Agenda and minutes

23.1     The minutes of the meeting held on 28 November 2019 were agreed as a correct record.

24.1     The following substitutions were made:

·         Cllr Barry Taylor substituted for Cllr Bob Bowdler

·         Cllr Ron Reed substituted for Cllr Johanna Howell

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.

25.1     There were no disclosures of interest.

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.

26.1     There were no urgent items.

26.1.      The Committee considered a report providing an outline of the NHS response to Covid-19 in East Sussex and the ongoing impact on NHS services for East Sussex residents.

26.2.      The Committee asked why Covid-19 rates had been so low in Hastings despite the levels of deprivation and Black Asian and Minority Ethnic (BAME) community.

26.3.      Darrell Gale, Director of Public Health, said that an investigation into why infection rates were so low in Hastings and Rother was underway. The current hypotheses include that:

·         Hastings Borough Council was decisive early on, cancelling some events due to be held in early spring and sending out messages warning people not to come and visit. This meant that people weren’t drawn into town before the lockdown began.

·         The relative lack of infrastructure between Hastings and Rother and the rest of the country, for example, the poor road and rail links, making the area relatively isolated.

·         Poor connectivity within Hastings, such as lack of pavements between North St Leonards, Churchwood and Hollington and the rest of town slowed the spread; and

·         The topography of ridges and valleys in Hastings means places like Ore Valley are quite remote from the town centre.

26.4.      The Committee asked whether, as cases had begun to rise again, there had been a corresponding increase in hospital admissions

26.5.      Joe Chadwick-Bell, Chief Operating Officer at East Sussex Healthcare NHS Trust (ESHT), confirmed that there was one positive Covid-19 case in the Trust and around six ‘Treat as Positive’ cases – where a person had a negative Covid-19 test but clinically were being treated as a positive case. There were also no patients in the critical care units with Covid-19.

26.6.      Darrell Gale said that hospital numbers had started to creep up nationally but had not yet locally. A lot of the increase locally and nationally in positive tests was amongst young people who were asymptomatic, or whose symptoms are so slight that they have what feels like a hangover for a day or two. This is a different cohort of people to that which had been affected during the spring.

26.7.      The Committee asked why cases had been low in Lewes District and asked whether it was due to a lack of community testing early on in the outbreak

26.8.      Darrell Gale said that initially testing was limited to Pillar 1 (tests in hospitals and care homes) because Pillar 2 (testing in the community via the sites at the Amex stadium and Bexhill) took longer to get up and running. This could explain why the infection rate in Lewes District appeared lower than may have actually been the case, i.e, there could have been a significant population  of people who caught the illness early on but would have been fit enough to not need hospitalisation and would also not have been able to be tested in the community. He added that the area does have a high infection rate amongst the elderly in care homes, particularly around Seaford.

26.9.  ...  view the full minutes text for item 27.

27.       

28.       

28.1.      The Committee considered a report providing an overview of ESHT’s future plans.

28.2.      The Committee thanked Adrian Bull for his work in improving the Trust since taking over as Chief Executive and wished him well in his retirement.

28.3.      Joe Chadwick-Bell updated the Committee on the status of services temporarily reconfigured during the Covid-19 pandemic. She confirmed that:

• chemotherapy and maternity services had moved back on site;
• Ophthalmology outpatient services had been returned to normal to some degree, although not in their entirety due to the lack of physical space due to infection control measures at both EDGH and Conquest Hospital; and
• the Cardiology Cath Labs were re-established on both sites, but only two of three total labs were operating due to workforce challenges.

28.4.      The Committee asked why the hospitals would need to be rebuilt rather than renovated.

28.5.      Joe Chadwick-Bell said the reason both hospitals are going to be rebuilt on their current locations is because the cost of improving the buildings to a modern standard and resolving the backlog of maintenance of both hospitals is so great it is easier to demolish them and rebuild them from scratch. It will be necessary, however, to continue to provide the existing services on both sites whilst they are rebuilt, so demolition and construction will need to be in stages.

28.6.      The Committee asked whether the development of the new hospital buildings would mean there would be further single-siting of services provided over both hospital sites.

28.7.      Joe Chadwick-Bell clarified that the Trust does not plan to undertake any reconfiguration of services other than those currently being reviewed, Cardiology and Ophthalmology services. in other words, the redesign of the two hospitals would not result in the reconfiguring of the services provided within them.

28.8.      The Committee asked for further details on the proposals around Ophthalmology services

28.9.      Joe Chadwick-Bell said that the final model had not yet been decided. Demand for ophthalmology is growing as the population ages and many of the conditions require ongoing treatment for many years, such as regular injections. The service is currently provided across Bexhill, EDGH and Conquest Hospitals. Subject to discussion and consultation, the plan, led by clinicians, is to meet demand and increase the capacity of the existing workforce by bringing their expertise to a single site that would be an eye centre for East Sussex. It would provide a full range of services and include purpose built theatres, diagnostics and outpatients areas built to meet the specification of the clinicians. In addition, ophthalmology services that do not need to be provided by a consultant would be provided in the community.

28.10.   The Committee asked what plans Building for our Future included for expanding car parking at the Conquest Hospital.

28.11.   Joe Chadwick-Bell said there were no plans for a multi-storey car park, but she would confirm what the plan was. She added that as outpatient model of care changes it would reduce car parking arrangements on both sites due  ...  view the full minutes text for item 28.

27.       

28.       

29.       

29.1.      The Committee considered a report on the HOSC Review Board’s draft report on NHS proposals for the future of the Eastbourne Station Health Centre.

29.2.      The Committee asked why health provision should be changed during the pandemic and whether it was possible to conduct an effective public consultation during the pandemic, particularly in reaching vulnerable groups.

29.3.      Jessica Britton said it was appropriate for the consultation to be paused in the initial response to the pandemic, but the CCG did not want to curtail the length of it and was keen to restart when it was appropriate to do so. Jessica Britton said that the CCG gave considerable thought to whether it was appropriate to restart the public consultation over the summer and took the view that Covid-19 restrictions are likely to remain in place for the foreseeable future. This meant it was necessary to try and restart normal activities where safe to do so, rather than wait for an undetermined amount of time for things to return to normal. Ahead of restarting, the CCG considered how best it could engage with those vulnerable groups identified in the Equality and Health Impact Assessment who had not already been engaged during the initial consultation period. The CCG also asked the Consultation Institute to review the consultation proposals and identify any gaps in the plan. Jessica Britton confirmed the public consultation outcomes would be independently reviewed and provided to the HOSC (via the Review Board).

29.4.      The Committee asked whether there would be sufficient GP practice capacity in the town centre if the Eastbourne Station Health Centre closed and whether this included the capacity in the new Old Town surgery due to become available in the near future.

29.5.      Jessica Britton said that the CCG has reviewed GP provision in Eastbourne and had determined that there was a higher proportion of GPs per patient in the town than the national average. She explained that the Clinical Director of the Victoria Primary Care Network (PCN), which covers some of the town centre GP practices, had advised they had managed to recently recruit additional GPs. She added that the Eastbourne Station Health Centre had a small registered patient list and the CCG hoped to be able to provide them with access to the wider integrated primary care services offered at other GP practices.

29.6.      Hugo Luck, Deputy Director of Primary and Community Care, East Sussex CCG, added that the Primary Care Networks (PCNs) established in Eastbourne are funded to provide new roles such as pharmacists, paramedics and physiotherapists to whom patients can be referred rather than always going to the GP, where clinically appropriate. This will free up GP time to see patients who need to see them. Dr Paul Deffley, Local Medical Director, East Sussex CCG, said that this new skill mix in primary care is important to meet the growing demand in the sector. There were also national campaigns to recruit new GPs and entice retired GPs  ...  view the full minutes text for item 29.

27.       

28.       

29.       

30.       

30.1.      The Committee considered its work programme

30.2.      The Committee RESOLVED to:

1) agree the work programme; and

2) agree to hold an additional meeting in 2021, if necessary, to ensure outstanding issues are considered by the Committee in a timely manner.