Agenda and minutes

29.1     The minutes of the meeting held on 12 December 2024 were agreed as a correct record.

30.1     No apologies for absence were received.

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.

31.1     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.

32.1     There were no urgent items.

33.1     The Committee considered a report from NHS Sussex providing a progress update on work underway to enhance routine and urgent dental care access for people across the county.

33.2     The Committee welcomed that the report included a number of positive developments, although noted its ongoing concern regarding the future provision of NHS dentistry in the county. The Committee commented that reform, in particular to the dental contract, by national Government was necessary to address the challenges in dentistry.

33.3     The Committee commented that its preference was for NHS Sussex to use East Sussex specific data wherever possible, rather than Sussex-wide information, and requested that NHS organisations bear this in mind when writing future reports.

33.4     The Committee asked how many of the 26,500 additional appointments for Sussex would be for East Sussex.

33.5     Carole Crathern, NHS Sussex Head of Primary Care Commissioning Dental & Optometry explained that the target for NHS Sussex of 26,500 additional appointments had only come a couple of weeks prior, and that it was still planning how these would be used. NHS Sussex was seeking to expand its urgent dental care and stabilisation programme based on demand.

33.6     The Committee asked why East Sussex only had 4 out of 17 ‘golden hello’ posts in Sussex.

33.7     Carole Crathern explained that Lewes and Hastings were the two areas in East Sussex that had been identified as priority areas for ‘golden hello’ posts, and that NHS Sussex had approved every application that it received from providers for those posts. Nish Suchak, East Sussex Local Dental Committee (LDC) Chair added that East Sussex had done comparatively well nationally in accessing golden hello posts. He added that one of the reasons few dentists had taken up golden hello posts was because it tied dentists in for 3 years, which was a high level of risk of practices to take on. He added that a lot of new dentists found it difficult to work for the NHS and reform to the national contract was needed.

33.8     The Committee asked how patients in Rother would be able to access services, including the Urgent Dental Care & Stabilisation Programme (UDCS), noting the lower level of contract performance as well as the size of the district and travel concerns.

33.9     Carole Crathern explained that NHS Sussex had not yet been able to identify providers willing to offer the UDCS in Rother, despite interest in other areas of the county. NHS Sussex was working to address this and set up sites delivering the programme in Rother, as well as to support providers in the district to increase their contract performance and delivery of Units of Dental Activity (UDA).

33.10   The Committee asked for clarity on how many patients were being treated privately in East Sussex.

33.11   Carole Crathern explained that NHS Sussex did not hold data on private patients.

33.12   The Committee asked which practices in Hastings were delivering the Additional Hours Scheme.

33.13   Carole Crathern said that the three practices in Hastings offering the  ...  view the full minutes text for item 33.

34.1     The Committee considered an update report on the implementation of the ophthalmology transformation programme at East Sussex Healthcare NHS Trust (ESHT), including updates on the areas that HOSC made recommendations on as part of its review of the service change.

34.2     The Committee asked how many disabled bays would be at Bexhill Hospital after the changes to parking had been made.

34.3     Lesley Carter, Matron for Ophthalmology, explained that there would be at least six disabled bays on the left hand side of the main entrance to the hospital. There would also be an additional two disabled bays in the car park on the right hand side of the hospital road going down, and that would be designated for patients only. This would result in an extra four disabled bays.

34.4     The Committee asked whether phase 3 of the transformation programme had been paused due to the Government’s announcement on changes to the New Hospitals Programme, and when phase 3 was now expected to be completed.

34.5     Richard Milner, ESHT Chief of Staff, explained that the pause to phase 3 was unrelated to the New Hospitals Programme as the ophthalmology transformation programme had been funded through ESHT’s own regular capital programme. Mike Farrer, ESHT Head of Transformation, explained that phase 3 was still required however there was more time to deliver it because it related to ensuring there was sufficient capacity to meet the 10 year activity projections. Phase 3 would be taken forward at the appropriate time in line with the Trust’s priorities and sufficient capital being available. 3 options were being explored as part of delivering phase 3, and the future demand and capacity model was being refreshed to ensure the new unit was the right size given recent activity changes. An options appraisal would be taking place in summer, after which implementation timelines could be determined.

34.6     The Committee asked if there were enough staff to maintain the service at its current level.

34.7     Lesley Carter, explained that phase 1 & 2 of the transformation programme had created space in outpatients which would allow the appointment of an additional full-time glaucoma consultant. There had also been an increase in the number of middle-grade doctors, and funding to support and expansion in nursing and non-medical staffing levels to support the service.

34.8     The Committee asked whether the service was sufficient without the implementation of phase 3.

34.9     Pantellis Ioannidis, Clinical lead for Ophthalmology, explained that at the moment the service is fully functional and available for patients. The benefits of phase 3 would be to bring optometrists and orthoptists who currently work out of Conquest Hospital into the same unit. The optometrists and orthoptists at Conquest could work safely and independently without consultant supervision, but bringing the whole ophthalmology unit together would benefit staff by increasing the skill mix of staff and have the full service under one roof.

34.10   The Committee asked about issues with non-emergency patient transport and how ESHT would be able to ensure patients  ...  view the full minutes text for item 34.

35.1     The Committee considered a report providing an overview of progress made by SECAmb to improve operational performance and meet the requirements of the NHS England Recovery Support Programme (RSP).

35.2     The Committee asked whether the increase in ambulance handover delays were driven more by pressures caused by winter demands or by patients with No Criteria to Reside.

35.3     Ray Savage, SECAmb Strategic Partnerships Manager (Sussex), explained that handover delay issues were multifactorial. Winter also saw an increase in patients with respiratory issues that caused a spike in demand for ambulances, as well as impacting the flow through hospitals that meant there were fewer bed spaces available. SECAmb worked collaboratively with all system partners to identify ways to manage pressures, including greater preventative care in the community and avoid hospital conveyances when a patient would be better treated in a different setting. Of the calls SECAmb received, roughly 15% could be dealt with over the telephone, and a further 30% of calls which received an ambulance response did not require hospital conveyance. Unscheduled Care Navigation Hubs (UCNHs) had been introduced that allowed a multi-disciplinary clinical team to review category 3 & 4 999 calls and determine the right clinical response for the patient, which was not necessarily an ambulance dispatch. UCNHs were helping to identify commissioning opportunities to develop pathways for patients within the community which would not only improve patient outcomes but reduce pressures on acute hospital trusts by reducing pressure on emergency departments (EDs).

35.4     The Committee asked whether all ambulances had the necessary equipment to treat patients with low oxygen levels.

35.5     Richard Harker, SECAmb Operating Unit Manager East Sussex, confirmed that all ambulances were stocked with advanced airway equipment and full advanced airway life support could be administered by all emergency ambulance crews.

35.6     The Committee asked what was being done to increase awareness of patients’ ReSPECT forms.

35.7     Richard Harker explained that ReSPECT forms were regularly utilised by SECAmb crews, as were Do Not Attempt Cardiopulmonary Resuscitate (DNACPR) order. If they had been uploaded to SECAmb’s systems they could be accessed prior to arrival at a scene. People with the forms are recommended to have a hard copy on scene so that ambulance crews can respect the patient’s wishes upon arrival.

35.8     Ray Savage added that SECAmb was working with NHS Sussex to improve digital patient record sharing which would increase the amount of information that a crew would have when they arrived on a scene.

35.9     The Committee welcomed that SECAmb may be leaving the Recovery Support Programme (RSP) and asked how workplace cultural improvements were being managed and monitored.

35.10   Matt Webb, SECAmb Associate Director of Strategy and Partnerships, explained that SECAmb had made significant improvements in the key areas that it had originally been placed into the RSP for. As part of the improvement journey SECAmb had developed a new organisational strategy which sought to sustain the improvements that had been made, including a strategic aim to ensure people enjoyed working at SECAmb.  ...  view the full minutes text for item 35.

36.1     The Committee considered a report seeking agreement of the HOSC Review Board’s report on audiology services in East Sussex, which included 16 recommendations for NHS Sussex.

36.2     The Committee thanked the Review Board for undertaking the review and producing the report and recommendations.

36.3     The Committee noted the importance of improvements in communications given that many people presumed that they had to access audiology services privately.

36.4     The Committee noted concerns about the level of regulatory oversight of private provision of earwax removal services and asked NHS Sussex to provide some further information for clarity.

36.5     The Committee asked for clarity on the timeline for the recommissioning of the age-related hearing loss service.

36.6     Ashley Scarff, Director of Joint Commissioning and Integrated Care Team Development (East Sussex), agreed to provide an update at the HOSC meeting in September, at which point the procurement process would be underway.

36.7     Ashley Scarff thanked the Review Board for its work and noted the recommendations in the report and agreed that NHS Sussex would provide a response. He added that some work was already underway, including communications with professionals that would be ongoing over the next few weeks.

36.8     The Committee RESOLVED to:

1)    agree the report and recommendations; and

2)    refer the report to NHS Sussex for consideration and response; and

3)    receive and update and response from NHS Sussex in September 2025.

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

37.2     The Committee RESOLVED to:

1)    amend the work programme in line with paragraphs 33.30, 34.18, 35.22 and 36.8; and

2)    defer the report on access to primary care services from June 2025 to September 2025; and

3)    request a future report on planned future capital works at ESHT; and

4)    to receive an assurance report on the provision and safety of current general surgery and neurosurgery at UHSx Hospitals for June or September; and

5)    request an update on delayed discharge be include in the Winter Plan item in June.

38.1     None.