Issue - meetings

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30.1.      The Board considered a report on the progress made with developing a long term health andsocial care plan for East Sussex, including detailed plans for 2020/21.

30.2.      The Board asked how the Clinical Commissioning Groups (CCGs) would help to ensure GP practices could continue to recruit and retain GPs.

30.3.      Martin Writer, Chair of Eastbourne, Hailsham and Seaford Clinical Commissioning Group (EHS CCG), there has been historic issues of GP recruitment and retention in East Sussex, particularly in the East of the county. The CCG now has, however, a significant boost in funding and plan for the next 3-4 years to bring in additional staff to the primary care sector that will allow it to become more resilient. There is a training scheme in place for GPs and a number of new doctors are in the process of becoming GPs; recruitments also continues of other health practitioners into GP practices, such as Advanced Nurse Practitioners, pharmacists, and paramedics as part of the new Primary Care Networks (PCNs).

30.4.      The Board asked about why there was not reference to COVID-19 in the East Sussex Health and Social Care Plan (ESHSCP).

30.5.      Keith Hinkley, Director of Adult Social Care and Health, explained that the ESHSCP is set on an annual basis and describes the plan for further integration of health and care services in East Sussex for that year. It therefore does not include a response to the Covid-19 pandemic, which would instead be dealt with through business continuity and emergency planning structures of East Sussex County Council, the CCGs and NHS healthcare trusts in partnership.

30.6.      The Board asked whether it would be possible to include examples of how health and care pathways have changed as a result of the integration programme to demonstrate to the public the improvements that have taken place.

30.7.      Keith Hinkley said it was important to provide the Board with enough information to fulfil its role of having a strategic oversight role of the ESHSCP. The reports coming to the Board are key policy and strategy documents with enough detail around performance for the Board to fulfil its functions. Other stakeholders are provided with information about the ESHSCP’s priorities and service designs in a different way. Future reports to the Board could, however, include examples of new services and pathways, as well as more granular details of some of the performance outcomes, to help illustrate the progress of integration.

30.8.      The Board RESOLVED to:

1. Note the update and the work being undertaken to put in place programme arrangements for 2020/21, including governance, key projects, objectives and Key Performance Indictors;

2. Endorse the draft proposal for an East Sussex Integrated Care Partnership (ICP), to help support delivery of our plan in 2020/21 and in subsequent years, noting that further work will be taking place in the coming weeks to support the ongoing development of the ICP; and

3. Endorse the proposed and updated outcomes framework setting out the  ...  view the full minutes text for item 30

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31.       

31.1.      The Board considered a report providing an update of progress against the priority objectives and lead Key Performance Indicators for the health and social care programme in 2019/20.

31.2.      The Board asked whether after the CCGs’ merger the CCG will report its Key Performance Indicators (KPIs) performance within the historic footprints of the three CCGs in East Sussex, so that people living in those areas can see whether performance has improved or not.  

31.3.      Ashley Scarff, Director of Partnerships & Commissioning Integration, confirmed that following the merger, the CCGs would produce a single KPI report that would be benchmarked internally, as well as externally against other place-based plans. The geography of the current three CCGs will become less relevant over time, however, and instead the base unit around which benchmarking will be undertaken internally will be the PCN footprints.

31.4.      The Board RESOLVED to note the progress in Quarter 3 against the priority objectives and lead Key Performance Indicators (KPIs) for 2019/20.

20.1.      The Board considered a report on the progress made with developing a long-term health and social care plan for East Sussex.

20.2.      The Board asked whether the closer working between health and social care would help improve the process of completing education, health and care plans (EHCPs) for children and young people in a timely manner.

20.3.      Stuart Gallimore, Director of Children’s Services, agreed there were sometimes issues with the production and co-ordination of the EHCPs between health and social care organisations. He said that the integrations plans designed to improve the disability pathway for children and young people would include addressing issues such as the co-ordination of the EHCPs.

20.4.      The Board asked why the Plan did not include more detail of the prevention agenda, for example, what was being done to reduce obesity and homelessness.

20.5.      Keith Hinkley, Director of Adult Social Care and Health, said that the Plan as presented to the HWB focuses on the integration between health and social care in East Sussex and includes a broad description of the key strategic objectives. There is more work being undertaken than is included in the Plan, including the core commissioning work of the individual organisations and individual programmes to develop joint working. He explained that there will be future iterations of the Plan produced that will provide more detail of these specific projects and programmes, which are designed to address issues such as housing and homelessness. These include engagement with the new Primary Care Networks (PCNs) to ensure they are involved in future joint working with social care and health teams; and bidding for further homelessness support grants to expand the rough sleeping initiative developed in Hastings. The HWB will have the opportunity to consider and comment on these projects at an appropriate time.

20.6.      The Board asked how plans to develop integrated community-based services could be reconciled with the closure of services like Little Oaks respite service in Eastbourne.

20.7.      Keith Hinkley said that there are significant demographic and funding challenges in East Sussex that can only be addressed in a sustainable way by reducing demand for acute care. This involves the long-term investment in integrated services and a greater focus on preventative and proactive care. At the same time, difficult decisions have to be made on a short-term basis about where to prioritise available resources year on year. This has led to situations, for example, like 2018/19 where the Council had to make significant savings to its Adult Social Care Department budget but at the same time invested in joint services with East Sussex Healthcare NHS Trust (ESHT) such as the Joint Community Reablement teams; Health and Social Care Connect (HSCC); new rough sleeping and homelessness services; and integrated locality teams.

20.8.      Stuart Gallimore added that sometimes it is more appropriate to provide a service in a different and more innovative way, rather than maintain it in its current state. In the case of Little Oaks, by working with partner organisations  ...  view the full minutes text for item 20