Issue - items at meetings - South Downs Health NHS Trust: Integration With West Sussex Community Services - Update

(papers to follow)

12.1    This item was introduced by Andy Painton, Chief Executive, and Andrew Harrington, Director of Operations, South Downs Health NHS Trust (SDH).

12.2    Members were informed that the South East Coast Strategic Health Authority (SHA) was due to consider the final business case for the integration of SDH with West Sussex community services in autumn 2010. However, the two organisations have effectively been integrated for over a year now.

12.3    Integration with East Sussex community services has also been agreed in principle with the East Sussex Primary Care Trusts and with the SHA, although this is subject to a detailed evaluation of the proposals.

12.4    The integrated trust faces major challenges in the coming months, including the need to make very significant savings and the requirement to develop the trust’s senior management to best reflect clinical input and to ensure it is capable of the challenges of running a much expanded organisation.

12.5    In response to a question from Cllr Kitcat concerning how a small trust could realistically expect to take on the work of two much larger organisations, Mr Painton told members that it was very important to think of the integration process as the creation of an entirely new organisation rather the take-over of any one organisation by another. The new entity would not be over-centralised, but would maintain the local foci vital to ensure quality community services, whilst centralising those services which benefited from being run centrally (e.g. infection control). Mr Harrington added that it made sense for SDH to be the organisation into which the others were integrated as it already existed as a free-standing legal entity, whilst the community services in both East and West Sussex had formally been part of their respective PCTs, and were therefore not in a position to take on any other organisation.

12.6    In answer to a question from Cllr Allen concerning economies of scale to be achieved by integrating community services across Sussex, Mr Painton told members that there were considerable economies to be realised by integrating SDH with its West Sussex counterpart (approximately £2 million), but relatively minor additional savings from including East Sussex services.

12.7    In response to a question from Mr Robert Brown concern the upgrading of trust estates to make them compatible with the requirements of the Disability Discrimination Act, Mr Painton told members that responsibility lay with the owners of the estates in question: this is principally SDH in Brighton & Hove, but is NHS West Sussex in terms of West Sussex community healthcare buildings.

12.8    In answer to a question from Cllr Allen concerning how the expanded trust would guarantee it maintained a local focus, members were told that this would be guaranteed by the recently unveiled GP commissioning arrangements, which would mean that services for local people were commissioned by GP consortia at a very local level. In addition, Mr Painton pointed out that the nature of community services tended to militate against large scale solutions: whilst it might be sensible to run some services on a county-wide basis, there would simply be no advantage in scaling up the majority of the trust’s work.

12.9    Members thanked Mr Painton and Mr Harrington for their input and invited them to return to a future meeting to provide an update on the progress towards integration.