Issue - meetings

26.1.      The Board considered a report providing an update on progress with implementing the revised integration programme after the first phase of COVID-19.

26.2.      The Board asked whether health inequalities impact assessments should be mandatory for all future integration projects, rather than just optional, and whether the East Sussex Health and Social Care Plan (ESHSCP) can include specific reference to how it plans to improve the health and wellbeing of Black and Minority Ethnic Communities (BAME) communities and health and care workers in East Sussex.

26.3.      Jessica Britton, Executive Managing Director, East Sussex Clinical Commissioning Group (CCG) said understanding and tackling health inequalities is integral to the ESHSCP and the population’s health needs are kept under continual review. in addition, a specific piece of work on population health needs has recently been undertaken that enables the ESHSCP to understand health inequalities in East Sussex based on specific areas of need, e.g. geographical location. She added that targeted and specific investment has also been made into Hastings through the CCG’s Healthy Hastings and Rother programme in support of identified needs of the local population. The HWB will continue to have a role in improving the health of the whole East Sussex population, including identifying areas of inequalities that can be focussed on.

26.4.      Dr David Warden, Chair of the East Sussex CCG, said the local response to the NHS Long Term Plan submitted by the ESHCP clearly states a strong desire to focus on prevention. The challenges are that it requires additional resources to create the preventative care services that will address these health inequalities, and that it can take several years or more to see the benefit of preventative services once they are in place.

26.5.      Mark Stainton, Director of Adult Social Care, added that addressing health inequalities, particularly amongst the BAME community is a key priority of all ESHCP partners, including East Sussex County Council, and will therefore be a key part of any integration plan that is developed. One of the strengths of the Target Operating Model for community health and social care services in East Sussex is that it effectively divides the county into eight localities and that means that each can focus on and target the differing health needs of the particular local population. He said this is one of the ways the practical ways in which the ESHCP will work to address health inequalities.

26.6.      Jessica Britton also reminded the Board that the Sussex Health and Care Partnership – the Integrated Care System (ICS) – has a specific programme of work for BAME population and staff, and the East Sussex Health and Social Care System Partnership Board recently reviewed this work and agreed that the findings will help inform and strengthen ESHCP integration plans.

26.7.      The Board asked whether a primary care review of GP provision in Hastings will be undertaken.

26.8.      Jessica Britton said the East Sussex CCG – through it Primary Care Commissioning Committee – already regularly reviews primary care provision in East  ...  view the full minutes text for item 26

15.1.      The Board considered a report on the progress on work to implement a revised East Sussex Integration programme in 2020/21 resulting from the changes brought about by the COVID-19 pandemic.

15.2.      The Board asked for clarity whether teenagers aged between 16 and 18 are treated by paediatric nursing teams in East Sussex or adult teams.

15.3.      Adrian Bull, Chief Executive of ESHT, said that in the western part of East Sussex where Sussex Community NHS Foundation Trust (SCFT) are commissioned to provide diabetic services to children they stop at aged 16, whereas in other parts of East Sussex the service stops at 18. He said that work is ongoing to resolve this gap. More broadly, the issues of transition of services for people moving from children to adults is a key one that many systems face difficulties in getting it right. ESHT has a Transition Group chaired by Vicky Carruth, Director of Nursing, that is looking at the issue, and the Trust has appointed a dedicated transition nurse role to ensure better transition of care, particularly for children moving from the paediatric neurology, cardiology and diabetes services into the adult services. He added that whilst there may be a contracting gap in terms of whether the service provided is a child or adult service, the affected children will not be left unattended without care during this time.

15.4.      The Board asked whether the potential ophthalmology project listed as part of the planned care programme would increase the capacity of the ophthalmology service and whether it would include a greater amount of community based ophthalmology services that save people having to attend a hospital.

15.5.      Adrian Bull explained the ophthalmology project is Sussex-wide and involves developing better collaboration between high street opticians and the hospital-based services in order to improve capacity and enable more community-based reviews of people with these long term conditions, which are common amongst patients using the service. This is part of a wider approach ESHT is taking to streamline the monitoring of people with long term conditions, which also includes upgrading ICT systems to enable better monitoring of patients.

15.6.      The Board RESOLVED to:

1) Note the progress made with producing a revised East Sussex health and social care integration programme, taking account of changes to our integrated working due to COVID-19; and

2) Note that detailed projects and metrics for the finalised programme will be worked up in the suggested areas to enable programme monitoring