Issue - meetings

15.       

16.       

16.1.      The Board considered a report and presentation providing an update on the key developments and progress in 2019/20 of the East Sussex Health and Social Care Plan (ESHSCP).

16.2.      The Board asked about the financial performance of the ESHSCP and whether the financial incentives within the system now support co-operation rather than work against it.

16.3.      Vicky Smith, Programme Director - East Sussex Health and Social Care Transformation, said broadly speaking the payment by results system has now been replaced by aligned incentive contracts. These contracts incentivise developing patient pathways throughout the health and care system, rather than encouraging acute hospitals to maximise the volume of health interventions they perform like a payment by results contract does. The financial framework for managing the collective resources of the organisations within the ESHSCP will build on existing framework agreements such as the Better Care Fund. This financial framework, however, will need to be reviewed in light of the impact of Covid-19 on the finances of the ESHSCP member organisations. 

16.4.      The Board asked how patients react moving from the six weeks of free social care they are entitled to into paid for care.

16.5.      Adrian Bull said that as long as two funding models exist side by side, there will be some issues surfacing when someone transfers from free at the point of use NHS care to means tested social care. In his experience, however, the elderly patients tend to accept this arrangement and the issues are often around their children feuding over their inheritance rather than prioritising their parent’s care.  The process of integration between health and social care teams that deal with the discharge of patients from hospital or assessment beds has made this process much easier to manage and better for patients. He explained as a result of Covid-19 that the NHS is currently paying for the up to six weeks of care that patients are entitled to free of charge,  and which is normally funded by local authority responsible for adult social care, to help ensure there are no delays  in the discharge process in order to free up bed space to deal with Covid-19.

16.6.      The Board asked about the involvement of primary care in the integration programme and the progress of improvement in primary care.

16.7.      Jessica Britton said that Covid-19 had been a challenging time for the whole health and social care service, including primary care. Infection control measures put in place to continue operating safely during the pandemic mean people now access primary care in a different way, although people will be able to have a face to face appointment if clinically appropriate to do so. Adrian Bull said he thought telephone booking and consultations had improved significantly over the Covid-19 outbreak.

16.8.      Jessica Britton said the performance of primary care varies across East Sussex due to the number of practices in the county. There is very good General Practice (GP) coverage in some areas and in other areas the CCG  ...  view the full minutes text for item 16