Agenda and minutes

20.1     The minutes of the meeting held on 21 September 2023 were agreed as a correct record.

21.1     Apologies for absence were received from Councillors Abul Azad, Sarah Osborne, Mike Turner, Graham Shaw and Simon McGurk.

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.

22.1     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.

23.1     There were no urgent items.

24.1     The Committee considered a report on planned changes to the delivery of paediatric services at Eastbourne District General Hospital (EDGH). Joe Chadwick-Bell, East Sussex Healthcare NHS Trust (ESHT) Chief Executive recognised that the planned changes would be a change in working practices for some staff at EDGH, and noted that there had been media coverage and public representations made to the Committee that related to the planned changes. Joe Chadwick-Bell and Dr Matthew Clark, Consultant Paediatrician and ESHT Chief of Women and Children reiterated what was in the report, that there would be no planned activity moves from the EDGH to the Conquest Hospital in Hastings.

24.2     The Committee asked why NHS Sussex did not consider the planned changes to be a substantial variation.

24.3     Jessica Britton, NHS Sussex Executive Managing Director, East Sussex responded that NHS Sussex did not view the planned changes to be a service change as they were related to how services were organised within the hospital. NHS Sussex anticipated that the changes would increase access and hours of access for children and young people, and therefore not a substantial variation.

24.4     Cllr Alan Shuttleworth shared his view that due to a lack of detailed information having been provided, the implementation of planned changes should be paused until there had been a review and a full consultation with all stakeholders. Cllr Shuttleworth also shared his concern that an unintended consequence of the planned changes could be that more children and families have to travel to the Conquest for treatment.

24.5     Joe Chadwick-Bell recognised Cllr Shuttleworth’s request, and reiterated that the same activity for planned care or urgent care would still come to Eastbourne, and there were no changes that would lead to children going to the Conquest. She emphasised that it was an internal reorganisation of where children would be seen within the hospital. The first stage of the planned implementation was of urgent care and was due to start on 8^th January 2024, and the second stage was of elective care and would begin in February 2024. Dr Matthew Clark noted that there had been a lot of discussions with staff and other stakeholders in the lead up, and no patient safety issues had been raised despite some differences in views over the proposed model of care. Rotas were in place to implement on 8^th January and to move away from the planned date would be disruptive and operationally difficult.

24.6     The Committee asked for more detail on how planned care and urgent care pathways would change when the planned changes were implemented.

24.7     Dr Clark explained that under the current model most children who presented at the EDGH Emergency Department (ED) would be triaged and the vast majority directed to the Urgent Treatment Centre (UTC) as they did not require input from a paediatric specialist. Any children who could not be treated at the UTC would be seen in the ED by emergency physicians, and only if they could not solve  ...  view the full minutes text for item 24.

25.1     The Committee considered a 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. The Winter Plan is a whole system health and social care plan, recognising the interdependencies of the system to meet the needs of the local population and runs from November 2023 to April 2024.

25.2     The Committee asked whether admission avoidance work happened all year round.

25.3     Jessica Britton responded that admission avoidance programmes run throughout the year and were a continuation of learning from previous years, but during winter these were expanded to increase the number of people who could benefit from admission avoidance. Two key elements of admission avoidance that had been taken as learning from thew previous Winter Plan was the increase in virtual ward capacity to 86 beds, as well as the single point of access which had been enhanced to provide professionals with advice to prevent patients needing to go to hospital. Urgent and Community response teams had also been improved to provide additional support in the community. Mark Stainton, East Sussex County Council Director of Adult Social Care & Health added that the capacity of the Joint Community Rehabilitation Service had been increased for winter so that rehab workers were in ED and could work with clinicians to remove patients before they were admitted.

25.4     The Committee asked for more detail on how the Mental Health Crisis Improvement plan would operate to achieve the impacts outlined in the report.

25.5     Jessica Britton responded that the Mental Health Urgent and Emergency Care Improvement plan covered the entirety of the Sussex, that aimed to reduce the number of people needing to go to EDs for mental health challenges. There were a number of long and short term action plans that underpinned this work, and was referenced in the winter plan in recognition of the increasing complexity of people visiting EDs. Jessica offered to provide more detail on the implementation of those plans.

25.6     Cllr Christine Robinson asked whether mental health support for children and young people was included as part of this plan, and if not whether it could be included in a future winter plan. Jessica Britton responded that the Improvement plan did not cover mental health support for children and young people, but a parallel plan was in development for children and young people as well, and consideration could be given to how to present this in future winter plans.

25.7     The Committee asked how vaccination uptake for seasonal flu and COVID-19 was being encouraged.

25.8     Jessica Britton responded that there had been heightened and targeted communications going into winter to encourage vaccine uptake. The number of people who had a flu vaccination in Sussex was at or above the level for the previous year. There had been very targeted work for Covid vaccination for people who were housebound, in care homes or who had respiratory  ...  view the full minutes text for item 25.

26.1     The Committee considered a report updating on hospital handover delays at the Royal Sussex County Hospital (RSCH) and ongoing work between University Hospitals Sussex NHS Foundation Trust (UHSx) and South East Coast Ambulance NHS Foundation Trust (SECAmb) to reduce them. Peter Lane, Hospital Director Royal Sussex County Hospital outlined that there are a number of short, medium and long term measures in place to reduce hospital handover times at the RSCH and patients are very rarely held in the back of ambulances. Paul Fisher, SECAmb Brighton Operating Unit Manager added that there was a lot of collaborative work to reduce hand over times and waits over 60 minutes, and it is hoped that benefit of this work will be seen in the next 6-12 months.

26.2     The Committee asked whether RSCH compared its handover times with other tertiary hospitals and if so, how it compared with them.

26.3     Alex Darling, Operations Manager at Brighton Make Ready Centre commented that SECAmb had data from 18 hospitals that it covered in the South East region, which included other trauma centres in the region and accepted a similar number of patients to the RSCH. When comparing data on handover delays the RSCH was almost always the hospital with the highest number of delays. Peter Lane commented that it was recognised that there was still more work to do to reduce handover times. Paul Fisher added that the challenges faced in reducing waiting times were recognised and both organisations work well together to deliver the best service that they can.

26.4     The Chair thanked both SECAmb and UHSx for all their hard work on this issue.

26.5     The Committee RESOLVED to note the report and receive an update report in 6 months time.

27.1     The Committee discussed the items on the future work programme.

27.2     The Committee discussed the problem of missed appointments, and how it related to wider problems such as cost of living pressures, transport links and the postal service, and felt that it would be beneficial for a report on the topic to be brought to a future meeting.

27.3     Cllr Marlow-Eastwood fed back positively the site visit with other HOSC members to the Conquest Hospital to see the investments that were being made in the site.

The Committee RESOLVED to:

1)    Amend the work programme in line with paragraphs 24.48, 26.5 and 27.2.

28.1     None.