Agenda and draft minutes

1.1       The Board agreed the minutes of the meeting held on 9 December 2025 as a correct record.

1.2       The Chair noted that this meeting marked the final Health and Wellbeing Board meeting for a number of long?standing members.

1.3       The Chair thanked Veronica Kirwan for her contribution to the Health and Wellbeing Board, as well as her wider contribution and commitment to patient voice and care in East Sussex.

1.4       The Chair thanked Dr Stephen Pike for his contribution as the Integrated Care Board representative on the Health and Wellbeing Board.

1.5       The Chair thanked David Kemp for his contribution to the Health and Wellbeing Board as well as his sustained commitment to joint partnership working.

2.1       Apologies for absence were received from Councillor Glazier and Becky Shaw. Mark Stainton chaired the meeting in Councillor’s Glazier’s absence. Dr Stephen Pike attended the meeting online.

3.1       There were no disclosures of interest.

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

4.1       There were no urgent items.

5.1       Elizabeth Funge, Assistant Director Education and Kathy Marriot, Assistant Director Early Helo and Social Care introduced the report and outlined the national context, including the Government’s Giving Every Child the Best Start in Life strategy and the requirement for local strategies and action plans.

5.2       Kathy Marriott highlighted the Best Start in Life Strategy’s core principles, including multidisciplinary working, integration of services and reducing inequalities, which are informed by evidence based programmes and the use of shared intelligence and data to target areas of need. Kathy outlined how this related to the three national pillars (better support for families; better access to early education and childcare; and improving quality in early years) and described East Sussex’s Family Hubs model (integrated with Early Help Services) and key priorities, including early identification of Special Educational Needs and Disabilities (SEND), improving vaccination uptake, healthy eating and managing obesity, and supporting parental mental health.

5.3       Elizabeth Funge described work to join up early education with Early Help and social care to ensure families receive integrated support and to improve access to childcare places and early education, including for disadvantaged two year olds and working families. Elizabeth emphasised inclusivity, early identification of SEND, quality across early years and reception, local governance arrangements, and the particularly stretching targets set for East Sussex on Good Level of Development (GLD).

5.4       Elizabeth noted that funding for delivering this work was received from the Department for Education however commented that the ambitious targets were reliant on stretched resources and needed to support a broad range of work in Family Hubs. East Sussex had been successful in securing a small amount of additional DfE funding through the RISE programme, which would support early work, particularly around early years and SEND.

5.5       Carolyn Fair emphasised that the strategy was ambitious but realistic about the challenges ahead. She highlighted that reducing inequalities was central and stressed that success would depend on partnership working and alignment of services and resources around families.

5.6       Councillor Ungar welcomed the strategy but raised concerns about accessibility of Family Hubs for some communities, including rural areas. He emphasised the importance of outreach and queried the rationale for higher targets for East Sussex given uneven attainment across the county, particularly in Hastings.

5.7       Kathy explained that Family Hubs aim to support children aged 0-19. While this programme focuses mainly on early years, the hubs offer broader services. In Eastbourne, Devonshire, and Shinewater, funding levels are lower than SureStart had previously received, so efforts are focused on effective delivery through partnerships with voluntary organisations and local groups. The Healthy Child Programme and health visitors help identify needs by visiting homes. A digital option is also available for parents who cannot access physical locations.

5.8       Elizabeth responded that attainment patterns were uneven by geography and pupil group and explained how strengthening early foundations and early identification should support improved outcomes in later phases.

5.9       Councillor Jobson asked how Family Hubs could support communication skills and the role of creative  ...  view the full minutes text for item 38.

6.1       Vicky Smith, Programme Director, East Sussex Health and Social Care Transformation introduced the report, which provided the quarter 3 update on progress against the Health and Wellbeing Board’s Shared Delivery Plan. She highlighted progress across all seven Board priorities, learning from the recent informal Health and Wellbeing Board development sessions, and early work to understand the implications of the changing national health and care planning framework. Vicky advised that the Shared Delivery Plan had been an effective vehicle for collaboration but that the system was now moving into a new phase of planning, with increasing emphasis on neighbourhood health, and that review of Shared Delivery Plan progress would be used to inform the development of a Neighbourhood Health Plan. Vicky also highlighted continued progress in establishing Integrated Community Teams (ICTs), including strengthened leadership arrangements and a growing focus on proactive, integrated care for people with complex needs.

6.3       Ashley Scarff highlighted the progress around ICTs across the five footprints and the benefits of multi-disciplinary teams working together to identify opportunities and respond to local needs and noted this was an important vehicle to making a difference and moving towards a preventative and sustainable approach.

6.4       The Chair reflected on the progress of the ICTs, noting the early indications of impact and the potential for this work to contribute to the preventative agenda, and the value of the Shared Delivery Plan as a vehicle for integration. The Chair noted the intention that neighbourhood health planning would build on existing work of the Shared Delivery Plan. The Chair also noted the value of the informal development sessions.

6.5       Councillor Jobson asked whether neighbourhood approaches would improve information sharing and coordination between hospital and community services.

6.6       Vicky explained that the intent of neighbourhood health is to organise hospital?based, community, primary care, and local authority services in a much clearer and less fragmented way around patients and identified populations and patients. She advised that while challenges remained, including barriers to joining up IT systems, ultimately the aim is to avoid instances of people needing to go into hospital where this is avoidable, for example through offering co-ordinated proactive care and closer working relationships between health and care staff working in local areas and neighbourhoods. When people do need to go to hospital, there will be a better system in place enabling them to come out as soon as possible with the right support in place.

6.7       Simon Dowse, Director of Transformation, Strategy and Improvement at East Sussex Healthcare NHS Trust (ESHT) commented that integrating services at neighbourhood and place level was central to ESHT’s strategy for the coming years. He commented that digital infrastructure, including tools such as Johns Hopkins, Plexus and the Trust’s electronic patient record programme, was developing to support improved interoperability, earlier identification of risk and more preventative, proactive care, although noted progress was incremental.

6.8       The Chair reiterated the vision that this work will reduce the need for people to avoid the need to go to hospital,  ...  view the full minutes text for item 39.

7.1       Vicky Smith introduced the report which set out proposals for the development of a Neighbourhood Health Plan for East Sussex, drawing on discussion at the informal Health and Wellbeing Board development session held on 12 February. She advised that, while detailed national guidance was still awaited, early indications placed a strengthened role on Health and Wellbeing Boards and place?based partnerships in overseeing neighbourhood health planning.

7.2       Vicky explained that the system was moving into a new phase of planning, with increasing emphasis on neighbourhood health, but stressed that this would build on existing work, including the Shared Delivery Plan, Joint Strategic Needs Assessment, and progress in establishing Integrated Community Teams (ICTs). She outlined indicative planning timescales, including the expectation of an interim strategic plan followed by a more detailed operational plan later in the year.

7.3       Vicky described proposals to continue informal Health and Wellbeing Board development sessions, noting their value in exploring complex system issues, and suggested that future sessions could include wider system partners to support co?production of the Neighbourhood Health Plan. She also highlighted the need to review Board membership and engagement, strengthen representation (including from borough and district councils), ensure place?based governance was fit for purpose, and maintain a strong focus on children and young people.

7.4       Ashley Scarff welcomed the approach and emphasised the importance of ensuring that plans operating across different geographies were aligned and complementary.

7.5       Ian Smith emphasised the scale of change required to shift towards population health management, proactive prevention and stronger strategic commissioning, and highlighted the Health and Wellbeing Board’s role in driving integration and accountability.

7.6       Councillor Ungar commented on the importance of strengthening borough and district council engagement in neighbourhood health planning.

7.7       The Chair reflected on the Board’s stewardship role and welcomed engagement from a range of experts and community representatives at both the Health and Wellbeing Board as well as from wider partners at the informal development sessions.

7.8       The Board RESOLVED to:

1. Endorse the expected role of HWBs and Place in the health system reforms and neighbourhood health planning;

2. Note the expected content of the new neighbourhood health plan that will be developed under the leadership of HWBs for 2026/27 and that, at the time of writing, guidance is still awaited from the Department of Health and Social Care (DHSC);

3. Endorse the proposed working arrangements to support the development the East Sussex Neighbourhood Health Plan with key stakeholders, as set out in paragraphs 2.12 – 2.16 of the report, and the timetable in Appendix 1; and

4. Delegate responsibility to the East Sussex Health and Care Partnership to coordinate the detailed interim Neighbourhood Health Plan development on behalf of the HWB.

8.1       8.1 Darrell Gale introduced the report on alcohol?related cognitive impairment (ARCI), explaining that it had emerged from work with the Multiple Compound Needs Board and alcohol care teams as a gap in current pathways affecting a small but highly complex cohort of individuals.

8.2       Thomas Gollins?Perron, Public Health Improvement Specialist gave a presentation explaining that ARCI is a form of brain injury associated with long?term alcohol use, leading to difficulties with memory, executive functioning and decision?making, and often presenting late and in crisis. He advised that ARCI is not recognised as a single diagnostic category, which contributes to gaps in pathways and exclusion from services, commenting that appropriate support is often dependent on diagnosis, while diagnosis commonly requires abstinence. He highlighted local analysis identifying a relatively small cohort with a disproportionate impact on individuals, families and services, including repeated hospital admissions. 

8.3       Dr Stephen Pike commented that ARCI had been a long?standing issue without a clear clinical pathway. He highlighted that individuals were often managed in crisis, that opportunities for intervention during inpatient stays were frequently missed, and that people with co?existing mental health needs were often unable to access mental health services while alcohol dependence remained. 

8.4       The Chair asked about upcoming training, including who this would be targeted at. In response, Thomas outlined a two?tier approach, comprising awareness training for frontline staff to support earlier identification, alongside more specialist training for clinicians to support diagnosis and management. 

8.5       Councillor Jobson asked for more information about “dry” supported accommodation and queried why preventative approaches outside hospital settings were not more developed. In response, Thomas explained that hospital based diagnostics were often required to support identification and diagnosis. Thomas also advised that further work was underway to better understand local accommodation needs and options, including how alcohol use is treated differently from drug use within supported housing. 

8.6       The Chair emphasised that, although the cohort affected by ARCI was relatively small, the impact on individuals, families and the wider system was significant, and highlighted the importance of developing more coordinated and preventative pathways through partnership working. 

8.7       The Board RESOLVED to:

1. note the health and wellbeing concerns outlined in this report and appendix 1 for this cohort and the emerging evidence on Alcohol-Related Cognitive Impairment in East Sussex; and
2. support the development of an ARCI pathway, delegating the governance around this to the Multiple Compound Needs (MCN) Board.

9.1       The Chair introduced the forward work programme.

9.2       The Chair highlighted the proposed agenda for the July meeting and noted that Better Care Fund recommendations could also now be brought to the July meeting for sign off by the Board following the publication of national guidance.

9.3       Ian Smith asked if the ICB strategic commissioning plan work could be included on a future agenda.  The Chair agreed that this would be scheduled at the earliest appropriate opportunity.

9.4       Councillor Maynard emphasised the importance of support and induction for elected members following the elections, particularly given the complexity of the health and care system and the Board’s stewardship role. He proposed that the Board formally record its recognition and thanks to Councillor Glazier for his leadership of the Health and Wellbeing Board since its inception.

9.5       The Board RESOLVED to agree the suggested additions to the work programme and to record its thanks to Councillor Glazier for his leadership of the Health and Wellbeing Board since its inception.

Meeting ended at: 15:25