Agenda and minutes

26.1     The minutes of the meeting held on 2 December 2021 were agreed as a correct record.

27.1     Apologies for absence were received from Councillor Abul Azad (Councillor Adeniji substituting), Councillor Sarah Osborne (Councillor Murphy substituting), Councillor Alan Shuttleworth (Councillor Lambert substituting), Councillor Amanda Morris (Eastbourne Borough Council) and Jennifer Twist (VCSE Alliance).

27.2     Apologies were also received from Jessica Britton (CCG/SHCP), Joe Chadwick-Bell (ESHT) and Dominic Ford (SPFT).

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.

28.1     Councillor Hallett declared a personal, non-prejudicial interest under item 6 as he is a Trustee of the 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.

29.1     There were none.

30.1     The Committee considered a briefing on Child and Adolescent Mental Health Services (CAMHS), and Children’s and Young People’s Emotional Wellbeing and Mental Health by the Sussex Partnership NHS Foundation Trust (SPFT) and the Sussex Health and Care Partnership (SHCP). A copy of the presentation slides used for the briefing is included under item 5 of the agenda for the meeting.

30.2     The Committee noted that some early support is provided via referrals from schools and asked what happens if children are excluded or not in school for another reason.

30.3     Alison Wallis, Clinical Director (SPFT) outlined that although there are referrals from schools, referrals cans also be made by GP’s or via self-referral. However, it is acknowledged that providing help and support is much more difficult if children or young people are not known to services. SPFT are working to increase the knowledge and information about mental health and wellbeing services (e.g. the i-Rock project), so that they are visible in the community and services are easier to access. Rachel Walker, Operational Director (SPFT) added that school support teams are also working with Pupil Referral units and special schools to enable access to services.

30.4     The slides in the briefing indicate that there are long waiting times for some services. The Committee asked what prioritisation is there for those who have been waiting and when does SPFT expect to see a significant improvement in waiting times.

30.5     Rachel Walker responded that those waiting for Autistic Spectrum Condition (ASC) services will be seen over the current calendar year, so all people waiting for an assessment will be seen this year, this is because an independent provider has been sourced to support with the those waiting the longest for assessment. There is also a system wide response to expand capacity and tackle the increase in demand. Work is also being undertaken to understand why there has been an increase in young people needing services. It is acknowledged that waiting times are too long and are impacting on outcomes for young people. Work is underway to make sure services recover and young people receive the services they need.

30.6     The Committee asked where the additional investment had been spent on services, particularly CAMHS, and what difference had this made?

30.7     Rachel Walker outlined that the additional investment had been spent on Autism assessments with approximately 600 assessments transferred to an external provider. Money has been spent on recruiting additional staff for Attention Deficit Hyperactivity Disorder (ADHD) services, which has a prevalence rate which is three to four times higher in East Sussex than in either Brighton and Hove or West Sussex.  Additional staff have also been recruited to provide Cognitive Behavioural Therapy (CBT), with the majority of referrals being for depression and anxiety. The additional money is being focussed on where there are the largest number of referrals and on those that have been waiting the longest. The additional funding will continue into the next year and beyond in order to achieve  ...  view the full minutes text for item 30.

31.1     The Committee considered a report which provided an update on various aspects of Urgent Care in East Sussex. Representatives from SECAmb provided an update on 999 and 111 ambulance services. These services continue to be challenged, as with the national picture, in terms of response times, telephone call answering times and dealing with increased demand for 111 services. However, SECAmb have performed well in comparison with other ambulance services in the region. Representatives from ESHT and the CCG provided updates on other aspects of Urgent Care, including Walk in Centres (WIC) and the Crowborough Minor Injuries Unit (MIU).

SECAmb Services

31.2     The Committee asked for more information on the increased call volumes for the 111 service.

31.3     John O’Sullivan, SECAmb outlined that call volumes were up year on year. Call volumes for the 111 service are still significantly above the contracted level SECAmb was commissioned to provide. Commissioners have created a clear pathway to access 111 services, and this has led to increased activity. It is expected that activity will continue to go up in 2022/23 due to the role of 111 as the single point of access for services.

31.4     The Committee asked if there was an impact when A&E departments are full and whether more people are still using the 111 service.

31.5     John O’Sullivan responded that Emergency Department (ED) capacity is not something that is within the 111 service’s control. However, the role of 111 is to triage patients as to whether they need to go to EDs or not. Of those patients who went through the 111 service, 82% had a direct ED booking. SECAmb is in the vanguard of ambulance services nationally who offer this service. There is still some reluctance by patients to go through the 111 service, but overcrowded EDs are not because of the 111 service and are more a result of patients who elect to present at A&E / Emergency Departments.

31.6     The Committee asked for an update on the new Make Ready Centres and the use of zero emission vehicles.

31.7     Ray Savage, Strategic Partnerships Manager SECAmb, outlined that the new Make Ready Centre at Falmer is now operational and combines facilities for staff welfare and vehicle servicing enabling an efficient service to be provided. The next development will be at Medway where the Make Ready Centre will be co-located with the operations centre for 999 and 111 services for the SECAmb east area. This will create efficiencies and inter-operability between 111 and 999 services, as it enhances the opportunities for dual role staff. The Medway operations centre will cover 999 and 111 services for East Sussex, Kent and Medway which comprises the east operational area of SECAmb. Currently there are separate operations centres in Ashford and Medway. Julie-Marie Allsopp-West, SECAmb, added that the Medway centre is due to become operational in Autumn 2022, with the building due to be handed over in August 2022.

31.8     Ray Savage outlined that SECAmb is exploring the use of zero  ...  view the full minutes text for item 31.

32.1     The Committee considered a report on hospital handovers, introduced by Ray Savage and Julie-Marie Allsopp-West from SECAmb and Richard Milner, Director of Strategy, Inequalities & Partnerships at East Sussex Healthcare NHS Trust (ESHT). It is recognised by SECAmb, ESHT and the CCG that delays in hospital handovers can cause patient harm. Much work has been undertaken to reduce delays over 60 minutes and the current focus is on achieving patient handover in under 30 minutes and meeting the national target of 15 minutes. Work is undertaken to support ambulance crews with handovers and hospitals are alerted whilst on route if an ambulance has a critically unwell patient. ESHT is working on this with SECAmb with a new set of targets for Emergency Department handovers and initiatives like “fit to sit”, ambulance awareness week, and dedicating 2 bays for handovers.

32.2     The Committee asked if there was a difference in handover times between the Conquest and Eastbourne DGH hospitals.

32.3     Ray Savage responded that performance between the two hospitals fluctuates, with a low point around September 2021. Separate charts showing the different hospital performance can be provided to HOSC in future.

32.4     The Committee welcomed the collaborative approach between SECAmb and ESHT to reduce handover times with initiatives like “fit to sit” and ambulance awareness week and asked why the handover time figures at the Royal Sussex Hospital were so high with 207 delays over 60 minutes in December.

32.5     Ashley Scarff responded that work is also taking place with colleagues in Brighton to reduce delays as a matter of priority. There is an acknowledgement that handover delays are symptomatic of wider system pressures and delays in patients flows through hospitals. The CCG is working closely with the Royal Sussex Hospital and the Brighton and Sussex University Hospitals NHS Trust (BSUH) on a refreshed hospital handover improvement plan, which will include sharing any learning from colleagues. It should be noted that the Royal Sussex has tertiary service pressures and estates constraints, but there is some work that can be done to reduce demand and improve patient flows and discharge.

32.6     The Committee asked if patients can be taken directly to ambulatory and emergency day care or do they have to go through A&E.

32.7     Julie-Marie Allsopp-West responded that there are some pathways to take patients directly to the right part of the hospital such as maternity and surgical, but not ambulatory care yet.

32.8     The Committee asked if stroke patients are included in the figures in the report.

32.9     Julie-Marie Allsopp-West confirmed that stroke patients are included in the figures. For stroke patients the receiving hospital is pre-alerted, and the patient is handed over to the team waiting for them within 15 minutes.

32.10   Ray Savage commented that admissions avoidance and the focus on alternative pathways (e.g. direct access bookings) is part of the current work. Work is also being undertaken to provide easy access to specific pathways that avoid A&E and identify suitable alternative pathways (e.g. a  ...  view the full minutes text for item 32.

Covid Verbal Updates

33.1     Adam Churcher and Rachael Skates from SPFT gave a verbal update on the impacts of the Covid Pandemic on their organisation and the provision of services. During the pandemic SPFT’s focus has been on providing safe and effective, high quality services. An outbreak control plan has been implemented with consistent messaging to staff and attention to detail on safe staffing levels. This has included dealing with the Government’s announcement concerning making Covid vaccination as a condition of employment. At SPFT Gold Command meetings are held twice a week to review measures and monitor infection prevalence amongst the workforce.

33.2     There is a continuing focus on infection control and at present the number of staff having to self isolate is in the low thirties. To date there have been five outbreaks which resulted in two ward closures. Ongoing monitoring shows there is a downward trend on absences due to Covid, with 95% of staff having had two vaccinations and 85% having had a booster. There is daily monitoring of the Covid situation and any outbreaks.

33.3     The Chair thanked everyone for the Covid situation updates.

33.4     The Committee RESOLVED to note the Work Programme with the addition of update reports on CAMHS and Hospital Handovers, as outlined in paragraphs 30.24 and 32.17 above, for the Committee meeting to be held on 22 September 2022.

34.1     There were none.