Appendix 3

East Sussex Health and Wellbeing Board (HWB) Shared Delivery Plan programme highlights

Our East Sussex Oversight Boards for children and young people, mental health, community and population health outcomes improvement are each responsible for overseeing and delivering key elements of the Shared Delivery Plan (SDP) improvement priorities for year 1 where relevant at Place in each of their areas.  In addition they deliver the programmes of work covering our shared HWB SDP priorities for East Sussex, and a brief summary of the highlights across all four East Sussex HWB priority programmes is set out below.

Children and young people

In keeping with the East Sussex SDP objectives for 2023/24, the aim of the East Sussex Children and Young People Health Oversight Board (CYPHOB) is to continue to develop and implement the children and young people priority programmes and projects, and to ensure that agreed service improvements, including pathway and service redesign are effectively implemented through collaborative working between commissioners and providers of health, mental health and care services. The following progress has taken place over the summer period:

· A focus on progress with Family Hub developments and the Perinatal Equity and Equality Plan has been considered to promote the best start for life and best outcomes for babies and young children.

• Work is being taken forward to develop accessible information, advice, guidance and self-help for children and young people’s mental health and emotional wellbeing. A self-harm needs assessment has been produced and reviewed including how the recommendations can be integrated into existing programmes and project delivery explored.

· The East Sussex whole system healthy weight plan 2021-26 was reviewed to ensure a clear focus on the health of children and young people.

· The development of an overarching health dashboard for children and young people has also been progressed by the CYPHOB to complement work sponsored through the pan-Sussex Children’s Board.

The CYPHOB has also endorsed the CORE20Plus5* ‘plus’ groups to benefit from additional focus across Sussex and locally to reduce health inequalities.  These are: looked after children and care leavers; children and young people with a learning disability or autism or life limiting illness; young carers, and; asylum seekers and migrants who have been staying in cohort hotels and in our communities living with families.

*Note: The NHS Children and young people ‘Core20Plus5’ framework was published November 2022 (the Core20Plus5 for Adults was published in November 2021). The framework is an approach to support the reduction of health inequalities in children and young people at both national and system level. It defines target population cohorts and identifies:

· ‘5’ focus clinical areas requiring accelerated improvement; Asthma; Diabetes; Epilepsy; Oral Health, and; Mental Health.

· The ‘Core20’ most deprived 20% of the national population as identified by the national Index of Multiple Deprivation (IMD). 

· ‘Plus’ ICS-chosen population groups experiencing poorer-than-average health access, experience and/or outcomes, who may not be captured within the Core 20% alone, and would benefit from a tailored healthcare approach or accelerated focus.

Mental health

In addition to the pan-Sussex SDP mental health improvement priorities and in keeping with the East Sussex HWB SDP objectives for 2023/24, the East Sussex Mental Health Oversight Board (MHOB) has agreed a set of project plans aimed at taking forward its 4 priorities of dementia, homelessness, improving access and data and intelligence. The MHOB has also agreed to progress high level ambitions related to the development of older people’s mental health services in East Sussex. The ambitions relate to improving available data, improving awareness and access to services, developing integrated pathways and delivering bespoke older people’s offers.  The following progress has taken place over the summer period:

· Emotional Wellbeing Services are now operational in 6 PCNs in East Sussex. Discussions are taken place with Seaford PCN regarding allocating available EWS staff to start working there are ongoing. Current plans are for Seaford EWS to be operational by the end of the Summer.

· Further engagement workshops have been collaboratively planned and developed to take place in Eastbourne and Hastings to take forward further stages of Community Mental Health Transformation on 15 and 21 September respectively. The workshops are for any partner organisation interested in finding out more about the work of Community Transformation and/ or wanting to contribute to progressing the programme’s aims at a local level.

· Invitations to Tender for the Lead Provider Mental Health Support Services contract has been prepared for ‘go live’ in September.

· The Housing and Supported Accommodation Working Group is undertaking a refresh of its Place Based Plan.

Community (integrated community teams)

· Initial engagement has begun over the summer to raise early awareness with teams about the developmental nature of the ICT model and concept and the forthcoming programme, and this will be ongoing in the coming months. Resources have also been identified to support programme delivery.

· The Community Oversight Board (COB) planned ‘relaunch’ will take place in October 2023, with refreshed terms of reference and membership reflecting the COB’s role as the programme board leading the implementation of ICTs in East Sussex linking with the pan-Sussex ICT Delivery Board. The meeting will allow time for focussed discussion on the role of the COB and the relationship with the pan-Sussex SDP ICT Delivery Board, and agreeing the scope and next steps for our Place-focussed implementation of ICTs across key functions within the emerging Sussex-wide framework, as well as updates on current activity.

· The footprints model for Integrated Community Teams (ICT) in East Sussex was explored through our local COB discussions during April – June, and agreed at the pan-Sussex ICT Delivery Board in July 2023. The model will be used in 2023/24 to help test the different types of functionality needed for ICTs to deliver an integrated offer of health, care and wellbeing in communities, and the current programme activity. This is based around five footprints for ICTs based on borough and district boundaries, with our twelve PCNs currently operationally grouped within three community health and care teams, and working across our borough and district-based community networks. Through recognising and building on existing relationships and community focussed partnership activity, we can start to link together the full range of East Sussex programmes (new and existing) that will underpin ICT development aligned to ICT footprints.

· Planning work has now started to enable profiles to be developed bringing together an initial cut of population health, service demand and other insight data for each ICT footprint by December 2023.

· The following projects are currently supporting community frontrunner and pilot activity which will shape and inform ICT development:

o The Hastings community frontrunner, the Universal Healthcare proposition, is progressing eight prototype pilot initiatives designed to test new ways of supporting access to healthcare and reducing health inequalities.

o The Foundry Population Health Management (PHM) Collaboration Pilot has also been progressing with the articulation of a proposed role to support neighbourhood community action and development targeted at a cohort of older, frail people at risk of social isolation and loneliness, falls and admission to hospital, together with the supporting evaluation arrangements.

· Strong connections will also be made with existing East Sussex programmes focussed on collaborative local community networks, asset-based community development and a system stewardship approach to social isolation and loneliness, all of which will all underpin the wider offer for ICTs.

Health Outcomes Improvement (HOI)

· The first meeting of the new HOI Oversight Board successfully took place on 23 August, with nominated members from our Sussex-wide leads and the East Sussex Health and Care Partnership being able to attend to agree the draft terms of reference, and initial scope of programme development activity.

· Progress is being made to establish Health Outcomes Improvement (HOI) as a core SDP delivery programme at Place, and ensure alignment with existing activity and team resources both locally and across Sussex. To support this a small ‘in-person’ round-table workshop is being designed across all four identified conditions (cardiovascular disease, chronic respiratory disease, mental health and frailty/healthy ageing) is being planned for 3 November 2023 to explore:

o Opportunities and priorities for primary prevention and pathway improvements to alleviate current demand, in light of the data, evidence and good practice examples, and;

o Commonality of themes across all four conditions to shape integrated responses and pathways

· Early engagement has taken place with leads and subject matter experts, at both Place and Sussex level, to scope the existing work and developments that directly supports pathways and access to services and/or is strategically aligned, to ensure programme activity builds on and does not duplicate existing progress. Stakeholder mapping has also taken place to support this.

· The planned initial round table discussions will help further accelerate collaboration to support strengthened delivery of existing and new objectives, highlighting immediate pathway improvements to ensure prevention and early intervention is effectively built into pathways, including supported self-management, and a holistic person-centred approach for people with multiple long term conditions, as well as long term actions to support improved population level health outcomes across the four conditions.

· Over time our programme work for health outcomes improvement will align and feed into integrated community teams model development in East Sussex, to ensure our collaborations can increasingly be tailored and managed across footprints.

Monitoring and KPIs

Our East Sussex Health and Care Executive Delivery Group (EDG), has also agreed an action for each Oversight Board to review and confirm or reconfirm the critical priority objective measures and KPIs, to ensure these align with SDP measures and support our understanding of progress and impacts. This will be progressed by each Oversight Board in line with the stage of programme development in the coming months. Our new East Sussex Population Health and Care Intelligence Steering Group will support this so that we can begin to align the following aspects to support our ambition to deliver improved population health and care outcomes via integrated community teams:

· the overall approach to embedding data-driven Population Health Management;

· the specific improvements we are seeking through transformation and integration, and;

· the context of needs, risks and assets within our communities.