Issue - meetings

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27.1.      The Committee considered a report providing an update on the Clinical Commissioning Groups’ (CCG) and East Sussex Healthcare NHS Trust’s (ESHT) expected financial outturn for 2018/19 and their future financial plans.

27.2.      The Committee received a number of responses to its questions from the witnesses in attendance.

Areas targeted for savings

27.3.      Jessica Britton, Managing Director, Eastbourne, Hailsham and Seaford CCG (EHS CCG)/ Hastings and Rother CCG (HR CCG), explained that Quality, Improvement, Productivity and Performance (QIPP) savings made by the CCGs are designed to help improve patient care and at the same time make healthcare more cost effective. Jessica Britton provided some examples of QIPP savings for 18/19:

• a communities pathway programme that involves training community-based staff to treat certain ailments that frail people are often admitted to hospital for that could better be treated in their home, for example, a blocked catheter, or non-injury fall;
• a programme to target and case manage persistent users of A&E (who often use it for non-medical reasons) to keep them out of hospital and better support them at home; and

·         a programme to ensure that GPs are referring patients to hospital outpatient appointments appropriately using the best possible clinical evidence to avoid instances of outpatient diagnostics being carried out unnecessarily.

27.4.      Jessica Britton added that medicine management is an area that can deliver £3-5m of savings per year whilst also providing a better service for patients through, for example, introducing medicine reviews for patients. QIPP savings have been identified in this area.

27.5.      Keith Hinkley, Director of Adult Social Care and Health, East Sussex County Council, said that there is a continued commitment in 19/20 towards a comprehensive programme of integration across community health and social care in East Sussex that will help significantly increase productivity and use the available funding more efficiently by managing people in the community; responding more quickly to people in crisis in their own homes; and facilitating speedier discharge from hospital. A report setting this out will go through the governance process of the CCGs and the Council in the next few months.

27.6.      Jonathan Reid, Finance Director, ESHT, said that Cost Improvement Plan (CIP) savings are also aimed at providing a better quality service whilst reducing costs. He said CIP savings include:

• better recruitment, retention, and workforce plans to reduce the reliance on costly agency staff;
• increasing productivity of community staff by rolling out laptops to them, allowing them to do more for less; and
• recruiting a Head of Procurement who looks for the best possible deal for purchasing medical supplies.

Risk assessment of savings plans

27.7.      Jessica Britton confirmed that the CCGs QIPP schemes all go through a both an Equality Impact Assessment, and a Quality Impact Assessment that are shared with the governing bodies to help them when taking a decision about a proposed QIPP scheme. All QIPP schemes  ...  view the full minutes text for item 27