Cheshire and

Chief Executive Appointment

OFFICIAL-SENSITIVE Cheshire and Merseyside Footprint Overview • Population of approx. 2.6 million • The STP/ ICS area is the 2nd largest footprint in England* • Complex system and late developer in ICS terms • 17 Providers** • 9 CCGs • 9 Local Authorities • 9 Places

*Taken from 2016 Sustainability and Transformation Plan ** And NWAS

OFFICIAL-SENSITIVE NHS Southport and Southport and Ormskirk All Current C&M HCP Organisations Formby CCG Hospital NHS Trust (S&O) NHS Knowsley Sefton Council Alder Hey CCG NHS St Helens CCG Children’s NHS FT NHS South Sefton CCG St Helens Council The Walton Centre NHS FT Wirral Community Health Mersey Care NHS FT and Care NHS FT (WCHC)

Liverpool City Council St Helens and Knowsley Teaching Hospitals NHS Trust (STHKTH)

NHS Wirral CCG NHS Warrington CCG Wirral University Teaching NHS Halton Council Hospital NHS FT (WUTH) CCG NHS Halton CCG Wirral Metropolitan Liverpool Liverpool Borough Council University Women’s Knowsley Council Warrington Borough Council Hospitals NHS FT NHS FT The Clatterbridge Cancer Bridgewater Community Centre NHS FT (CCC) Liverpool Heart and Chest NHS FT (LHCH) Healthcare NHS FT (BCH) Countess of Chester NHS Cheshire CCG Warrington and Halton Hospital NHS FT (COCH) Hospitals NHS Trust (WHH) Key Cheshire West and Cheshire and Wirral Chester Council East Cheshire NHS Local Authority Partnership NHS FT (CWP) Trust Clinical Commissioning Group (CCG) Cheshire East Council Mid-Cheshire Trust Hospital NHS FT OFFICIAL-SENSITIVE Cheshire and Merseyside Footprint Overview • 2.6 million people • Similar age structure to England • More young people in Liverpool • More older people in Sefton and Cheshire East

• Deprivation levels vary significantly across the sub-region content/uploads/2021/03/Ethnicity-profiles-in-Cheshire-Merseyside.pdf

OFFICIAL-SENSITIVE Why the ICS opportunity is important to us

• We need to collectively respond to the needs of our population and communities: • High indices of deprivation • Complexity and variety of individual need • Inequalities of access and outcomes

• There is now pan system recognition and will for a system-wide step change - responding to shared challenges across health and care but ALSO beyond

• We need a framework which allows us to capitalise upon and embed increased democratic linkages and clear connections with communities

• We need a financially sustainable system that can respond to and support the system’s infrastructure needs

• There is growing international evidence that the only effective way to address these problems is through collaboration and integration


OFFICIAL-SENSITIVE Why the gap • Causes of death in the North West

• Causes of death and disability combined (DALYs) in the North West

OFFICIAL-SENSITIVE Why are we doing this?

• The NHS has been largely organized to provide episodic treatment for acute illness • However it now needs, more than ever to deliver joined up support for increasing numbers of older people and those living with chronic conditions • There continues to be an unacceptable inequality in the health of our population and life expectancy is stalling • The wider determinants of health are well known but often tackled in silos • The integration of health and care has the potential to drive improvements in population health by reaching beyond the NHS to involve local authorities and other agencies to tackle the wider determinants of health that drive longer term health outcomes and inequalities.

OFFICIAL-SENSITIVE HCP Vision, Mission and Aims

Vision: • We want everyone in Cheshire and Merseyside to have a great start in life and get the support they need to stay healthy and live longer Mission: • We will tackle health inequalities and improve the lives of our poorest fastest. We believe we can do this best by working in partnership Aims: • Improve the health and wellbeing of local people • Shift from an illness focus to a health and wellbeing model • Provide better joined up care, closer to home

OFFICIAL-SENSITIVE OFFICIAL-SENSITIVE How we see that collaboration can occur

OFFICIAL-SENSITIVE Our emerging system


OFFICIAL-SENSITIVE Cheshire and Merseyside Overview

Primary Care Networks 51 Place 9 C&M HCP 1

OFFICIAL-SENSITIVE Table from Designing integrated care systems (ICSs) in England Our Places or ICPs • Clinical care redesign (including (simplifying and standardising care pathways) • Forming provider partnerships and alliances (including GPs) to redesign and integrate services • Developing new provider models • Joining up council/ hospital/ community services • Closer working with LA and VCS partners on prevention and health inequalities • Population health management Integrated Place Based Care • Planning, managing and delivering services together for our populations in our neighbourhoods would enable us to focus on need be that a health need or a wider determinant of health need • Linking education, employment and service delivery in a Place/Borough enables us to shape our workforce and build resilience and opportunity in communities • Linking health skills and knowledge with housing and care across our neighbourhoods enables us to support our families in need or at risk of harm How • Will involve local discussion, influence or decision making • Alignment with appropriate governance structures – statutory roles like HWBB and OSCs but also decisions • Some local choices – our place development priorities are summarized within the annex

OFFICIAL-SENSITIVE Provider Collaboratives Preferred approach: • Two provider collaboratives: one for acute and specialist services and one for mental health, learning disability and community services. Each to have a lead • The groups should be convened under a single provider collaborative ‘partnership’ where there are issues to be addressed that require all providers to be engaged • Initial priorities to be established Q2 onward 21/22 • Development of culture, infrastructure and shared decision making principles need to align to development of priorities • Collaboration should support efficiency, improved quality and the closer system working with opportunity to delegate


OFFICIAL-SENSITIVE Key Reference Documents • Integrating care: Next steps to building strong and effective integrated care systems across England • Integration and innovation: working together to improve health and social care for all • FRC guidance on Board Effectiveness ba5abfed25219147/2018-Guidance-on-Board-Effectiveness-FINAL.PDF • Recast ICS Strategy 2021-25 • Health and Care Partnership Memorandum of Understanding1 • Cheshire and Merseyside People Plan • Getting under the skin research and BAME action plan1 1 Supplied upon request

OFFICIAL-SENSITIVE Our Place & Place Priorities HCP is committed to devolved decision making. Taking decisions closer to populations but also supporting integration around neighbourhoods and with local partners where appropriate. Responsibilities, teams and decisions will be established at a system level where it makes sense to do so and the greatest potential for improvement can be achieved. This means we need to be focused on developing our places as well as our ICS system: 1) Integrated Care Partnership (ICP) Governance: clearly defined formal arrangements for place partners to meet and work together to deliver outcomes set by the Health & Wellbeing Board (HWB) and ICS. 2) ICP nominated ‘Place Lead’ with remit for integrated working who will connect with ICS 3) Shared vision and plan for reducing inequalities and improving outcomes of local people approved by HWB (underpinned by local population health and socio-economic intelligence) 4) Agreed ICP development plan 5) Defined footprints (e.g. neighbourhoods) for delivery of integrated care, clinically led by PCNs working with social care, community, mental health, public health and other community groups. 6) Programme of ongoing public and wider stakeholder engagement at place Places will be expected to develop an integrated approach to commissioning between health and local authority (such as shared posts, joint teams and pooled budgets) to underpin and support the work of the ICP OFFICIAL-SENSITIVE Political Make up of C&M Councils Council Political Make Up Next Election Liverpool City Labour (maj) May 2022 Halton Labour (maj) May 2022 Sefton Labour (maj) May 2022 St Helens Labour (maj) May 2022 Knowsley Labour (maj) May 2022 Cheshire West and Chester NOC (Labour min) May 2023 Cheshire East NOC (Labour and Ind) May 2023 Warrington Labour (maj) May 2024 Wirral NOC (Lab min) May 2022

20 | Presentation title OFFICIAL-SENSITIVE List of Cheshire and Merseyside MPs

• Chris Matheson (City of Chester, Lab) • (Bootle, Lab) • Fiona Bruce (Congleton, Con) • (Garston & Halewood, Lab) • Kieran Mullan (Crewe & Nantwich, Con) • (Knowsley, Lab) • Edward Timpson (Eddisbury, Con) • (Liverpool Riverside, Lab) • (Liverpool Walton, Lab) • (Ellesmere Port & Neston, Lab) • (Liverpool Wavertree, Lab) • (Halton, Lab) • (Liverpool West Derby, Lab) • David Rutley (Macclesfield, Con) • (Sefton Central, Lab) • Esther McVey (Tatton, Con) • Damien Moore (Southport, Con) • (Warrington North, Lab) • Conor McGinn (St Helens North, Lab) • Andy Carter (Warrington South, Con) • (St Helens South & Whiston, Lab) • (Weaver Vale, Lab) • (Wallasey, Lab) • (, Lab) • Alison McGovern (Wirral South, Lab) • (Wirral West, Lab) 21 | Presentation title OFFICIAL-SENSITIVE Place, CCG & Local Authority Continuity Local Authority CCG Wirral Council Wirral CCG

Cheshire West and Chester Council Cheshire CCG Cheshire East Council

Halton Council Halton CCG

Warrington Council Warrington CCG

Liverpool City Council Liverpool CCG

St Helen’s Council St Helens CCG

Knowsley Council Knowsley CCG

South Sefton CCG Sefton Council Southport & Formby CCG

OFFICIAL-SENSITIVE C&M Trusts Most Recent CQC Rating Trust Rating & Date Alder Hey Children's NHS Foundation Trust Good (April 2021) Bridgewater Community Healthcare NHS Foundation Trust Requires Improvement (December 2018) Cheshire and Wirral Partnership NHS Foundation Trust Good (June 2020) Clatterbridge Cancer Centre NHS Foundation Trust Good (April 2019)

Countess of Chester Hospital NHS Foundation Trust Countess of Chester: Requires Improvement (May 2019)

East Cheshire NHS Trust Good (October 2019) Liverpool Heart and Chest Hospital NHS Foundation Trust Outstanding (July 2019) Liverpool University Hospitals NHS Foundation Trust Good (January 2021) Liverpool Women's Hospital NHS Foundation Trust Good (April 2020) Mersey Care NHS Foundation Trust Good (April 2019) Mid Cheshire Hospitals NHS Foundation Trust Good (April 2020) North West Ambulance Service NHS Trust Good (June 2020) Southport and Ormskirk Hospital NHS Trust Requires Improvement (November 2019) St Helens and Knowsley Teaching Hospitals NHS Trust Outstanding (March 2019) The Walton Centre NHS Foundation Trust Outstanding (August 2019) Warrington and Halton Hospitals NHS Foundation Trust Good (July 2019) Wirral Community Health & Care NHS Foundation Trust Requires Improvement (July 2018) Wirral University Teaching Hospital NHS Foundation Trust Requires Improvement (April 2021)

23 | OFFICIAL-SENSITIVE NHS Provider contacts

Alder Hey Children’s Hospital NHS FT Louise Shepherd CEO [email protected]

Bridgewater Community Healthcare NHS FT Colin Scales CEO [email protected]

Cheshire and Wirral Partnership NHS FT Sheena Cumiskey CEO [email protected]

Countess of Chester NHS Foundation Hospital Dr Susan Gilby CEO [email protected]

Clatterbridge Cancer Centre NHS Foundation Liz Bishop CEO [email protected] Truts East Cheshire NHS Trust John Wilbraham CEO [email protected]

Liverpool University Foundation Trust Steve Warburton CEO [email protected]

Liverpool Heart and Chest Hospital NHS Jane Tomkinson CEO [email protected] Foundation Trust

Liverpool Women’s Hospital NHS Foundation Kathryn Thompson CEO [email protected] Trust Mersey Care NHS Foundation Truts Joe Rafferty CEO [email protected]

Mid Cheshire Hospital NHS Foundation Trust James Sumner CEO [email protected]

Southport and Ormskirk NHS Trust Trish Armstrong-Child CEO [email protected]

St Helens and Knowsley Hospitals NHS Trust Ann Marr CEO [email protected]

Warrington and Halton Hospitals NHS Foundation Dr Simon Constable CEO [email protected] Trust Wirral Community Health and Care NHS FT Karen Howell CEO [email protected]

Wirral University Hospital Trust Janelle Holmes CEO [email protected] 24 | OFFICIALThe- WaltonSENSITIVE Centre NHS Foundation Trust Jan Ross CEO [email protected] CCG Contacts

NHS Liverpool CCG Jan Ledward AO [email protected]

NHS Southport /Sefton CCG’s Fiona Taylor AO [email protected]

NHS St Helens CCG Mark Palethorpe AO [email protected]

NHS Cheshire CCG Clare Watson AO [email protected]

NHS Warrington CCG/ NHS Halton CCGs Andrew Davies AO [email protected]

NHS Knowsley CCG Dianne Johnson AO [email protected]

NHS Wirral CCG Simon Banks AO [email protected]

25 | OFFICIAL-SENSITIVE Local Authority Contacts

St Helens Council Kath O’Dwyer CEO Katho’[email protected]

Warrington Council Steven Broomhead CEO [email protected]

Sefton Council Dwayne Johnson CEO [email protected]

Knowsley Council Mike Harden CEO [email protected]

Halton Council David Parr CEO [email protected]

Liverpool Council Tony Reeves CEO [email protected]

Wirral Council Paul Satoor CEO [email protected]

Cheshire West and Chester Council Andrew Lewis CEO [email protected]

Cheshire East Council Lorraine O’Donnell CEO Lorraineo’[email protected]