Agenda item

6.1.      Stephen Lightfoot introduced the report, which summarised recently announced reforms to the NHS including the abolition of NHS England and changes to ICBS, including a reduction in running costs and a new blueprint for ICBs; as well as the local response, including a proposal for a new ICB on a Sussex and Surrey footprint which had been approved by government and would commence in April 2026. Stephen commented on the significant uncertainty this had created for staff. Stephen also noted the recent announcement to cease Healthwatch organisations and thanked Healthwatch partners and volunteers for their engagement with patients which provided key insights when developing health and care services. The direction in the NHS Plan to more care in the community, use of digital and technology and focus on prevention aligned with the SDP and welcomed the ongoing role of health and wellbeing boards to deliver care to local communities.

6.2.      The Chair noted the timescale over which these changes had occurred and the new ICB footprint which would no longer be coterminous with the devolution proposal for a Sussex authority. The Chair commented that the closure of Healthwatch was disappointing and that their reports had been invaluable and that the Board would consider how it would work with Healthwatch colleagues going forward. 

6.3.      Councillor Ungar thanked Stephen for the report and sought clarification on the funding for NHS Sussex and raised concerns about Sussex not receiving the funding it needs. He additionally asked whether a reason had been provided for closing Healthwatch given that the Integrated Care Partnership was also being abolished, leaving uncertainty around how the role would be fulfilled for a professional body to conduct public engagement.

6.4.      Stephen Lightfoot responded that it was critical that the voices of the public and patients were heard in the development of services. It was not currently clear how this would be ensured, but it would be necessary to find mechanisms that fulfilled this role, as Healthwatch had done effectively. Regarding funding for NHS Sussex, Stephen clarified that the new leadership team within NHS England had reviewed the national fair shares allocation model, which was based on demographics, population age, deprivation levels, and health. NHS Sussex was receiving £186 million (4%) in excess funding according to this model. The ICB would likely need to come up with a three-year plan to work back towards its national fair share.

6.5.      Councillor Webb commented that the timescale for ICB reform had been unrealistic. He welcomed the continuation of the HWB as well as the work being done to support health staff throughout the process.

6.6.      Stephen Lightfoot acknowledged that responding to the timescale had been challenging and had not allowed for the desired engagement with partners and the public. However, the proposal reflected the best that the ICB could do within these constraints. Working closely with staff was critical given the uncertainty they had faced since March. The expectation was to have a new Chair by July, a new Board in August, and a staff consultation following this. Staff were being updated at each stage.

6.7.      Mark Stainton acknowledged the impact of reforms on NHS Sussex as well as the critical role that Healthwatch East Sussex had played within the HWB and wider system. Regarding the new ICB for Sussex and Surrey, it would be vital that the leadership and management structure recognised two discrete systems given the differences between and within each proposed mayoralty. In addition, the funding regime and resource allocation would need to reflect the particular challenges around age and deprivation in East Sussex compared to wider Sussex and Surrey. He also commented that it was important that current levels of uncertainty for both the NHS and local government would not hinder the well-established partnership working in East Sussex. The ongoing role of the HWB was welcome as it could be the only statutory joint voice going forward, however there may be potential to continue the Sussex Integrated Care Partnership on a non-statutory basis, but there were many details still to be understood.

6.8.      Stephen Lightfoot commented that the prospect of a larger ICB footprint presented an opportunity for a stronger role for Place in system governance, with a key role for Integrated Community Teams. The HWB would have a more significant role in the future as a collaborator with the Mayoral Strategic Authority.

6.9.      The Chair noted the good partnership work established in East Sussex and the need to build on this.

6.10.    The Board RESOLVED to note the submission from NHS Sussex to NHS England which responds to national guidance on Model Integrated Care Boards and next steps for the transition arrangements for Sussex.