Agenda and minutes

            The Minutes of the meeting held on 15 February 2022 were signed as a correct record, (noted the meeting scheduled for 28 June 2022 was cancelled).

The minutes from the Health and Wellbeing Board meeting held on 23 March 2022 were submitted for the information of the Board.

The Chair presented the Health Policy and Performance Board’s Annual Report for 2021-22.

RESOLVED:  That the Annual Report be received.

The Board received an update on the proposal to consolidate and expand Breast Screening Services at Bath Street, Warrington, and the impact the proposed service change would have on service users from Halton.

The Board welcomed Lucy Gardner, Director of Strategy and Partnerships and Pat McLaren, Director of Communications and Engagement – Warrington and Halton Teaching Hospitals NHS Foundation Trust, who both delivered the update using a presentation.

The update included a recap of the proposals to reconfigure Breast Services across Halton, Knowsley, St Helens and Warrington; information and data on the usage of the Breast Screening service over all areas; and an update on the proposal to cease Breast Screening services at Kendrick Wing, Warrington Hospital. 

Members were also provided with the outcomes of the public consultation for the second and final phase of the proposals.  The Board welcomed the proposals especially taking into consideration the ageing facility at the Kendrick Wing.  The following additional information was noted following Members’ questions:

·         Halton residents had a local facility at the Captain Sir Tom Moore Building, which was now fully operational offering breast care services to residents of Halton and Warrington; and

·         Further to a question presented at the February meeting, the breast screening uptake in Halton for 2019/20 was 68.6%, which was almost the same as the national figure of 69.1%.

RESOLVED:  That the Board

1)    notes the contents of the report and presentation; and

2)    supports the proposed next steps as described.

The Board received a report and presentation of the Strategic Director of Partnerships, Mersey Care NHS Foundation Trust, which provided information on Mersey Care NHS Foundation Trust’s internal organisational developments and the local performance measures against national standards.

The Chair welcomed Donna Robinson, Tim McPhee and Rachel Mayner, from Mersey Care NHS Foundation Trust, who presented the item. 

The presentation gave an introduction to Mersey Care; introduced the Board of Directors and local structures; outlined Mersey Care Services within Halton – Adult Mental Health Services, ADHD Services, Autism Assessment and Diagnostic Service; Learning Disabilities Services; and introduced the Think Wellbeing Service (IAPT).  The information presented sought to assure the Board of the Trust’s continuous pursuit of excellence within the Borough.

The following information was provided from Members’ questions:

·         The mental health crisis line was publicised mainly using leaflets and social media;

·         A dedicated mental health response team will be available in Halton at the end of October / beginning November, using its own ambulance; this will be mirrored by the Police who will have their own response car dedicated to mental health crisis calls;

·         Once 999 was dialled and a patient in crisis was identified, they would divert the call to the mental health team; if the team was unavailable, a regular ambulance was able to attend and the crew would use the crisis number to make contact with mental health specialists;

·         Members’ recognised that during the pandemic the demands made on the mental health service were unprecedented and remained extremely high to date;

·         Adult autism referrals were also at an unprecedented high level and were predicted to double this year;

·         Mental health practitioners could be placed in GP surgeries (which was trialled successfully in Wigan); this would need to be worked through at a local level to be able to introduce them in Halton.

It was the consensus of the Board that mental health services and learning disability and autism services all deserved more lengthy debate to be able to fully understand the complexities of each.  Donna Robinson invited Members to discuss the situation further and advised that she could be contacted regarding this in the future.

RESOLVED:  That the Board

1)    notes the organisational developments within the Mersey Care Operating model; and

2)    notes the commissioning activity and performance for the Borough against national standards.

The Board received a report from the Director of Public Health, which advised of the launch of the Marmot Report: All Together Fairer written by Professor Sir Michael Marmot on health inequalities.

The report was written by Sir Michael and his team of researchers in partnership with Cheshire and Merseyside’s local authorities.  It set out measurable actions for each area, as well as the sub region as a whole, to create a fairer, equitable society.

The Director’s report summarised the implications of the findings for Halton and presented comparisons with neighbouring authorities across Cheshire and Merseyside.  The report outlined actions still required and gave some examples of actions already taking place, following the publication of the Marmot Report.

It was commented by one Member that the recent rise in the cost of living would only exacerbate inequalities across Halton, particularly in the more deprived wards.  The Board discussed their concerns regarding the health inequalities in life expectancy locally and across Cheshire and Merseyside.  

The Director of Public Health welcomed suggestions from Members that could help to offer solutions in combatting inequalities for the communities in Halton.   Further to a request from the Chair, she would provide Board Members with updated ward information on life expectancy, once this was finalised by analysts.

RESOLVED:  That the report is noted.

The Board considered a report of the Strategic Director – People, which provided an update on the One Halton Place Based Partnership development, within the context of the Cheshire Merseyside Integrated Care System (ICS).

The Health Policy and Performance Board received reports in November 2021 and February 2022 setting out the requirements for the formation of Integrated Care Systems regionally.  This consists of an Integrated Care Board (ICB) and an Integrated Care Partnership (ICP), along with at Place level, a Place Based Partnership (PBP).  Locally, this was the One Halton Place Based Partnership – these arrangements were set out in NHS Reforms White Paper, Integration and Innovation, published in February 2021.

The Board welcomed Mr Anthony Leo, who is the Director of the One Halton Place Based Partnership.  He introduced himself and advised the Board of the aims of the Partnership, particularly in addressing health inequalities that exist across Halton.

The report provided the Board with some context, an overview of progress and the current position of the One Halton Place Based Partnership. 

RESOLVED:  That the Board notes the report.

The Board received the final report of the Scrutiny Review undertaken in 2021/22, titled 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’.

It was noted that the Elected Member Social Care Commission was established as part of a North West ADASS approach to learning lessons from the Covid-19 pandemic.  In particular, the role of the Commission was to investigate the impact of the pandemic on people and communities in the North West and what lessons could be learnt for further waves of infection and future service design.

The report explained how the review was conducted; presented information that was considered by the topic group over the course of five meetings; and gave the actions agreed in relation to each of the ten NWADASS recommendations, which were the focus of the scrutiny topic in terms of looking at local implementation.

RESOLVED:  That the Board

1)    notes the contents of the report and comments made; and

2)    endorses the report and associated actions and recommend the report be submitted to the Executive Board.

The Board received a report from the Strategic Director – People, which requested agreement of the topic brief for the Health Policy and Performance Board’s Scrutiny Group for 2022/23 and the proposed activity schedule for presentations and feed-in to the scrutiny.

Further to feedback from the last Health PPB meeting, a topic was chosen for 2022/23.  It was agreed that this would focus on the current issues around the Adult Social Care Workforce, including looking at workforce planning and development needs.  The Topic Brief and Schedule of Activity were attached to the report and the Board was requested to agree these so the scrutiny group could progress.

RESOLVED:  That

1)    the Topic Brief is approved; and

2)    the proposed activity schedule for the topic group is approved as representative of the input required to fulfil the brief.

The Board received the Performance Management Reports for quarter one of 2022/23.

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 2022-23.  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. 

RESOLVED: That the Performance Management reports for quarter one of 2022/23 be received.