Agenda item

5.1.      Vicky Smith, Programme Director, East Sussex Health and Social Care Transformation introduced an update report on the East Sussex Health and Social Care Shared Delivery Plan (SDP) Integration Programme. The report outlined the ongoing joint plans for year 3 of the SDP in East Sussex, covering children and young people, housing, improving health outcomes, integrated community teams, mental health, improving hospital discharge and strengthening the role of the Health and Wellbeing Board (HWB). The report also outlined headlines from the NHS 10 Year Health Plan, including local implications, and shared the outcomes of the recent informal HWB development session on the importance of the life course. It was noted that discussions at the session also explored some of the current contextual challenges to partnership working.

5.2.      Ashley Scarff, Director of Joint Commissioning and Integrated Care Team Development, NHS Sussex, thanked Vicky for the report and noted the need for flexibility when working towards the aims and priorities of the SDP within the changing healthcare landscape.

5.3.      Mark Stainton, Director of Adult Social Care and Health (ASCH) commented that the seven SDP priorities were appropriate and targeted towards population needs. Mark agreed on the importance of retaining flexibility, noting that the 10 Year Health Plan was newly released and all partners continued work to understand its implications. Further detail on this would be provided at the next meeting. The Plan broadly reflected the priorities of the Sussex Integrated Care Strategy Improving Lives Together, however there remained significant change occurring in the wider system related to governance including Integrated Care Boards (ICBs), local government reorganisation, and the creation of a Mayoral Strategic Authority, and it would be important not to lose sight of the SDP priorities when responding to this change.

5.4.      Councillor Ungar welcomed the report and commented that it would be useful to include how many of those experiencing delayed discharge were self-funders. He gave an example of a self-funder saving money on care home costs by delaying a family member’s discharge and enquired if this was a wider issue.

5.5.      Mark Stainton responded that figures on self-funding could be provided, however staff within both the Trust and the local authority sought to help progress discharge for all individuals. This was supported by a contract with an organisation specifically to help self-funders discharging from hospital, whereby a family in which an individual has been identified as self-funding, would be referred for assistance. Delaying discharge to avoid costs was not a typical approach and most relatives preferred to see their family members cared for in an appropriate setting.

5.6.      Simon Dowse, Director of Transformation, Strategy and Improvement at East Sussex Healthcare NHS Trust (ESHT) added that avoidance of costs had not emerged as an issue for patient flow or internal decision-making. However, ESHT was working on its latest discharge programme so would identify this if it was an emerging issue. 

5.7.      Councillor Webb thanked officers for the report and welcomed the plans overall, however expressed concerns about inconsistencies in Special Educational Needs and Disabilities (SEND) support, including the recommissioning of wheelchair provision, which had been discussed at People Scrutiny Committee, and reduced funding for housing related support.

5.8.      Stephen Lightfoot, Chair of NHS Sussex welcomed the SDP objectives and the inclusion of children and young people as a priority. This had been reflected in the HWB seminar at which information on school readiness had emerged as a priority. Stephen fed back that the SDP could also consider the long term health outcomes of children and young people in relation to weight management in terms of obesity and eating disorders.

5.9.      Mark Stainton clarified that the funding for housing related support, which for ESCC was a non-statutory service, was a £500,000 contribution by district and borough councils and a further £500,000 from ESCC which would fund a residual service. This had enabled the access criteria to be revised to focus on those at risk of homelessness. The priority for ESCC was households with children at risk of homelessness, and households with adults at risk of needing care if housing needs are not met. The focus of district and borough councils would be homelessness prevention.

5.10.    Deborah Ennis, Assistant Director Commissioning and Transformation noted that the recommissioning of the wheelchair contract had been a recommendation of the area-wide SEND inspection. Additional funding had been put into this contract to address the backlog in wheelchair provision, and there were plans for a pan-Sussex contract going forward. Overall, there had been improvements in waiting times.

5.11.    Ashley Scarff confirmed this additional funding and seen positive progress as a result. Re-procurement could not take place until the end of the current contract but doing so on a pan-Sussex basis would seek to make best use of resources.

5.12.    The Chair thanked Vicky for the report and endorsed the work undertaken at the HWB development day.

5.13.    The Board RESOLVED to:

1. endorse the refreshed East Sussex HWB Shared Delivery Plan (SDP) priorities and plans for year 3 (25/26), noting that the recent publication of the Government’s 10 Year Health Plan and wider health and care reform may impact on the Sussex SDP and delivery in general; and

2. agree the outcomes from the informal HWB development session on the importance of the life course, and the contextual challenges and risks for our partnership working.