Agenda item

7.1.      Ashley Scarff, Director of Joint Commissioning and Integrated Care Team Development, NHS Sussex introduced the report which set out plans for the East Sussex Better Care Fund (BCF) for 2025/26. He outlined that the BCF was part of embedded spend in the East Sussex health and care system with a set of national conditions and reporting requirements. It allowed the health and social care sectors to pool their resources to remove organisational barriers to joint commissioning, although did not represent the totality of joint work in the county. National objectives for the fund for 2025/26 had been simplified and reconciled with the strategic shifts outlined in the NHS 10 Year Plan, however further reforms to the BCF were expected for 2026/27. The objectives for the East Sussex BCF for 2025/26 reflected the Government’s commitment to reform via a shift from sickness to prevention and from hospital to home, including a focus on hospital discharge.

7.2.      Stephen Lightfoot thanked Ashley and Mark for the report and supported the plans and the collaborative process by which they had been developed. He particularly endorsed the aim to be more proactive, including through work on avoiding admissions and treating people at home. Discharge had been an area of challenge for several years and Stephen noted that the plans included the continuation of existing schemes in 2025/26 and enquired about what would be done differently this year to achieve better performance through these.

7.3.      Mark Stainton responded that work had been ongoing for some time to improve discharge. This included ensuring that patient numbers were being measured correctly, starting the discharge journey shortly after admission, and being flexible about moving between different pathways as new information emerged. There had been heavy investment in supporting discharge capacity in the community and a healthy independent home care market. This was also true of bedded care, although there were some areas of particular specialty where there were capacity challenges. The contract to expediate discharge for self-funders was also a part of this work. There remained work to do despite recent sustained improvements in East Sussex, including addressing internal process issues to avoid cross-referral; using a trusted assessor approach; and maximising the use of Discharge to Assess capacity. It would also be important to ensure that the right proportion of patients were being discharged on each pathway. Professor John Bolton OBE had undertaken some work on this in Sussex, and decisions were needed on if the proportions he had recommended reflected the unique needs in East Sussex. However, work on discharge to date provided assurance that the improvements could be sustained.

7.4.      Ashley Scarff commented that the discharge scheme within the BCF plans included Home First pathways and additional Discharge to Assess beds. A multi-agency approach would seek to achieve a good balance between these types of capacity to best meet need. A small portion of the Fund had additionally been earmarked to provide the flexibility needed to maximise flow, particularly going into the winter months.

7.5.      Councillor Webb commented that it was welcome to see clear objectives in the plans and specific focuses on reducing inequalities in access to NHS services, deprived communities, and supporting and involving unpaid carers.

7.6.      The Chair commented that the BCF had been a significant driver of the HWB’s work and had contributed to many advancements despite the progress still to make.

7.7.      The Board RESOLVED to:

1.  note the better care fund requirements for 2025-26; and

2.  approve the East Sussex BCF plans for 2025-26 recognising the discussion underway to review the metrics targets for the year ahead.