Issue - meetings

36.1     The Board considered a report providing an update on the ESBT financial position and progress with the Strategic Investment Plan (SIP).

36.2     In response to questions from the Board, officers made the following key points:

·         Work is ongoing to identify each ESBT organisations’ cost reduction plans and service redesign plans. This is being done to avoid duplication, and to potentially develop a single cost reduction plan and single service redesign plan across ESBT.

·         One of the key learning points from the 2017/18 test bed year has been the difficulty in attracting additional staff to ESBT for the newly developed roles and the tendency instead for staff to move from different areas of the existing workforce, creating gaps elsewhere.  Work will be undertaken to mitigate against this happening where possible during 2018/19.

·         There is now a better understanding of the support needed to develop the ESBT Locality Teams. Central support team will now assist operational managers in developing the teams during 2018/19.

·         The CQC was complementary about the ESBT community resilience workstream, for example, the development of community link workers, who make contact with and support local community and voluntary organisations in order to develop the health and wellbeing resilience in their communities. The possibility of ensuring link workers contact town and parish councils will be explored.

·         NHS Improvement (NHSI) and NHS England (NHSE) have requested that the CCGs demonstrate that they have identified all possible efficiency savings. This is to enable the contract discussions for 2018/19 to begin with the CCGs presenting the best possible financial position that is still realistic and deliverable. From this point discussions will progress about how the CCGs can achieve its designated control total.

·         The Sussex and East Surrey Sustainability and Transformation Partnership (STP) could potentially provide a strengthened collaborative position with which to engage in contract discussions with NHSI and NHSE because it includes several other CCGs with similar financial issues. 

·         ESBT was forecast to overspend on prescribing by £850k by the end of the year. This is due to the national lack of availability of cheaper medicine stock resulting in ESBT paying more for prescribing medicines than was previously the case. If this was not the case ESBT would have achieved an efficiency of £5.3m through new initiatives such as the medicines management teams that visit care homes and GP practices to assist with prescribing and electronic repeat prescriptions.  The total expenditure on prescribing is around £70m.

36.3     The Board RESOLVED to:

1.    note the East Sussex Better Together (ESBT) system financial position and scale of forecast outturn variance;

2.    note that we are working closely with our NHS regulators, NHS England (NHSE) and NHS Improvement (NHSI) to ensure there is complete transparency and understanding of the position and mitigating plans in the remainder of 2017/18 and into 2018/19; and

3.    endorse the recovery actions being developed and implemented collaboratively through the ESBT structures, including the financial planning framework for 2018/19