Report to: East Sussex Health and Wellbeing Board
Date of meeting: 12 December 2023
By: Executive Managing Director, East Sussex, NHS Sussex and Director of Adult Social Care and Health, East Sussex County Council
Title: East Sussex Shared Delivery Plan (SDP) programme update
Purpose: To receive a progress report on the Sussex Integrated Care System (ICS) joint Shared Delivery Plan (SDP), as it relates to delivering the agreed Health and Wellbeing Board (HWB) priorities for the population of East Sussex.
RECOMMENDATIONS:
East Sussex Health and Wellbeing Board (HWB) is recommended to:
1) Note the content of the progress report; and
2) Note the outline proposals being developed for a strengthened East Sussex ‘Health, Care and Wellbeing Partnership’ and accountability to the Health and Wellbeing Board, which will be brought to the March meeting of the HWB.
1.1 Delivery Area 4 in the Shared Delivery Plan (SDP) Our plan for our population builds on our East Sussex Health and Wellbeing Strategy Healthy Lives, Healthy People (2022 – 2027), and sets out eight key milestones in 2023/24 related to our shared priority programmes and projects for our East Sussex population covering:
· Children and young people
· Mental health
· Community, including a new joined-up community approach through the development of Integrated Community Teams (ICTs)
· Health outcomes improvement
1.2 The eight milestones also align with, and in some cases directly support, delivery in East Sussex of pan-Sussex objectives in the SDP for long term, immediate and continuous improvements. These are being managed through the eleven new pan-Sussex Delivery Boards that have been set up to support the SDP. These arrangements have continued to bed in and there is membership in common across the pan-Sussex Delivery Boards and our key East Sussex Place-based governance groups, including our four Oversight Boards that are responsible for delivering programmes of change in the above areas and the Health and Care Partnership Board.
1.3 The purpose of this report is to share a summary of progress with the following strategic developments that are being led by our East Sussex Health and Care Partnership:
· East Sussex SDP programme progress
· Local development of Integrated Community Teams (ICTs)
· Strengthening our East Sussex Place Partnership collaboration across health, care and wellbeing
2 Supporting information
East Sussex SDP programme progress
2.1 The eight high level East Sussex SDP commitments and milestones are set out in Appendix 1 for ease of reference. A brief summary of the East Sussex SDP programmehighlights across the four East Sussex priority programmes at Place is contained in Appendix 2. In quarter 4 of 2023/24 we will review our progress across all eight commitments and milestones, including the milestones being delivered through pan-Sussex partnership activity, in order to update our plans for 2024/25 (year 2 of the SDP). This will be reported to the HWB meeting in March 2024.
2.2 A review is also underway to confirm or reconfirm our shared critical priority objective measures and key performance indicators (KPIs), to ensure these support our understanding of progress and impacts. This work is being progressed through each Oversight Board in line with the stage of development for their programme.
2.3 Our approach to understanding and coordinating our work more broadly at Place level across the different shared intelligence and insight requirements we have is also being reviewed. A focussed meeting in December will bring together public health and business intelligence leads across our organisations to explore and co-design how we can collaborate across these functions to support a shared understanding of the needs, impacts and outcomes for our population. Discussion will take in our planning across the following:
· Developing data-driven population health management and including our understanding of needs, risks and strengths within our new ICT footprints
· Measuring the improvements we are seeking through transformation and integration, to support our strategic ambition to deliver improved shared health and care outcomes, as set out in our HWB Strategy
Local development of Integrated Community Teams
2.4 As discussed at the last meeting of the HWB, Integrated Community Teams (ICTs), will be made up of professionals working together as a ‘team of teams’ across different organisations with local communities, individuals, and their carers. This will involve integrated working across primary care, community, mental health, local authority partners, voluntary, community and social enterprise organisations and other local partners.
2.5 The year one milestones for Integrated Community Teams include having a clear model informed by Joint Strategic Needs Assessments, Health and Wellbeing Strategies, and local population data and insights from local people and communities. In East Sussex we have agreed five ICT ‘footprints’ based on our borough and district boundaries, and initial work will be progressed through an ICT community ‘frontrunner’ in Hastings.
2.6 To ensure a consistent approach across Sussex there is a pan-Sussex ICT Delivery Board. The East Sussex Community Oversight Board is the programme board responsible for leading ICT implementation in East Sussex, alongside similar Place-focussed delivery arrangements in Brighton & Hove and West Sussex. In light of this Community Oversight Board (COB) relaunched in October 2023 having refreshed its terms of reference and membership to reflect this new role, and the links with the pan-Sussex ICT Delivery Board.
2.7 In addition to co-designing the emerging overarching principles and framework for ICT delivery, our current focus is the scope and next steps for our implementation of ICTs in the East Sussex context across their key functions within the emerging framework, including:
· Planning: making changes based on data and evidence for their communities
· Improving population health and tackling health inequalities
· Integrating health, care and wellbeing services at the local level
· Creating appropriate models of care with and for communities to deliver agreed outcomes
2.8 To ensure we build on progress, our learning and insight from our existing integrated care developments and current pilot programmes and projects, including the Universal Healthcare project in Hastings, has been reviewed to inform shared areas of focus and next steps. More detail is contained in Appendix 2, including the planning for establishing an initial ICT in Hastings as our community frontrunner in quarter 4 2023/24, to establish a blueprint model for establishing ICTs in all five footprints in East Sussex.
Strengthening our East Sussex Place Partnership collaboration across health, care and wellbeing
2.9 At the inception of the Sussex Integrated Care System (ICS) there was local agreement that ‘Place’ is key to strategic leadership, local commissioning and delivery within the ICS. This was to help enable a clear focus on population needs and get the best value out of the full range of collective resources available to improve the health, care and wellbeing of the population. This also reflects our local context in relation to local democratic accountability, strategic planning structures and collective resources available for populations, and also national policy expectations as set out in the White Paper for health and social care integration (February 2022): Joining up care for people, places and populations.
2.10 At East Sussex ‘Place’ level the East Sussex Health and Care Partnership brings together local NHS partners including NHS providers and Primary Care Networks (PCNs) with representatives of the County Council, Borough and District Councils, East Sussex VCSE Alliance and Healthwatch. The Partnership acts as a forum for the local strategic management of integration activity and oversees delivery of the East Sussex elements in the Shared Delivery Plan (SDP), with accountability to the East Sussex Health and Wellbeing Board (HWB).
2.11 The September report to the HWB signalled that discussions were taking place with Borough and District (B&D) Councils about shaping our current ‘East Sussex Health and Care Partnership’ into a ‘East Sussex Health, Care and Wellbeing Partnership’. This is with the intention of further strengthening our collaboration across shared programmes of work where there are connections to services and policy such as economic development, planning, housing, leisure, wellbeing and environmental services for local communities.
2.12 It has also felt timely and important to develop proposals for our HWB more broadly aimed at strengthening our ability to collaborate to deliver an integrated offer of health, care and wellbeing in our communities across care, prevention and the wider determinants of health. This will refresh and strengthen our accountability to the HWB in its statutory role and responsibility for the East Sussex population, as well as be in keeping with the role of the HWB and Place in our Integrated Care System.
2.13 To progress this the following steps have been taken:
· The terms of reference for the key partnership groups within our Place health and care governance have been shared to help identify where all five B&D Councils should be represented, and where this could be done collectively to support capacity.
· Ahead of this B&D Councils have agreed to each be represented on the Community Oversight Board, as we move into implementing our Integrated Community Teams model. This will help strengthen our focus on prevention as part of improving health outcomes for our population as well as the integrated offer of health, care and wellbeing to individuals with more complex care needs within the ICT model, and nominations are underway for this.
· Discussion has taken place with Borough and District housing leads to explore and shape initial proposals for further strengthening the specific relationship between health, social care and housing specifically within our partnership and programme governance to support improved outcomes. Appropriate reporting of key shared strategic partnership priorities and programmes concerning housing has also been explored within this.
· The East Sussex Housing Partnership Board considered and endorsed a suggested initial approach at its meeting in November, and this will be fed back to B&D Council Chief Executives as part of the next steps to finalise proposals. The finalised proposal will be considered at the March 2024 meeting of the Partnership Board, ahead of being brought to the HWB for endorsement.
3. Conclusion and reasons for recommendations
3.1 Joint work in East Sussex has continued to take place to progress delivery of our objectives across our HWB Strategy SDP priorities for children and young people, mental health, community and improving population health outcomes. Involvement in the new SDP Delivery Boards at a pan-Sussex level has also continued to be cemented to align planning, commissioning and delivery to ensure improvements for our population. An overview of progress in 2023/24 across all of our HWB objectives in the SDP will be brought to the next meeting.
3.2 In the context of our new Sussex ICS and developing pan-Sussex governance arrangements, the existing core East Sussex Health and Care Partnership governance has been kept under review in 2023/24, to ensure capacity and resources are aligned to support effective collaboration at Place. This is intended to both support our ICS and continue to ensure accountability to the East Sussex HWB in overseeing an integrated offer of health, care and wellbeing for the East Sussex population, as set out in the White Paper for health and social care integration: Joining up care for people, places and populations (February 2022). Pending further discussion with local partners in the coming weeks, including Borough and District Councils, the VCSE sector and Healthwatch, finalised proposals will be brought to the next meeting of the HWB for consideration.
JESSICA BRITTON
Executive Managing Director, East Sussex, NHS Sussex
MARK STAINTON
Director of Adult Social Care and Health, East Sussex County Council
Contact Officer
Vicky Smith, Programme Director East Sussex Health and Care Transformation
Email: vicky.smith@eastsussex.gov.uk
Appendices
Appendix 1 East Sussex HWB SDP milestones
Appendix 2 Draft East Sussex programme progress summary