Agenda item

5.1          The Board considered a report providing an update on progress with the East Sussex system integration and related areas of collaboration.  This included the arrangements for the new Sussex Integrated Care System (ICS) and statutory bodies that came into force on 1 July and subsequent amendments to the HWB terms of reference agreed by the Council on 12 July, and a refresh of the Board’s Strategy ‘Healthy Lives, Healthy People’, which provides the overarching strategic framework for the work of health, social care and the wider system for the population of East Sussex.

5.2          The Board asked why the cardiology service may not be provided from the Eastbourne District General Hospital (EDGH) in future, subject to the outcome of the review process, when a new hospital is planned for the site.

5.3          Mark Stainton, Director of Adult Social Care, advised the timeline for the Building for our Future hospital programme to deliver new hospital buildings is several years, whilst the HWB Strategy is for 3+2 years. This means the NHS will have needed to make clinical decisions around the provision of cardiology and ophthalmology services before any new hospital will have been built. He advised the cardiology and ophthalmology reconfigurations are being reviewed by the Health Overview and Scrutiny Committee (HOSC).

5.4          The Board asked whether the new Special Educational Needs and Disability (SEND) strategy will ensure children’s neuro-diversity is recognised with their Education, Health and Care Plans (EHCPs).

5.5          Alison Jeffrey, Director of Children’s Services, said East Sussex County Council (ESCC) and the NHS organisations in East Sussex are committed to improving their joint working around Children’s Services. There are proposals that NHS Sussex is assisting ESCC to resource that are designed to improve the response to children who are neuro diverse and try and ensure they receive more help sooner. It is important SEND needs are captured in EHCPs and schools are supported to assist children who are neuro diverse, even those without an EHCP.

5.6          The Board asked whether discharge to assess will continue to be provided.

5.7          Mark Stainton confirmed that discharge to assess will remain as a core element of the range of services offered to assist patients who are medically fit to leave hospital and require ongoing social care.

5.8          The Board asked what the reasons are for the performance in Emergency Departments (ED).

5.9          Mark Stainton said that there are several reasons including that demand for ED is higher than it was two years ago; there are staff recruitment and retention issues exacerbated by COVID-19 outbreaks that compromise staff availability; and the flow of patients who are medically ready for discharge is also not as swift as it could be at times given the exceptional challenges with the independent sector care market, particularly home care. Discharge to Assess has helped alleviate many of these issues around patients who are medically ready for discharge, as they can be moved to home care or block purchased care homes where the necessary assessments can be carried out. The outbreak of hot weather is also likely to increase demand through greater cardiac and respiratory issues.

5.10       The Board asked whether future iterations of the Strategy should factor in adaptations to extreme weather under the challenges section.

5.11       Vicky Smith, Programme Director - East Sussex Health and Social Care Transformation, agreed it would be helpful to add extreme weather events to the challenges section in future versions of the strategy. Cllr Keith Glazier, Chair of the Board, also agreed that it could be useful to include in the future and provided assurance that such plans were already in place. ESCC, for example, has activated its service plans for helping the most vulnerable residents through the level 3 weather warning. This includes making contact with those at highest risk, advising carers to contact GPs with health concerns and sharing the latest public health advice. Other public organisations such as Sussex Police, East Sussex Fire and Rescue Service and the district and borough councils have released similar information. Darrell Gale, Director of Public Health (DPH), added that people most at risk of overheating in hot weather are those in single aspect flats, new builds, and on converted properties. Future Public Health strategies would include adaptations to buildings as a way of mitigating against climate change. He added Public Health has a small team supporting the Town Deal in Hastings to look at health inequalities and help get green jobs into Hastings to help deliver the Borough Council’s own building adaptations.

5.12       The Board RESOLVED to:

1)         note the contents of this update and the work that has taken place to respond to recent national and local developments, including the updated Health and Wellbeing Board terms of reference (Appendix 1); and

2)         endorse the refreshed HWB Strategy ‘Health Lives, Healthy People 2022 – 2027’ (Appendix 2)