Appendix 2
Summary of changes to the East Sussex Health and Care Partnership Governance
The East Sussex Health and Care Partnership brings together NHS, Local Government (County, Borough and District Councils), Healthwatch and Voluntary, Community and Social Enterprise (VCSE) partner organisations to work collaboratively to deliver shared priorities in the Joint East Sussex Health and Wellbeing Strategy Healthy Lives, Healthy People, and the Sussex Assembly Improving Lives Together Strategy.
On behalf of the Health and Wellbeing Board, the Partnership leads on delivering shared programmes aimed at improving population health outcomes, with a clear focus on reducing health inequalities and increasing levels of prevention and integrated care. Priorities cover children and young people, mental health, community services, health outcomes improvement and housing for people of all ages and align with pan-Sussex SDP plans to ensure a strong focus on the population.
The work of our Sussex Integrated Care System (ICS) is taking place in an environment of almost constant pressure, which is felt by all parts of our health and care system. Changes being implemented to our ICS system architecture which are intended to help with the challenges include:
· Plans to establish a new committee in common between the NHS ICB and NHS providers to focus on increasingproductivity and efficiency, and the overall sustainability of healthcare services in Sussex focussing on NHS elements of Improving Lives Together and the SDP
· Developing pan-Sussex NHS provider collaboratives to better enable improvements to healthcare services, supported by the outcomes-based strategic commissioning role of the ICB.
These changes primarily involve new working arrangements within or between NHS organisations and focus on healthcare on a Sussex-scale. There will also be a need for County Council services to engage with these arrangements as they evolve to ensure joint commissioning and delivery is aligned within the system across health, social care and public health.
In light of this, in the new Sussex system architecture the continuing pivotal role of the three Place Health and Care Partnerships is to bring together the contribution of the Voluntary, Community and Social Enterprise (VCSE) Sector and Local Authorities with NHS providers, the ICB and others to deliver an integrated offer of health, care and wellbeing to their population. This is tailored to the JSNA for the population and the complex ecosystems of planning and delivery that exist in East Sussex, Brighton & Hove and West Sussex, accountable to the Health and Wellbeing Being Boards.
The role of the East Sussex Health and Care Partnership is framed around the specific deliverables contained in the ‘East Sussex’ section of the Sussex Shared Delivery Plan (SDP), and the priorities shared across the NHS and East Sussex County Council (ESCC) for our Place. These are driven through our robust understanding of our population needs in the JSNA and annual State of the County report, and ambitions set out nationally in the NHS Long Term Plan, the joint Sussex Improving Lives Together Strategy and the East Sussex Health and Wellbeing Board Strategy.
As part of early consideration of the focus and role of the East Sussex Health and Wellbeing Board (HWB) and Health and Care Partnership, at its meeting on 28 March 2024, the East Sussex Health and Social Care Executive Delivery Group agreed some initial proposals to ensure our Place partnership is fit for purpose in 2024/25. These changes are aimed at:
· Streamlining our formal Place Health and Care Partnership governance, in light of the changes to our system architecture and the need to retain a clear strategic focus on population needs driven by the statutory JSNA and HWB Strategy.
· Responding to changes in expectations about increased delegation of resources to Places within our ICS, lessening the immediate need for system executive leadership and grip across local NHS and Local Authority activity, finance and performance, which our longstanding East Sussex Health and Care Partnership had originally been designed around.
· Better aligning existing capacity and roles to support our Place Health and Care Partnership to enable us to deliver our SDP and the expectations of our HWB effectively.
The following changes to our formal partnership and programme governance initially agreed as of April 2024 are:
· Merging our Executive Delivery Group with our Health and Care Partnership Board and having a strengthened single quarterly Partnership Executive Board meeting, potentially with a broader breadth of membership from Borough and District Councils. This acknowledges that Executive leads at Place will still meet informally to discuss and manage shared system issues at Place level.
· Ensuring grip on delivery of shared SDP priority programmes of change for our population across the collective resources of the NHS, ESCC and wider partners, through facilitating the following thematic boards which will report directly into the East Sussex Health and Care Partnership Board:
o Children and Young People Health Oversight Board
o Mental Health Oversight Board
o Community Oversight Board
o Health Outcomes Improvement Oversight Board
o Housing Strategic Partnership Board
· These Boards will each be responsible for agreeing SDP milestones for their area and leading programmes of work aimed at progressing them in-year, as well as tracking the delivery of outcomes and KPIs that will be reported through to the Partnership Board.
· Refreshing our approach to enabling joint planning and transformation at Place to reflect new arrangements for leadership at pan-Sussex level. This acknowledges that pan-Sussex enabling programmes can still connect with non-NHS partners via the appropriate Place governance, and through individual organisations and networks, to support successful implementation and integration at Place level. In light of this, agreement has been reached to stand down the following groups:
o East Sussex Chief Finance Officers Group
o East Sussex Strategic Workforce Group
o East Sussex Digital Board
· The joint steering groups for Communications and Involvement and Population Health and Care Intelligence will be retained. As ‘communities of practice’ in these functional areas these groups will help actively progress priority programmes of work aligned to SDP delivery, including better understanding our communities and working with their strengths and assets to support neighbourhood delivery.
NHS Sussex have also been considering the additional impact of the adjustments to staffing levels in the context of the new ICB organisational operating model across Sussex. This extends to both the Place joint health and care governance and wider Local Government-led partnership work, and is intended to further ensure reduced duplication of work at system and Place, and well aligned capacity at all levels within our ICS. This is connected to work to review the pan-Sussex SDP system delivery arrangements. The priority focus and next steps for Place-based partnership governance may need to be further reviewed in light of the outcomes of this review.
The following diagrams show the changes to our Health and Care Partnership Board structure.
Diagram 1: East Sussex Health and Care Partnership governance structure in 2023/24
Diagram 2: East Sussex Health and Care Partnership governance structure in 2024/25
This refreshed partnership and programme governance will support delivery of our SDP milestones and will underpin our East Sussex Health and Wellbeing Board’s (HWB) strategic leadership of the health and care system in East Sussex, aligned to the Sussex ICS. Our review and proposals to further strengthen our HWB’s vision and stewardship role will focus on the full breadth of partnership activity to improve health, care and wellbeing outcomes for our population, and ensure this is aligned with the wider ambition of the Sussex Health and Care Assembly.