Agenda and minutes

            The Minutes of the meeting held on 23 November 2021 were signed as a correct record, subject to noting that Councillor Bevan had submitted her apologies prior to the meeting.

The minutes from the Health and Wellbeing Board meeting held on 6 October 2021, were attached for the information of the Board.

The Board considered a report from the Clinical Chief Officer – NHS Halton and NHS Warrington CCGs and the Director of Strategy and Partnerships – Warrington and Halton Teaching Hospitals NHS Foundation Trust (Lucy Gardner in attendance), notifying them of the proposal to consolidate and expand Breast Screening Services at Bath Street, Warrington, by relocating Breast Screening Services from the Kendrick Wing at Warrington Hospital.

The report provided some general data relating to patient numbers on the service provided across the four Boroughs – Warrington, Halton, St Helen’s and Knowsley.  The Board was advised that Phase 1 of the Breast Service reconfiguration was complete and the Breast Assessment and Symptomatic Clinics had been relocated from Warrington Hospital to Halton Hospital’s Captain Sir Tom Moore Building, where a new £2.1m Breast Centre had been created on the ground floor. 

Phase 2 was now in progress and Lucy Gardner described to the Board the public consultation process that was required for the consolidation of the Warrington Breast Screening Service at Bath Street.  A methodology plan was appended to the report for Members information, which included the timescales involved. 

The following was noted after Members’ questions:

·         Attendance at a breast screening clinic was purely voluntary – not all patients who were invited attended their appointment;

·         Halton was still on a 3 year cycle of appointments and these were currently on track; and

·         The consultation would be shared with Healthwatch.

Members queries relating to comparisons with local and national attendance figures and a breakdown of the makeup of the 36 patients attending the Kendrick Wing would be sent following the meeting, as the information was not at hand.

RESOLVED:  That the Board

1)    notes the report; and

2)    supports the deployment of the consultation plan, as described.

The Board considered a report from the Chief Commissioner for Halton, which provided an update of Primary Care Services in the Borough and the improvement plans in place.

The Board welcomed Dr David Wilson from Grove House Partnership and Denise Roberts, Deputy Chief Nurse: NHS Halton CCG, who gave a presentation in support of the report, which showed some general practice and out of hours access data.  This included the total number of consultations (face to face, on the telephone and e-consultations); data relating to NHS 111 calls passed to the GP Out of Hours service; and activity at the Urgent Treatment Centres, between August 2019 and December 2021.

It was reported that the NHS England and NHS Improvement (NHSEI) had provided additional Winter Access Funding (WAF) to support a local Primary Care Winter Access Plan.  The local plan includes four elements (below) and these were outlined in the report:

·         Expansion of General Practice appointments;

·         Consistent offer across all Halton Practices for urgent/same day appointments;

·         Data validation and improvement plans; and

·         Community pharmacy consultation scheme.

Further to the information presented, the following comments/queries were made:

·         Some Members felt the information given did not reflect what they were hearing in the community from constituents, for example experiencing long waiting times on the telephone when trying to get through to a surgery to make a doctor’s appointment;

·         The above scenario often forced patients to use A&E and others just gave up, meaning a diagnosis could be missed;

·         Not all patients needed to see a GP and were triaged to other services; the resources were in place but it was difficult to change peoples’ mind-set that they must see a GP;

·         There were concerns that some clinicians and other hospital staff would leave their professions or reduce their hours due to demands made upon them over the past couple of years resulting from the impacts of Covid-19;

·         All surgeries were contractually obligated to offer e-consultations – links to these were available on practice websites and the NHS App also leads  the user to the e-consultation link.

RESOLVED:  That the Board receives and notes the update provided.

The Director of Public Health and Protection provided the Board with an update on the Public Health response to Covid-19 Coronavirus.  

The update and accompanying presentation included the most recent Covid-19 figures and data for Halton; how the Halton Outbreak Support Team (HOST) were working to successfully identify and manage local outbreaks; and gave details of the most recent information on testing and vaccination for people in Halton.

Responses to Members questions were given and the following additional information was provided:

·         It was accepted that not all people who tested positive reported this to the NHS but took it upon themselves to isolate and do the right thing;

·         Eventually the virus would move to an endemic stage and testing would cease for those without symptoms;

·         A booster vaccination was needed in order to prolong the protection period of two vaccinations and reduce the risk of serious illness and/or hospitalisation;

·         There was a plan to vaccinate vulnerable 5 to 11 year olds before the general population;

·         Deaths caused by the virus in Halton totalled 375 – a comparison with other boroughs’ would be included in a report at a future meeting; and

·         When the Government do eventually cease all restrictions, schools would be supported as they were now and be encouraged to continue with Covid learned behaviours and the use of PPE.

            RESOLVED:  That the update be received.

The Board received an update from the Strategic Director – People, HBC and the Chief Commissioner, NHS Halton CCG, on the One Halton Place Based Partnership development with Cheshire Merseyside Integrated Care Board (ICB) and Integrated Care Partnership (ICP).

Further to the report to the Board in November 2021 where the requirements for the formation of Integrated Care Systems regionally and an Integrated Care Partnership at Place level was discussed, these were detailed in NHS Reforms and now set out in the White Paper Integration and Innovation, published in February 2021, and would build on the NHS long term plan.

Appended to the report was a Development Advisory Group briefing, dated 5 January 2022, which gave details of the new target date of 1 July 2022 for the statutory arrangements to take effect and ICBs to be legally and operationally established. 

The briefing also contained information on recruitment to senior roles, a Covid-19 update and responses to key questions that had been raised.  A response was provided to the Chair’s query regarding funding arrangements and whether they would be pooled or aligned, as discussed in paragraph 3.7.

RESOLVED:  That the report be noted.

The Board considered a report of the Strategic Director – People, which provided an update on safeguarding in Halton.

The report outlined the impacts of Covid-19 on individuals, families, communities and wider society and how it had touched every part of people’s lives and that many of the existing protective factors in the lives of adults at risk of abuse and harm had been temporarily absent or limited.

The impact of the Pandemic on care homes and domiciliary care sectors was discussed, for both residents and staff, as well as the potential for compassion fatigue, and emotional and physical stresses amongst those continuing to provide support. 

It was also reported that the implementation of the Liberty Protection Safeguards (LPS), the replacement for Deprivation of Liberty Safeguards (DoLS), had been delayed further.  Members were advised that since writing the report, a new date for its implementation had been scheduled for April 2023.

RESOLVED:  That the report is noted.

The Board received an update on the Homelessness Service provision and activity during the Covid-19 pandemic.  This included future service development, highlighting agency engagement and activity towards reducing homelessness within the Borough.

As with the previous update it was announced that the Ministry of Housing Communities and Local Government (MHCLGH) issued guidance to all Local Authorities, designed to ensure that everyone known to be rough sleeping, or those deemed to be at imminent risk of rough sleeping, would be offered accommodation.  Its purpose was to protect vulnerable clients from the risk of contracting Covid-19, with additional funding made available to support the response; Halton was allocated a total of £6,000.

The report outlined Halton’s response to the pandemic and the Housing Solutions Team’s robust approach to tackling homelessness and meeting the needs of vulnerable homeless clients.  Data relating to the usage of commissioned provision and numbers of clients was also presented.

In relation to future activity, information was provided on rough sleepers, domestic abuse, armed forces personnel, prison release clients, the refugee resettlement programme, agency support, substance misuse support service and Government funding.

In response to Member’s questions, Officers provided the process a person should follow if they were at risk of eviction and the steps the Council would take to assist and provide advice to them.

RESOLVED:  That the report is noted.

The Board received a report of the Strategic Director – People, which presented proposals for scrutiny topic areas for the 2022-23 review.

It was noted that the 2021-22 scrutiny review: North West Association of Directors of Adult Social Services (NWADASS) Elected Member Commission: The Impact of Covid-19 on People with Care and Support Needs, their Families, Carers and Communities, was still underway.  The final recommendations from this had been delayed due to pandemic related issues, but the final report would be included on the June agenda.

It was agreed that despite this delay a topic group for 2022-23 should still be identified, so the necessary arrangements could be put in place.    As part of Member involvement in the current business planning process, a range of topic ideas had been identified for consideration:

1)    Approaches to Adult Social Care Workforce Planning;

2)    Provision of Learning Disability Services in Halton; and

3)    Skills and Training Opportunities for Social Care Provider Staff.

Members discussed these proposals and a suggestion was made to link numbers one and three together, this was agreed.  An outline brief for the topic areas would be brought to the next Board meeting in June for final approval.

RESOLVED:  That the Board agrees

1)    ‘Approaches to Adult Social Care Workforce Planning’ and ‘Skills and Training Opportunities for Social Care Provider Staff’ be selected as the topic group for the year 2022-23; and

2)    all Members of the Board were invited to join the membership of the topic group.

The Board received the Performance Management Reports for quarter three of 2021/22.

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 three of 2021-22.  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 commented that due to some data no longer being required and some being reported annually, the format of the reports required changing; this would be looked at for future reports.

RESOLVED: That the quarter three Performance Management reports be received.