Agenda item

25.1     The Committee considered a report on the NHS Sussex Winter Plan. The Winter Plan sets out how the local health and social care system plans to effectively manage the capacity and demand pressures anticipated during the Winter period. The Winter Plan is a whole system health and social care plan, recognising the interdependencies of the system to meet the needs of the local population and runs from November 2023 to April 2024.

25.2     The Committee asked whether admission avoidance work happened all year round.

25.3     Jessica Britton responded that admission avoidance programmes run throughout the year and were a continuation of learning from previous years, but during winter these were expanded to increase the number of people who could benefit from admission avoidance. Two key elements of admission avoidance that had been taken as learning from thew previous Winter Plan was the increase in virtual ward capacity to 86 beds, as well as the single point of access which had been enhanced to provide professionals with advice to prevent patients needing to go to hospital. Urgent and Community response teams had also been improved to provide additional support in the community. Mark Stainton, East Sussex County Council Director of Adult Social Care & Health added that the capacity of the Joint Community Rehabilitation Service had been increased for winter so that rehab workers were in ED and could work with clinicians to remove patients before they were admitted.

25.4     The Committee asked for more detail on how the Mental Health Crisis Improvement plan would operate to achieve the impacts outlined in the report.

25.5     Jessica Britton responded that the Mental Health Urgent and Emergency Care Improvement plan covered the entirety of the Sussex, that aimed to reduce the number of people needing to go to EDs for mental health challenges. There were a number of long and short term action plans that underpinned this work, and was referenced in the winter plan in recognition of the increasing complexity of people visiting EDs. Jessica offered to provide more detail on the implementation of those plans.

25.6     Cllr Christine Robinson asked whether mental health support for children and young people was included as part of this plan, and if not whether it could be included in a future winter plan. Jessica Britton responded that the Improvement plan did not cover mental health support for children and young people, but a parallel plan was in development for children and young people as well, and consideration could be given to how to present this in future winter plans.

25.7     The Committee asked how vaccination uptake for seasonal flu and COVID-19 was being encouraged.

25.8     Jessica Britton responded that there had been heightened and targeted communications going into winter to encourage vaccine uptake. The number of people who had a flu vaccination in Sussex was at or above the level for the previous year. There had been very targeted work for Covid vaccination for people who were housebound, in care homes or who had respiratory diseases, and increasing uptake remained a continued focus for NHS Sussex. Richard Milner, ESHT Chief of Staff added that hospitals in East Sussex had not seen an increase in flu or COVID-19 patients and this was not presenting any additional concerns, although winter challenges remained.

25.9     The Committee asked about what measures had been put in place to prevent staff burnout and increase recruitment and retention of staff.

25.10   Jessica Britton commented that for NHS Sussex there were a number of programmes to support staff wellbeing and highlight the support that people could access. Different organisations were working collectively to try and promote flexibility in workforce in how they recruited and advertised to posts across East Sussex to increase resilience. Planned industrial action had also prompted work to understand how to best deploy and be flexible with the workforce across East Sussex during periods of strike action.

25.11   Richard Milner added that ESHT rotas had been booked six weeks ahead in order to be best prepared for winter. During the pandemic a lot of psychological and trauma support for staff was put in place to help support staff and reduce burnout, and a lot of that remained in place post-pandemic. ESHT also had a number of Mental Health First Aiders who staff could speak to when they needed support. The prospect of industrial action remained a challenge and ESHT aimed not to cancel any urgent elective care of cancer appointments, and the number one priority was to protect emergency care.

25.12   Mark Stainton added that there had been considerable success in recruiting to the independent care sector from overseas, and there were 200 extra home care staff this year which had had a positive impact on capacity. The challenges for recruitment in bedded care were slightly less acute, and there was good capacity in both of these areas. ESCC had a full wellbeing offer for staff and ongoing recruitment campaigns for its own workforce, and the Adult Social Care and Health department had half the level of vacancies than six months prior. He noted that demand and the complexity of care was increasing and so ESCC was exploring the use of digital technology as much as possible to streamline administrative tasks and focus practitioner time.

25.13   The Committee asked if the recruitment of home carers had resulted in a higher number of carers or whether new staff were only filling vacancies caused by high turnover.

25.14   Mark Stainton explained that the home care sector had a high number of staff vacancies and therefore could not meet ESCC’s requests for new care packages. New staff were mostly filling existing vacancies but there had also been some growth as there was a drive to increase the amount of people being cared for at home rather than in bedded care. Overseas recruits were spread evenly across the county and had started on three-year visas. The announced increase in the National Living Wage would hopefully help in further boosting recruitment although this would present a financial challenge for local authorities.

25.15   The Committee asked for more detail on the High Intensity Users programme and what success this had shown in Brighton & Hove.

25.16   Jessica Britton explained that it was a service that worked with people who regularly attended ED for a number of reasons, often more psychosocial. There were case workers who worked with individuals over an extended period of time of 6-9 months to signpost and support in accessing other services that may be helpful to them and reduce their need to attend ED. There was a case worker in both EDGH and Conquest and had a caseload of around 30 people and the programme was beginning to see some success in reduced attendances and received positive feedback from people using the service.

25.17   The Committee asked whether there was a likelihood of the system declaring a critical incident due to industrial action.

25.18   Richard Milner explained that the system was experienced in handling periods of industrial action and there was ongoing work to minimise the impact of any action and avoid a critical incident. The focus was on cancelling the minimum number of operations and protect resources for urgent and emergency care.

25.19   The Committee asked whether the target of eliminating 72+ hour waits in ED for mental health problems by October had been achieved and what the current average wait time was.

25.20   Jessica Britton answered that the elimination of 72+ hour waits had not yet been achieved and there was a continued focus on improving flow to improve admission time for those requiring in-patient mental health treatment. Over 72 hours was not the average amount of time that most people spent waiting in ED and offered to share that information outside the meeting.

25.21   The Committee RESOLVED to note the report.