space becomes available for new patients;

·       The numbers of NHS dentists lost across Cheshire and Merseyside was considered alarming; Mr Knight would check the numbers lost in Halton since his last visit to the Board;

·       As mentioned above two of the main challenges were the numbers of dentists leaving the profession and the unattractiveness of NHS contracts; and

·       The Cheshire and Merseyside Dental Improvement Plan 2024-26 included looking at different types of contracts for dentists and also other staff such as hygienists and nurses.

RESOLVED:  That the report is noted.

The Board considered a report from the Executive Director, Adults, which provided recommendations for several amendments to be made to the Property Pool Plus (PPP) Policy, and provided some background and rationale for the recommended policy changes.  

The Board was advised that in 2020 the PPP partner scheme local authorities (Halton, Knowsley, Liverpool City, Sefton and Wirral) undertook a review of the jointly administered PPP housing allocations policy, which resulted in the approval and implementation of a revised PPP policy and upgraded IT system.  The revised policy was implemented in January 2024.

The report outlined the recommended changes and rationale for these (two in particular); changes to qualification criteria; corrections and minor changes; and amendments to the discretion criteria.

It was reported that to further ensure that the Policy was compliant with new legislation and to seek views on the recommendations, a 12 week formal consultation process would begin.

One Member raised concerns over what he felt was a poor relationship between the Registered Providers and the Council and he was disappointed with the PPP partner scheme.  He gave examples of some complaints he had received from residents regarding the poor condition of some properties on Castlefields.  After receiving complaints from people on the waiting list, he felt the allocations of properties was flawed in some way.

With regards to those clients without online access, it was explained that housing officers were available to help customers to register.  There were also drop in sessions for customers and in some cases home visits were made.

RESOLVED:  That

1)    the Board notes the report and Policy; and

2)    the majority of the Board endorse the consultation process.

The Board welcomed the Director of Public Health (DPH), who presented the Public Health Annuary Report (PHAR) for 2023-24 – Healthy Start, Healthy Future.

The PHAR was an important vehicle by which a DPH could identify key issues, flag problems, report progress and therefore, serve their local populations.  It is also a key resource to inform local inter agency action and remained a key means by which the DPH was accountable to the population they served.

For the year 2023-24 the PHAR focussed the impact of empowered young people who had embraced key messages from the Personal, Social and Health Education (PHSE) curriculum, who were inspired to promote change within their school community.  The children and young people were supported to make this change through the work of the Healthy School's Team in collaboration with schools and their partners.  The Public Health Team's Healthy Schools Program worked with schools and colleges to help create a healthy school environment that built lifelong health enhancing habits.  

This culminated in an event where the different programmes that they had developed were shared and their contributions celebrated. 

The PHAR highlighted some of the key health challenges as well as some of the ways that the healthy schools programme tackled these.  Members were referred to the case studies presented with some of Halton’s schools and the different areas of focus such as obesity, vaping, intergenerational initiatives (care homes), young health champions and wellbeing.

The challenges being faced with children and young people taking up vaping were discussed.  The dangers of vaping were still unknown but concerns were raised around the ‘normalisation’ of using vapes and that they were considered to be a safe alternative to cigarettes.  Their misuse, by non-smokers, was on the increase by children and young people, which was a concern for all.

One Member suggested that a video be made by young people, aimed at young people (peers) warning of the dangers of vaping, as a way of communicating this message, which could be played in schools. 

The Board welcomed the Annual Report and supported the recommendations made.

RESOLVED:  That the Board

1)    notes the contents of the report; and

2)    supports the Public Health Annual Report's recommendations

The Board received a report and presentation from the Director – Halton Place, NHS Cheshire and Merseyside, on the utilisation of mental health beds for Halton residents.

The presentation gave details on:

·       the type and number of adult mental health inpatient commissioned beds for Halton residents;

·       utilisation of commissioned beds and any out of area placements;

·       services commissioned to support patients to safely remain in the community, reducing avoidable admissions, providing better quality and outcomes for local people; and

·       the challenges faced in ensuring local people were able to access inpatient mental health beds locally, when they needed them. 

To provide some context to the total number of adult bed days, numbering 14,890, this was equivalent to a total of 40 beds available in Halton each day.  The Board was provided with information on the numbers of adult mental health bed days utilised in Halton, in comparison to other Mersey Care locations.  The same was provided for older adult bed days.

It was commented that the Council’s Mental Health Teams struggled to access these beds at times; this would be discussed at the next ICB meeting.

For its next steps, it was reported that NHS Cheshire and Merseyside was implementing a Mental Health System Flow Programme in 2024-25.  This was intended to reduce the numbers of patients waiting in a community setting for admission to a hospital bed; to reduce the numbers of patients waiting in acute hospital emergency departments for discharge into the community or to a mental health inpatient bed; and to reduce the number of patients who were clinically ready for discharge in mental health in-patient settings.

RESOLVED:  That the Board note the contents of the report and presentation.

The Board received a report from the Director of Legal and Democratic Services, which introduced proposed revisions to the Joint Health Scrutiny Arrangements, which were in operation across Cheshire and Merseyside.

The revised draft was attached at Appendix one, with the proposed changes highlighted in yellow.  The Board was requested to endorse the revised arrangements and recommend it to Council for approval.

Following one query, the Board was advised that no notifications had been received from the new Government regarding any further revisions to the arrangements.

RESOLVED:  That the Board

1)    notes the report and Appendix; and

2)    endorses the revised Joint Health Scrutiny Arrangements and recommends it to Council for approval.

The Board received the Performance Management Reports for quarter one of 2024/25.

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 one of 2024-25.  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. 

Key developments within the report were welcomed.  It was noted that some of the data was incomplete as it was only available up to the end of May due to the transfer from the Carefirst reporting system to the Eclipse reporting system and some data would not be available until October.   

RESOLVED: That the Performance Management report for quarter one of 2024/25 be received.