Agenda item - Member Involvement

To consider the following matters raised by councillors:

(a)  A letter has been received from Cllrs Bruno De Oliveira and Tristram Burden on A&E services at the Royal Sussex County Hospital (copy attached).

(b)  A letter has been received from Cllr Hill on city council governance changes and the future arrangements for the Health Scrutiny functions (copy attached).

33A – letter from Cllrs De Oliveira and Burden: RSCH A&E

33.1    Cllr Tristram Burden presented a letter from Cllr Burden and Cllr De Oliveira concerning conditions at the Royal Sussex county Hospital (RSCH) A&E department.

33.2    Introducing his letter, Cllr Burden told the committee that local residents had been in touch with him and with Cllr De Oliveira to share harrowing experiences of RSCH A&E. Problems included overcrowding; a lack of safe spaces for vulnerable people; the side corridor, which should be a quiet space being used to manage disruptive patients; and people being unable to hear their names being called due to the level of noise in the department. Cllr Burden recognised that there are medium term plans to make significant improvements to the RSCH emergency department, but was concerned that not enough is being done to manage pressures in the short-term.

33.3    The Chair responded: “I’d like to thank Cllrs De Oliveira and Burden for their letter. I’m sure that many of us have first-hand experience of the issues that they raise. We’ve had the hospital trust at previous HOSC meetings to talk about their capital plans, and it’s really good news that almost £50 million has been secured to make improvements to the emergency department. This is a considerable amount of money in the current NHS capital funding context, and shows that the issues at the Royal Sussex are being taken seriously. We also appreciate that the pressures brought to bear in the Hospital Emergency Department are not solely due to emergency medical problems but issues relating to a lack of capacity in other parts of the health and care system, for example in mental health services.

However, these capital improvements won’t happen overnight, and the HOSC does need assurance that absolutely everything that can be done to manage problems in the short term is being done. We have the Chief Executive of University Hospitals Sussex, Dr George Findlay, with us today to talk about the recent CQC inspection report on the trust, and I think this presents an opportunity for members to enquire about short term plans for A&E. We will need a dedicated item to explore this issue properly however, and if members agree, I am happy for it to be included on the agenda for the next scrutiny meeting. The hospital trust have said that they would be happy to attend a future meeting and will ensure that A&E leaders and representatives from across the local health and care system, including adult social care, Integrated Care Board commissioners, and other NHS providers, are present to provide operational detail.

33B     letter from Cllr Hill: Council governance changes

33.4    Cllr Hill introduced her letter, telling the committee that it was not her intention to discuss the relative merits of cabinet and committee governance, but rather to make the case for a standalone Health Overview & Scrutiny Committee (HOSC). Cllr Hill noted that the proposed new People O&S committee would have a very broad remit and it was difficult to see how the very busy HOSC could be absorbed into a new committee without loss of focus. It was also important to recognise the valuable role played by HOSC’s co-opted members. Any new arrangements should ensure that all current co-optees continue to play just as prominent a role.

33.5    The Chair responded “Thank you for your letter. The Council is currently reviewing its arrangements for Overview and Scrutiny in the light of the full Council decision on 28^th March to move to a Leader and Cabinet system on 16 May . The proposals include a new Overview and Scrutiny system with two Committees, one dedicated to People and one to Place. The proposals, as I understand them, are for the People Scrutiny Committee to incorporate the HOSC functions. This is something that is done elsewhere and the agenda of the meeting can be divided so as to ensure focus on HOSC issues for a specified part of the agenda. The Council will ensure that the statutory requirements for Health Overview and Scrutiny continue to be met in the implementation of the new arrangements. The proposals have not been finalised and therefore it is not possible to provide further detail at this stage, however, I am keen to hear the views of our current co-optees which I will then be very happy to feed back for consideration as part of the design of the new system.”

33.6    Geoffrey Bowden (Healthwatch) noted that Healthwatch England is increasingly looking at housing as a health issue. It would make sense for Healthwatch to be represented on any committees looking at the wider determinants of health in addition to being represented on the HOSC. Mr Bowden also noted that HOSC meetings are typically lengthy; it is evident from this that HOSC has plenty to do as a standalone committee.

33.7    Cllr Shanks noted that HOSC is a body focused on external scrutiny of NHS partners rather than internal scrutiny of council services; it makes little sense to combine these very different functions in a  single committee. Also, the Sussex Integrated Care System is still in its infancy and requires close scrutiny.

33.8    Cllr O’Quin agreed that it was important HOSC continued to have a clear external focus. Future arrangements should definitely also include seats for all current HOSC co-optees.

33.9    Cllr Evans concurred that HOSC’s status as an external committee should be preserved, as its effectiveness would be otherwise reduced.

33.10  Cllr Hill noted that the majority of councils do operate a standalone HOSC. It would also be helpful for there to be a clearer relationship and referral pathway between the health scrutiny committee and the Health & Wellbeing Board.

33.11  Theresa Mackey (Older Peoples Council) noted that she strongly supported the maintenance of a standalone HOSC.

33.12  The Chair thanked everyone for their contributions.