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 1 November 2024 to 31 March 2025. The plan was developed against demand and capacity modelling for each of the key workstreams, and the outcomes have been evaluated against the objectives. This review identifies key areas of improvement to be incorporated into planning for Winter 2025-26.

5.2           The Committee asked what the barriers to discharging patients from hospital were and how capacity can be developed in the community to receive people out of hospital.

5.3           Ashley Scarff, Director of Joint Commissioning and Integrated Care Team Development NHS Sussex, responded that managing hospital discharge was a system-wide issue, requiring collaboration between all system partners. NHS Sussex have been working with partners to develop consistency in their approach to discharge; there was a correlation between the ability to discharge ‘No Criteria to Reside’ (NCTR) patients and bed occupancy levels, so this work is ongoing.

5.4           Mark Stainton, Director of Adult Social Care and Health, East Sussex County Council, clarified that NCTR refers to patients that no longer had a medical criteria to reside in hospital, but there are multiple reasons why people might need to remain in hospital longer than necessary. A number of NCTR patients have multiple and complex needs, including cognitive needs, so multiple agencies are engaged to safely discharge them. Significant capacity exists in the home care market, but bedded care placements were more limited and more complex needs made discharge into bedded care more complicated. While much work went into preventing people needing to go into hospital in the first place, there was also work done with hospital trusts to map patient journeys through hospital, particularly where they had an extended length of stay, to locate where they encounter barriers to discharge and address these ahead of time. While there had been a sustained improvement in the number of patients waiting for discharge, there was still a lot of progress needed.

5.5           Simon Dowse, Director or Transformation, Strategy and Improvement, East Sussex Healthcare Trust (ESHT) added that bed occupancy numbers could be misleading as what mattered from a hospital operational perspective was whether the right beds were available to meet patient need. This fluctuated day to day and multi-agency discharge events (MADE) had been successful in improving intra-day bed occupancy levels. The trust continues to work with community based bed capacity and the social care sector to improve flow of people. ESHT were also conducting analysis of its own processes to manage patients’ movement as quickly as possible.

5.6           The Committee asked how Integrated Care Board (ICB) savings plans will impact this capacity next winter.

5.7           Ashley Scarff clarified that the ICB was having to make savings in the cost of running the organisation, which is separate to its commissioning budget. The savings plans  ...  view the full minutes text for item 5

23.1     The Committee considered a report on the NHS Sussex Winter Plan 2024/25. 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 reflects on lessons learnt from previous winters and other system pressures.

23.2     The Committee asked what level of vaccine uptake was being aimed for over the winter and how vaccination take up compared with previous years’ levels.

23.3     Dr James Ramsay, NHS Sussex Chief Medical Officer, explained that vaccine uptake was monitored against national levels, and that NHS Sussex was in line with national averages despite a slow initial uptake. There was reduced uptake this year than in recent previous years, due to vaccine hesitancy and fatigue in both the general population and the workforce. NHS Sussex was working with providers to increase uptake within staff groups.

23.4     The Committee noted that the Joint Committee on Vaccination and Immunisation (JCVI) had announced that it was planning to tighten eligibility for vaccinations in 2025 and that this would need to be considered as part of on next year’s Winter Plan.

23.5     The Committee asked what was being done to improve vaccine take up with vulnerable groups.

23.6     Dr Ramsay confirmed that work was ongoing to increase vaccine uptake in vulnerable groups. People who were more likely to require acute services and healthcare over the winter, such as those with learning disabilities or frailty were being identified at a primary care level and support was being put in place to increase vaccine uptake in these people. In line with the general population there had been reduced uptake in these groups than in previous years, but that NHS Sussex continued to try and increase uptake.

23.7     The Committee asked for more information on temporary staffing levels that would be required over the winter period.

23.8     Richard Milner, ESHT Chief of Staff, noted that temporary staffing would not be coordinated system-wide but by individual provider trusts. ESHT sought to minimise its use of temporary staff and so had enhanced processes for booking staff rotas and managing staff leave over the period to have these set 6-8 weeks in advance. ESHT had a ‘bank’ system for permanent staff that wished to do additional hours which didn’t have the same associated cost as using temporary staff. Planning for staff levels began in August to ensure temporary staff were not required over the winter period. John Child, SPFT Chief Operating Officer, noted that the processes for SPFT were similar to ESHT to have staffing levels and rosters planned well in advance of winter. SPFT had ‘safer staffing numbers’ which mandated minimum staff levels for safety and quality of care, and processes in place to bring in temporary staff to meet patient need and acuity.

23.9     The Committee asked what the  ...  view the full minutes text for item 23