Agenda and minutes

11.1     The Board RESOLVED to agree the minutes of the previous meeting as a correct record.

12.2     Apologies for absence were received from Cllr David Elkin and Dr Susan Rae (substitute Dr Binodh Bhaskaran).

Disclosure by all Members present of personal interests in matters on the agenda, the nature of any interest and whether the Members regard the interest as prejudicial under the terms of the Code of Conduct and the CCGs’ Conflicts of Interest Policy.

13.1     There were no declarations of interest.

Notification of any items which the Chair considers urgent and proposes to take at the appropriate part of the agenda.

14.1     There were no urgent items.

15.1     The Board considered verbal questions from Cllr Colin Swansborough and Cllr John Ungar.

15.2     In response to the questions, the following information was provided:

·         East Sussex Better Together’s (ESBT) financial position for August and September will be reported to both the ESBT Scrutiny Board and the ESBT Strategic Commissioning Board (SCB) as part of the Quarter 2 monitoring in December.

·         The Joint Community Reablement Service (JCR) and other ESBT community-based initiatives have recruitment and retention challenges, in large part due to the nationwide challenge of recruiting care staff. A generic job description under an NHS contract with NHS branding has been developed for the JCR to help tackle this shortage of staff, and it has had a positive impact in attracting people to work for the Service. Other initiatives include reaching out to community colleges in order to draw in a broader, younger workforce than the traditional care worker demographic. 

 15.3    The Board RESOLVED to request that further information on the ESBT workforce and GP recruitment and retention initiatives is circulated by email.

16.1     The Board considered a report providing an update on the East Sussex Better Together (ESBT) financial position and progress with the Strategic Investment Plan (SIP).

16.2     In response to questions from the Board, the following information was provided:

·         One of the key overarching aims of ESBT is for health and social care organisations to work better with districts and borough councils, communities, and local groups. Locality Forums are key to achieving this aim and they will begin operating during October.

·         There are 9 ESBT schemes included in the report that are currently rated amber or red in terms of their performance and risk. There are, however, 36 schemes in total across ESBT and the other 27 schemes remain on track.

·         Some schemes have so far had low referral rates from GPs and other healthcare practitioners. This is being addressed by a communications plan that will raise awareness and confidence amongst clinicians to refer patients to these new schemes.

·         The rate of non-elective admissions in the ESBT area has dropped significantly against national and regional trends. This demonstrates that ESBT schemes designed to keep people out of hospital, such as Health and Social Care Connect (HSCC) and the Crisis Response Teams, are starting to gain traction within the wider health system.

·         There have been challenges to date with independent providers developing the necessary capacity to deliver new ESBT services at the pace that is required, for example, Care Home Plus and Technology Enabled Care Services (TECs). The ESBT Alliance Executive is in the process of  engaging with independent care home providers to establish what capacity the sector has. Further work will then be carried out to support providers and incentivise them to develop the capacity that is needed to deliver Care Home Plus.

·         Some of the challenges facing the ESBT programme are outside of its direct control, such as changes to the National Tariff prices and payment rules, Better Care Fund requirements, and the requirement to meet control totals over a wider geographic area, i.e., across the Sussex and East Surrey Sustainability and Transformation Partnership (STP).

16.3     The Board RESOLVED to:

1) note the East Sussex Better Together financial position and progress with the Strategic Investment Plan; and

2) request monthly updates on the progress of ESBT by email

17.1     The Board considered a report providing an update on progress with the development of the ESBT Alliance Outcomes Framework and a sample of performance data for the first quarter of 2017/18.

17.2     The Chair noted the ESBT Scrutiny Board’s comment in relation to this report and it was confirmed that officers were considering the feasibility of the scrutiny board’s recommendation to include appropriate housing and education indicators in the Outcomes Framework.

17.3     Officers agreed to look at the feasibility of including indicators that demonstrated evidence of effective working across the system and good logistics between organisations. It was explained that certain workforce indicators already included in the Framework should help to capture improvements in working as a single health and care system.

17.4     The Board RESOLVED to note the report

18.1     The Board considered a report providing an update on the further developments within the ESBT Alliance and integrated strategic commissioning arrangements for 2017/19 onwards.

18.2     In response to a question from the Board, officers explained that the majority of health and care services in the ESBT area will be provided or commissioned by the developing ESBT Accountable Care Organisation. Some services could be ‘allocated down’ to Integrated Locality Teams as part of this work ,whilst some commissioning could be ‘delegated up’ to be carried out at Sussex and East Surrey Sustainability and Transformation Partnership (STP) level. Services could also be delivered in partnership with Connecting 4 You across the whole of East Sussex. In addition, the Health and Wellbeing Stakeholder Group will allow ESBT to work collaboratively with a broader set of stakeholders in the independent, community and voluntary sectors; and the Housing Health Sub-Group facilitates close working with district and borough councils.

18.3     The Board RESOLVED to:

1) Note the decision taken by each of the ESBT Alliance partner’s governing bodies to proceed with further health and social care integration in the form of a single new health and care organisation by 2020/21

2) Note the agreement of each of the ESBT partner’s governing bodies to accelerate this through strengthening the commissioner provider ESBT Alliance arrangement for 2018/19, to make the required year on year improvements to our system financial position and quality (as set out in the high level milestone map in Appendix 1)

3) Note the proposed timetable and next steps as set out in section 6 to progress development and strengthen our Alliance arrangements for April 2018

19.1     The Board considered a report providing an update on progress with the set up and development of a new collaborative health and wellbeing stakeholder group.

19.2     The Board RESOLVED to:

1) Note progress with the development of the new Health and Wellbeing Collaborative Stakeholder Group, including draft Terms of Reference for the Group and the recruitment process

2) Welcome a representative from the group at the next meeting of the SCB on 20 December 2017

20.1     The Board RESOLVED to agree its work programme.