Agenda item

5.1       The Committee considered an update and evaluation report on the NHS Sussex Winter Plan. The Winter Plan set out how the local health and social care system plans to effectively manage capacity and demand pressures anticipated during the Winter period and ran from October 2022 to April 2023.

5.2       The Committee asked how information sharing could be improved between hospital Trusts and ambulance crews.

5.3       Claudia Griffith, Chief Delivery Officer NHS Sussex responded that there was a programme of work taking place across the whole system to improve digital integration of patient care records so that ambulance crews had access to them when they arrive at a scene, and this work was ongoing.

5.4       The Committee asked what impact the winter period had on elective surgery waiting times, and how many patients were waiting over a year for surgery.

5.5       Claudia Griffith explained that elective waiting times had grown significantly since the beginning of the pandemic, but that East Sussex Healthcare NHS Trust (ESHT) had met the nationally set target of no one waiting longer than 78 weeks by the end of March, and was ahead of schedule in meeting the target for this year of no patients waiting over 65 weeks. University Hospital Sussex NHS Foundation Trust (UHSx) had not been able to meet the 78 week target due to the impact of industrial action, but was expected to have cleared the backlog of patients waiting more than 78 weeks by the end of July. NHS Sussex was exploring all available options to make best use of capacity that could help reduce patient waiting times. Claudia agreed to provide the number of people waiting more than a year in East Sussex outside the meeting.

5.6       The Committee asked for further details on whether there were any differences in recovery and outcomes for patients being cared for via new ‘Virtual Wards’ service model in the community, as opposed to those in hospital.

5.7       Claudia Griffith answered that there was evaluation work both locally and nationally to understand the clinical and financial impact of virtual wards. Initial assessments suggested the impact had been positive, but NHS Sussex was also bringing in an external consultant to fully understand the impact of new service models in order to evaluate whether they should be expanded. The outcomes of this work could be fed back to the HOSC.

5.8       The Committee asked why patients who had contacted 111 and were given a reserved slot at the Emergency Department (ED) were arriving at hospital to find that they had to wait.

5.9       Claudia Griffith answered that while there was an option to book appointments at EDs, there was still a need for clinical prioritisation. Therefore, if booked slots coincided with surges in demand then clinicians would focus attention on those at greatest risk, and it would not always be possible to maintain the slot.

5.10     The Committee asked how many patients in East Sussex had NHS access to Livi on line consultations.

5.11     Claudia Griffith confirmed that Livi was put in place to provide additional capacity during the pandemic and not as a core service. EDs and 111 both had access to Livi as a way of managing demand and getting patients the most suitable treatment. Claudia agreed to provide follow up information on which GP surgeries still had access to Livi.

5.12     The Committee asked what the impact on clinical outcomes was for the 22.5% of patients who do not receive a cancer diagnosis within 28 days.

5.13     Claudia Griffith answered that while it was positive that East Sussex hospitals were above the national standard for people receiving a cancer diagnosis, there was always room for improvement. As well as the 28 day target there was also monitoring of the number of people who received treatment within 62 days to understand where there may be particular constraints in the system, and continuous clinical review of patients waiting longer. Community diagnostic centres, including one in Bexhill, are being used to try and reduce diagnosis times.

5.14     The Committee asked what impact the use of the former Spire hospital site had had on waiting times.

5.15     Richard Milner, Chief of Staff ESHT confirmed that he would find out and share those numbers.

5.16     The Committee asked what the coverage of virtual wards across East Sussex was, and whether funding for virtual wards is ongoing.

5.17     Claudia Griffith confirmed that in East Sussex there were around 40-50 virtual ward beds, which had high utilisation of on average 80-90%, although their capacity was variable depending on the complexity of patient needs. NHS Sussex was looking to expand the model for the next winter. The funding is ongoing, but the system is undertaking a review to fully understand their impact and make best use of resources.

5.18     The Committee asked if there was any coproduction with service users built into the mental health crisis review.

5.19     Claudia Griffith confirmed that the crisis pathway review was a relatively quick piece of work which aimed to get recommendations out ahead of next winter and had involved a range of stakeholders. There would be work beginning in July to look at how better to support mental health patients in EDs which would be a piece of coproduction and include patients, staff, primary care and others.

5.20     The Committee RESOLVED to:

1) Note the report; and

2) Request an update on the Winter Plan 2023/24 at the December HOSC meeting.