East Sussex Health and Wellbeing Board
MINUTES of a meeting of the East Sussex Health and Wellbeing Board held at Council Chamber, County Hall, Lewes on 27 June 2023.
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MEMBERS PRESENT |
Councillor Keith Glazier (Chair) Councillor Carl Maynard, Councillor Trevor Webb, Councillor Teresa Killeen MBE, Jessica Britton, Dr Stephen Pike, Mark Stainton, Darrell Gale, Alison Jeffery, Veronica Kirwan and Charlotte O'Brien |
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INVITED OBSERVERS PRESENT |
Councillor Andy Batsford, Councillor Paul Davies and Sophie Hepworth |
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PRESENTING OFFICERS |
Vicky Smith, Programme Director - East Sussex Health and Social Care Transformation Lourdes Madigasekera-Elliott, Public Health Strategic Lead - Creating Healthy Places |
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ALSO PRESENT |
Graham Evans, Head of Public Health Intelligence Nick Kendall, Public Health Practitioner Julia Powell, Community Pharmacy Surrey and Sussex.
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1. Minutes of meeting of Health and Wellbeing Board held on 7 March 2023
1.1 The minutes of the meeting held on 7 March 2023 were agreed as a correct record.
2. Apologies for absence
2.1 The following apologies for absence were received from members of the Board:
2.2 The following substitutions were made for members of the Board:
2.3 The following apologies for absence were received from invited observers with speaking rights:
2.4 The following substitutions were made for invited observers with speaking rights:
3. Disclosure by all members present of personal interests in matters on the agenda
3.1 Councillor Carl Maynard declared a personal non prejudicial interest under item 6 Better Care Fund Plans, as the Disabled Facilities Grant element of the funding is administered by District and Borough councils, and he is a member of Rother District Council. Councillor Trevor Webb declared a personal non prejudicial interest under item 6, Better Care Fund Plans, as the Disabled Facilities Grant element of the funding is administered by District and Borough councils, and he is a member of Hasting Borough Council.
3.2 Councillor Carl Maynard declared a personal non prejudicial interest under item 7, East Sussex Public Health and Planning Memorandum of Understanding, as he is a member of Rother District Council.
4. Urgent items
4.1 There were none.
5. Draft Sussex Integrated Care Strategy Shared Delivery Plan (SDP)
5.1 The Board considered a report on the draft Sussex Integrated Care Strategy, Shared Delivery Plan (SDP). The report included a summary of the background to the development of the Shared Delivery Plan, the governance arrangements to support delivery, and next steps for submission of the Plan to NHS England.
5.2 Jessica Britton, NHS Sussex commented that from an NHS Sussex perspective it was welcome to see the East Sussex Health and Wellbeing Board’s priorities reflected in the wider SDP, and similarly those for West Sussex and Bright and Hove. The key elements of the Plan are those longer term priorities that partners can work on jointly such workforce, digital and the development of integrated community teams which will underpin future service delivery. Some of the more immediate priorities for continuous improvement and collaborative working are also included in the Plan such as health inequalities, mental health and learning disability. The Plan sets out a direction of travel and key objectives and priorities for the health and care system, that supports how partners in East Sussex can work together whilst gaining the benefit of the strategic approach across Sussex.
5.3 Mark Stainton, Director of Adult Social Care and Health commented that he was happy to support the endorsement of the SDP. The three priority areas outlined in the SDP align with the Council’s priorities, together with the enhanced focus on children and young people. If the NHS Sussex Integrated Care Strategy previously considered by the Board sets out the ‘what’ that the SDP starts to describe the ‘how’. The governance arrangements set out in the report should be seen as equally important as the contents of the Plan, as they clearly set out the role of ‘place’ in the delivery of the Plan.
5.4 The Board commented that it was clear how much work had gone into the development of the SDP. The Board made number of comments and asked questions about the report, which are summarised below.
5.5 Alison Jeffery, Director of Children’s Services commented that from a Children’s Services perspective the way in which the Children’s Board for Sussex can influence all eleven workstreams is to be welcomed. Under the mental health section, the commitment to review the profile of spending on mental health across the population is also to be welcomed. If the health and care system wish to be more preventative then more investment in services for children and young people will be needed, as many mental health conditions often begin in adolescence.
5.6 In the section of the SDP which sets out the ambitions for improving living at ‘place’ for East Sussex, there is table titled “Difference this will make to local people and workforce in East Sussex and how it will be measured”. The Board asked what the reduction in the number of inappropriate referrals to mental health secondary services, and an increase in appropriate referrals to secondary mental health services meant in relation to more people being able to access support with their mental health needs, more quickly and closer to home.
5.7 Vicky Smith, Programme Director, East Sussex Health and Care Transformation responded that the plans and measures for mental health in East Sussex are linked to the pan-Sussex plans for community services transformation with mental health. The transformation programme aims to widen access to a range of mental health support at a primary care level for the population, and better access to appropriate specialist support at a secondary care level for people with more serious mental health issues. The transformation programme continues commitments and delivery made in previous years. Within the programme there are a number of strands including appropriate accommodation and housing-related support, working with District and Borough Councils and the voluntary sector.
5.8 Jessica Britton added that there are delivery boards operating across East Sussex and Sussex which are in place to support the delivery of these ambitions. There is a pan-Sussex Mental Health, Autism and Learning Disability delivery board which takes responsibility for overseeing the expansion of community based mental health services. This includes the rollout of mental health practitioners in Primary Care Networks which expands the range of opportunities that there are alongside other community-based services to access services locally. People may then not need to access secondary care mental health services. Through the review of the profile of spending and the need for children’s services, there are also plans to increase mental health teams in schools and emotional health and wellbeing services for children and young people outside special support services. It will be possible to track and see the growth in access for local people to those services, and partners will be able to see what action has taken place.
5.9 Mark Stainton commented that under the housing options work there is intensive housing support available for those people leaving hospital settings. As well as the pan Sussex board there is also an East Sussex ‘place’ based board which has a workstream on accommodation which is looking at a model similar to the “discharge to assess” programme to support people leaving inpatient mental health services. This will provide a small number of commissioned places for people to move into before moving on to more permanent accommodation.
5.10 Veronica Kirwan, Healthwatch East Sussex, outlined that Healthwatch were able to provide some detailed feedback on the SDP at the Sussex Health and Care Assembly which took place in May. Healthwatch is pleased to see the feedback on the language and targets has been taken on board and NHS acronyms in the Plan have been removed to make the document more publicly accessible. In terms of communications with the public, Veronica Kirwan asked if there is a plan to have a more publicly accessible version of the Plan.
5.11 Vicky Smith confirmed that there are plans within the communications strategy for the SDP to have a more accessible version and/or summary document.
5.12 The Board RESOLVED to:
1) Endorse the East Sussex milestone plans that will enable delivery of East Sussex population and Place priorities, as set out in Delivery Area 4 of the SDP, and the collaborative arrangements in East Sussex to support delivery (in paragraphs 2.11– 2.16 of the report) and;
2) Endorse the draft SDP as set out in Appendix 1 and agree that the Health and Wellbeing Board submits a statement of support, prior to the SDP being submitted to NHS England (NHSE) and the NHS Sussex Integrated Care Board (ICB).
6. Better Care Fund Plans 2023-25
6.1 The Board considered a report on the Better Card Fund (BCF) Plans for 2023-25 which includes allocated funding of around £180 million over the next two-year period. It is one of roles of the Health and Wellbeing Board to approve Better Care Fund Plans. The Board asked a number of questions which are summarised below.
6.2 The Board asked about some concerns that have been expressed regarding delays to the Disabled Facilities Grant (DFG) process, especially in relation to those people in social housing, and whether these problems had been resolved.
6.3 Mark Stainton responded that the problems have not been resolved completely, but the nature of the challenges and issues are different across the five District and Borough councils who administer the scheme. The County Council has the responsibility to identify the need and then the relevant District or Borough council will work through the DFG process. Hastings Borough Council has recently agreed some additional resources to speed up the grant process. A separate issue has been delays around getting permission from landlords to carry out adaption work and some social landlords will deny permission where they deem the property to be under occupied. This is not something the County Council has influence over but is happy to support councils such as in Hastings where this may be a particular problem.
6.4 It was clarified that the County Council and District and Borough councils have influence over the parts of the process that are under their control, such as obtaining contractors to carry out the work. However, this can also be another cause of delays as it can sometimes be difficult to secure a building contractor to carry out the adaption work.
6.5 Councillor Andy Batsford confirmed that Hastings Borough Council (HBC) has agreed additional resources to speed up the DFG process and remove delays. However, obtaining owner or landlord permission remains a challenge, particularly with social landlords who have reservations about adapting properties and would rather move people. HBC is also looking at securing some additional Occupational Therapist resources from the East Sussex County Council (ESCC) Team to speed up the process.
6.6 Mark Stainton commended HBC for allocating additional resources to the DFG process and clarified that the DFG process under discussion was for adults and there is a different process for children. He commented that he is aware of number of questions that the Leader of HBC has raised about the DFG process and is putting together a response to those questions.
6.7 The Board RESOLVED to:
1) Note the Better Care Fund requirements for 2023-25; and
2) Approve the East Sussex Better Care Fund Plans for 2023-25 recognising the 2024/25 plans are subject to review later this year.
7. East Sussex Public Health and Planning Memorandum of Understanding (MOU)
7.1 The Board considered a report and short presentation on the East Sussex Public Health and Planning Memorandum of Understanding (MoU). The Board asked a number of questions about the report which are summarised below.
7.2 The Board commented that it was good that Public Health and local planning authorities at the Borough and District councils are working together on this and asked if consideration had been given to working with social landlords and private renting forums/landlord associations.
7.3 Darrell Gale, Director of Public Health responded that the document is essentially about the planning process and the role of local authorities. In regard to housing, the Public Health Team have done some work on health and housing and is working through some of the issues with social housing providers. The Team is also undertaking a new piece of strategic housing work and have employed a strategic housing manager to work in partnership to develop solutions with housing providers and the District and Borough councils.
7.4 Cllr Andy Batsford commented that it would be good for ESCC to take a lead on this issue and asked if the MoU will be applied to the disposal of County Council land.
7.5 Darrell Gale responded that the MoU document was really about the planning system rather than Estates and disposals of assets. The strategic Planning lead for the part of Planning system that ESCC is responsible for is also a signatory of the MoU. It is a useful reminder of the role councils have to play in the management of the assets they hold including highways. Darrell Gale will take forward this work with the strategic Estates Team at ESCC to ensure the MoU is reflected in any disposal and Estates strategies.
7.6 The Board RESOLVED to note the Memorandum of Understanding between the County Council and Borough and District Councils in respect of planning from a Public Health perspective.
8. Pharmacy Closures in East Sussex - Update report
8.1 The Board considered an update report on Pharmacy closures in East Sussex, which provided an update on the changes and the actions to be taken in regard to the pharmacy closures and the impact on the Pharmaceutical Needs Assessment (PNA).
8.2 Veronica Kirwan commented that Healthwatch had received some feedback on out of hours pharmacy services as part of its roadshow work, where the public did not know where to go to find out which pharmacies are open out of hours. This may be a communications issue and Healthwatch would be happy to work with the Public Health team to address this.
8.3 The Board RESOLVED to:
1). Approve the removal of the Supplementary Statement posted regarding Lloyds Pharmacy (in Sainsburys) St Leonards;
2) Agree that no supplementary statement will be required regarding Lloyds Pharmacy (in Sainsburys) Hampden Park; and
3) Approve the issue of a Supplementary Statement for Lloyds Pharmacy in Sainsburys in Newhaven.
9. Work programme
9.1 The Board considered the items on the future work programme for the Health and Wellbeing Board.
9.2 Mark Stainton outlined that due to unavoidable clashes with other statutory meetings it was going to be necessary to cancel the Health and Wellbeing Board meeting on 18 July 2023. The options for those reports scheduled for the meeting on 18 July are to combine them with the other items on the September meeting agenda or rearrange another meeting to consider them. It was clarified that none of the reports, which are annual reports, are time critical but it would be good for the Board to consider them as soon as practical.
9.3 The Board RESOLVED to cancel the meeting due to be held on 18 July 2023 and agreed to move the reports to the Health and Wellbeing board meeting on 28 September 2023.
10. Any other items previously notified under agenda item 4
10.1 There were none.
The meeting ended at 3.01 pm.
Councillor Keith Glazier (Chair)