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 16 July 2024.
|
MEMBERS PRESENT |
Councillor Keith Glazier (Chair) Councillor John Ungar, Councillor Trevor Webb, Stephen Lightfoot, Amy Galea, Ashley Scarff, Mark Stainton, Darrell Gale, Carolyn Fair, Veronica Kirwan, Councillor Dr Kathy Ballard and Councillor Paul Davies |
|
|
|
|
INVITED OBSERVERS PRESENT |
Councillor Paul Coleshill, Councillor Teresa Killeen MBE and Becky Shaw |
PRESENTING OFFICERS Simon Kiley, Healthwatch East Sussex
1. Minutes of meeting of Health and Wellbeing Board held on 5 March 2024
1.1 The minutes of the meeting held on 5 March 2024 were agreed as a correct record.
2. Apologies for absence
2.1 The following apologies for absence were received from members of the Board:
· Dr Stephen Pike, NHS Sussex
· Joe Chadwick-Bell, East Sussex Healthcare Trust.
2.2 The following apologies for absence were received from invited observers with speaking rights:
· Duncan Kerr, VCSE Alliance
· Mark Matthews, East Sussex Fire and Rescue Service
· Simon Morris, Sussex Police and Crime Commissioner
2.3 The following substitutions were made for members of the Board:
· Amy Galea, NHS Sussex substituted for Dr Stephen Pike.
3. Disclosure by all members present of personal interests in matters on the agenda
3.1 There were none.
4. Urgent items
4.1 There were no urgent items.
5. NHS Sussex Shared Delivery Plan (SDP) Year 2 Refresh
5.1 The Board considered a report on the Year 2 refresh of the NHS Sussex Shared Delivery Plan (SDP) introduced by Amy Galea, Chief Integration and Primary Care Officer, NHS Sussex. A copy of the Improving Lives Together, Shared Delivery Plan for year 2 is contained in Appendix 1 of the report and Appendix 2 of the report contains a summary of changes to the East Sussex Health and Care Partnership Governance.
5.2 Members of the Board asked what assumptions had been made about funding for the year 2 refresh of the SDP given that there would be a new Government and the pressures on Adult Social Care. Amy Galea responded that the main assumption behind the Integrated Care Strategy (ICS) was that the Health and Care Partnership would utilise the amount of money available across the NHS and local authorities in a joined up way for the best outcomes for residents.
5.3 Stephen Lightfoot, Chair of NHS Sussex commented that the SDP was a Health and Care Shared Delivery Plan which was not just an NHS Sussex plan and also involves the local authorities across Sussex. From an NHS Sussex perspective there is a really strong role for Place and a partnership approach in the delivery of the SDP. He welcomed the changes in governance and the inclusion of the Sussex Housing Partnership linking more closely the issues of housing, health, and wellbeing. He indicated his support and endorsement of the SDP.
5.4 The Chair commented that he was keen to see that the SDP included the health and wellbeing priorities and the progress that has been made in year one. It also showed that the partners are monitoring where they would want to be as part of the implementation of the SDP. Councillor Dr Kathy Ballard commented that she endorsed the Plan and that the focus should be on prevention. She welcomed the progress that has been made and the inclusion of housing in the delivery of the SDP.
5.5 The Board RESOLVED to:
1) Endorse the update for year 2 of the 5-year SDP, and provide any further feedback to the NHS Sussex Integrated Care Board (ICB), to strengthen the SDP update and the collaborative arrangements to support delivery;
2) Approve the continuation of the East Sussex Health and Wellbeing Board (HWB) population and Place priorities as set out in Appendix 1 (pages 86 – 94) of the report, and;
3) Note the changes to the Place partnership governance to support delivery of the HWB priorities.
6. Proposals for strengthening our East Sussex Health and Wellbeing Board
6.1 The Board considered a report on the proposals for strengthening the East Sussex Health and Wellbeing Board, introduced by Mark Stainton, Director of Adult Social Care. The report set out the proposed future role of the Health and Wellbeing Board with a strong focus on Place and joint working to improve the health and wellbeing of the population in East Sussex. The report covers the arrangements that will be put in place to support this, which are outlined in section 2.15 of the report.
6.2 The Chair noted the work that had taken place since the last Board meeting on the proposals and that the Board now had the opportunity to endorse the proposals.
6.3 Councillor Ungar asked if there would be an opportunity for all Board members to be involved in the deep dive discussions of the informal strategy workshop sessions. Mark Stainton confirmed that the sessions would involve all Board members and may also include subject matter experts who could be invited to attend the sessions to provide more information and contribute to the discussion.
6.4 Stephen Lightfoot commented that it would be really helpful to have subject matter experts involved in some of the workshop sessions. He strongly supported the principle of having the informal sessions which provide an opportunity to discuss and debate some of the options to develop the right plans for our population. He also commented that he would like to be able to share this good practice with the other Health and Wellbeing Boards in Sussex. The Chair outlined that the Board would be happy to share the proposals with the other Health and Wellbeing Boards and would welcome any feedback from them on good practice.
6.5 Councillor Dr Kathy Ballard commented that she was excited by the new approach of having informal discussions about the Strategy and getting feedback from the Board members. She asked if all the Board members would be expected to attend the sessions and how the outcomes would be fed back to the Board and incorporated in future work. Mark Stainton outlined that all Board members would be invited to the informal sessions. The product of the deep dive informal Strategy sessions will form part of the standing update item on health and care updates and will be presented to the Health and Wellbeing Board at the following formal Board meetings. The plan is that all the sessions will contribute to the refresh of the Health and Wellbeing Strategy which is due in early 2027. If the Board agrees the proposals, then by 2027 the Board will have covered all the chapters in the Health and Wellbeing Strategy in time for the refresh.
6.6 Mark Stainton clarified that all Board members, including those who are invited observers, would be invited to the informal strategy sessions as the participation of everyone is welcomed. As the sessions are not formal Board meetings, there is more flexibility around who can be invited.
6.7 Councillor Webb asked if it would be possible to consider holding the Health and Wellbeing Board meetings at different locations around the county and have a later start time to encourage more attendance. Mark Stainton responded that it would be logistically difficult to move the location of the formal Health & Wellbeing Board meetings, but it could be something that is considered for the informal strategy sessions, particularly if there is a geographical element to the topic under discussion. Stephen Lightfoot commented that in West Sussex the formal Health & Wellbeing Board meetings are held in Chichester, but they are planning to hold seminars in Crawley and Worthing.
6.8 The Board RESOLVED to:
1) Agree the suggested future vision, role and focus of the HWB, as outlined in paragraphs 2.11 – 2.14 of the report; and
2) Agree the proposed new way of working, set out in paragraphs 2.15 – 2.17 and Appendix 3 of the report, to strengthen the HWB’s statutory role as the key strategic stewardship group for the health and care system in East Sussex.
7. Better Care Fund Plans 2024/25
7.1 The Board considered a report on the Better Care Fund (BCF) plans for 2024/25. Mark Stainton introduced the report which sets out the plans for year 2 of the BCF funding. The grant conditions remain unaltered and there have been a few minor changes to the funding which are set out in the report and in more detail in Appendix 1 of the report which contains the financial template. Appendix 2 contains the BCF narrative report which covers the two-year period of the funding. The Board is asked to approve the BCF plans for 2024/25.
7.2 The Chair commented that the report provided evidence that longer-term funding works and that future longer-term funding from Government would be welcomed as this aids the surety and planning of services.
7.3 Ashley Scarff, Director of Joint Commissioning and ICT Development (East Sussex), NHS Sussex commented that the BCF template in Appendix 1 is an NHS England format which works well electronically but some sections can appear small in the printed format. He outlined that the work around demand and capacity planning continues throughout the year to aid modelling and ensure the Plan remains robust. The Discharge Fund element of the Plan will continue to evolve throughout the year, particularly the development of schemes for the winter period.
7.4 Stephen Lightfoot commented that he would like to put on record that NHS Sussex is grateful for the way East Sussex County Council (ESCC) colleagues have collaborated on the BCF. He stated that there are a really good set of initiatives in the Plan and agreed that longer-term funding enables better outcomes to be achieved. He outlined that the NHS Sussex contribution to the BCF is £57.5 million which has been increased by 6% compared with an overall increase of NHS budgets of 1%. This represents an investment in this activity and ensuring that the expenditure has an impact is important. Section 3.8 of the report sets out the four key measures that are mandated to monitor the delivery of the Plan, but it will also be important to look at more local measures, such as those around high intensity services users, carer support and urgent community care response.
7.5 Stephen Lightfoot added that in terms of impact, discharge is an important part of the activity delivered by the BCF funding. For example, in East Sussex Healthcare Trust (ESHT) hospitals the number medically fit to discharge patients as of 30 June 2022 was 115. This rose to 177 as of 30 June 2023 and then to 232 as of 30 June 2024, which represents a 29% increase and reduces the number of beds available. It will be important to use some of the BCF funding investment to reduce the number of patients ready and waiting for discharge from hospital. Going forward it will be important for the partners to achieve as much impact as possible from the BCF funding.
7.6 Mark Stainton agreed with the point made around measures and that it will be important to develop further measures, in addition to the four mandated measures, for the £94 million worth of expenditure. Some measures, such as those around the Disabled Facilities Grant, are reported in other places. ESCC, NHS Sussex and the NHS Trusts also carry out performance monitoring on a regular basis, some of which reflects the activity funded by the BCF. This could be drawn together to produce outturn monitoring information. There has been some very good joint working on discharge, with money ringfenced for discharge schemes across the Sussex health and care system.
7.7 Mark Stainton outlined that there are increasingly high levels of demand being experienced by the health and care system. In East Sussex the demography means that 26% of the population are over 65 years old, which is double the national average, and there has been an increase in the number of people over 85 years old. ESCC works well with ESHT and other partners to facilitate the timely discharge of patients and nobody waits for funding from Adult Social Care to get out of hospital. The position is complex with a number of reasons behind delayed discharges from hospital. Everyone in the system has a role to play in the collaborative work to tackle delayed discharges and only a small proportion in East Sussex are due to people waiting for social care.
7.8 The Chair commented on how much progress there has been in this area of work over the years and the local health and care system partnership is probably as advanced is it could be. Amy Galea, commented on the amount of learning that has taken place as a system, and the work of the transfer of care hubs has been reviewed recently. All partners have an understanding at a patient level of what is required and what needs to be done to support patient flow through the system.
7.9 The Board RESOLVED to:
1) Note the Better Care Fund requirements for 2024-25; and
2) Approve the East Sussex Better Care Fund Plans for 2024-25 recognising these represent an update on 2023-25 plans approved by the Board in June 2023.
8. Healthwatch East Sussex Annual Report 2023/24
8.1 The Board considered a report on the Healthwatch East Sussex Annual Report for 2023/24 ‘The value of listening’ which was introduced by Simon Kiley, Head of Evidence & Insight and Veronica Kirwan, Chief Executive Officer, Healthwatch East Sussex. The Board received a short presentation which set out the key highlights and achievements within the Annual Report.
8.2 The Board members commented on the superb work Healthwatch undertakes, which is really useful and valued, especially the advocacy work and making sure peoples’ voices are heard and acted on. The report is very positive and complements the range of work across the health and care system.
8.3 Councillor Webb commented on the work that was undertaken with Fishermen’s Mission around the new legislative requirements for fishermen to have a medical certificate to state they are medically fit to go to sea. He asked what the coverage was across the fishing communities in East Sussex. Simon Kiley responded that Healthwatch had worked with the Fishermen’s Mission and NHS Sussex to ensure as wide a coverage as possible to cover all the fishing communities.
8.4 Mark Stainton acknowledged the vital role that Healthwatch plays in the health and care system. In particular the outcomes from the Listening Tours where recommendations have been included in the work the Council is doing and have been inputted into the work on the Adult Social Care Strategy. The ‘enter and view’ visits that Healthwatch undertakes provide valuable information and insight on how well services are working. The work with seldom heard groups and ensuring the patient voice is heard, also fits in with the work the People Scrutiny Committee is undertaking on inclusion.
8.5 Councillor Ungar outlined that he had seen at first hand how the work of Healthwatch empowers the community to give their views and engage in a positive way, even if what they are saying may be negative. The Annual Report this year is once again an excellent report.
8.6 Stephen Lighfoot thanked Healthwatch for their Annual Report on behalf of NHS Sussex and outlined that this is for the range of work done and also the way in which it is carried out. The collaborative and constructive approach to all the work undertaken by Healthwatch is very positive and strong. The report is very well presented and has good case studies which illustrate the impact Healthwatch has. It also illustrates the value for money that can be achieved with a relatively modest budget, which perhaps the NHS can learn from.
8.7 The Board RESOLVED to note the Healthwatch East Sussex Annual Report 2023/24.
9. Director of Public Health Annual Report 2023/24
9.1 The Board considered the Director of Public Health’s Annual Report for 2023/24 ‘Creativity for Healthier Lives’ which was introduced by Darrell Gale, Director of Public Health. He outlined that the Director of Public Health Annual Report is a statutory instrument to put on record the work that is being done on the health and wellbeing of the local population. This is the fourth report in a series of reports that focus on the wider co-determinants of health, and that joy, love and happiness are really important co-determinants of health. The Annual Report is not in its final form due to the delays brought about by the pre-election period for the general election but will be finalised shortly. The report also covers next year’s Annual Report which will be focussed on coastal health and the impact of being a coastal county.
9.2 The Board thanked Darrell and the Public Health Team for an excellent and inspiring report. The Board commented that they were very excited by the creative approach to health and noted that projects could be taken into hospitals as well as communities. The projects provide love and joy, and there is no better way than visiting projects to see the impact they have on people’s lives.
9.3 Councillor Ungar thanked Darrell for the Annual Report which had enthused him and shows the strength and enthusiasm of the Public Health Team in delivering their work. He outlined the work that the People Scrutiny Committee is undertaking on healthy ageing. The evidence heard as part of the review demonstrates how well Public Health staff are working which also gives a greater presence in communities. The work being undertaken is a proactive way of improving healthy ageing with a modest amount of funding and shows the strength and depth of the work.
9.4 The Chair endorsed the report and the comments made by the other Board members. He thanked Darrell for the report.
9.5 Ashley Scarff welcomed the report and commented that NHS Sussex supports the work of the Public Health Team, particularly the work on the wider determinants of health and the importance of prevention. It also showcases the vital contribution the voluntary sector makes to the health and wellbeing of the local community.
9.6 Darrell Gale thanked the Board for their positive feedback on the Annual Report and the work of the Public Health Team, which illustrates the breadth and depth of work that is undertaken.
9.7 The Board RESOLVED to review and champion the 2023-24 Annual report of the Director of Public Health in East Sussex - Creativity for Healthier Lives, ahead of wider dissemination and publication.
10. Work programme
10.1 The Board considered the work programme. Mark Stainton outlined that there is one change to the work programme for the meeting on 26 September 2024 as the report on the Social and Wellbeing Plan has been withdrawn by NHS colleagues and will be rescheduled for a later date. He added that following the Board’s agreement under item 6, the informal ‘deep dive’ sessions on the Health and Wellbeing Strategy will be scheduled and the venues booked.
10.2 The Board RESOLVED to agree the work programme.
11. Any other items previously notified under agenda item 4
11.1 There were none.
The meeting ended at 3.45 pm.
Councillor Keith Glazier (Chair)