Agenda item - Sussex Health & Care: System Development and Governance

Presentation on the development of Sussex Health & Care, the local Integrated Care System for Sussex (slides attached).

35.1    This item was presented by Lisa Emery, NHS Sussex Chief Transformation, Innovation & Digital Officer; by Lola Banjoko, NHS Sussex Managing Director, Brighton & Hove; and by Rob Persey, BHCC Executive Director, Health & Adult Social Care. Ms Emery explained the purpose and goals of the Integrated Care Strategy, telling members that:

·         The Strategy aims to work at scale (e.g. Sussex) where it makes sense to do so, and at place (e.g. Brighton & Hove) where there is more value in local working;

·         There have been real improvements in partnership working over the past few years, but there is a need to build on these strong foundations;

·         The Strategy has system-wide priorities around workforce, digital, partnerships, and neighbourhood working;

·         There are place priorities also: cancer, mental health, children & young people, multiple compound needs, and multiple complex conditions.

35.2    In response to a question from the Chair about the role of HOSCs in scrutinising the Integrated Care Strategy specifically, and the Integrated Care System generally, Ms Emery told members that it was for HOSCs to determine what to focus on, but that the System would welcome HOSC involvement, particularly in terms of scrutiny of delivery: e.g. there would be a HOSC role in scrutinising the Shared Delivery Plan (the delivery plan for the Integrated Care Strategy).

35.3    Cllr West commented that public understanding of the Integrated Care System was not assisted by the decision to adopt local names for the nationally prescribed System infrastructure: calling the local Integrated Care Partnership the Sussex Health & Care Assembly etc.

35.4    In response to a question from Cllr Rainey on place-based structures, Ms Banjoko told the committee that there is a place-based partnership co-chaired by the NHS Sussex Managing Director (Brighton & Hove) and the BHCC Executive Director, Health & Adult Social Care. Local priorities have been developed also. These reflect the demographics of Brighton & Hove in terms of having a young population, lots of diversity, homelessness issues and so on. The Brighton & Hove priorities will look very different to the place priorities for East and West Sussex. Ms Emery added that there would be elements of system priorities that would be delivered at a place level also.

35.5    The Chair asked a question about the potential need for joint scrutiny of system-wide change plans. Ms Banjoko responded that there may be a requirement for formal joint scrutiny in the future, but that these plans are still at a relatively early stage in development and there is nothing new in the pipeline to share with HOSCs at the current time. There are change plans around regional children’s cancer services and around West Sussex stroke services which are already with the relevant HOSCs.

35.6    The Chair noted that workforce is clearly a major challenge and that it is important to think about solutions at scale in terms of joint recruitment, training, mentoring and so on. Ms Emery agreed, also stressing the importance of working closely with education sector partners.

35.7    In response to a question from the Chair in joint working in practice, Mr Persey told members that there is lots of joint working already in place: for example, social workers embedded in Primary Care Network multidisciplinary teams, supporting specific patient cohorts, social prescribing etc.

35.8    The Chair asked how local people could hold a complex system to account. Ms Banjoko responded that organisational responsibilities to engage with and respond to local people are still in force. There are also defined roles for HOSCs and Health & Wellbeing Boards in the new system. Mr Persey added that Healthwatch has an important role to play here also.