Brighton & Hove City Council
Health Overview & Scrutiny Committee
4.00pm25 January 2023
Council Chamber, Hove Town Hall
MINUTES
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Present: Councillor Moonan (Chair)
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Also in attendance: Councillor West (Group Spokesperson), Barnett, Grimshaw, John, Lewry and Sankey
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Other Members present: Geoffrey Bowden (Healthwatch Brighton & Hove), Nora Mzaoui (CVS representative), Theresa Mackay (Older People’s Council)
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PART ONE
28 Apologies and Declarations of Interest
27(a) Declaration of Substitutes
27.1 Cllr Sankey attended as substitute for Cllr O’Quinn.
Theresa Mackay attended as substitute for Michael Whitty (Older People’s Council)
27(b) Declaration of Interests
27.2 There were none.
27(c) Exclusion of the Press and Public
27.3 RESOLVED – that the press and public be not excluded from the meeting.
29 Minutes
28.1 RESOLVED – that the minutes of the 23 November 2022 meeting be agreed as an accurate record.
30 Chairs Communications
29.1 The Chair gave the following communications:
Following very high demand for health services at the end of the year a critical incident was put in place across Sussex. This allowed the NHS to put in additional measures and use all available capacity across the health and care system. Although this has now been stepped down, all services remain extremely busy and NHS services in Sussex currently remain in business continuity with additional measures in place and people may continue to experience disruption over the coming weeks.
Additional changes were also required during the recent industrial action.
I am sure later in the year HOSC will have a full report on performance over the winter as a whole but in the meantime, can I ask the public to please thinkcarefully about the best service for your needs.
Only use 999 and A&E departments for serious or life-threatening emergencies.
Remember you can get expert advice about minor health concerns from a pharmacist and that NHS111 provides support 24 hours a day online or over the phone and will direct you to the most appropriate service for your need.
With Covid and flu still circulating at high levels, make sure you’ve had all the vaccines you’re eligible for so you have the best possible protection against serious illness.
Covid vaccine appointments can be booked online or by calling 119, or walk-in sessions remain available for adults at Hove Tesco, Hove Polyclinic and St Peter’s Church each week.
Flu jabs can be booked at many pharmacies in the city.
Find out more or make a booking at www.nhs.uk/wintervaccinations or by calling 119.
Finally, members may recall that we had planned to have an item on Trans healthcare at this meeting, with a particular focus on the new Sussex gender dysphoria service pilot. This was something that I had originally asked to come to the October 2022 HOSC, but was delayed while the tender for the Sussex service was being concluded.
The contract has now been awarded. However, after the announcement of the award, it swiftly became clear that elements of the new contract had caused considerable upset in the local Trans community, and that NHS commissioners and the new provider needed to do much more work on the design and implementation of the service with the community and with clinicians before the pilot could begin. This work is now underway, and I have accepted that it wouldn’t be appropriate to have these issues discussed at a public forum like HOSC before community engagement has been concluded.
I have received assurances from NHSE commissioners that they remain committed to providing the best possible care for Trans people, and that they will definitely be able to come to the April HOSC meeting to talk about the full range of specialist Trans services, included the gender dysphoria pilot, specialist adult services and service for young people.
31 Public Involvement
30.1 There were no public questions.
32 Items Referred from Council
31.1 There were no referrals from Council.
33 Member Involvement
32.1 Cllr Platts asked a member question: “What is the assessed impact of public toilet closures on the successful delivery of the Council’s Health & Wellbeing Strategy?”
32.2 The Chair responded by stating that no assessment has been undertaken on the impact of public toilet closures on the delivery of the Joint Local Health & Wellbeing Strategy. Public Health have been asked to provide advice on the public health implications of the budget proposals relating to public toilets. This will be included as part of the Equality Impact Assessment that will be included in the papers for Budget P&R Committee on 9th February and Full Council on 23rd February.
32.3 Cllr Platts asked a supplementary question: “Will the Council commit to undertaking a full impact assessment, that includes a consultation with key stakeholders and regular users of the park and reviewing the decision about Council closures before any partial or full closures take place?” The Chair responded that she was unable to answer this directly, as she is not a member of the administration, but she would engage with the administration to ensure that a response is provided.
34 Southern Water: Flood Overflow Management
· The Environment Agency’s inspection of bathing water quality is limited and infrequent. Southern Water have been trialling testing buoys that can provide accurate and up to date information about water quality. These could potentially be rolled-out around the coast.
· Southern Water is engaged in an outflow awareness programme; not all outflows are owned or managed by Southern Water.
· Southern Water systems have ample capacity to manage in dry or rainy conditions, but struggle in stormy weather, where rainwater and sewage combine (in a ratio of 95/5), and threaten to cause surface flooding unless overflows are deployed.
· Reducing, or slowing, the flow of rainwater into the sewer system lessens the risk of overflows being required. Source control measures (domestic water butts, permeable paving, grassed areas etc.) can have a major impact. For example, a trial on the Isle of Wight, using rainwater harvesting on 200 properties, has reduced local overflows from 15-20 per annum to zero.
· Optimising existing infrastructure also has an important role to play, for instance by introducing a digital system that enables pumping stations to distribute water around the system more effectively.
· The construction of big infrastructure is another option. However, this is both carbon intensive and disruptive, so is not a favoured option where alternatives exist.
· It is important to recognise that storm overflow is not the only source of bathing water pollution; bird and dog waste are both significant polluters, and people flushing items that should not be flushed leads to sewers being blocked or compromised, reducing the system’s effectiveness.
33.2 In response to a question from the Chair about co-working with the city council (BHCC), Dr Willison responded that Southern Water meet regularly with the BHCC transport and maintenance teams. There are opportunities to align maintenance and investment activities here, since around 40% of rainwater overflow comes from roads and roofs. Dr Willison agreed to forward details of these contacts.
33.3 Cllr West noted that Brighton & Hove is a resort city, and sea pollution will have a serious detrimental impact on our economy. Increasingly common storm events will inevitably lead to more flood overflow. We urgently need a solution to this issue. In response to a question from Cllr West on what Southern Water intended to do about rainwater flooding downhill into the city from the South Downs, about infrastructure investment, and about the replacement of hard road surfacing with permeable surfacing, Dr Willison told members that local authorities are responsible for surface water management. However, Southern Water is keen to work constructively with partners on solutions: e.g. potentially using BHCC land to develop wetlands to slow water flow. There is limited funding for investment in the near future, but possibly more scope from 2025-30.
33.4 In response to a question from Cllr West as to whether Southern Water was willing to invest outside its own systems, Dr Willison responded that this was an option. However, Southern Water was also exploring other funding vehicles to create financing to support additional expenditure without increasing billing to customers.
33.5 Cllr Grimshaw asked who, other than Southern Water, owns outflows. Dr Willison responded that this was currently being mapped by the Environment Agency, but that local authorities would likely be significant owners.
33.6 In response to a question from Cllr Grimshaw on the impact of leaks on overflows, Dr Willison responded that this is a factor, and Southern Water invests considerable sums in detecting and addressing leaks.
33.7 Cllr Grimshaw suggested that Southern Water might potentially work with other agencies to alert households (e.g. by text message) when there was a risk of flood overflow in the area so that people could change their behaviours temporarily (take a shower rather than a bath, or not flush the toilet etc.). The Chair supported this idea. Dr Willison agreed that it was an interesting idea and one that he would take away and explore.
33.8 In response to a question from Geoffrey Bowden on fines, Dr Willison told the committee that he was unaware of any major fines paid by Southern Water in the past six months, although there had been large fines paid in previous years. Fines were effectively covered by shareholders rather than by customers.
33.9 Cllr Rainey asked about communications to customers, for example to encourage people not to flush items that could cause blockages. In response, Dr Willison agreed that more could be done to target both domestic and business users, potentially in concert with local authorities.
33.10 In response to a question about the impact of overflows on seafront businesses (e.g. water sports), Dr Willison told members that the current level of overflows is not acceptable. However, it is important to see this in historical context: before privatisation there was regular high level discharge of untreated sewage into the sea. The situation now is much better, with far lower levels of discharge.
33.11 In response to a question from Cllr Rainey on the removal of interceptors from pipes, Dr Willison offered to take up any specific query outside the meeting.
33.12 In answer to a question from Cllr Sankey on Southern Water profits, Dr Willison told the committee that the company did make an operating profit in some years, but that all profits were reinvested in infrastructure improvements etc. There has been no shareholder dividend paid since 2017.
33.13 In response to a query from Cllr Sankey about raw sewage leaks near playing fields, Dr Willison responded that he was not aware of the specific instance mentioned. However, this sounded like an asset failure rather than an overflow issue.
33.14 In answer to a question on ratings from Cllr Sankey, Dr Willison told members that Southern water was rated 1 star in 2021. However, this was expected to rise to 2 stars in 2022 and to 3 by 2024. In fact overflow performance does not contribute to this rating; overflows are monitored by the Environment Agency, and Southern Water is actually the best performing water company in terms of this metric, although there is clearly room for improvement.
33.15 Cllr Sankey asked why the Southern Water CEO has declined to attend the HOSC given the scale of overflows and the position the Environment Agency takes on this. Dr Willison responded that Southern has sent very senior officers to talk to the HOSC. Dr Willison said he was personally happy to attend as many council meetings as necessary. The Environment Agency has commented on custodial sentences for senior officers of water companies who act illegally. However, the challenges of overflows need to be dealt with in partnership as the vast majority are legal and are explicitly permitted by the Environment Agency.
33.16 Cllr John suggested that Southern Water could pay for dog waste to be collected. Cllr John also asked how overflow targets would be met if sufficient funding could not be accessed, reiterated the point that the committee would like to talk directly to the CEO, and suggested that Southern Water might want to consider funding public toilets. Dr Willison responded by reiterating that overflows are not illegal.
33.17 The Chair asked that all additional information requested at the meeting be provided in one email. The Chair thanked Dr Willison for his contribution.
33.18 RESOLVED – that the report be noted.
33.19 Southern Water subsequently sent written responses to questions that members had asked in writing in advance of the meeting. These responses are included below.
Brighton and Hove City Council
Health Overview and Scrutiny Committee
Answers from Southern Water
Storms are becoming more frequent and extreme as a result of climate change. Does Dr Willison agree that by taking and ecosystem services approach to flood prevention would prove more cost effective, resilient and carbon efficient than reliance on increasing levels of downstream hard engineering to cope with ever greater quantities of flood water?
From a health perspective, does Dr Willison agree this green approach would lead to less effluent over topping episodes contaminating bathing water?
Yes – this approach is key to the innovative work currently being undertaken by the Clean Rivers and Seas Task Force.
Therefore, can I ask, will SW agree to consider committing serious financial support to highway authorities and landowners to invest in significant source flood management, rather than SW aiming to spend so much on their own flood water containment?
and
Over the last few years, we have seen an increase in marine life off Sussex coast. Regular sightings of dolphins, porpoise and seals. Southern Water is polluting their habitat, how is this being addressed?
and
Climate change is leading to more extreme weather conditions including increased incidence of, and more severe, rainstorms. How is SW improving its systems to ensure this is accommodated for in ways other than overflow into bathing water?
We are committed to protecting our natural environment – investing in natural capital and working in collaboration with customers and stakeholders are fundamental to our Pathfinder work.
Storm overflows are an emergency release valve during heavy rain, protect homes and businesses from flooding during heavy rain. Our Clean Rivers and Seas Task Force is dedicated to finding the best ways to drastically reduce use of storm overflows and roll them out to the region. You can find the latest report on its activity here.
The Task Force prioritises nature-based solutions where at all possible., Examples include:
· Incentivising and promoting Sustainable Drainage solutions (SuDS).
· Partnering with the Department for Education to deliver a £1.7million project whereby 247 schools will receive free solutions to divert rainwater back to the environment, rather than running off hard surfaces and into the sewer network.
· Using wetlands as a low carbon, nature-based solution to cleaning wastewater (southernwater.co.uk)
It’s not good enough to simply build more storm tanks – although where this is required, we will of course do so. But this doesn’t tackle the root cause of most of our storm releases. Instead, we must prevent rainwater from getting into the network, or slow its flow, so we can create a sustainable system fit for the future.
In the peak summer season last year, every beach along the south coast was polluted with raw sewage and some were forced to closed. Our tourist economy is built around our popularity as a seaside resort and this is extremely off-putting for visitors to say the least. Can you let me know the ways in which you are working to ensure this does not happen again this summer?
As highlighted above, our Clean Rivers and Seas Task Force is dedicated to reducing reliance on combined storm overflows, which will reduce the number of spills into the environment.
The latest report goes into detail about their Pathfinder Projects,
including results of the pilots:
Latest news, reports, and updates (southernwater.co.uk)
Alongside the work of the Task Force, our Drainage and Wastewater Management Plan is a 25-year plan for handling surface and wastewater. Details can be found here:
Drainage and Wastewater Management Plans (DWMPs) (southernwater.co.uk)
We welcome your goals to reduce storm releases by 80% by 2030, but our residents would rather see a 100% target. Can you explain why you can’t carry out the urgent work at the level needed to ensure that our bathing water is 100% free of sewage?
We acknowledge – and agree – that storm overflows are used too often, and that customers and stakeholders very rightly demand that the use of CSOs be tackled urgently. If we were to design a brand-new water supply and treatment system from scratch, we would not include any reliance on storm overflows
With the current network there are limits to how far the engineering can take us. A 100% reduction is – regretfully – neither achievable nor realistic, so we would not make this commitment.
Completely eliminating the use of storm overflows would require one of two options. Either:
1. remove all the storm water or
2. treat all the storm water.
Removing stormwater from the system would involve digging up every single road, every street, and every property to disconnect the storm water. This would be incredibly disruptive and expensive and would push bills to unaffordable levels.
Treating all stormwater would come with a huge environmental cost.
· Water companies currently use around 5% of the national grid and consume 1-2% of the UKs CO2. Pumping what is almost exclusively rainwater has a significant CO2 footprint.
· Every sewage treatment works relies on biological processes and requires a calorific value. When the treatment systems are fed rainwater, it starves the organisms that provides the treatment and results in a poorer quality effluent.
Our Task Force is dedicated to finding a practical route around these issues – finding an environmentally sound solution which does not impact customer bills. We are collecting promising evidence that rolling out the work undertaken in our Pathfinder projects will result in a significant reduction of storm overflow use. We will be doing this as soon as legislation and regulators allow.
Major investment in sustainable drainage systems in Brighton and Hove could massively reduce sewage entering the sea. The purpose of these systems is to soak up excess rainwater and reduce the volume of pouring into drains during extreme weather (which is set to get worse due to climate breakdown), which leads to pipes overflowing and sewage being released into our bathing water. Would you be able to promise investment in a number of these schemes here in Brighton and Hove?
We think this is a fantastic idea. However, in most cases, we do not own the land or impermeable area that contributes towards the excess stormwater runoff. We are exploring a delivery model whereby we make a financial contribution towards Local Authority public realm schemes to incorporate sustainable drainage so pressure on the sewage system can be reduced.
The Environment Agency does not test seawater for microplastics, yet they can have grave consequences for human health and that of marine life when they enter the sea. Can you let me know what work Southern Water is doing to reduce the level microplastics in the sea?
We are funding research to better understand how to extract these materials from the water we treat – and filter them out of wastewater to stop them being released back into the environment. We’re not the source of plastics in our oceans, but we are a link from source to sea. We take our opportunity to intervene very seriously.
For example, we’re part of a study by research body UKWIR (UK water Industry Research) to examine the risk of microplastics in freshwater settings.
Plastic pollution (southernwater.co.uk).
Interceptors were not designed to catch things in the sewer that should not be there such as sanitary products or Fat, Oil and Grease (FOG). The design of the interceptor is Victorian and was originally designed to stop odours travelling back up the sewer.
Sewers are built to nationally agreed standards which provide for good levels of protection from flooding. However, the sewers are designed to cope with foul wastewater only. Regrettably, heavy rainfall can cause surface water to infiltrate the sewer causing it to become overloaded. Unfortunately, they do not have unlimited capacity and there are occasions when, due to heavy rainfall are unable to cope and when this happens, there is a risk of overflow at low points in the system.
Whilst we hope you do not experience any difficulties, our 24-Hour Call Centre is on hand to provide information concerning the frequency and nature of any flooding/problems. They can also arrange for a sewer crew to attend and carry out an investigation and clean-up operation, if required.
The Covid period saw a massive increase in open water swimming and water sports. We have seen first-hand the positive affect these sports and activities have had on people's lifestyles, health and mental wellbeing. Last year we saw these same people avoiding the sea and giving up their newfound hobbies because they didn't think the sea was safe. What is Southern Water doing to help these people?
Southern Water’s releases are monitored by the Environment Agency (EA) who are also responsible for water quality testing. For bathing water sites, the EA take samples during the bathing water season, which is between May 1st and September 30th . The classifications that are subsequently attributed to each bathing water indicate to beach users the prevailing water quality. Southern Water does not offer bathing water advice but rather works with local authorities and regulators to provide information about storm water release and operational issues.
For near-real time information about releases of stormwater or wastewater near bathing water sites, please see our Beachbuoy app here: https://www.southernwater.co.uk/water-for-life/our-bathing-waters/beachbuoy
In a meeting with Sussex MPs and Sir James Bevan on 22nd March 2023, Sir James said that water quality is better than at any time since the industrial revolution. We agree that there is still work to be done to reduce CSO discharges.
In view of the desire to protect public health, which is the subject we are concerned with over sewage release into the environment, Sarah is interested in whether SW might contribute to the funding public toilets which the Council find increasingly challenging to maintain.
We are open to discussions with the Council to explore how this might work.
Whilst Southern Water is a factor in bathing water quality, it is not its sole guardian. For example, the Environment Agency deems the cause of the recent classification of Brighton’s bathing water from ‘Excellent’ to ‘Good’ as being the result of increased beach usage by the public.
The presentation makes a number of references to the role of communities in reducing the volume of water entering the sewage system and making sure that items which might cause blockages are disposed of elsewhere. How is SW investing in these communities and communicating with them?
Work in the
community
Last year we donated £28,000 in Community Centre Grants and
Local Grants to support young people in Sussex. This includes
organisations in Brighton - the Clock Tower Sanctuary and Hangelton
Community Centre. Later this year further grants will become
available for gardening and volunteer groups to support sustainable
water practices and support underrepresented groups with access to
nature.
In February, we provided free standpipes for Brighton Half Marathon to reduce plastic bottle usage and impact to local environment.
You can request a representative to attend a community event here School and Community talks (southernwater.co.uk).
Through our Customer and Community Grants Scheme, individuals and organisations can apply for a one-off grant to alleviate financial hardship or support charity and community projects.
Work in
schools
We funded two rain gardens
and delivered lessons on the importance of harnessing rainfall, in
partnership with The Aquifer
Partnership (Moulescoomb Primary and
Wallands Primary in Lewes).
We work with schools to support and deliver teaching in subjects such as geography, PSHE and Citizenship. We have spoken to 1,312 young people in Brighton and Hove since January 2023
We have released a new Primary level teaching resource that you can find here https://www.southernwater.co.uk/water-for-life/education
35 Sussex Health & Care: System Development and Governance
35.1 This item was presented by Lisa Emery, NHS Sussex Chief Transformation, Innovation & Digital Officer; by Lola Banjoko, NHS Sussex Managing Director, Brighton & Hove; and by Rob Persey, BHCC Executive Director, Health & Adult Social Care. Ms Emery explained the purpose and goals of the Integrated Care Strategy, telling members that:
· The Strategy aims to work at scale (e.g. Sussex) where it makes sense to do so, and at place (e.g. Brighton & Hove) where there is more value in local working;
· There have been real improvements in partnership working over the past few years, but there is a need to build on these strong foundations;
· The Strategy has system-wide priorities around workforce, digital, partnerships, and neighbourhood working;
· There are place priorities also: cancer, mental health, children & young people, multiple compound needs, and multiple complex conditions.
35.2 In response to a question from the Chair about the role of HOSCs in scrutinising the Integrated Care Strategy specifically, and the Integrated Care System generally, Ms Emery told members that it was for HOSCs to determine what to focus on, but that the System would welcome HOSC involvement, particularly in terms of scrutiny of delivery: e.g. there would be a HOSC role in scrutinising the Shared Delivery Plan (the delivery plan for the Integrated Care Strategy).
35.3 Cllr West commented that public understanding of the Integrated Care System was not assisted by the decision to adopt local names for the nationally prescribed System infrastructure: calling the local Integrated Care Partnership the Sussex Health & Care Assembly etc.
35.4 In response to a question from Cllr Rainey on place-based structures, Ms Banjoko told the committee that there is a place-based partnership co-chaired by the NHS Sussex Managing Director (Brighton & Hove) and the BHCC Executive Director, Health & Adult Social Care. Local priorities have been developed also. These reflect the demographics of Brighton & Hove in terms of having a young population, lots of diversity, homelessness issues and so on. The Brighton & Hove priorities will look very different to the place priorities for East and West Sussex. Ms Emery added that there would be elements of system priorities that would be delivered at a place level also.
35.5 The Chair asked a question about the potential need for joint scrutiny of system-wide change plans. Ms Banjoko responded that there may be a requirement for formal joint scrutiny in the future, but that these plans are still at a relatively early stage in development and there is nothing new in the pipeline to share with HOSCs at the current time. There are change plans around regional children’s cancer services and around West Sussex stroke services which are already with the relevant HOSCs.
35.6 The Chair noted that workforce is clearly a major challenge and that it is important to think about solutions at scale in terms of joint recruitment, training, mentoring and so on. Ms Emery agreed, also stressing the importance of working closely with education sector partners.
35.7 In response to a question from the Chair in joint working in practice, Mr Persey told members that there is lots of joint working already in place: for example, social workers embedded in Primary Care Network multidisciplinary teams, supporting specific patient cohorts, social prescribing etc.
35.8 The Chair asked how local people could hold a complex system to account. Ms Banjoko responded that organisational responsibilities to engage with and respond to local people are still in force. There are also defined roles for HOSCs and Health & Wellbeing Boards in the new system. Mr Persey added that Healthwatch has an important role to play here also.
36 Sussex Integrated Care Strategy
36.1 This item was presented by Lisa Emery, NHS Sussex Chief Transformation, Innovation & Digital Officer; by Lola Banjoko, NHS Sussex Managing Director, Brighton & Hove; and by Rob Persey, BHCC Executive Director, Health & Adult Social Care.
36.2 Nora Mzaoui asked a question about the role of the third sector in preventative care. It is positive to see the importance of the sector recognised in the Strategy, but it needs to be recognised that many CVS services are overstretched already and more funding is needed if they are to play a greater role in preventative care. Mr Persey responded by noting the importance of prevention in future system planning, particularly in relation to young people. The NHS is coming to recognise the importance of primary/early prevention, having traditionally focused on prevention in terms of preventing people entering secondary care. There is an important role for the CVS in this agenda, perhaps being sub-contracted by NHS providers as well as being commissioned directly. Ms Banjoko added that the need to embed the CVS as a part of core service delivery rather than as an added extra is recognised, as is the need to join up local authority and NHS funding and to provide multi-year funding settlements. This all needs to be managed in a very challenging financial environment.
36.3 Ms Emery suggested that engagement plans for the Shared Delivery Plan could be shared with the HOSC at a later date and the Chair welcomed this.
37 BHCC Health & Adult Social Care Budget Pressures
37.1 This item was introduced by Michelle Jenkins, BHCC HASC Assistant Director, Resources; and by Rob Persey, Executive Director, HASC.
37.2 Theresa Mackay (Older People’s Council) asked how HASC would manage future demand. Ms Jenkins responded that there is a statutory duty to provide services to eligible people in need of support, so demand management has to focus on prevention. Mr Persey agreed that a focus on prevention was key, but a longer term funding settlement would be really helpful also.
37.3 Cllr Sankey expressed sympathy for HASC’s budget position and her support for a preventative approach. She asked how confident HASC was in its ability to delivery 2023/24 savings targets. Mr Persey responded that he would not have submitted an unachievable savings target. This said, however, HASC (and children’s care) are demand-led services and financial planning can be undermined by a few additional high cost care packages needing to be provided. It is also the case that service budgets have been shaved for a number of years in anticipation of a long term funding settlement that has not yet materialised. The scope to make further savings is limited.
37.4 Cllr Sankey asked why life expectancy has started to fall. Mr Persey replied that this is due to a combination of factors, including poor diet, obesity, and substance and alcohol misuse. It is important that young people understand the benefits of a healthy lifestyle and there is consequently a focus of preventative services on young people and on communities experiencing health inequalities.
37.5 Cllr West noted that the Council’s external auditor had flagged significant financial risk, and limited further opportunities to draw on reserves. What has HASC’s budget performance been like across the year? Mr Persey responded that HASC has not made all its in-year savings targets, but is nonetheless expected to come in on-budget. Next year’s savings targets are realistic and are supported by robust programmes of work. Ms Jenkins added that there is limited value in focusing on individual TBM reports across the financial year, as reports can be impacted by a single expensive placement. It is also the case that in-year savings programmes can take a number of months to start generating savings, so early TBMs may look bad even when plans are progressing well and will deliver on target by year end. However, it is not possible to continue cutting services for ever.
37.6 Cllr Sankey noted that plans include a 0% uplift to many block contracts and asked whether this meant workers would not receive a pay rise. Mr Persey responded that a number of contracts are being uplifted by 5-6% and that Living Wage commitments will be unaffected.
37.7 In response to a query from Cllr Sankey about plans to dispose of unused space at Wayfield Avenue, Ms Jenkins replied that this is space in a mental health residential home that was previously used to deliver a now discontinued day service.
37.8 In response to a question from the Chair about the Section 75 agreement with Sussex Partnership NHS Foundation Trust (SPFT), Mr Persey explained that savings have been agreed with the Trust. This will involve pushing some costs back to SPFT.
37.9 The Chair thanked officers for their contributions. Cllr Moonan also noted that members need to recognise that HASC delivers crucial services, and that it can’t sustain more cuts for ever.
38 Healthwatch Brighton & Hove: Current and Planned Activities
38.1 This item was introduced by Geoffrey Bowden, Chair of Healthwatch Brighton & Hove. Mr Bowden told the committee that he had circulated a list of activities that Healthwatch has undertaken in the past year. The list was by no means complete, but gives an indication of the volume and the breadth of Healthwatch activity. Although Healthwatch is not primarily a campaigning group, it nonetheless has been engaged in pushing for specific outcomes in certain respects: e.g. for maintaining GP provision at New Larchwood, and in lobbying for public toilet provision.
38.2 Mr Bowden also noted that Healthwatch receives a large volume of concerns about GP services, and particularly about problems people face in getting an in-person GP appointment. HOSC might wish to scrutinise this issue, and potentially also look at maternity and mental health, and at dentistry. The Chair noted that there would be an item on primary care at the April 2023 HOSC meeting and NHS colleagues would be asked to address GP numbers and the issue of virtual Vs face to face appointments. The other areas raised by Mr Bowden would be considered as part of the future committee work programme.
38.3 Cllr West thanked everyone at Healthwatch for their hard and effective work. Cllr West noted that there has been a really worrying rise in poor health in recent years, which he ascribed to a Conservative government presiding over an increasing wealth gap, destroying the healthcare system, and to Brexit. Mr Bowden responded to say that he felt unable to comment on this, but would like to note that Healthwatch is suffering badly from inflation.
38.4 Mr Bowden noted that Healthwatch has to use its powers carefully in the current climate. For example, Healthwatch has enter & view powers, but recognises that healthcare settings are operating under intense pressures, and consequently uses these powers very carefully so as not to add to the burden. Healthwatch is also navigating the issue of being part of the Sussex Integrated Care System at the same time as being an independent watchdog.
38.5 The committee thanked Healthwatch staff and volunteers for all their much appreciated work over the past year.
The meeting concluded at Time Not Specified
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