Agenda item - Sussex Winter Plan 2022-23

Report of the Executive Director, Governance, People & Resources (copy attached).

27.1    This item was presented by Claudia Griffith, NHS Sussex Chief Delivery Officer; Lola Banjoko, NHS Sussex Managing Director (Brighton & Hove); and Rob Persey, BHCC Executive Director, Health & Adult Social Care. Dr Jane Padmore, Chief Executive, Sussex Partnership NHS Foundation Trust (SPFT); and Dr Andy Heeps, Deputy Chief Executive, University Hospitals Sussex NHS Foundation Trust (UHSx), were also on the call to answer member queries.

27.2    Ms Griffith told the committee that the Sussex system faced very challenging circumstances this winter, with the usual winter pressures exacerbated by the need to recover planned care activity lost through the Covid pandemic and by the additional disruption likely to be caused by industrial action. However, there is a robust system-wide plan in place, with positive buy-in from all partners. Key areas of focus include improving ambulance response times, ensuring timely discharge from acute settings, and supporting the most frail in order to reduce admissions into hospital. Additional funding for social care announced in the Autumn Statement is to be welcomed.

27.3    In response to a question from Cllr O’Quinn on strikes, Dr Heeps told members that detailed planning had been done. It is important to stress that the dispute is not between UHSx and the Royal College of Nursing (RCN), but between the RCN and Government. The Trust continues to work very well with RCN. Emergency care will not be impacted by strike action, and while planned care will be hit, the Trust is confident it will receive advance notification of any industrial action which will enable it to work to minimise the impact on patients. Dr Padmore reported a similar picture at SPFT, noting that the Trust has communicated its support to all staff whether or not they are engaged in industrial action.

27.4    In response to a question from Cllr O’Quinn about staff retention at 111, Ms Griffith responded that there has been a historical problem in retaining relatively low paid 111 staff. There is ongoing work with the South East Coast Ambulance Trust (SECAmb) about this and SECAmb does have a forward plan to improve staffing.

27.5    Cllr John asked about plans to deal with the impacts of cold weather, particularly given that many may be unable to afford to heat their homes. She noted the Somerset prescribing warmth pilot as a possible model to be explored locally. Dr Heeps responded by saying that the situation was currently relatively stable, with unseasonally warm weather and the most recent Covid cycle receding somewhat. The system is prepared to use acute capacity across Sussex to manage demand when and if required. Mr Persey added that the council would shortly be issuing a directory of local warm spaces. Work was also underway to target support to the most vulnerable communities. In addition, public health and NHS providers are working together to support care homes: e.g. by providing additional care in homes to reduce admissions to hospital.

27.6    In response to a query from Cllr Rainey around gritting plans, Mr Persey told members that the detail of local planning to deal with icy weather was in the Brighton & Hove Cold Weather Plan. The Cold Weather Plan dovetails with the system winter plan, providing more granular information about planning across a range of services, including preparations for extreme weather, support for rough sleepers and so on.

27.7    Cllr Rainey asked a question about schemes to reduce mental health admissions. Dr Padmore responded, telling the committee that short term interventions at home were being used to reduce admissions. There was also work ongoing to improve the flow through acute mental health services, particularly in terms of ensuring timely discharge from hospital into appropriate care. Council adult social care services and local community & voluntary sector organisations are key partners in this work.

27.8    In answer to a question from Cllr Rainey about accessing mental health support, Dr Padmore replied that work is carried out to advertise how to access services. However, more does need to be done: e.g. closer working with 111 to ensure that callers are not advised to present at A&E if there is a more appropriate alternative. Mr Persey added that a local Mental Health Needs Assessment has recently been published. This is a significant piece of work and will be used to raise awareness of mental health and of the significant challenges we face locally.

27.9    The Chair asked a question about the adequacy of local GP services, given the paucity of GPs, particularly in the most deprived parts of the city. Ms Griffith responded that there are problems with people being able to access appointments, particularly face to face. Additional investment is being provided to improve face to face capacity, to provide better telephone access, and to better understand demand for primary care. The recently opened Urgent Treatment Centre and investment in community pharmacy services will also help. Ms Banjoko added that there is an important role to be played by the community & voluntary sector here, with the potential to better use community assets to provide primary care and to target community support to people who need to attend primary care frequently.

27.10  The Chair asked how the inevitable tensions between health and adult social care concerning hospital discharge into care settings were being managed. Mr Persey replied that delays to timely discharge remain a national and local concern. However, relationships have improved considerably over recent years, with a them Vs us dynamic having been replaced with a mutual recognition of the challenges faced by each sector and a commitment to work together to improve outcomes. This is not just about discharge; avoiding admissions is as important.

27.11  The Chair thanked all the presenters for their contributions.

27.12  RESOLVED – that the report be noted.