Agenda item

1.1.        The Committee considered a presentation providing an update on the progress of the Connecting 4 You health and social care transformation programme in the High Weald Lewes and Havens (HWLH) area of East Sussex.

1.2.        Keith Hinkley, Director of Adult Social Care and Health, East Sussex County Council; Ashley Scarff, Director of Commissioning and Deputy Chief Officer, and Sam Tearle, Senior Strategic Planning & Investment Manager, both from High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG), answered questions from HOSC Members.

The key achievements of the Connecting 4 You programme

1.3.        Ashley Scarff said that Connecting 4 You (C4Y) has helped improve multi-agency working, with both Sussex Community NHS Foundation Trust (SCFT) and the East Sussex County Council (ESCC) Adult Social Care Department aligning their services towards the four “Communities of Practice” and improving community care pathways. Keith Hinkley said that the key improvement of C4Y has been to align operational services so that they are able to provide unified case management for patients.

1.4.        Ashley Scarff outlined some new services that have been introduced as part of C4Y that have resulted in a reduction in hospital admissions, including:

·         Consultant Geriatricians who proactively outreach into local communities to support old and vulnerable people;

·         Community Diabetes Service, with significant focus on education for patients to manage that long term condition;

·         Joint Musculoskeletal Service with Eastbourne, with Hailsham and Seaford Clinical Commissioning Group (EHS CCG) that is piloting a self-referral service for people with physiotherapy needs, for example, chronic back pain. This is receiving extremely positive feedback from patients and clinicians.

1.5.        Keith Hinkley added that the High Weald Lewes Havens (HWLH) area is receiving new joint health and social care services such as Health and Social Care Connect (HSCC) and the Joint Community Reablement teams that are being delivered across the whole of East Sussex.

Progress of C4Y

1.6.        Ashley Scarff explained that the health and social care budgets have been aligned and the C4Y Programme Board receives a combined financial plan that shows the aggregated budget for the whole health and social care economy in the HWLH area. However, at this stage they are not pooled in the same way as they are for the East Sussex Better Together (ESBT) Alliance, which has an agreed Strategic Investment Plan (SIP) for 2017/18.

1.7.        Sam Tearle explained that a detailed timeline of the C4Y programme will be presented to the C4Y Programme Board on 19 July; it will include how the SIP and the Multi-Specialty Community Provider (MCP) model for C4Y will be progressed. He said that the pace of the programme will increase over the summer and into autumn.

1.8.        Keith Hinkley added that strategic investment planning for the HWLH area is flagged in ESCC’s State of the County document that was agreed by Cabinet in June. He said that it is expected that decisions about the SIP, alongside the design of the MCP model, will be made towards the end of 2017. It will be difficult to develop more integrated services until the MCP model is agreed.

C4Y within wider Sussex and East Surrey Sustainability and Transformation Partnership (STP)

1.9.        Ashley Scarff explained that Horsham and Mid Sussex CCG and Brighton & Hove CCG are also looking at a MCP model of integrated care. The three CCGs comprise the footprint within the Sussex and East Surrey Sustainability and Transformation Partnership (STP) called Central Sussex and East Surrey Area (CSESA) South and have considerable commonality. They share the same community healthcare provider –SCFT – as well as a shared mental health provider – Sussex Partnership NHS Foundation Trust (SPFT) – and all three use the acute hospital services of Brighton & Sussex University Hospital NHS Trust (BSUH) for some or all of their residents. There is also an imperative for the CCGs to work together due to financial and capacity pressures on the acute system, especially in Brighton & Hove, and pressure from NHS England to work together at scale and in the most efficient way possible.

1.10.      Ashley Scarff explained that from the CCGs perspective it was the right decision for HWLH CCG to withdraw from ESBT. If HWLH CCG had continued with ESBT, he explained, the process of providing integrated health and social care might be further ahead, but only for 10-15% of the CCG’s population. He added that HWLH CCG recognises the need to maintain a pace of change but the best approach involves making the most appropriate connections with other CCGs and providers.

1.11.      Keith Hinkley said that there is an ongoing review across the whole STP of governance arrangements, including in the CSESA South footprint, that is due to be completed in October. This means that further work might need to be undertaken in the autumn on the governance arrangements of C4Y, which could impact on the planned development of a SIP and MCP model.

Consultation on C4Y

1.12.      Ashley Scarff explained that local people will have seen the C4Y engagement programme that has been visible at various forums and meetings held in several locations within the programme’s footprint.

1.13.      He agreed with the Committee that engagement, feedback and insight from front line staff was critical. The CCG Board is constantly being fed the opinions healthcare providers and of GPs – who are an integral part of the structure of CCGs. C4Y events have also been held, including one in January where team leaders from health, social care and voluntary sector providers were involved. 

 Definition of self-management

1.14.      Ashley Scarff explained that self-management forms a key part of the C4Y strategy and refers to helping people, especially those with long term or complex conditions, manage their own conditions in order to help keep them away from reactive, hospital care. This is good for the individual, carer, family, and the healthcare system as whole, because healthcare professionals are not reactively responding to a crisis at the most costly point in the healthcare pathway.

1.15.      Keith Hinkley added that there is a national and international evidence base about the gains in the health of a population as a whole if people have a better understanding of, and ability to manage, their own health, for example, being able to access their case records, or access healthcare professionals, via an online portal.

Streamlined point of access

1.16.      Keith Hinkley explained that ESCC manages the streamlined point of access – Health and Social Care Connect (HSCC) – on behalf of the whole health and social care system. HSCC has drawn together health and social care practitioners in to a single place for patients and health and social care professionals to connect with the healthcare system and be guided to the most appropriate point within it.

1.17.      Keith Hinkley said that significant investment has been made to the clinical and practitioner input within HSCC so that the right decisions about the urgency of a patient’s need, and the appropriate care for them, are made at a very early point in the patient’s contact with the healthcare system. He added that feedback is very positive but there remain areas of improvement, for example, improving response times to calls.

1.18.      He said that HSCC has drawn together multiple points of access but will not become a single point of access due to the complexity of health and social care, and the fact that many patients will continue to contact their GP in the first instance. Therefore, the key to making HSCC work is ensuring that all practitioners – including GPs – understand the need to refer patients to HSCC so that they can enter the healthcare system at the appropriate point. Training for staff is underway so that they are aware of HSCC.

1.19.      The Committee RESOLVED to;

1) note the report;

2) request a further update on Connecting 4 You in the autumn containing a timeline of key events for the transformation programme;

3) request an additional report on Connecting 4 You for March 2018; and

4) request a visit to the Health and Social Care Connect (HSCC) centre in Eastbourne.