Agenda item - Sussex Winter Planning 2025-26

20.1    The item was presented by Nicki Smith, NHS Sussex Director of Emergency Preparedness, Resilience and Response. Joining her were Steve Hook, BHCC Director of Adult Social Services; Nigel Kee, University Hospitals Sussex NHS Foundation Trust Chief Operating Officer; Michelle Arrowsmith, University Hospitals Sussex; Tanya Brown-Griffith, NHS Sussex Director for Joint Commissioning and Integrated Care Teams (Brighton & Hove); John Child, Chief Operating Officer, Sussex Partnership NHS Foundation Trust; and Dr James Simpkin (primary care).

20.2    Ms Smith outlined planning for winter 2025-26. This year’s planning builds on learning from previous winters with particular priority given to starting the planning cycle early; developing clear escalation plans; focusing on discharge, staff vaccination and communications; and holding 2 discharge events relatively early in the winter.

20.3    Ms Brown-Griffith added that Brighton & Hove specific work includes: focus on the unscheduled care hub which helps deliver effective use of ambulances; the development of a neighbourhood health alliance which offers proactive care planning to people most at risk of un-planned admission; a particular focus on supporting people with COPD; and an integrated approach to admission avoidance via Better Care Fund supported collaborative work.

20.4    Cllr O’Quinn asked about staff vaccination. She was informed that current rates are around the national average. This year’s focus includes having roving teams rather than expecting all staff to book slots at a clinic. Some partners are also offering vouchers.

20.5    Cllr O’Quinn asked about use of AI. Mr Child responded that there is work in its early stages looking at supporting clinical triage. This has very careful governance in place. Mr Kee added that the hospital trust is similarly in the early stages of developing AI programmes, also with robust governance.

20.6    Cllr Parrott asked about consideration of people with protected characteristics. Ms Brown-Griffith assured members that there is a robust equalities impact assessment of winter plans. Specific work includes information on falls prevention being translated into 30 languages.

20.7    Cllr Parrott asked about planning for people in a mental health crisis. Mr Child responded that there have been improvements made to the urgent mental health pathway in recent months, for example the establishment of crisis cafes with extended opening hours. SPFT mental health liaison teams work in A&E and ensure timely assessment of mental health needs. However, there remain significant challenges in terms of waits for mental health beds and in terms of mental health phoneline capacity. There has been no specific additional national resourcing made available for the coming winter.

20.8    Geoffrey Bowden asked about provision for the homeless and for asylum seekers. Md Brown-Griffith responded that Arch provides a range of services for these vulnerable communities, including pop-up on-street vaccination offers. Steve Hook explained the important role that SWEP (severe weather emergency protocol) arrangements play in supporting homeless people. In past years there has been additional national funding for SWEP, but none has been offered this year.

20.9    Bernadette Kemp (Old People’s Council) voiced concerns about the impacts of midday discharge on older patients. Mr Kee responded that there is a big push for earlier discharge but there is recognition that there are specific issues relating to some patients, particularly for people who live alone. Mr Hook added that homecare commissioning has been revised to provide additional discharge support. There are particular issues for people with dementia and additional step-down beds are being provided at Ireland Lodge. There is a multi-disciplinary admission prevention team operating from the Royal Sussex and this has diverted around 2000 people from hospital admission since 2023.

20.10  Cllr Mackey asked what had been learnt from the previous winter. Ms Smith replied that the main learning points were to begin planning earlier in the year, to have clear escalation routes, to schedule testing events at an earlier point, to be really focused on vaccination and communications, and to ensure that clinicians are fully engaged with every initiative. Mr Kee added that learning also included the importance of good quality staff engagement and using discharge lounges in more intelligent and holistic ways. Dr Simpkin noted that from a primary care perspective learning included the need to focus on the patients at highest risk of admission and on making early referrals into multidisciplinary teams.

20.11  Cllr Parrott asked whether staff vaccination schemes extended to community & voluntary sector workers playing a key role in winter planning and delivery. Ms Smith responded that she was unsure but would be happy to provide a written response.

20.12  Mr Bowden asked about the negative impacts of beginning planning later last year. Steve Hook replied that one negative example concerned the multi-agency discharge events. Last year the first of these events took place in the week before Christmas which presented a number of logistical problems which could have been avoided had the event been held a week or so earlier.

20.13  Nora Mzaoui noted that Community Works will meet imminently to discuss winter plans. She asked whether it will be possible to adjust plans if community sector colleagues identify gaps. Ms Brown-Griffith replied that local plans can be flexed in this way.

20.14  Cllr O’Quinn asked a question about access to GPs over the Christmas period. Dr Simpkin responded that GP surgeries are in fact open as usual on every day other than bank holidays. While January is a busy time, the period before Christmas is not always particularly busy.

20.15  Cllr Hill asked about ambulance handover performance and how the ideas of non-managerial staff on improving performance are captured. Mr Keen responded that there have been dramatic recent improvements in ambulance wait times, particularly with regard to the 60 minute target. UHSx works very closely with South East Coast Ambulance NHS Foundation Trust on this and key roles are played by non-clinical staff across the emergency department.

20.16  Cllr Hill asked about the potential impact of strikes across winter. Mr Kee responded that services have become increasingly adept at managing industrial action and maintaining good standards of both emergency and elective performance.

20.17  Cllr Hill asked about waiting times for acute mental health beds. Mr Child responded that the waits are longer than anyone would want. However, there has been some recent improvement in terms of patients waiting at the Royal Sussex (RSCH) A&E for a mental health admission.

20.18  Mr Bowden asked about capacity issues at RSCH A&E. Ms Smith responded that a new acute medical unit will open imminently. This is a key stage in the implementation of planned emergency floor improvements and will help increase capacity.

20.19  The Chair asked whether the winter plans were adequately resourced. Mr Kee replied that close working is the key factor: if partners work well together and each organisation manages staff sickness effectively, the system should cope.

20.20  The Chair asked about contingency plans. Mr Kee responded that there are a range of Sussex-wide escalation plans. Ms Smith added that there are also close links across the south east region.

20.21  Cllr Hill proposed an amendment to the report recommendation to include an additional recommendation: “that HOSC Committee recommends that consideration be given to a planned roll-out of vaccinations for individuals working in the Voluntary, Community, and Social Enterprise sector who play a vital role in supporting the winter plan”. This was seconded by Cllr Parrott and agreed by the committee.

20.22  RESOLVED – that the report be noted; and that HOSC Committee recommends that consideration be given to a planned roll-out of vaccinations for individuals working in the Voluntary, Community, and Social Enterprise sector who play a vital role in supporting the winter plan.