Agenda and draft minutes

Health Overview and Scrutiny Committee
Thursday, 28th November, 2019 10.00 am

Venue: Council Chamber, County Hall, Lewes

Contact: Harvey Winder  01273 481796

Webcast: View the webcast

Items
No. Item

16.

Minutes of the meeting held on 26 September 2019 pdf icon PDF 131 KB

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Minutes:

16.1     The minutes of the meeting held on 26 September 2019 were agreed as a correct record.

17.

Apologies for absence

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Minutes:

17.1     Apologies for absence were received from Cllr Amanda Morris.

17.2     The following substitutes attended the meeting:

  • Cllr Jim Sheppard for Cllr Angharad Davies
  • Cllr Bob Bowdler for Cllr Phil Boorman
  • Cllr David Watts for Cllr Johanna Howell.

 

18.

Disclosures of interests

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.

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Minutes:

18.1     There were no disclosures of interest.

19.

Urgent items

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.

 

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Minutes:

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19.1.     The Committee considered a verbal update from Joe Chadwick-Bell on the recent Care Quality Commission (CQC) inspection of East Sussex Healthcare NHS Trust (ESHT).

19.2.     Joe Chadwick-Bell explained that the trust provided considerable information to the CQC ahead of the inspection. The CQC then undertook a three-day inspection between the 6th and 8th of November.

19.3.     The CQC focussed on community services, including the Irvine unit at Bexhill; pharmacy; outpatients at Conquest Hospital; the full paediatric service at both hospital sites; and both community and hospital end of life care. NHS England and NHS Improvement also inspected the trust’s efficiency under the ‘use of resources’ domain on behalf of the CQC. The inspection of the trust’s leadership under the ‘well-led’ domain was also due to take place from the 10th to 11th of December.

19.4.     Joe Chadwick-Bell said that the Trust expected to see a copy of the CQC’s report in late January to allow time for accuracy checking and that the final report should be published in the middle of February. She said feedback so far from the CQC had been limited but largely positive, for example, around the outpatient transformation and end of life care.

19.5.     The Committee RESOLVED to note the update.

 

20.

Winter Planning in East Sussex pdf icon PDF 163 KB

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20.1.     The Committee considered a report on the plans across East Sussex to deal with seasonal demand surges, extreme weather and other issues associated with the winter months. The Committee then asked the witnesses present a number of questions.

20.2.     The Committee asked how much additional funding had been made available for the winter period and whether it was designated for specific areas of spend, for example, improving Delayed Transfer of Care (DTOC) rates

20.3.     Mark Stainton explained that local authorities and the NHS both receive separate allocations of winter funding from the Department of Health in recognition that there is a need to increase resources in both social care and health to maintain patient flow.  Jessica Britton said that the Local Accident & Emergency Delivery Board (LAEDB) agrees jointly how the funding is allocated. She said she would confirm to the Committee the exact allocation the Clinical Commissioning Groups (CCGs) in East Sussex received for the winter period via email.

20.4.     Mark Stainton confirmed that East Sussex County Council (ESCC) had received approximately £2.3m of winter funding to be spent on reducing DTOC. He said that DTOC had now been consistently low in East Sussex for a long period of time, so the money was being directed towards the cohort of patients who are not yet DTOC patients but who, if nothing is done, could become classified as such. These are the patients who are medically optimised to be moved through the Discharge to Assess pathways, so the winter money was being spent on increasing the capacity of the Discharge to Assess pathways via spot purchasing nursing home beds and increasing homecare capacity.

20.5.     Joe Chadwick-Bell said that the contract agreement between East Sussex Healthcare NHS Trust (ESHT) and the CCGs included dedicated winter funding of approximately £4-5m. This money has been allocated by the trust to a number of schemes, such as opening additional acute and community beds; recruiting additional therapy staff to assist with the Discharge to Assess pathway; and extending the opening hours of pharmacies on the acute hospital sites to seven days.

20.6.     The Committee asked what additional capacity will be available for the Discharge to Assess pathways

20.7.     Mark Stainton explained that ESCC is purchasing 10 additional nursing home beds from the independent sector for the duration of the winter period. This will increase the capacity of the Discharge to Assess pathway for people with a range of more complex needs who can be discharged from a hospital bed but need to be assessed in an intermediate bed before being discharged back home or to residential care. He said some of the beds were already opened and the remainder would be opened on 24th December alongside ESHT’s additional acute and community beds.

20.8.     Mark Stainton added that for the Home First Discharge to Assess pathway – discharging people directly to their own homes for assessment – the  ...  view the full minutes text for item 20.

21.

Clinical Commissioning Group (CCG) merger pdf icon PDF 151 KB

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21.1.     The Committee considered a report providing an update on the proposals to merge the three East Sussex CCGs. The Committee then asked the witnesses present a number of questions.

21.2.     The Committee asked how local representatives will be appointed to the East Sussex CCG Governing Body

21.3.     Terry Willows explained that localities, such as Hastings, High Weald, Eastbourne, etc., will be represented by a GP who is elected by the GP membership for that locality to the CCG’s Governing Body.

21.4.     In addition to the Governing Body meetings, locality meetings are expected to involve the broader GP membership and local residents interested in being involved. Healthwatch and Patient Participation Groups representation is also being considered for CCG committees that, once established, will exercise powers delegated from the Governing Body.

21.5.     The Committee asked whether the local authority representatives on the CCG board will have voting rights

21.6.     Terry Willows explained that local authority representatives cannot be voting members due to the Health and Social Care Act 2012 only permitting employees or appointees of the statutory body, the CCG, a vote. He added that the current local authority representative of the existing CCG Boards, the Director of Public Health, plays a very full role in deliberations and discussions.

21.7.     The Committee questioned whether there was sufficient engagement by the CCGs of district and borough councils.

21.8.     Terry Willows said that he would reflect on the feedback that the district and boroughs were not sufficiently involved in CCG decision making. He said the core reason to merge the CCGs was to improve commissioning of the wider determinants in relation to health, such as housing, and district and boroughs have an important role to play in delivering in these areas, for example, in their role as housing authorities. Jessica Britton added that the CCGs work closely on a range of projects with district and borough councils, including prevention and health improvement programmes like Healthy Hastings and Rother. She said the locality structure of the new East Sussex CCG will provide opportunities for additional engagement with stakeholders like the district and borough councils at a locality level.

21.9.     The Committee asked what difference the public would see once the new CCG was in place

21.10.  Terry Willows said the aim is for the East Sussex CCG to engage with patients and public in an improved and consistent way. He hoped, therefore, that the public would notice they are being listened to more by the new CCG and that it was commissioning new services that better meet the public’s needs.

21.11.  Terry Willows explained the new operating structure of the CCG will include additional capacity in the communications and engagement team, which will help take information from the localities and use it to help inform decision making at an East Sussex level.  The CCG is also looking at improving public engagement with the CCG decision-making process,  ...  view the full minutes text for item 21.

22.

HOSC future work programme pdf icon PDF 222 KB

Additional documents:

Minutes:

22.1      The Committee considered a report on its work programme

22.2      The Chair explained that all HOSC members would be invited to attend to observe the first meeting of the HOSC review board looking at the proposals for the Eastbourne walk-in centre if they are published ahead of the next HOSC meeting on 26 March.

22.3      The Committee RESOLVED to agree its work programme subject to the addition of:

1) a report on ESHT’s CQC inspection at its 26 March 2020 meeting.