Issue - meetings

1.1.        The Committee considered a report about the financial and clinical sustainability of the NHS in East Sussex including the Financial Recovery Plans (FRP) of the three Clinical Commissioning Groups (CCGs); the progress of the Sussex and East Surrey Sustainability and Transformation Partnership (STP); and the Clinically Effective Commissioning (CEC) workstream of the STP.

1.2.        Dr Adrian Bull, Chief Executive, East Sussex Healthcare NHS Trust (ESHT); Jessica Britton, Managing Director, Eastbourne, Hailsham and Seaford CCG (EHS CCG)/ Hastings and Rother CCG (HR CCG); Ashley Scarff, Director of Commissioning and Deputy Chief Officer, High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG); and Samantha Williams, Assistant Director of Planning, Performance and Engagement, East Sussex County Council (ESCC); provided answers to a number of questions from HOSC.

Financial Recovery Plans (FRP) of the CCGs

Details of savings plans

1.3.        Ashley Scarff explained that the C4Y FRP involved delivering £9.2m of savings in order to reach a deficit control total of £10.7m. If this target is reached the CCG will receive £10.7m of Commissioning Sustainability Funding (CSF) that will mean it ends the year without a deficit. The FRP comprises a mixture of short and long term savings plans, for example, a major MSK redesign a number of years ago now delivers cumulative savings of £1.25m per year, which is identified in the FRP. Short term savings are to be made from discretionary spend such as overheads and corporate costs that can be stopped more swiftly and that do not have an impact on patient care, for example, vacancy freezes in CCG offices.

1.4.        Jessica Britton explained that the East Sussex Better Together (ESBT) CCGs’ FRP includes the delivery of £18m of Quality, Improvement, Productivity and Prevention (QIPP) schemes in order to contribute to reaching a combined deficit control total of £32m across both CCGs. As with the C4Y FRP, achieving this deficit control total will result in a CSF payment of £32m.  The QIPP programme includes 18 schemes, some of which aim to improve the organisational efficiency of the CCGs; some of which involve reviewing contracts to ensure they are cost effective;  and some of which involve the development of new services or pathways that are more cost effective, for example, pharmacists supporting GP practices and community health services to ensure people are given the right medications; and the High Intensity User Service that involves community-based services providing pro-active care to high users of hospital services to reduce instances of them reaching a crisis point and presenting in A&E, which is a more costly outcome to the health system. In addition the CCGs are working to ensure all other spend is contained within current budgets.

Unmitigated risk in FRP

1.5.        Ashley Scarff said that HWLH CCG has identified savings schemes for all but a few hundred thousand of the target £9.2m savings in its 2018/19 FRP. These identified savings, however, are on a spectrum from assured delivery at one end to savings that are at a high risk of  ...  view the full minutes text for item 12