Issue - meetings

7.1       The Director of Adult Social Care and Health introduced the report. The following points were made in response to questions from the committee:

·         The East Sussex Better Together (ESBT) outcomes framework was developed based on the key statutory requirements of each organisation and what local people have said is important in their lives. These elements have been drawn together into the key areas ESBT is looking to address. The pilot framework has been shared with stakeholders and a single performance system is being developed to manage and monitor it.

·         The intention is to develop more detailed performance indicators against each of the outcomes to measure delivery. The framework is made up of a mix of indicators based on actual data about the delivery of services and perception indicators, which reflect requirements in the national NHS and Adult Social Care Outcomes Frameworks to ask people about felt experience. Some other measures will be subject to multi-agency case audit.

·         The options appraisal process reflects the principles agreed by Cabinet which have been converted to a scoring framework. Representatives of all ESBT Alliance organisations will form part of a panel which will score options, aiming to achieve a consensus view. Sovereign bodies will ultimately decide on the way forward based on the panel’s recommendation.

·         The NHS wants and needs to transform services in a similar way to social care. Health services are also experiencing pressures and need to reduce demand by focusing on prevention. Spending more on social care can reduce demand on acute care and there are benefits to all by working as a whole system and looking at how the collective health and social care budget is spent.

·         There is a need to retain democratic accountability and management of performance in any new governance structure. ESBT Alliance governance is currently complex due to the mix of old and new, but ultimately the aim is to simplify how health and social care are commissioned and delivered. NHS regulation also needs to adapt to new ways of working.

·         Staff have been engaged through the normal engagement processes within individual organisations but additional mechanisms have been added specifically in relation to ESBT issues such as the changes to service models.

·         Staff are aware of potentially large scale change and if there is organisational change the usual policies will apply. Staff have already experienced significant change due to the service changes implemented to date through ESBT.

·         Following the options appraisal process there will be a public report to Cabinet in July setting out the proposed way forward. This will be followed by a further round of staff engagement to explain the next steps.

·         The ESBT Scrutiny Board has enabled scrutiny at each stage of the process and this will continue. Further thought would be needed as to how scrutiny would operate in a full accountable care system.

7.2       RESOLVED to note the report.