Agenda and minutes

1.1       The Committee agreed the minutes were a correct record of the meeting held on 23 March 2017.

2.1       Apologies for absence were received from:

·         Cllr Phil Boorman (substitute: Cllr Peter Pragnell)

·         Cllr Bridget George

·         Cllr Joanna Howell

·         Cllr Andy Smith

·         Cllr Mike Turner

·         Jennifer Twist

2.2       The Chair noted that Julie Eason had resigned her position due to new work commitments. He thanked her for the contribution she had made to the Committee over the years and wished her well in her new endeavours.

2.3       The Chair welcomed the new Members of HOSC and thanked Cllrs Frank Carstairs, Tania Charman, Alan Shuttleworth and Bob Standley for their contributions during the course of their time on HOSC.

Disclosures by all members present of personal interests in matters on the agenda, the nature of any interest and whether the member regards the interest as prejudicial under the terms of the Code of Conduct.

3.1       There were none.

Notification of items which the Chair considers to be urgent and proposes to take at the appropriate part 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 urgent.

4.1       Jessica Britton, Chief Operating Officer, Eastbourne, Hailsham and Seaford Clinical Commissioning Group (EHS CCG) and Hastings and Rother Clinical Commissioning Group (HR CCG) informed HOSC that the East Sussex Better Together (ESBT) programme had won the award for fostering commissioner and provider collaboration in transforming health services at the National Healthcare Transformation awards on 28 June.  The ESBT programme was also nominated for the I-Rock Project in Hastings, a mental health programme for young people.

4.2       Jessica Britton said that the award demonstrated that the ESBT programme was truly bringing together health and social care. She thanked HOSC for its support over the past three years.

4.3       The Committee congratulated everyone involved in ESBT for their achievement.

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.

1.1.        The Committee considered a report on the progress of East Sussex Healthcare NHS Trust (ESHT) End of Life Care (EOLC) project.

1.2.        Catherine Ashton, Director of Strategy, and Hazel Tonge, Deputy Director of Nursing, both from ESHT, answered questions from HOSC Members.

New EOLC team structure

1.3.        Hazel Tonge explained that the new EOLC team structure – including the Senior Nurse who will coordinate and oversee the EOLC service across both hospital sites – came together in May and is currently focussed on making sure the right governance arrangements are in place to ensure both the Conquest Hospital and Eastbourne District General Hospital (EDGH) team work to the same standards. There is currently not enough available data to demonstrate success of the new arrangement, but in two months’ time there should be. The two teams have, however, said that they are now functioning as one team, have access to the same specialist support, and are supporting each other.

1.4.        Hazel Tonge explained that EOLC Practice Development Facilitators have trained 1,065 acute ward staff on the new Individualised Care Plan. A patient’s individualised care plan includes symptom controls and their preferred plan for death, and also includes where to refer them within the healthcare system.

Culture and leadership

1.5.        Hazel Tonge explained that staff have told her that there is a very different culture in the organisation than there was two years ago. Staff now feel secure enough to seek support and raise concerns – for example, through weekly nurse meeting groups – or access counselling should they require it. The NHS Staff Survey results reflect this observation.

Extending the service to 24/7

1.6.        Hazel Tonge said that she has written a draft options paper for the ESHT Board to consider setting out the advantages and disadvantages of maintaining a 5 day service or moving to a 7 day one.  The Trust Board will consider it during July and decide on the necessary financial support.

Identifying patients in the last year of their life

1.7.        Hazel Tonge said that ESHT’s priority currently is to identify those patients in the last days of their life. The EOLC teams are working with non-palliative teams, such as cardiology and gastroenterology, but the process is not yet complete. There is an awareness and engagement workstream in place to raise clinicians’ awareness of palliative care, but raising awareness is a nationwide challenge – which is why so much national guidance is written on the subject.

1.8.        Jessica Britton said that the ESBT Alliance is developing an EOLC Strategy. This involves ESHT working with CCGs to develop a system where staff from primary, community and acute care can share information about patients who are in the last year of their life, with their consent. The EOLC Strategy will also develop awareness raising programmes and training courses to assist clinicians to identify those patients in the last year of their life. Further details of the strategy are likely to be available by next year.

1.9.        Catherine  ...  view the full minutes text for item 6.

7.1       The Committee RESOLVED to note the work programme.