Wirral Community Health and Care NHS Foundation Trust is a community trust sitting within the Cheshire and Merseyside integrated care system (ICS). Its board, led by Prof. Michael Brown (chair) and Karen Howell (chief executive), actively 'champions and promotes' the importance of community care provision, which includes a vast array of services. This includes community and specialist nursing, community cardiology, crisis intervention, urgent response and intermediate care, supported by building social benefit and value in partnership with the communities it serves. This also supports the national ambition to shift more care into the community and to promote wellness and independence. As a population health-focused organisation, the trust recently received a CQC rating of 'good' with 'areas of outstanding'. Karen is shortly leaving the trust to become CEO for Greater Manchester Mental Health NHS Foundation trust and Mark Greatrex takes over in June for an interim period.
Along with many other community trusts, Wirral Community Health and Care NHS Foundation Trust face challenges around securing adequate resources to expand services to deliver more care in the community supporting the national direction of travel.
Despite the challenging external and operational environment, I saw nothing but dedication to delivering high-quality care for patients in the place they want it most. There was a real sense of pride from leaders and staff during my visit, reflected in this year's staff survey which saw the trust's highest-ever response rate. This is largely down to the culture of the organisation, rooted in three core values: compassion, open and trust. These values were co-produced with staff; I really felt them during my visit.
The trust's executive team told me about some of the core achievements and challenges they face. Leaders were keen to emphasise the importance of their community trust as a 'connector and convenor', of partnerships and collaboration acting as the glue between wider system partners to deliver holistic, joined-up care for patients closer to home.
The team demonstrates its commitment to being data-driven with a trust information gateway producing a live single source of service performance measurement, available to all staff. Each team can look at its key performance indicators and record and plan accordingly, giving staff ownership and empowerment over their activity.
Collaborative working is clearly a key driver for trust staff and senior leaders. As part of the visit, I heard how system working is carried out in practice. Wirral's Home First model, which provides support for people who no longer need hospital care but do need formal support to go home, is provided by a multidisciplinary, co-located team that sits within the community trust.
The team is made up of health and social care professionals from across the community trust, Wirral University Teaching Hospital NHS Foundation Trust and the council support approximately 170 discharges a month. As part of the Home First approach, patients are supported to return home with the personalised, wraparound care plan they need to stay independent and well.
The impact of this approach resulted in a 66% reduction in delayed discharges from December 2022-23. Home First discharges now account for 28% of all new care provision within the Wirral system, taking pressure off the domiciliary care market. This shows the benefits of delivering more holistic care within the community, both for individuals and wider system flow.
I also visited the Community Cardiology Service, which provides help, education and treatment to those living with cardiovascular conditions in Wirral. This allows patients to access vital support from specialist nurses, GPSIs and cardiologists in the community. The highly specialist team offers diagnostic tests, specialist procedures and medication management for risk reduction and prevention.
As well as the fantastic work carried out to support older people in the community, I also saw the newly transformed younger persons sexual health service, 'Our Place', which sits within the Community Trust HQ (St. Catherine's Health Centre), part of the wider sexual health service provided in collaboration with Liverpool University Hospitals NHS Foundation Trust. The space was co-designed with children and young people who use the service, and who wanted a place they could come to for support in an environment that felt comfortable and safe.
This complements the wider spectrum of 0 to 19+ services delivered by Wirral Community Health and Care NHS Foundation Trust, fast becoming a significant proportion of their service delivery. This reflects the strong improvement work that the trust is doing to transform provision across Cheshire and Merseyside systems within which they provide services in.
The executive team then organised a marketplace session, where I heard from staff who deliver a vast spectrum of services in the community, from long Covid support and wound care, to end-of-life, frailty services, urgent care and staff networks with inclusion and equity at their heart, ensuring the organisation is 'getting it right for everyone'.
My time at Wirral Community Health and Care NHS Foundation Trust gave me just a small glimpse into the huge breadth of services delivered across the community, from birth right through to the end of life. Staff working within the community acutely recognise the privilege of supporting people throughout their lives and are eager to scale up the innovative work they are providing across significant geography.
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