Agenda and minutes

28.1     The minutes of the meeting held on 15 December 2022 were agreed as a correct record.

29.1     Apologies for absence were received from Councillor Christine Brett and Councillor Candy Vaughan.

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.

30.1     Councillor Colin Belsey declared a personal, non-prejudicial interest under item 7 the new Elective Hub at Eastbourne District General Hospital (EDGH) as he has been dealing with issues raised by constituents in his Division regarding the preparatory works on site.

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.

31.1     The were no urgent items.

32.1     The Committee considered an update report on the NHS Sussex Winter Plan. The Winter Plan sets out how the local health and social care system plans to effectively manage the capacity and demand pressures anticipated during the Winter period and runs from October 2022 to April 2023.

32.2     The Committee asked how the virtual wards were staffed and where the patients were located.

32.3     Claudia Griffith, Chief Delivery Officer NHS Sussex responded that the virtual wards were a national model which is being piloted across Sussex. They are not located in any particular area and are supported by existing staff in community health services and by hospital clinicians. The concept is to try and keep people at home and wrap services around them for clinical conditions that can be safely managed at home.

32.4     The Committee asked if the virtual wards model was expensive and whether it could be expanded.

32.5     Claudia Griffith outlined that the model was more efficient but there is an issue with being able to increase the workforce in order to be able to expand the pilot. There are National Plan targets to increase capacity and there is a focus on how virtual wards could be used for patients with respiratory conditions and frailty patients who are at risk of admission.

32.6     The Committee noted that ambulance handover times had improved and asked how long patients were having to wait for an ambulance.

32.7     Claudia Griffith explained that the are a number of factors involved in ambulance response times for category 1, category 2, category 3 and category 4 calls. It is not just handover delays that affect response times and there have been a number of capacity issues for the South East Coast Ambulance Foundation Trust (SECAmb) which have affected response times. NHS Sussex has worked with SECAmb to support them and has used other Trusts such as the South Central Ambulance Service NHS Foundation Trust to provide additional capacity. Claudia Griffith agreed to circulate some information on ambulance response times for category 1, 2, 3 and 4 calls.

32.8     Claudia Griffith added that handover delays were very low at the current time and are in single figures for delays over one hour. Charlotte O’Brien, Director of Transformation and Improvement at ESHT commented that there had been only one handover delay over one hour this week at East Sussex Healthcare Trust (ESHT) hospitals.

32.9     The Committee observed that this winter period and particularly the time around Christmas and New Year had been challenging. It asked what the impact had been on staff and for an update on staffing issues.

32.10   Claudia Griffith acknowledged that it had been a really challenging situation and the health system does have a very tired workforce. There has been a lot of effort to support staff, but the situation remains very pressured taking into account the industrial action as well as winter pressures. There has been a significant focus on recruitment and retention and there is a workforce programme  ...  view the full minutes text for item 32.

33.1     The Committee considered a report on the proposed changes to Children’s Specialist Cancer Services presented by representatives from NHS England (NHSE).

33.2     The Committee commented that the majority of patients who need to travel will be immunocompromised due to their treatment and will therefore probably chose to travel by car. Also, there are areas of deprivation within East Sussex where patients and their families may struggle with travel costs. The Committee asked what travel and access support will be provided for patients, their families and carers under the proposals.

33.3     Dr Chris Streather, Regional Medical Director, NHSE London outlined that a travel time analysis had been undertaken as part of the development of the proposals. This showed that travel times for the two options under consideration by public transport were slightly better, but travel times by car were longer. The Team is drawing on the experience gained from the development of the north London Principal Treatment Centre (PTC) to ensure travel and access is not made more difficult. The Evelina London Children’s Hospital has experience of caring for other immunocompromised children and their travel and access needs.

33.4     Hazel Fisher, Director of Transformation and Programmes, Specialised Services, NHSE London added that they are talking to Great Ormond Street about the support they currently provide for children and there are good transport models in place. NHSE are looking at travel, access and deprivation and this will be covered by the Equalities Impact Assessment (EQIA) that will be included with the Pre Consultation Business Case (PCBC). There are exemptions available for the Ultra Low Emission Zone on a pay and reclaim basis and transport parking spaces are available. In an emergency there is currently a transport service in place that is run by the Evelina Children’s Hospital.

33.5     The Committee asked if children are entitled to patient transport services (PTS) to London.

33.6     Dr Chris Streather responded that NHSE would look at this.

33.7     The Committee commented that if a child goes to a specialist centre for treatment it will be important for the parents or carers to stay with the child. The Committee asked if provision for parents and carers is going to be part of the PCBC and whether the changes will put pressure on existing provision.

33.8     Dr Chris Streather confirmed that this will be part pf the PCBC. Hazel Fisher outlined that NHSE had asked both providers how they will accommodate parents and carers. This might be met via the provision of pull down beds or separate overnight accommodation. Provision for parents and carers will also be in the consultation document.

33.9     Based on the discussion, the Chair asked the Committee if they would agree that the proposed changes do not constitute a substantial variation to health services for East Sussex residents. The Chair also summarised the Committee’s desire to remain involved in the development of the proposals and outlined the methods available to the Committee including responding to the public consultation.

33.10   The Committee RESOLVED  ...  view the full minutes text for item 33.

34.1     The Committee received a report on the proposals for the development of a new Elective Surgery Hub at Eastbourne District General Hospital (EDGH).

34.2     The Committee welcomed the proposals and the benefits to patients in terms of increased capacity and the reduction in waiting times. The Committee asked how this development fitted in with the New Hospitals Programme and the Building for Our Future programme.

34.3     Charlotte O’Brien outlined that the New Hospitals Programme is a broader programme of new hospital buildings and the development of the Elective Hub complements the New Hospitals Programme. ESHT is currently waiting to hear about the amount of funding that will be allocated under the New Hospitals Programme.

34.4     Tracey Rose, Programme Director Building for Our Future at ESHT added that the new Elective Hub project will not affect the Building for Our Future programme. The new Elective Hub project will replace four of the eight operating theatres at EDGH which are in need of replacement. Currently the Trust is waiting for confirmation of the funding from the New Hospitals Programme that will be spent across all three hospital sites – EDGH, Conquest Hospital in Hastings and Bexhill Hospital. The Trust will be able to update the Committee once more details are available.

34.5     The Committee asked for clarification of whether a new hospital is still an option for Eastbourne.

34.6     Tracey Rose responded that the options under consideration include a new build hospital at Eastbourne, a total refurbishment of the existing EDGH and other options. The option chosen will depend on the amount of funding that is made available. The Building for Our Future programme will also include the refurbishment of the other hospitals at Bexhill and the Conquest in Hastings.

34.7     Some Committee members asked why EDGH was chosen for the Elective Hub rather that the Conquest Hospital, and what the ambitions were for the Conquest Hospital site.

34.8     Charlotte O’Brien responded that the New Hospital Programme funding will provide new facilities across all three sites. Tracey Rose added that the plans for the Conquest include an expanded Intensive Care Unit and new wards. Works will also include providing a new roof and new buildings on the Conquest site. The EDGH was chosen for the new Elective Hub as there was physical estate to enable this and because the eight main operating theatres needed to be replaced.  The new Elective hub provided an opportunity to replace four of the operating theatres, which had an extensive backlog of maintenance work. The operating theatres at the Conquest have already been refurbished. It was clarified that the operating theatres at the Conquest are not as old as the ones at EDGH and do not need replacing.

34.9     The Committee asked what the impact of the proposals will be on the Uckfield day surgery unit, will staff will have to move, and what are the plans for the released capacity.

34.10   Charlotte O’Brien outlined that although 29% of activity at Uckfield will be dealt with  ...  view the full minutes text for item 34.

35.1     The Committee considered a report on Primary Care Networks (PCNs), which are groups of GP practices in East Sussex, and emotional wellbeing services provided through PCNs. There are twelve PCNs in East Sussex which include all GP practices, with the largest covering around 100,000 registered patients and the smallest covering around 28,000 patients.

35.2     The Committee asked what services were being provided under the enhanced hours service, and how aware the wider public are of PCNs and the recruitment of specialist staff.

35.3     Liz Davis, Director of Primary Care Operations NHS Sussex outlined that each PCN makes its own decision regarding which services to provide under the enhanced hours arrangements. PCNs are expected to offer enhanced hours services across the whole population covered by the PCN. NHS Sussex does not control which clinics are provided but has some information on enhanced hours services that are being offered. In terms of informing the wider public of the services being offered by the PCN, every PCN is expected to engage with patients, families, local councillors and other stakeholders on the services that they offer. Liz Davis offered to speak to Cllr Shuttleworth outside the meeting regarding the Alps PCN.

35.4     Cllr Turner asked about the work to tackle health inequalities and the provision of a GP surgery in Baird ward in Hastings, which has been under consideration for some time.

35.5     Liz Davis agreed to look into this and get in touch with Cllr Turner after the meeting. Jessica Britton added that there had been a significant amount of effort tackle health inequalities and there is wider work in Hastings to tackle health inequalities. She indicated that she could speak to Cllr Turner about this work outside the meeting.

35.6     Claire Newman, Service Director for Primary Care and Wellbeing at SPFT commented that health inequalities can be analogous with serious mental health conditions. There are priorities to provide physical health checks for patients with serious mental health issues who are likely to die up to 18 years earlier than average. Access to mental health facilitators is now almost fully deployed in all PCNs for mental health issues and to provide health checks for people with serious mental health issues.

35.7     The Committee asked about the governance arrangements for PCNs, and how as a HOSC the Committee could monitor their performance and be satisfied they are making the best use of resources.

35.8     Liz Davis responded that the governance arrangements are quite ambiguous. The Integrated Care Board (ICB), which is NHS Sussex, will be conducting a financial and activity audit at the end of the 2023/24 financial year. The audit will focus on what the money has been spent on and its impact, together with questions about the PCN’s service plans. All PCNs are expected to undertake patient engagement and the requirement for this has been reiterated to PCNs. The results from the audit will be collated and information can be sent to interested parties.

35.9     The Committee commented that it would  ...  view the full minutes text for item 35.

36.1     The Committee discussed the items on the future work programme. The Committee requested that the report on Hospital Handovers scheduled for the June 2023 meeting includes data from the Royal Sussex and Pembury hospitals as well as the ESHT hospitals broken down at hospital level.

36.2     The Committee agreed to schedule the report on the Patient Transport Service for the 21 September 2023 HOSC meeting.

36.3     The Committee requested that an update report on the implementation of the transport and access recommendations from the Cardiology and Ophthalmology transformation reviews be brought to a future meeting. The Senior Scrutiny Adviser will liaise with Jessica Britton, NHS Sussex and ESHT on the timescales for the report.

36.4     The Committee RESOLVED to:

1) amend the work programme in line with paragraphs 36.2 and 36.3 (above);

2) add an update report on PCNs to the work programme for the 21 September 2023 HOSC meeting (paragraph 35.18) ;

3) receive an update report on the development of the new Elective Hub at an appropriate time (paragraph 34.17); 

4) Request a future update report on the proposed changes to Specialised Children’s Cancer Services (paragraph 33.10); and

5) add an update report on the NHS Winter Plan to the agenda for the 29 June 2023 HOSC meeting (paragraph 32.31).

37.1     There were none.