Agenda item

Report by Executive Managing Director, East Sussex, NHS Sussex and Director of Adult Social Care, East Sussex County Council.

36.1     The Board considered an update report on the East Sussex Health and Social Care Integration Programme and the development of a Shared Delivery Plan (SDP) for the NHS Sussex Integrated Care Strategy (ICS). The SDP brings together immediate health and social care system priorities around access to services and the co-ordination of prevention services.

36.2     The Board commented that the report was well put together and meaningful and stressed the importance of getting the approach right to ensure collaborative working across all the partners. The Board asked a number of questions about the report which are summarised below.

36.3     In terms of improving health outcomes, the Board asked why there were no crosses against preventable sight loss under the frailty category in the table identifying high level of need by place, according to the East Sussex public health outcomes framework (appendix 4, page 49 of the report).

36.4     Vicky Smith, Programme Director, East Sussex Health and Social Care Transformation responded that she thought this was an oversight and will investigate and arrange for it to be corrected as necessary.

36.5     Councillor Batsford commented that he thought there should be more focus on health inequalities in places such as Hastings where there are some of the poorest areas in East Sussex and there are high levels of need. The Chair commented that the focus of the report is on health inequalities which the SDP is seeking to address.

36.6     The Board sought reassurances that the approach to health inequalities would take into account the areas throughout the county where there are areas of greater inequality. The Board also asked if the proposed workshops would use an analysis of information that has previously been gathered as a basis for asking further questions, rather than asking open questions that we might already know the answers to.

36.7     Vicky Smith outlined that the priorities identified in theImproving Health Outcomes: Summary of Opportunities Analysis (appendix 4 of the report) is a summary that brings together public health information on the four conditions (CVD, Mental Health, Respiratory and Frailty) which are being used as indicators of poor health. They are then being used as a lens to focus on areas of work where there are opportunities for prevention and other work where change is possible. It aims to show where there might be outliers in health outcomes compared with the England average, including within Borough and District council communities, which might need to be explored in more detail. This is also why there is an integrated community team approach to the work to examine these differences and produce an integrated plan based on community intelligence and insight.

36.8     The intention is to develop a set of co-designed workshops which will bring together all the expertise that people and communities have on their local areas as well as the information clinicians and health professionals have. The plan is to refresh the approach and bring together intelligence and insight, and link this to measurable outcomes for population health and more immediate actions for within year activity.

36.9     The Board asked who in the NHS and Social Services are ultimately accountable as shown in the simplified governance structure for the development and sign off of the Integrated Care Strategy (page 20 of the report).

36.10   Mark Stainton, Director of Adult Social Care and Health responded that the ultimate accountability does not lie in one place, as the ICS brings together a whole range of health and care organisations. For provider Trusts they are accountable to the NHS Sussex Board (ICB); for East Sussex County Council (ESCC) services they are accountable to local people through the Lead Member, Cabinet and Health and Wellbeing Board (HWB); and as a system the accountability is to the Sussex Health and Care Assembly which is pan Sussex and includes the Chairs of three Sussex HWBs, senior council officers, non-executive members and officers of NHS Sussex. The diagram on page 20 of the report attempts to show these different governance arrangements. Neither the Health Overview Scrutiny Committee nor the HWB are a sub-set of ESCC, and the diagram is attempting to show where local government governance sits.

36.11   Alison Jeffery, Director of Children’s Services commented that she was really keen on the SDP having a bigger focus on children and young people in East Sussex. When it comes to prevention and investment in services it will be important to invest in services such as those for mental health.

36.12   The Board RESOLVED to:

1) Note the progress with planning to support our implementation of the shared ambition and priorities set out in the Sussex Integrated Care Strategy and joint East Sussex Health and Wellbeing Board Strategy;

2) Endorse the direction of travel and the recommended planning milestones for2023/24, which will also form the basis of the East Sussex Place contribution to the Sussex Shared Delivery Plan (SDP), and;

3) Agree to explore holding a meeting of the HWB in June 2023 in order to come to a view on whether the SDP takes account of HWB Strategy priorities, and enable the requirements of the HWB and timescales set by NHS England as outlined in paragraphs 2.4 – 2.7 to be met.