Issue - meetings

1.1.        The Committee considered a presentation providing an update on the progress of the Connecting 4 You health and social care transformation programme in the High Weald Lewes and Havens (HWLH) area of East Sussex.

1.2.        Keith Hinkley, Director of Adult Social Care and Health, East Sussex County Council; Ashley Scarff, Director of Commissioning and Deputy Chief Officer, and Sam Tearle, Senior Strategic Planning & Investment Manager, both from High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG), answered questions from HOSC Members.

The key achievements of the Connecting 4 You programme

1.3.        Ashley Scarff said that Connecting 4 You (C4Y) has helped improve multi-agency working, with both Sussex Community NHS Foundation Trust (SCFT) and the East Sussex County Council (ESCC) Adult Social Care Department aligning their services towards the four “Communities of Practice” and improving community care pathways. Keith Hinkley said that the key improvement of C4Y has been to align operational services so that they are able to provide unified case management for patients.

1.4.        Ashley Scarff outlined some new services that have been introduced as part of C4Y that have resulted in a reduction in hospital admissions, including:

·         Consultant Geriatricians who proactively outreach into local communities to support old and vulnerable people;

·         Community Diabetes Service, with significant focus on education for patients to manage that long term condition;

·         Joint Musculoskeletal Service with Eastbourne, with Hailsham and Seaford Clinical Commissioning Group (EHS CCG) that is piloting a self-referral service for people with physiotherapy needs, for example, chronic back pain. This is receiving extremely positive feedback from patients and clinicians.

1.5.        Keith Hinkley added that the High Weald Lewes Havens (HWLH) area is receiving new joint health and social care services such as Health and Social Care Connect (HSCC) and the Joint Community Reablement teams that are being delivered across the whole of East Sussex.

Progress of C4Y

1.6.        Ashley Scarff explained that the health and social care budgets have been aligned and the C4Y Programme Board receives a combined financial plan that shows the aggregated budget for the whole health and social care economy in the HWLH area. However, at this stage they are not pooled in the same way as they are for the East Sussex Better Together (ESBT) Alliance, which has an agreed Strategic Investment Plan (SIP) for 2017/18.

1.7.        Sam Tearle explained that a detailed timeline of the C4Y programme will be presented to the C4Y Programme Board on 19 July; it will include how the SIP and the Multi-Specialty Community Provider (MCP) model for C4Y will be progressed. He said that the pace of the programme will increase over the summer and into autumn.

1.8.        Keith Hinkley added that strategic investment planning for the HWLH area is flagged in ESCC’s State of the County document that was agreed by Cabinet in June. He said that it is expected that decisions about the SIP, alongside the design of the MCP model, will be made towards the end of 2017. It will be difficult to develop  ...  view the full minutes text for item 5

33.1     This item was introduced by Wendy Carberry, High Weald Lewes Havens Clinical Commissioning Group (HWLHCCG) Chief Officer; Ashley Scarff, HWLHCCG Director of Strategy; Alan Beasley, HWLHCCG Chief Finance Officer; and by Siobhan Melia, Director of Partnership and Commercial Development, Sussex Community NHS Trust (SCT). The speakers also introduced and took questions on the HWLHCCG Annual Operating Plan item (item 6) at this point.

33.2     Wendy Carberry told the committee that HWLHCCG patient flows differ considerably from those of the other East Sussex CCGs. For Eastbourne, Hailsham & Seaford CCG (EHS) and Hastings & Rother CCG residents, the great majority of healthcare activity takes place within the county. In particular, most people living in these areas access secondary care services at either Eastbourne District General Hospital or at the Conquest Hospital, Hastings. However, although HWLHCCG residents receive the majority of primary and community services within East Sussex, the great majority of people access secondary care services from out of county providers – particularly from hospitals in Brighton, Hayward’s Heath and Tunbridge Wells.

33.3     This means that HWLHCCG has to contribute to planning for better integration and co-working across three health systems: East Sussex, Brighton & Hove & Mid Sussex, and West Kent.

33.4     Wendy Carberry told the committee that HWLHCCG has been criticised for over-emphasising flows into acute care when one of the principle strategic NHS goals is to reduce reliance on acute care. However, the CCG believes that district general hospitals have an integral role to play in designing effective health and care systems; a view which is supported by NHS England and by NHS Five Year Forward View planning guidance. The CCG’s plans fit well with the requirements of NHS Sustainability & Transformation Plans (STPs)

33.5     The CCG felt that too much of its time was being spent on East Sussex Better Together (ESBT), when only around 10% of HWLH residents receive their healthcare exclusively within East Sussex. The CCG was also uncomfortable with the pace of change involved in year two of the ESBT project.

33.6     In consequence, HWLHCCG withdrew from ESBT. The CCG is committed to working with partners towards better system integration in East Sussex and in the other areas that it works with. This includes working with Brighton & Hove and Horsham & Mid Sussex CCGs on an ‘A23 South’ programme; working with Kent CCGs on an integration programme centred upon Maidstone & Tunbridge Wells hospitals; working directly with Sussex Community Trust and Brighton & Sussex University Hospitals Trust to develop the Queen Victoria Hospital, Lewes as a hub for community services; and working with MTW and Kent CCGs on developing Crowborough Community Hospital as a community and gerontology hub. In East Sussex, the CCG has launched its ‘Connecting 4 You’ programme and has invited the County Council and other key partners to join the Programme Board.

33.7     The CCG is committed to implementing the NHS Five Year Forward View. One area of focus will be on improving community services, working in close partnership with Sussex Community Trust. Another focus will be on  ...  view the full minutes text for item 33