Agenda item - Chairs Communications

28.1    The Chair gave the following communications:

At the last HOSC meeting we heard from University Hospitals Sussex on their improvement planning following a critical CQC inspection of maternity and surgical services. I wanted to have a progress update at today’s meeting, but unfortunately this was not possible. We will have a full update at the July meeting. In the meantime I asked UHS for a brief update:

Brighton and Hove HOSC

CQC Improvement Plans

Since receiving the Warning notices for maternity services and surgery in 2021, the Trust has been working with clinical leaders and frontline staff to make the improvements required. Using our Patient First methodology for continuous improvement we have focussed on immediate actions like increasing the number of staff who have had appraisals and who are up to date with their training. Alongside these sort of short-term actions we are also continuing to make every effort to recruit more staff, for instance in maternity services (where there is a national shortage of midwives) we are hopeful that a cohort of undergraduate trainee midwives will stay with the Trust and take up substantive posts later this year.

The committee will be aware that the NHS locally as well as nationally continues to operate under severe pressure. The number of patients attending our emergency departments has risen considerably with knock on impacts across the hospitals. The number of patients who are medically fit for discharge but for whom a suitable alternative placement (home, residential or nursing care) for their on-going care has been identified is at an all time high. Alongside all of this our staff are affected by Covid and we continue to have significant numbers of staff away off sick from work with it each week. Not only does this make delivering care more difficult it also has a negative impact on our ability to release staff for activities such as training. Nonetheless, we continue to ensure that services are safe and to make every effort to address the issues raised with us by the CQC, which is a top priority for our Board.

We anticipate that the CQC will re-inspect in April and we are planning to make a detailed response to the CQC by the end of the month.

ICS. I was also keen to have an update at this meeting on plans to develop new regional NHS structures. Again, this was not possible and I will aim to have a full update at the July meeting. In the interim I have received the following update from the CCG and HASC:

The Health & Social Care Bill which is currently progressing through parliament requires the establishment of regional statutory Integrated Care Systems (ICS). There are 42 ICSs across the country, bringing NHS organisations, local authorities, and wider partners together to improve health and care services and outcomes for local populations. Sussex has been operating as a non-statutory ICS since April 2020.

Health and care organisations across Sussex have worked in partnership over the last few years, and this has enabled better joined-up and collaborative working for the benefit of local people. This has been crucial in how the health and care system has responded to the pandemic, and there is now an opportunity to build on these strong foundations with the creation of a statutory ICS, which will include two main bodies: an Integrated Care Board (ICB) and Integrated Care Partnership (ICP).

Our ICB will be known as NHS Sussex and will become the new NHS statutory organisation, agreeing the strategic priorities and resource allocation for all NHS organisations in Sussex. The ICB will take on the commissioning functions currently carried out by Sussex CCGs. The ICP will be known as the Sussex Health and Care Assembly and will be a statutory joint committee between the NHS and local government, which will agree the strategic direction of our health and care system.  The Assembly will have a specific responsibility to develop an ‘integrated care strategy’ for its whole population using the best available evidence and data and addressing health inequalities and the wider determinants which drive these inequalities. The Sussex Health & Care Assembly will be the principle forum at which the views of local government will be expressed. Arrangements for partnership working at ‘place’ (e.g. Brighton & Hove) do not form part of formal ICS governance, but are being progressed by all partners. The Assembly will have a key role to play in terms of interacting with the three places within the ICS.

The membership and governance of both the ICB Board and ICP is currently being finalised following an extensive engagement process across partner organisations. Details of these will be published in the coming weeks and a draft ICB constitution will also be published in early May for comment.

Assuming that the progression of the Bill is as anticipated, the ICS will go live on 01 July 2022. To prepare for this, all local systems have been asked by NHS England to agree the formal local arrangements and meet nationally-decided criteria.

The Department of Health & Social Care is in the process of updating its guidance on health scrutiny; and new guidance, including how HOSCs should go about scrutinising ICS, will be published later this year.

28.2    The Chair told members that she has concerns about the ICS, including the potential for private sector provider involvement, and the degree to which services would genuinely be oriented to the needs of ‘place’. She also noted that the “extensive engagement process” mentioned in the statement on ICS development had not included the Chair of the HOSC.

28.3    The Chair also welcomed Geoffrey Bowden, Chair of Healthwatch Brighton & Hove to the meeting as the new Healthwatch co-optee.