Issue - meetings

19.1.      The Committee considered a report providing an update on planning across East Sussex to deal with seasonal surges in demand, extreme weather and other issues associated with the winter months.

19.2.      Ashley Scarff, Director of Commissioning Operations – High Weald Lewes Havens CCG; Jessica Britton, Managing Director of East Sussex Better Together CCGs; Mark Angus, Winter Director, Sussex and Surrey CCGs; Andy Cunningham, Head of Care Management (Hospitals), (in attendance from the Adult Social Care Department); Dr Adrian Bull, Chief Executive, East Sussex Healthcare NHS Trust (ESHT) and Joe Chadwick-Bell, Chief Operating Officer, ESHT, provided answers to a number of questions from HOSC.

Maintaining 85% bed capacity over the winter period

19.3.      Mark Angus explained that 85% is recognised nationally as the ideal occupancy rate for beds in an acute hospital. However, it is also recognised that occupancy rates will usually be higher than 85% over winter months due to the fact that, whilst the number of admissions are not necessarily much higher, patients who are admitted tend to be sicker and therefore are admitted for longer periods. He said that the winter resilience plans aim to manage this period of generally higher occupancy safely and effectively within hospitals, whilst also ensuring that the whole healthcare system can respond in a co-ordinated way to individual surges in demand.

Avoiding unnecessary readmissions due to early discharge of patients

19.4.      Mark Angus said that the healthcare system in East Sussex performs relatively well in relation to readmission rates. This is due to a number of checks and balances that are made during the discharge process that ensure patients are only discharged when ready to leave hospital. He confirmed that this process does not change during the winter period. Joe Chadwick-Bell added that figures showed that since introducing same-day ambulatory care at the A&E Departments readmissions rates had not risen. This demonstrated that whilst patients were receiving a shorter period of care than they would if admitted as an emergency inpatient they were not experiencing worse outcomes.

Personal Management Plans for patients with chronic conditions

19.5.      Joe Chadwick-Bell explained that patients with a long term condition generally have a shared care plan agreed between their consultant and GP that clinicians will have access to. The East Sussex Better Together (ESBT) Alliance has amended the care pathways for five long term conditions so that should a patient with one of these conditions be in crisis they are referred to the ESBT Crisis Response Team and managed in the community, where possible.

Readiness of NHS 111 over winter and ability to book appointments

19.6.      Mark Angus said that there is a detailed plan for NHS 111 over the winter based on lessons learned from last year, including ensuring that there is sufficient workforce in place to meet expected demand. Recruitment to 111 has been encouraged by introduction of a national career framework, which clearly defines the career path opportunities for both non-clinical and clinical call-handlers to improve the attractiveness of the role  ...  view the full minutes text for item 19