Agenda and minutes

          The Minutes of the meeting held on 22 March 2023, having been circulated, were signed as a correct record.

          The Board received a report and presentation from the Clinical Development Lead for Care Homes which provided a progress update of the work to date within the Care Home Sector.

Nationally, Nursing Homes across the country required further investment to drive up the standards of care, and to ensure professionals recognised and received recognition for the work undertaken within care homes.  To help do this, the Clinical Lead Development Officer was created and funded via the Cheshire and Merseyside Local Action Board.  The aim of the post aim was to enhance quality within the Care Home Sector focussing on Nursing Care Homes

The presentation outlined:

·       The role of the Clinical Development Lead Officer;

·       Work undertaken to date; 

·       The work plan for the remainder of the 12 month project;

·       Case studies to evidence the positive outcomes of the work undertaken to date; and

·       Future developments. 

RESOLVED:  That the presentation be received.     

          The Board received a presentation from the Place Director – Halton, which provided an update on the One Halton Place Based Partnership. 

The new arrangements for the Integrated Care Systems (ICS) came into effect on 1 July 2023 and the aim was to improve outcomes and reduce health inequalities.  Locally, the One Halton Partnership Board was the vehicle for delivery of national priorities, local priorities and Halton’s Joint Health and Wellbeing Strategy.  Membership of the Board included representatives from Local Authorities, NHS/Foundation Trusts and Primary Care. 

          The key priorities of the Board were to:

·       Improve population health and healthcare;

·       Tackle unequal outcomes and access;

·       Enhance productivity and value for money; and

·       Support broader social and economic development.

The presentation set out the context and provided an overview of progress and the current position.  It also outlined how Halton compared to the rest of the North West and how the challenges in Halton would be addressed.

RESOLVED:  That the presentation be noted.

          The Board received a presentation from the Place Director – Halton, which provided an overview on the current position in relation to access to General Practice (GP) Services in Halton and the National Delivery Plan for recovering access to Primary Care, NHS England.

          Access to GP services is one of the key enablers in supporting residents health and wellbeing.

          The presentation outlined the following key points:

·       Between April 2022 and March 2023, there had been a 29% increase in GP appointments;

·       In March 2023, across the 9 Cheshire and Merseyside Places, Halton had the:

o   second highest number of appointments provided face-to-face;

o   second lowest of appointments provided by telephone;

o   joint third highest % of appointments provided by a GP; and

o   third highest % of appointments provided on the same day.

·       Between April 2022 and March 2023, “Did Not Attend” appointments had increased;

·       The 4 key areas to alleviate pressure and address the increasing demands on Primary Care:

o   Empowering patients;

o   Implementing modern General Practice access;

o   building capacity; and

o   cutting bureaucracy.

The Board discussed the above points and shared experiences of local issues regarding difficulties that residents in Halton had received.  It was suggested that Healthwatch Halton and the Voluntary Sector would be able to gather together some intelligence from local communities about access to GP appointments. 

RESOLVED:  that the presentation be noted.

          The Board received a report and presentation from the Director of Strategy and Partnerships, Warrington and Halton Hospitals (WHH) which provided an update on the WHH Foundation Trust’s Plan for the provision of a Community Diagnostic Centre (CDC) in Halton.

          It was noted that the Plan would be delivered in 3 phases:

1)    Phase 1 - Warrington and Halton Diagnostics Centre at Nightingale building, Halton Hospital site.  All works completed and services fully operational with effect from 26 June 2023;

2)    Phase 2 – Warrington and Halton Diagnostics Centre at Halton Health Hub, Runcorn Shopping City.  Planned to be operational in late November 2023; and

3)    Phase 3 – Warrington and Halton Diagnostics Centre at Captain Sir Tom Moore building, Halton Hospital site.  Planned to be fully operational in Summer 2024.

RESOLVED:  that the Board:

1)    note the report and presentation; and

2)    support the WHH Trust’s plan for the development of the CDC at the Halton site.

          The Board received an update report from the Head of Primary Care (Cheshire and Merseyside) on the Commissioning of Primary Care Dental Services. 

          The report outlined that currently there was 13 dental practices and 2 Urgent Care Plus providers offering urgent dental care for patients that did not have a regular dentist.   Despite ongoing challenges, there was increased activity across Cheshire and Merseyside.  Commissioners were keen to explore the use of Dental Care Professionals i.e. Dental Therapists and Dental Nurses as these could free up Dental Performer time and support access for new patients. 

The report also described the development of a Dental Improvement Plan which was approved by ICB System Primary Care Board in June 2023.  An important part of the Plan was to develop access sessions for new patients across 60 practices in the ICB. 

Commissioners were seeking an additional 30,000 appointments across Cheshire and Merseyside and would link with Local Authorities to identify suitable organisations who work with vulnerable people e.g. the homeless and asylum seekers.  In addition to this, a number of Foundation Dentists would work across Cheshire and Merseyside from September this year.

          The Board acknowledged that the update was encouraging and Public Health asked to be part of future conversations about how children’s dental health could be improved. 

          The Head of Primary Care agreed to:

·       Circulate a copy of the Dental Improvement Plan to the Board;

·       Confirm the number of practices that carry out NHS work; and

·       Provide further updates to the Board in due course.

RESOLVED:  that the report be noted.

The Board received a report and presentation from the Director of Public Health, which provided an update on the development of Halton’s Public Health Annual Report (PHAR).

Each year a theme would be chosen for the PHAR and for this year the focus would be on health improvement and prevention work to support the Halton community with their health in the different stages of their lives, as well as coping with pressures, such as the recent pandemic and the rising cost of living.

The report would use 4 key life stages as a guide to the issues including the following sections:

1)    Start – looking at children’s health and giving children and young people the best possible start to their lives;

2)    Strong – acknowledges busy lives and a range of pressures, needing services to be flexible and accessible;

3)    Live – providing community and work based services that allow people with busy working lives to take action for their health as well as get help when it is needed; and

4)    Well – living healthy and independent lives as we age, reducing impact poor health can have on our health and social care system as well as for individuals.

The Plan also contained some free local offers e.g. mental health for men, free blood pressure checks, free help to stop smoking etc.  It was suggested that the offers be promoted via Halton Housing Trust (HHT) via their magazine that was sent out to tenants.  HHT also agreed to promote and signpost a range of health services, discussed at the meeting, to their tenants during home visits.

RESOLVED: That the theme and development of the PHAR be noted.

          The Board considered a draft version of some updated Terms of Reference which took into account several changes that had occurred since the last refresh in 2019.

          In November 2022, the Department of Health and Social Care set out new guidance for all Health and Wellbeing Board in light of the changes to the NHS, in particular, the establishment of the Integrated Care Boards (ICB) and Integrated Care Systems (ICS).  The guidance was to support the ICB and ICP (Integrated Care Partnership) Leaders, Local Authorities and Health and Wellbeing Boards to understand how they should work together to ensure effective system and place-based working and to determine how best to deliver holistic care and prevention activities in the communities. 

          The Board previously received guidance that set out the functions of the Health and Wellbeing Board in relation to the new strategic partners and the revised Terms of Reference reflected these.

Members of the Board were invited to make any comments or suggestions before the end of July 2023.  A final version of the document would be presented to the Board at the next meeting.

          RESOLVED:  that the Board:

1)    note the refreshed draft Terms of Reference; and

2)    feedback any comments by the end of July 2023.

The Board received a report from the Executive Director of Adult Social Services, which provided an update on the Better Care Fund 2022/23 Year-End return, following its submission on 26 May 2023. The update provided the Board with information on the four national conditions which had been met, progress on the four national metrics, income and expenditure actual, year-end feedback and adult social care fee rates.

          RESOLVED: The Better Care Fund Year-End return for 2022/23 be noted for information.