Issue - items at meetings - Sussex Together

Presentation from Amanda Philpott, NHS Sussex on NHS plans to work more closely across Sussex (see attached)

.1         This item was introduced by Amanda Philpott, Director of Strategy and Provider Development, NHS Sussex. Ms Philpott told members that the NHS spend across Sussex was approximately £2.6 billion per annum. Given that government funding is likely, at best, to flat-line for the foreseeable future, and that health sector inflation, even in the context of a public sector pay freeze, is predicted to run at around 4% pa, some £440 million additional funding would be needed by 2013 to continue to meet increasing population health need through the current configuration of Sussex services. Since this extra money will not be available, the challenge for the local NHS is to make significant efficiencies. In addition, the Foundation Trust  (FT) programme should see all NHS provider trusts becoming FTs by 2014. To become an FT a trust must prove that it is financially viable – i.e. capable of making a sustainable annual profit from its activities.

76.2    The process via which these efficiencies will be found is called ‘Sussex Together’ and will be co-ordinated by NHS Sussex. However, the initiative will be clinically led – by both GP commissioners and provider clinicians – as well as having input from adult social care professionals, services representing the wider determinants of health (e.g. housing) and LINks.

76.3    Sussex Together has initially identified four main priority areas: frail elderly, unscheduled care, planned care and ‘other’ (focusing particularly on medicine management, paediatrics and maternity). The aim is to establish best practice within Sussex, and then ensure that local services and pathways demonstrate a consistent approach in line with this best practice. It will be for individual Clinical Commissioning Groups (CCGs) to implement this at a local level.

76.4    Thus far, Sussex Together has identified £160 million of potential savings. This is a fairly urgent process, as the more quickly savings can be identified and enacted, the bigger the budgetary impact. Providers have responded very positively to the challenge, even though they compete with one another for custom. A Sussex Clinical Senate has been established, bringing together clinicians from across the county and building on the successes of existing clinical networks.

76.5    Ms Philpott assured members that lessons had been learnt from previous attempts to reconfigure the Sussex health economy, and that there was no agenda to shut hospitals. Hospital trusts recognised that these were difficult financial times and that they had to work together – with each other and with GP commissioners – in order to remain sustainable. The boards of all Sussex NHS trusts are signing up to the principles of Sussex Together.

76.6    In response to a question from Cllr Follett regarding the Sussex Clinical Senate, members were told that it was hoped the Senate would enable provider clinicians to contribute to commissioning decisions at a remove – sharing their knowledge without inappropriately influencing commissioner choices. The Senate would effectively be a continuous clinical summit, and should cost relatively little (most clinicians involved will already be paid for service-planning so will not expect additional reimbursement).

76.7    In answer to a question from Cllr Marsh as to why this type of planning could not be left to CCGs, the committee was told that CCGs were still at a nascent stage of development, and in addition there are benefits from sharing best practice across Sussex.  CCGs are at the heart of the Sussex Together initiative.

76.8    In response to a question from Cllr C Theobald on maternity/paediatrics, members were told that this was likely to be a very significant issue going forward, with the need to balance people’s reasonable expectations of locally accessible services with a configuration of services that accords with guidance from the Royal Colleges on optimum unit size.

76.9    The Chair thanked Ms Philpott for her contribution and requested a further update in Autumn 2012.