Items
No. |
Item |
21. |
Minutes of meeting of Health and Wellbeing Board held on 20 October 2017 PDF 109 KB
Additional documents:
Minutes:
21.1 The
minutes of the meeting held on 20 October were agreed as a correct
record.
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22. |
Apologies for absence
Additional documents:
Minutes:
22.1 Apologies for
absence were received from the following:
Members:
Cllr
Linda Wallraven
Invited observers with speaking rights:
Cllr
Claire Dowling, Cllr Margaret Robinson, Becky Shaw.
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23. |
Disclosure by all members present of personal interests in matters on the agenda
Additional documents:
Minutes:
23.1 Cllr Trevor Webb
declared a personal interest in item 7 (minute 27) as a fundraiser
for SSAFA – the Armed Forces Charity.
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24. |
Urgent items
Notification of items which the Chair considers to
be urgent and proposes to take at the end of the agenda. Any
members who wish to raise urgent items are asked, wherever
possible, to notify the Chair before the start of the meeting. In
so doing, they must state the special circumstances which they
consider justify the matter being considered urgently
Additional documents:
Minutes:
24.1 There were no urgent items.
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25. |
Support for people with dementia in the East Sussex Better Together area PDF 87 KB
·
A Report by the Director of Adult Social Care and Health
Additional documents:
Minutes:
25.1 The Board
considered a report providing information about local arrangements
for diagnosis and post diagnosis support for people with dementia
in the East Sussex Better Together (ESBT) area of East Sussex.
25.2 The Board was
informed that a new Dementia Post Diagnostic Support
Service will be provided from April 2018 to replace the Dementia
Advisors programme. The Service will include 10.5 whole time
equivalent (wte), Dementia Community
Development Workers (DCDW), delivering practical support to carers
and patients across the ESBT area. One additional wte DCDW will be commissioned to support those
individuals and families where an early onset dementia has been
identified. The new contract is expected to be awarded at the end
of the week.
25.3 The following
additional information was provided in response to questions from
Members:
-
All GPs running the Memory Assessment Services (MAS)
Clinics complete a part-time, one year post-graduate certificate in
dementia.
-
MAS Clinic GPs would not diagnose urgent or severely
complicated cases of dementia, and would refer patients who are
acutely ill with dementia, or displaying disturbed behaviour, to
secondary care specialists for diagnosis. There is also recourse to refer these patients to
a dementia specialist who runs a monthly tertiary clinic in
Polegate. In total, 97% of patients
with suspected dementia are referred to the MAS clinic for
diagnosis, and 95% of those who are referred to a MAS clinic are
diagnosed by the MAS GPs – with 5% being referred to
secondary care specialists.
-
People with learning difficulties and suspected
dementia will typically be referred to the Learning Disability
Service unless the individual prefers to be seen by a MAS Clinic
GP.
-
The recommissioning of the Dementia Post Diagnostic
Support Service was not carried out as a cost saving measure. The
previous Dementia Advisors Service contract involved a minimum
payment to the Alzheimer’s Society and additional funding
paid out for additional work on top, however, the additional
capacity was not being utilised. The 10.5 wte Dementia Community Development Workers
currently employed in the Dementia Advisors Service will be
redeployed to make more effective use of the funding envelope, and
the admiral nurse will be employed as an additional
spend.
-
Whilst the MAS Clinic GPs are drawn from the pool of
existing GPs and there is a continued shortage of GPs, particularly
in the Hastings area, there are several practice nurses who have
the postgraduate certificate and take part in the MAS Clinics. This
means that further practice nurses could be upskilled if necessary
to fill future gaps in MAS clinic staff if GPs are not available to
fill them.
-
The current referral time from GP to MAS Clinic is 5
weeks. NHS England is to introduce a new standard of 6 week’s
referral time, so the MAS is already meeting the
target.
-
Examples of how the voluntary sector is involved in
the MAS include:
-
ESBT Community Link Workers help identify
appropriate voluntary agencies and inform GP Practices.
-
GP practices are developing care navigators to
proactively search for voluntary ...
view the full minutes text for item 25.
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26. |
Support for people with dementia in the Connecting 4 You area PDF 582 KB
·
Report by Director of Adult Social Care and Deputy
Chief Officer, High Weald, Lewes and Havens CCG
Additional documents:
Minutes:
26.1 The Board
considered an update on the implementation of the
High Weald
Lewes Havens Clinical Commissioning
Group’s
model of Dementia care.
26.2 The following
additional information was provided in response to questions from
Members:
·
Weekly memory wellbeing cafes, leisure sessions, and
free transport to access community interventions are included in
the Golden Ticket model of care due to their health and wellbeing
benefits to dementia patients. The wellbeing interventions are
subsidised by High Weald Lewes Havens Clinical Commissioning Group
(HWLH CCG).
·
There is evidence that 4-5 interventions early in
the progression of dementia can help to delay the need for
residential care by 535 days.
·
In year 1 of the Golden Ticket programme
there is a total anticipated system benefit of £74k, rising
to £929k in year 2 and £1,452k in year 3. Not all of
this benefit is immediately cash releasing and will largely be
realised through the reduction in demand for care home placements,
which will benefit the Adult Social Care Department of
ESCC.
·
The Golden Ticket has won or been the runner-up in a
number of national awards, including those hosted by the Health
Service Journal (HSJ) and British Medical Association.
·
There are plans to roll-out the Golden Ticket across
the Central Sussex and East Surrey Area (CSESA) South footprint
(which covers Brighton & Hove and mid-Sussex).
26.3
The Board RESOLVED to note the report.
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27. |
East Sussex Local Safeguarding Children Board Annual Report 2016/17 PDF 188 KB
·
Report by Director of Children’s
Services
Additional documents:
Minutes:
27.1 The Board
considered a report on the Local Safeguarding Children Board (LSCB)
Annual Report 2016/17.
27.2 The presentation was provided by the Director of
Children’s Services following apologies from the Independent
Chair of the Children’s Safeguarding Board.
27.3 The following
additional information was provided in response to questions from
Members:
- Sussex Police has
acknowledged that ‘cuckooing’ – occupying the
homes of vulnerable people for the purposes of carrying out
criminal activity – is a real problem and the
Superintendent who is responsible for leading the response to the
crime says it is the second highest priority after serious and
organised crime. It is a tough issue to successfully confront but
all agencies are working in a coordinated way to have as much
impact as possible.
- ESCC has a
duty of safeguarding children but has no powers to inspect and
close illegal schools. It therefore works closely with Ofsted and
the Department for Education (DfE) to
identify illegal schools and take appropriate action in relation to
them. There are, however, relatively few instances of illegal
schools in East Sussex due to the demographics of the
county.
- ESCC has
limited powers to intervene in relation to undeclared home-schooled
children but is aware that a number children are being home
educated as the numbers are rising nationally. There is an
important distinction between those parents who home educate their
children on for philosophical reasons and do a good job; those who
find their child is out of school and opt for it as an alternative,
e.g., when their child has been excluded; and those who
purposefully keep their child out of school to due to wider issues
that are likely to be a safeguarding concern. The latter group will
not inform the Council that their child is being home schooled and
are not obliged to do so. ESCC has lobbied the Government to tackle
this issue by introducing a requirement that parents register home
schooled children with the local authority, rather than make it
voluntary, as ESCC does have the power to inspect on an annual
basis registered home school facilities.
27.4 The Board
RESOLVED to note the report.
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28. |
Delivering the Hastings Listening Tour PDF 39 KB
·
Report by Executive Director Healthwatch East
Sussex
Additional documents:
Minutes:
28.1 The Board
considered a report on Healthwatch East Sussex’s Hastings
Listening Tour.
28.2 The following
additional information was provided in response to questions from
Members:
-
The independent evaluation of the Listening Tour
recognised that no other Healthwatch organisation had done a piece
of work as in-depth as this before.
-
The CCGs welcome the report as it provides a
richness of information that will build on the JSNAA health profile
of Hastings.
-
Healthwatch East Sussex is determined to carry out
another Listening Tour in East Sussex, possibly in the Havens area,
Eastbourne, or rural areas (on a smaller scale). The location will
be determined by JSNAA health profiles; and feedback from the
public, partner organisations, and Healthwatch
volunteers.
-
The evaluation has also identified areas for
improvement, such as increasing the number of volunteers who are
willing to go out in the middle of the night to speak with the
street community. Healthwatch is now engaging with partner
organisations who may already have such volunteers to work with
them.
-
The number of rough sleepers in Hastings are quite
high – with 43 known to be rough sleeping in the town. The
Seaview Project, (a specialist rough sleeping organisation),
however, has expressed concern that the street community, i.e.,
street drinkers and beggars, are being conflated with rough
sleepers, when in fact the latter are much less likely to
contribute to crime levels.
-
Being a rough sleeper has the greatest impact on
physical and mental health, meaning that they may be a small cohort
but are very vulnerable and cost considerable
resources.
-
Ex-service personnel in reality comprise a very
small number of rough sleepers. Those who are ex-servicemen often
have very complex needs and are effected by war trauma. The Armed
Forces Network in East Sussex – hosted by Hastings and Rother
CCG – has a silver award for its provision of access to
health and social care for armed forces veterans.
-
Homelessness is not just about rough sleeping; a
number of people in Hastings are living in insecure or temporary
accommodation, sometimes long-term, and often with their
children.
-
Hastings Borough Council and HR CCG have a number of
new initiatives to tackle rough sleeping and people in temporary
accommodation, but the numbers of both continue to
rise.
-
The analysis to 133 online responses to maternity
services gathered as part of the Hastings Listening Tour will
follow the methodology of the previous report of enter and view
inspections of East Sussex Healthcare NHS Trust (ESHT), i.e.,
analysing the responses through a working group comprising
representatives of Healthwatch, ESHT and women who have used the
service.
-
The public are becoming more aware that changes are
being made to health and social care at a sub-regional level
– via the Sussex and East Surrey Sustainability and
Transformation Partnership (STP) – and that Healthwatch East
Sussex will begin to build in awareness raising of the STP into its
consultation and engagement work with the public.
-
The new leadership of the STP is likely to move
forward ...
view the full minutes text for item 28.
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29. |
Care Quality Commission Local Area Review - next steps and timeline PDF 225 KB
·
Report by the Director of Adult Social Care and
Health
Additional documents:
Minutes:
29.1 The Board
considered a report on the next steps and timeline in relation to
the Care Quality Commission’s (CQC) Local Area Review of East
Sussex.
29.2 The Board
RESOLVED to:
1. Note the timeline for next steps leading up to
publication of the findings from the East Sussex Local Area
Review;
2. Agree to a virtual sign off process for the CQC
Action Plan following the summit and prior to it being submitted to
CQC; and
3. Agree to an Action Plan update report being
brought to the 13 March 2018 Board
meeting and the frequency of update reports it requires
thereafter.
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30. |
NHS Updates
·
High Weald Lewes and Havens Clinical Commissioning
Group (CCG)
·
Eastbourne, Hailsham and Seaford CCG
·
Hasting and Rother CCG
Additional documents:
Minutes:
30.1 The Board
considered updates from the three East Sussex Clinical
Commissioning Groups (CCGs).
High Weald Lewes Havens Clinical Commissioning Group
(HWLH CCG)
-
A single executive team has been appointed for CSESA
South in order to free up resources to deliver commissioning work
and share best practice amongst the four member CCGs.
-
HWLH CCG is prepared for winter pressures and has
full contingency plans in place.
-
Delayed Transfers of Care (DTOCs) have been reducing
thanks to considerable partnership working and actions such as
utilising community beds as much as possible.
Eastbourne, Hailsham and Seaford Clinical
Commissioning Group (EHS CCG) / Hastings and Rother Clinical
Commissioning Group (HR CCG)
-
The other GP practices in the Hastings locality have
been thanked for rapidly picking up 17,000 additional patients
following the closure of the Cornwallis Plaza Surgery.
-
The Quality, safety and access to services in the
ESBT area has improved considerably, in particular the performance
of the A&E Departments at ESHT. On the evidence of this
system-wide improvement in the ESBT area, some additional funding
has been secured to help the system during the winter period that
will be used in the A&E Departments and in GP practices.
-
A key message to get across to the public is to use
GP practices and pharmacies and only go to A&E in an
emergency.
-
ESBT was the winner of the HSJ’s Improved partnership between health and local government
award.
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