Agenda and minutes

Health and Wellbeing Board - Wednesday 11th March, 2020 2.00 pm

Venue: Town Hall, Bootle

Contact: Amy Dyson  Democratic Services Officer

No. Item


Apologies for Absence


Apologies for absence were received from Andrew Booth and Richard Freeman.



Minutes of Previous Meeting pdf icon PDF 119 KB




That the Minutes of the meeting held on 4 December, 2019 be confirmed as a correct record.



Declarations of Interest

Members are requested at a meeting where a disclosable pecuniary interest or personal interest arises, which is not already included in their Register of Members' Interests, todeclare any interests that relate to an item on the agenda.


Where a Member discloses a Disclosable Pecuniary Interest, he/she must withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest, except where he/she is permitted to remain as a result of a grant of a dispensation.


Where a Member discloses a personal interest he/she must seek advice from the Monitoring Officer or staff member representing the Monitoring Officer to determine whether the Member should withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest or whether the Member can remain in the meeting or remain in the meeting and vote on the relevant decision.



No declarations of any disclosable pecuniary interests or personal interests were received.




Sub Group Updates pdf icon PDF 72 KB

Report of the Director of Public Health

Additional documents:


The Board considered the report of the Director of Public Health that provided an update and a summary of activity from the five identified sub-groups:


1.    Update from Health Protection Forum, last meeting held in December 2019

2.    Health and Wellbeing Executive

3.    Special Educational Needs and Disabilities Continuous Improvement Board (SEND CIB)

4.    Children’s and Young People’s Partnership Board

5.    The Adults Forum




That the report be noted.



Improving Partnership Communications pdf icon PDF 79 KB

Report and Presentation by the Head of Strategic Support


The Board received a presentation from Elena Lloyd, Corporate Communications Manager, Sefton Council and Lyn Cooke, Head of Communications of Engagement, CCGS in Sefton, regarding the combined Health and Wellbeing communications strategy.


The Presentation outlined the approach to developing a communications strategy in order to support the work of the Health and Wellbeing partnership in Sefton. The views and support of members of the board was sought and the next steps were set out regarding the development of the strategy.


The proposed approaches of the presentation included:


·       Review existing strategies and key messages to start developing an overarching narrative

·       Look at examples of best practice

·       Mapping existing communications

·       Creating a communications working group for Sefton

·       Development of a Communications Strategy and Action Plan




(1)           the proposed approach to the development of the Communications Strategy, including a development session for members, be approved;


(2)           the development of a communications working group and nomination of a communications and engagement representative from each organisation to participate in a Communication Working Group be approved;

(3)           a review of the draft Communications Strategy at the June 2020 Health and Wellbeing Board and its adoption, subject to required updates, be agreed; and

(4)           it be noted that there will be a review of the agreed Communications Strategy in June 2021.



SEND Continuous Improvement Plan Update pdf icon PDF 231 KB

Report of the Interim Director of Children's Social Care and Education

Additional documents:


The Board considered the report of the Head of Strategic Support updating on the SEND Continuous Improvement Plan.


The report updated the board on actions taken and progress made with regard to the improvements required following the Ofsted and Care Quality Commission Joint Local area special educational needs and/or disabilities (SEND) revisit.


The report detailed the key actions and responses being taken:


·       to improve the poor progress made from starting points by pupils with a statement of special educational needs or an EHCP at Key Stage 2;

·       to increase the use of Personal Health Budgets (PHB) as part of EHCPs;

·       to improve the lack of awareness and understanding of Health Professionals in terms of their responsibilities and contribution to EHCPs;

·       to address the weakness of co-production with parents, and more generally in communications with parents; and

·       to address the weakness of joint commissioning in ensuring that there were adequate services to meet local demand.




(1)           the performance information at Appendix A in conjunction with the information in the report be approved;

(2)           it be noted that changes had now been introduced which meant many of the action plan objectives were being met plus where required appropriate remedial actions were in place;

(3)           it be noted that the impact of some of the changes made required confirmation;

(4)           it be noted that the completion of reviews remained a risk, and the remedial action being taken be endorsed;

(5)           the feedback from parents and carers and the draft report and baseline for KPI4/1/2/3/4/5/6 be approved;

(6)           the draft Joint Commissioning Strategy and the Joint Commissioning Strategy and associated action plan for SEND be approved; and

(7)           the progress against the SEND improvement plan be approved and shared with the Cabinet at the earliest opportunity.



Children and Young Peoples Plan 2015- 2020 - Priority One – Yearly review of Educational Attainment level pdf icon PDF 79 KB

Report of the Head of Education

Additional documents:


The Board considered the report of the Interim Head of Education on the Yearly review of Educational Attainment Level  as part of Priority One of the Children and Young People’s Plan. 


The Health and Wellbeing Board had previously requested a focus on the progress against the four priority areas of the current Children and Young People’s plan. In June 2019 the second update was received by the board which presented progress against priority 1, giving each child a positive educational experience. At this meeting the board requested an updated review be brought back to the Board at its March meeting.


The report included an analysis of the local Secondary education offer at Key Stage 4, including Special schools and 14-16 provision in the FE sector. This was made up of performance summaries for Key Stage 4 attainment, progress and GCSE levels as well as educational performance data and numerous info-graphs regarding Sefton schools in the North, Central and South localities. The report also included analysis of the local post-16 curriculum offer to meet a diverse range of needs and facilitate progression to positive destinations at the end of key stage 5, detailed through data and info-graphs.




That the report be noted.




Health and Wellbeing Strategy Delivery pdf icon PDF 85 KB

Report of the Director of Public Health


The Board considered the report of the Director of Public Health that detailed the Health and Wellbeing Strategy Delivery.


The report detailed the way in which the Board would see the 2020-2025 Health and Wellbeing Strategy for Sefton be delivered and measured.


The report included the Strategy of the Health and Wellbeing Board footprint of Sefton, taking place from 1st April 2020. It detailed the Delivery of the Strategy through a number of local plans, strategies and boards including oversight over said delivery. It also included a Performance Framework on measures, focuses and future presentations.




That the Health and Wellbeing Strategy Delivery, as detailed within the report, be approved.



Adult Safeguarding Annual Report pdf icon PDF 98 KB

Briefing Paper to the Adult Safeguarding Annual Report

Additional documents:


The Board considered the report of Joan Coupe, Safeguarding Adults Co-ordinator and Deborah Butcher, Head of Adult Social Care who presented the Adult Safeguarding Annual Report.


The report contained a foreword from the Chair of the Merseyside Safeguarding Adults Board (MSAB) detailing the role of the Board, its relevance to Sefton and the surrounding area, its commitment to keeping adults safe from abuse, exploitation and harm and thanks to the Members, Sub-Groups and individuals who helped to collate the report.


The report included information about the Board, its members and its role in the community regarding  safeguarding adults who were at risk of abuse or neglect as well as being committed to effective communication between communities, professionals and partners in developing effective safeguarding for those at risk.


The report described the Voices Project, a 12-month project commission by MSAB in collaboration with the Healthwatch Teams in Knowsley, Liverpool Sefton and Wirral. It detailed the aims, activities, analysis and recommendations of the project.


The report included numerous info-graphs regarding safeguarding data in Sefton and the surrounding area.


The report detailed the achievements and further aims of its subgroups:


·       (Four Individual) Safeguarding Adults Review Groups

·       Communication and Engagement

·       Policy, Procedure and Practice

·       Quality Assurance

·       Performance and Audit

·       Workforce Development


The report finally detailed its priorities from 2018-2020:


·       Voice of the Service User and Front-Line Staff

·       Assurance and Challenge

·       Safeguarding Adult Reviews (SARs)

·       Effective Communication

·       Effectiveness of the Board


Councillor Cummins, Cabinet Member - Adult Social Care, indicated Sefton was withdrawing from the Merseyside safeguarding arrangements to re-establishment of localised borough arrangements.




(1)       the report be noted; and

(2)       the comments of the Cabinet Member - Adult Social Care be noted.



Changes to Pharmacy Service Provision pdf icon PDF 80 KB

Report of the Director of Public Health


The Board considered the report of Director of Public Health which detailed the NHS England Notification of Changes to Pharmacy Service Provision arrangements. The report explained that the Health and Wellbeing Board had legal duties as part of assuring continuing adequate pharmacy service provision in their area. NHS England formally provided notification to Health and Wellbeing Boards regarding changes to pharmacy provision.


The report set out the Board’s duties in this area and recommended arrangements whereby the formal process was delegated to the Chair of the Board and the Director of Public Health outside of formal Board meetings.




That NHS England Notifications of Changes of Pharmacy Provision arrangements be delegated to the to the Chair and Director of Public Health.




Primary Care Networks Presentation

Presentation by Tracy Jeffes, Director of Corporate Services, Southport and Formby CCG


The Board received a presentation from Tracey Jeffes, Director of Place - South Sefton CCG.


The presentation covered:


·       The context for Primary Care Networks (PCNs)

·       What Primary Care Networks were

·       National Policy for PCNs

·       PCN relevance to local plans and priorities

·       PCNs in Sefton

·       Initial Priority Areas



Tracey Jeffes summarised by emphasising the role PCNs had in improving the health and wellbeing of local people:


PCNs were new and needed time to develop, however they presented a significant opportunity to strengthen the collective ambition to support the sustainability of general practice, integrate care and improve the health and wellbeing of local people.


The presentation detailed the need to focus on the following to work with all HWBB partners:


·       Intelligent planning for delivery of specifications and individual PCN plans tailored to needs of each area to ensure sustainability of General Practice services.

·       Recruitment to additional roles

·       Building on early successes e.g. further development of integrated care teams including social care link workers across all PCNs

·       Clear, co-ordinated approach to the development of “Team 100”, understanding the contribution of all health, care and wellbeing partners

·       Connecting with our communities in a coherent way with all partners




That Ms. Jeffes be thanked for her presentation.



Integrated Commissioning pdf icon PDF 445 KB

Report of the Interim Director of Adult Social Care


The Board received the report of the Interim Director for Adult Social Care on the subject of Integrated Commissioning.


The report detailed current policy context, national and regional best practice, progress around the previous Making Integration Happen strategy 2016-2020, future proposals for integrated commissioning and the main outcomes to be affected through its successful implementation.




(1)           The commencement of the programme of work set out in the report be approved; 

(2)           The provision of governance and oversight by the Health and Wellbeing Board be approved;

(3)           The request for the subsequent decision making to be made by the Cabinet Members for Health and Wellbeing, and Adult Social Care and Children, Schools and Safeguarding be approved.



GP Appointment Availability pdf icon PDF 94 KB

Report by the Clinical Commissioning Group

Additional documents:


The Board received a report from the CCG regarding inequality of provision of GP services across Sefton Borough, both in the number of GP appointments and the quality of GP provision.


The report addressed the difficulties when trying to compare one GP practice with another due to variations in:


·       Practice size, individual circumstances and deprivation

·       Workforce

·       Varying access models and mode of appointments

·       Different timescales when pre-booking appointments

·       Varying lengths of GP appointments offered

·       Differing levels of patient demand and appointments where patients ‘do not attend’


The report described how the  online access a system called E-consult had been implemented and that patients could consult with their GP practice by completing an online form. The response time was usually between 24 or 48 hours and promoted self-help and the use of pharmacies. It had been rolled out to GP practices in 2019/20 with varying levels of mobilisation and usage. Both CCGs were exploring e-consult becoming part of each 7-day access service offer.


The report discussed the availability of seven day access services in both CCGs since October 2018, providing:


·       Over 2000 additional appointments across Sefton in the evenings and weekends

·       Flexibility and a range of services at more convenient times for patients

·       First contact physiotherapy in Southport, Formby and soon South Sefton, enabling the patient to bypass a GP, in turn freeing up capacity


The report detailed the work of Primary Care Networks and the variations of their size and demographics; and how they delivered extended hours and provided medicine management hubs, producing efficiencies and reducing workload in GP practices.  


The national GP patient Satisfaction survey was carried out between January and March each year, with survey results published in July.  The latest survey results published in July 2019 showed the following:


Overall Experience of GP Practice




South Sefton


Southport and Formby



The report acknowledged the higher than average satisfaction levels and stated the continuous work of the CCGs to support practices through interventions and implementations in order to provide good quality primary medical care.




That the report be noted.





Marmot Region Proposals pdf icon PDF 94 KB

Report by the Clinical Commissioning Group


Additional documents:


The Board received the report of NHS CCG Accountable Officer and Director of Public Health concerning Cheshire and Merseyside working together as a Marmot Community: Strengthening system leadership for population health and reducing health and wellbeing inequalities.


The report outlined its purpose to set out:


·       The intention of Cheshire and Merseyside (C&M) to become a Marmot Community

·       The background to the proposal and links to the work that had already been undertaken in both C&M and in Sefton

·       How it supported delivery of Living Well in Sefton and Sefton2gether


The report highlighted its recommendation that:


·       The Sefton Health and Wellbeing Board (HWBB) supported the proposal for C&M to become a Marmot Community

·       The Sefton HWBB provided strategic leadership and oversight of its implementation across partner organisations within Sefton

·       The C&M Health and Care Partnership financed, oversaw and assured this initiative with the support of partners


The report detailed how health inequalities in C&M remained a challenge as life expectancy remained below the national average, social gradient in health remained as well as stark differences between the poorest and richest 10% of the population.


The report described its vision for C&M through Better Lives Now, setting out the case to take action to reduce the occurrence of ill health, action to deliver appropriate health and care services and action on the social determinants of health.


The report also advocated a Whole System Approach recognising good quality health care was a determinant of health, but most of the determinants of health were outside the health care system. Marmot outlined key policy objectives which could be achieved through a range of drivers for health inequalities.


The report outlined the key benefits of becoming a Marmot Community:


·       Access to international expertise

·       Developing excellence in systems leadership for Population Health

·       Strengthening joint working with the NHS and local authorities

·       Maximising our impact on health inequalities together

·       Promoting excellence in practice in C&M


The report also detailed the role of the C&M partnership and what was needed to build on current work.


The report summarised the benefits of becoming part of the Marmot Community before detailing the policy and financial implications of the report.




(1)           the report be noted; and

(2)           the Board support the proposal for C&M to become a Marmot Community.