Agenda and minutes

            The Minutes of the meeting held on 24 March 2021 having been circulated were signed as a correct record.

            The Board received a presentation from Lucy Gardner, Director of Strategy and Partnerships at Warrington and Halton Teaching Hospitals, which provided an update on the outcomes of the consultation exercise on the plan to utilise unused retail space in Runcorn Shopping City to deliver a number of clinical services. The plan had been developed by Warrington and Halton Teaching Hospitals NHS Foundation Trust in partnership with the Council and Liverpool City Region. It was noted that to date 254 survey responses had been received and 51% of those had used one of the services that it was proposed could be provided within the retail space.

            It was anticipated that following the period of consultation, the services could begin to be provided in the retail space from October/November.

            In addition the Board received an update on the breast service reconfiguration proposal to the Sir Captain Tom Moore site at Halton Hospital. The consultation process would be completed on 8 July and the results would be shared with Board members.

            On behalf of the Board the Chair thanked Lucy Gardner for her presentation.

            RESOLVED: That the presentation be noted.

            The Board considered a report which provided an update on the amendment to the One Halton Health and Wellbeing Strategy 2017-2022, considering the impact of Covid-19 across the six priority areas and the health inequalities in the Borough. Key data and statistics had also been updated. A copy of the amended Strategy document had been previously circulated to the Board.

            It was noted that the North West had seen higher rates of Covid-19 than England overall and had experienced restrictions over and above national measures as a result. People in more deprived groups were also most affected by control measures and restrictions and would bear the brunt of the economic impact of Covid-19 unless measures were in place to protect them. There had been a fall in income for younger workers and lower earners, with a rise in applications for Universal Credit and Jobseekers Allowance. Any economic downturn would lead to poorer health outcomes across the priority areas.

            RESOLVED: That

1.    The amended strategy be approved for publication and use; and

2.    The Board considers the impact of the Covid-19 pandemic in preparing the next Health and Wellbeing Board Strategy.

            The Board considered a report on the continued use of Lilycross Care Centre which was opened to patient admissions on 11 May 2020 as a response to the regional request for 300 extra community beds to support the anticipated surge of Covid patients at the beginning of the pandemic. The unit was opened to residents in all the boroughs of Cheshire and Merseyside but would primarily focus on the discharges from St Helens and Knowsley Hospitals and Warrington and Halton Hospitals, initially CQC registered as a residential home and subsequently increased its offer to allow patients requiring nursing support.

            The report outlined the designate use of the Centre, the demand for the surge beds and the Covid designated beds, and the level of activity within the Centre during 2020/21.

            The Board was advised that the termination point for the 2020/21 contract with the provider was January with the minimum extension for 6 months which would cover the anticipated summer wave. However the CCG felt that the potential need for the continued additional bed base across the Mid Mersey region justified the potential financial risk and had committed to maintain the facility until March 2022. It was noted that given the current fall in the demand for Covid designated beds there was an opportunity to reconsider the ring fencing of the Covid 16 beds and these were now available for non Covid patients.

            RESOLVED: That

1.    the Board note that the CCG has continued the contract with Lilycross Care Centre for 2021/22; and

2.    the additional community beds available at Lilycross Care Centre support the hospital discharge programmes and provide the designated Covid beds for the borough.

            The Board received a report which presented the new models of support, care, rehabilitation and treatment through the Better Care Fund following the Intermediate Care Reviews. In Halton the review had progressed, incorporating the work and learning from the pandemic and work undertaken from the frailty service.

            The report outlined the proposed reconfiguration 2021/22 and beyond. The substantial work had been completed across partners to develop a new model of care and Appendix 1 set out the agreed pathway and background information. It was noted that:

·         The main body of the Reablement Service remained unchanged;

·         Oakmeadow remained at 19 Intermediate Care Beds in the new model and further work was required on transitional capacity in 2021/22 and beyond; and

·         The block purchase of 500 hours per week of domiciliary care to continue to assist system flow would remain for 2021/22 with a review in the autumn to determine 2022/23 and beyond.

RESOLVED: That the contents of the report and associated appendix.

            The Board received a presentation from Damien Nolan, Divisional Manager – Urgent Care and John Regan, Director, Premier Care Limited regarding Domiciliary Care provision in Halton. The Board noted the background to the new contract arrangements, an overview of the Transforming Domiciliary Care Programme, details of the Pandemic Response and how Premier Care and the Council were continuing to work together to maintain the delivery of high quality services to the local population.

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

            The Board considered a report which provided an update in relation to the proposed arrangements for the One Halton Integrated Care Partnership (ICP) and sought approval to progress the next phase in the development of the place based approach to integrated health and care in Halton.

            In March 2021 the Board delegated responsibility to the local authority Chief Executive to develop the One Halton Integrated Care Partnership (ICP) by engaging with One Halton Partners and Cheshire & Merseyside Health and Care Partnership (also referred to as ICS).

            In May 2021 an informal One Halton ICP Meeting was established on an interim basis to steer One Halton and its partners through a period of change until a formal Halton ICP Board could be established. Through the One Halton ICP meetings, a revised governance structure, Terms of Reference and Memorandum of Understanding had also been developed and copies of these were included in the report.

            The Board noted that whilst the foundations were already in place to progress One Halton to an ICP, work would continue to develop this further over the next 18 months and a summary of the next steps was outlined.

            RESOLVED: That

1.    The report be noted;

2.    The progress made by the Council, NHS Halton Clinicial Commissioning Group and provider partners in establishing a One Halton ICP is noted;

3.    The new governance structure for One Halton is approved (Appendix 1);

4.    The proposed Terms of Reference for the One Halton ICP Board were supported (Appendix 2);

5.    The draft collaboration agreement/Memorandum of Understanding is supported (Appendix 3);

6.    Responsibility for the development and implementation of a Halton Integrated Care Partnership is delegated to the One Halton ICP Board and the One Halton SRO; and

7.    The One Halton Stakeholder Briefing is noted.

            The Board considered a report of the Director of Public Health, which provided a briefing on the Pharmaceutical Needs Assessment (PNA), including risks associated with it and proposed local governance. It was noted that the current 2018-21 PNA remained live and the next PNA must be published by 1 October 2022.

            The report detailed the proposed arrangements for producing Halton’s next PNA. It was proposed to use the current framework developed across Merseyside to produce the next Halton PNA, with some minor amends. This would ensure that although each local authority PNA would be developed locally and differ according to the local area and population, it would be in the same format which would make it easier to use and review.

            The Board was requested to nominate a board-level sponsor with responsibility for the PNA, with the management of the PNA being passed to the local steering group led by public health. The steering group would oversee the operational development and consultation for the PNA, reporting back to the Board for approval at strategic stages of the process, in line with regulations.

            Once the draft PNA was completed this would be submitted to the Board for approval to publish it for the statutory 60-day consultation period. Following the consultation period, a response to each point that was fed back through the consultation process would be provided and any necessary amendments to the document would be made.

            RESOLVED: That

1.    The Director of Public be nominated as the Board level sponsor for the PNA;

2.    The financial risks associated with the PNA be logged through the Council’s risk assessment and register process; and

3.    The establishment of a local steering group to oversee the PNA development process in line with national regulations. This group will report back to the Board on the draft before the statutory consultation begins and make amends to the final version of the PNA following the 60-day statutory consultation.

The Board was provided with an update on the Public Health response to Covid-19 Coronavirus.  

The presentation included the most recent Covid-19 figures and data for Halton; how the Halton Outbreak Support Team 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.

            In summary:

·         Number of cases had increased in Halton over the last 2 weeks;

·         Hospital admissions had also increased slightly but were not as high as the peak in January and February;

·         Overall testing numbers had remained stable as we were delivering a more targeted pop-up offer;

·         Over 90% of those aged 60 and over living in Halton have had both doses of the COVID-19 vaccine;

·         There have been a total of 306 COVID-19 deaths in Halton residents since the start of the pandemic; and

·         An update on the work of the Halton’s Outbreak Support Team was provided.

RESOLVED:  That the presentation be noted.

The Board will receive a presentation from the Director of Public Health, Eileen O’Meara, on the Public Health Annual Report 2020/21.

A copy of the Report can be viewed using the link below:

https://report.haltonbc.info/phar2020/index.html

            The Board received a presentation from the Director of Public Health, on the Public Health Annual Report (PHAR) 2020/21 Each year a theme was chosen for the PHAR and for 2020/21 the Report focussed upon coronavirus. The report took a look back over the last year and reflected on the challenges the whole community faced highlighting the strength and resilience of people in Halton during these very difficult times. The report highlighted the joint working with NHS colleagues in Halton CCG. Bridgewater Community Healthcare Trust. Warrington and Halton Hospital Trust, St Helen’s and Knowsley Hospital Trust and in the community through Halton Voluntary Action and local pharmacies. It also acknowledged the work of Halton Staff, the support of elected members and made recommendations for the remainder of 2021.

            RESOLVED: That the presentation be report.