Agenda and minutes

8.1.        The minutes of the meeting held on 10^th June were agreed as a correct record subject to the addition of Cllr Barnes having given her apologies.

9.1.        Apologies for absence were received from Cllr Abul Azad, Cllr Sarah Osborne, Cllr Amanda Morris, and Jennifer Twist.

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.

10.1.     Cllr Richard Hallett declared a personal, non-prejudicial interest in item 5 as a member of Friends of Crowborough Hospital.

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.

11.1.     There were no urgent items

12.1.     The Committee considered an update on a number of issues relating to urgent care in East Sussex.

12.2.     The Committee asked whether the Clinical Assessment Service has a target for its clinical call back time 

12.3.     Simon Clarke, Head of Operations Integrated Urgent Care (IUC) at South East Coast Ambulance NHS Foundation Trust (SECAmb), said that in 46% of cases where someone calls NHS 111, they will receive a call back from the Clinical Assessment Service (CAS). This call will be from a healthcare professional from the CAS multi-disciplinary team that includes dental nurses, mental health professionals, midwives, general nurses, GPs, Advanced Nurse Practitioners, paramedic practitioners and paediatric nurses. Depending on the acuity of the patient’s symptoms, NHS Pathways will drop them in to a call back queue at the CAS and an appropriate clinician will call them back depending on their skill set. The target call-back times are 20 minutes, 1 hour, 2 hours, 6 hours, 12 hours and 24 hours. The system is generally risk averse and will often set a quicker call back than may be necessary.

12.4.     Simon Clarke explained that just under 40% of patients have been receiving their call back within the set time frame, which was the result of demand far outstripping planned activity. The Trust is mitigating this issue by prioritising call backs for patients with shorter wait times, as they are perceived as higher risk. A Patient Safety team, which is not part of the CAS, will also provide patients who are close to or beyond their waiting time with a welfare call to check whether anything has changed and if their symptoms have gotten worse. Simon Clarke added that this team will not close any of these cases but may recommend to a CAS operator that they are closed. There is also a Clinical Navigator reviewing the call queue on a 24/7 basis to see if any high acuity patients have not been called, or who may need an upgraded call time based on their symptoms.

12.5.     The Committee asked what the pathway is for a patient who calls NHS 111 and is booked into a GP appointment.

12.6.     Simon Clarke explained that patients who ring 111 are triaged by a health advisor using the national NHS Pathways system.  Following a series of questions, NHS Pathways will present the health advisor with a number of services from the Directory of Services (DOS) to refer the patient to. Simon Clarke said that 27% of all patients who call 111 are now being directly booked into an appointment, either by a health advisor or a CAS clinician, to a variety of services including GP practices, Urgent Treatment Centres (UTCs), Emergency Departments (EDs), Walk-in Centres, and GP Primary Care Hubs. GP Extended Access appointments and better access to mental health support and services will also be added to the DOS soon.  

12.7.     Simon Clarke said that the DOS may include the option for a call back from the patient’s own GP practice,  ...  view the full minutes text for item 12.

13.1.     The Committee considered the Review Board’s draft report on NHS proposals to move mental health inpatient services, which are currently provided at the Department of Psychiatry in Eastbourne District General Hospital, to new facilities to be built on a different site at either Bexhill or Hailsham.

13.2.     The Committee asked whether the CCG and Trust are confident they can deliver the proposals on budget.

13.3.     Jessica Britton said the CCG and Trust are confident that their current plans will deliver the programme on budget. They will continue to refresh and review the plans if there are any changes, and if there are any substantial changes then HOSC will be updated.

13.4.     The Committee asked whether a smaller inpatient mental health satellite service could be retained at Eastbourne District General Hospital (EDGH).

13.5.     Jessica Britton said that the replacement of the Department of Psychiatry was an opportunity to replace existing, dated services with high quality facilities for patients. The existing site does not have the necessary footprint for outdoor therapeutic services, so the new service could not be reprovided at EDGH to meet the requirements of a modern facility. It will be possible, however, to upgrade the dormitory beds at the St. Raphael’s ward on the Conquest Hospital site without moving the service offsite. The CCG and Trust will continue to enhance community mental health provision locally, meaning that patients will still be able to access a high quality community mental health services from the Eastbourne area and throughout the county.

13.6.     The Committee asked what will happen to the urgent care lounge (UCL) at the EDGH when the Department of Psychiatry closes.

13.7.     Simone Button explained that the UCL and psychiatric liaison services are integral part of the acute hospital. Sussex Partnership NHS Foundation Trust (SPFT) wants to retain the ability to assess patients who attend ED with mental health problems as quickly as possible and be able to move them to a therapeutic UCL whilst they await an inpatient bed elsewhere. These services have dedicated staff and the Trust will ensure they have the right levels of expertise including clinical, nursing and support staff when the Department of Psychiatry closes in 2024, although there may be some cross over of staff to cover both sites.  

13.8.     The Committee asked whether the consultation analysis will include the views of people with protected characteristics, and how stakeholders will be involved in future design of the services.

13.9.     Jessica Britton confirmed that ORS’ analysis of the public consultation will include details of the views of people with protected characteristics and the Decision Making Business Case (DMBC) will make it clear how these views impacted the final plans for the new service. The CCG and Trust conducted an extensive Equality and Health Inequalities Impact Assessment (EHIA) that identified groups with protected characteristics, and they were all targeted during consultation process. Paula Kirkland, Programme Director at SPFT, added that the trust is currently procuring a contractor  who will help develop detailed building  ...  view the full minutes text for item 13.

14.1.     The HOSC considered its work programme.

14.2.     The Committee RESOLVED to agree its work programme subject to the addition of a report on community mental health services and Child and Adolescent Mental Health Services (CAMHS) at its December meeting.