Issue - meetings

5.1       The Committee considered an update and evaluation report on the NHS Sussex Winter Plan. The Winter Plan set out how the local health and social care system plans to effectively manage capacity and demand pressures anticipated during the Winter period and ran from October 2022 to April 2023.

5.2       The Committee asked how information sharing could be improved between hospital Trusts and ambulance crews.

5.3       Claudia Griffith, Chief Delivery Officer NHS Sussex responded that there was a programme of work taking place across the whole system to improve digital integration of patient care records so that ambulance crews had access to them when they arrive at a scene, and this work was ongoing.

5.4       The Committee asked what impact the winter period had on elective surgery waiting times, and how many patients were waiting over a year for surgery.

5.5       Claudia Griffith explained that elective waiting times had grown significantly since the beginning of the pandemic, but that East Sussex Healthcare NHS Trust (ESHT) had met the nationally set target of no one waiting longer than 78 weeks by the end of March, and was ahead of schedule in meeting the target for this year of no patients waiting over 65 weeks. University Hospital Sussex NHS Foundation Trust (UHSx) had not been able to meet the 78 week target due to the impact of industrial action, but was expected to have cleared the backlog of patients waiting more than 78 weeks by the end of July. NHS Sussex was exploring all available options to make best use of capacity that could help reduce patient waiting times. Claudia agreed to provide the number of people waiting more than a year in East Sussex outside the meeting.

5.6       The Committee asked for further details on whether there were any differences in recovery and outcomes for patients being cared for via new ‘Virtual Wards’ service model in the community, as opposed to those in hospital.

5.7       Claudia Griffith answered that there was evaluation work both locally and nationally to understand the clinical and financial impact of virtual wards. Initial assessments suggested the impact had been positive, but NHS Sussex was also bringing in an external consultant to fully understand the impact of new service models in order to evaluate whether they should be expanded. The outcomes of this work could be fed back to the HOSC.

5.8       The Committee asked why patients who had contacted 111 and were given a reserved slot at the Emergency Department (ED) were arriving at hospital to find that they had to wait.

5.9       Claudia Griffith answered that while there was an option to book appointments at EDs, there was still a need for clinical prioritisation. Therefore, if booked slots coincided with surges in demand then clinicians would focus attention on those at greatest risk, and it would not always be possible to maintain the slot.

5.10     The Committee asked how many patients in East Sussex had NHS access to Livi on line consultations.

5.11     Claudia Griffith  ...  view the full minutes text for item 5

32.1     The Committee considered an update report on the NHS Sussex Winter Plan. The Winter Plan sets out how the local health and social care system plans to effectively manage the capacity and demand pressures anticipated during the Winter period and runs from October 2022 to April 2023.

32.2     The Committee asked how the virtual wards were staffed and where the patients were located.

32.3     Claudia Griffith, Chief Delivery Officer NHS Sussex responded that the virtual wards were a national model which is being piloted across Sussex. They are not located in any particular area and are supported by existing staff in community health services and by hospital clinicians. The concept is to try and keep people at home and wrap services around them for clinical conditions that can be safely managed at home.

32.4     The Committee asked if the virtual wards model was expensive and whether it could be expanded.

32.5     Claudia Griffith outlined that the model was more efficient but there is an issue with being able to increase the workforce in order to be able to expand the pilot. There are National Plan targets to increase capacity and there is a focus on how virtual wards could be used for patients with respiratory conditions and frailty patients who are at risk of admission.

32.6     The Committee noted that ambulance handover times had improved and asked how long patients were having to wait for an ambulance.

32.7     Claudia Griffith explained that the are a number of factors involved in ambulance response times for category 1, category 2, category 3 and category 4 calls. It is not just handover delays that affect response times and there have been a number of capacity issues for the South East Coast Ambulance Foundation Trust (SECAmb) which have affected response times. NHS Sussex has worked with SECAmb to support them and has used other Trusts such as the South Central Ambulance Service NHS Foundation Trust to provide additional capacity. Claudia Griffith agreed to circulate some information on ambulance response times for category 1, 2, 3 and 4 calls.

32.8     Claudia Griffith added that handover delays were very low at the current time and are in single figures for delays over one hour. Charlotte O’Brien, Director of Transformation and Improvement at ESHT commented that there had been only one handover delay over one hour this week at East Sussex Healthcare Trust (ESHT) hospitals.

32.9     The Committee observed that this winter period and particularly the time around Christmas and New Year had been challenging. It asked what the impact had been on staff and for an update on staffing issues.

32.10   Claudia Griffith acknowledged that it had been a really challenging situation and the health system does have a very tired workforce. There has been a lot of effort to support staff, but the situation remains very pressured taking into account the industrial action as well as winter pressures. There has been a significant focus on recruitment and retention and there is a workforce programme  ...  view the full minutes text for item 32

22.1     The Committee considered a report on the NHS Sussex Winter Plan. The Winter Plan sets out how the local health and social care system plans to effectively manage the capacity and demand pressures anticipated during the Winter period. The Winter Plan is a whole system health and social care plan, recognising the interdependencies of the system to meet the needs of the local population and runs from October 2022 to April 2023.

22.2     The Committee welcomed the degree of collaboration and focus on admission avoidance in the Winter Plan and asked if there were any particular areas or specialities where there were concerns.

22.3     Adam Doyle, Chief Executive Officer NHS Sussex, outlined there were four main areas which the system is working on areas of risk. These are:

• The numbers of people having a response to an ambulance call out. Work started two months ago to reduce 60 minute handover delays to ensure patients are seen quickly and free ambulances to respond to other calls and also as part of the rapid improvement programmes looking at patients who could be seen by a different service (e.g. community nursing teams) rather than waiting for an ambulance.
• Work to monitor and reduce the number of people in Emergency Department (EDs) waiting over 12 hours for a bed. Performance against this measure is quite good in East Sussex.
• Working with the Sussex Partnership Foundation Trust (SPFT) on mental health presentations in emergency (ED) and urgent care pathways to make sure people are seen quickly.
• The risk to the workforce from staff shortages across the system and the affect on staff morale. There is a weekly leadership meeting which looks at staffing issues. This is also being addressed in longer term through the 10 year workforce plan.

22.4     The Committee asked what the position was for upper gastrointestinal (GI) surgery at the Royal Sussex Hospital after the suspension of some non-urgent surgery following the Care Quality Commission (CQC) inspection and the subsequent press release.

22.5     Adam Doyle outlined that NHS Sussex works very closely with the CQC and was aware of the inspection and suspension of some surgery. All patients who have been affected by this have been contacted to let them know what their care pathway will be. Communications were sent out by the University Hospitals Sussex Trust (UHSx) and NHS Sussex will review how communications are handled should a similar situation occur in future. Adam Doyle offered to speak to Cllr Osborne outside the meeting concerning the communications with GP practices in her area.

22.6     The Committee asked what the impact had been on bed occupancy and making sure patients are seen, as the Winter Plan had been operating since October.

22.7     Adam Doyle responded by providing an overview of the position. From October to the end of November all measures were tracking in the right direction in terms of the numbers of people waiting over 12 hours for a bed and over 60 minutes for a handover from an ambulance.  ...  view the full minutes text for item 22