Shaping and Developing Healthwatch East Sussex

Health Update – January 2012 Issue 4

The County Council is producing this update on a regular basis to keep stakeholders informed of the NHS reforms.

This Update along other information on the NHS reforms can be found on the East Sussex Strategic Partnership website – Health and Wellbeing Section.

National overview

The Health and Social Care Bill is still going through the parliamentary process. In addition, the Public Health changes have seen several ‘Update’ papers being published but more are also due. These Update papers provide clarity and guidance to key issues but it is important to note the overall direction of travel remains the same, with Public Health at a local level moving to the County Council and a new national body ‘Public Health England’ being created.

Strategic Health Authority (SHA)

Nationally

Each SHA is responsible for enacting the directives and implementing fiscal policy as dictated by the Department of Health at a regional level. In turn each SHA area contains various NHS Trusts which take responsibility for running or commissioning local NHS services. The SHA is responsible for strategic supervision of these services. To reduce expenditure and to try and ensure business continuity,the SHAs have followed the PCTs and merged into 4 Cluster groups.

Locally

The Surrey and Sussex SHA has become part of the South of England SHA Cluster which became operational in October 2011 under the leadership of Dr Geoff Harris as Chairman and Sir Ian Carruthers aschief executive of NHS South of England.

Sir Ian Carruthers visited East Sussex as part of his getting to know the area in November 2011.

Primary Care Trusts

Nationally

To reduce expenditure and to try and ensure business continuity, PCTs have merged into Cluster groups. This will remain until March 2013 when Clinical Commissioning Groups and other bodies such as the NHS Commissioning Board take over.

Locally

NHS Sussex, our local cluster, is now in place with the Board and senior officers appointed. Our local PCTs, East Sussex Downs and Weald PCT and Hastings and Rother PCT are still the statutory bodies,but local capacity has been reduced as part of the wind down process. NHS Sussex and our local PCTs will also formally finish in March 2013.

Clinical Commissioning Groups (the new name for GP Commissioning Groups)

Nationally

97% of the country is now covered by Clinical Commissioning Groups (CCGs).

All CCGs and potential CCGs have been going through a process of being assessed by the Strategic Health Authority on their ability to manage their business in the future. This ‘pipeline’ process has had two stages and the outcomes should be known early in the New Year.

Locally

We have two consortia established (Hastings and Rother, Eastbourne). The areas covering Lewes and the Havens, and High Weald are in the process of establishing themselves and this will be completed around the New Year – well before the April 2012 deadline.

East Sussex Healthcare NHS Trust

The Trust is undertaking a clinical strategy review. The aim of this is to:

set out sustainable future for Trust services
a framework within which services can be developed, redesigned and reconfigured over next 5 years.

The key drivers for the change are:

Clinical sustainability – increasing specialisation, workforce challenges, improving quality of care; and
Financial sustainability - £100m Trust savings required over next 5 years.

The clinicalstrategy will cover 8 areas which in total make up 80% of the Trusts income. These arrears are: emergency care, acute medicine, general surgery, trauma & orthopaedics, paediatrics, maternity, stroke and cardiology.

Timeline:

–Vision, aims and priorities – agreed Spring 2011

–Preferred models of care for 8 areas – agreed Sept 2011

–Detailed delivery options developed by Dec 2011

–Public consultation on major change proposals – early 2012 (tbc)

–Implementation of other changes – 2012/13 onwards

Stakeholder involvement:

–The County Council and in particular Adult Social Care and Children’s Services engagement in development of care models and options

–Role for Health and Wellbeing Board in ensuring fit with local needs and all partners’ commissioning plans

–Health Overview and Scrutiny Committee (HOSC) has been involved in scrutinising the strategy development process which has been on going since January 2011. HOSC will be formally consulted on proposals for ‘substantial’ change to services and will undertake a full review to inform recommendations

Public Health

Nationally

Nationally the debate has focused on the role of Public Health England and theemployment of Public Health staff. This is still unclear and we await further guidance from the Department of Health as part of the national Update process. There has also been a debate about the Public Health budgets which seem to be very diverse across England.

Locally

Having the Public Health team in County Hall has certainly helped generate further joint working and a much more shared understanding of roles and responsibilities.

The service review of Public Health has been undertaken by Solutions for Public Health. There was a stakeholder event in October 2011 and this helped to o help generate some of the key areas for the future.

An action plan will be produce in response to the report and this will be available in the New Year.

Joint Strategic Needs Assessment

Nationally

A main function of Health and Wellbeing Boards is to assess the needs of the population through the Joint Strategic Needs Assessment (JSNA). The JSNA is an ongoing process which describes the future health, care and well-being needs of the local population and the strategic direction of service delivery to meet those needs. This process supports the delivery of better health and wellbeing outcomes for the local community by informing decision making and the commissioning of services.

Locally

The East Sussex JSNA process, which commenced in 2007, is an evolving process and to date comprises:

JSNA Scorecards which present a range of indicators at different geographical levels. Indicators cover: demography; social/environmental context; lifestyle and risk factors; the burden of ill-health in terms of mortality, primary care and hospital care; social care, health and children’s services and the user Perspectives on services;

Comprehensive needs assessments which look in depth at for example the needs of a particular population group (children) or a service area (sexual health services);
Focused work on increasing life expectancy in the 20 wards across East Sussex with the lowest life expectancy compared to the rest; and
Several national profiles which focus on a particular geographical area, population group or services.

All existing JSNA products are now on the ESCC website and can be accessed through the following link:

A new JSNA website for East Sussex is currently in development, due to be completed in January 2012. The new website will be more user-friendly and will incorporate search facilities and an A-Z to ensure users have easier access to the full range of products.

New statutory JSNA guidance will be published in draft form in January 2012 and formally published after the Health and Social care Bill has gained Royal Assent. This will be used to inform the JSNA development plan for 2012/13.

Contact:

Cynthia Lyons, Deputy Director of Public Health

Tel: 01273 336032

Graham Evans, Head of Public Health Intelligence

Tel: 01273 336038

Health and Wellbeing Board

Nationally

The Health and Social Care Bill requires the County Council to establish a Health and Wellbeing Board. This is a statutory requirement of the new legislation. It is a formal (but unusual) Council Committee as GPs, officers,Councillors and other local representativeswill act as a Board. This new Board will have statutory powers from April 2013. Until then the Board will have an advisory and influencing role.

Locally

The Shadow Health and Wellbeing Board has had 2 meetings. The next meeting is in March 2012.

The Shadow Board will be developing its Health and Wellbeing Strategy during the year using the joint Specific Needs Assessment as its evidence base.

Healthy Living Pharmacies

Nationally

With the clear need to improve the health of the nation, pharmacies have launched a national initiative called the Healthy Living Pharmacy. This initiative aims to improve the access to services through pharmacies to support health interventions such as smoking cessation and sexual health services.

Local areas (Primary Care Trust areas or larger) have to big to take part and bids can be submitted to a national timetable.

Locally

Pharmacy in East Sussex is following the national direction to support the public health agenda. East Sussex Local Pharmaceutical Committee (the local representative committee for community pharmacy) working with the East Sussex and Brighton PCTs put together a bid to take part in the Healthy Living Pharmacy (HLP) initiative.

The bid was successful, and through a rigorous application process 21 community pharmacies across Brighton and East Sussex have been chosen for Wave 1 of the HLP initiative. These pharmacies will become accredited as HLPs in April 2012. After having selected a leader who has received leadership training, the next stage is for each pharmacy to nominate a healthcare assistant to become a healthy living champion (HLC). These staff will receive two days local training to meet local needs to deliver public health messages and support delivery of locally commissioned services.

It is then up to the pharmacy to deliver exceptional service and provide the range of locally commissioned services, which include stop smoking services, services for substance misusers and sexual health services, together with the full range of advanced services which include Medicines Use Reviews and the New Medicines Service.

In April 2012 each pharmacy will be visited and judged as to whether they have achieved HLP status. We will then launch HLPs with a robust locally devised communication plan.

Evaluation is being undertaken nationally for all the pathfinder sites.

A wider roll out is anticipated in the late Summer of 2012.

For any of the above

Contact:

Barbara Deacon, Policy Officer

T 01273 335012

Shaping and Developing HealthWatch East Sussex

‘The local consumer voice for health and social care’

Nationally

East Sussex County Council Chief Executive Becky Shaw has joined the National HealthWatch Programme Board. The board brings together leaders from Local Authority, officers from the Local Government Association, and the Department of Health, to discuss and debate the implementation of the HealthWatch aspects of the Health Reform Bill.

The Department of Health has published the analysis of the Consultation on allocation options for distribution of additional funding to local authorities for Local HealthWatch, NHS Complaints Advocacy and PCT Deprivation of Liberty Safeguards (DOLS) in hospitals

The analysis presents the responses to the consultation and provides clarity on a number of issues that had been raised during the consultation.

Within East Sussex

1. LINK Transition Year Work Programme

The LINk has been focusing on a number of activities that will form what is becoming known as the LINk legacy, specific areas are the process for identifying priorities, enter & view activities of LINk participants, engagement activities with communities and organisations and research into services.

For a more detailed update on LINk activities visit the LINk Website.

2. HealthWatch East Sussex

At the beginning of December a wider stakeholder event took place at the Towner Gallery in Eastbourne, with representatives from NHS, CCGs, County Council, voluntary and community organisations, the LINk, and the LINk Host Team. The discussion focused on the themes that have been emerging from previous engagement activities held during the last six months.

The themes discussed were how HealthWatch East Sussex:

- should be structured

- can be independent but not self serving

- can be inclusive of everyone

- can work with the NHS and Social Care

- can be a high quality organisation

- can provide the right services to the public

The comments and views expressed will be used to inform the contract specification that will be published later in 2012.

The event did not discuss how HealthWatch should be branded as this piece of work is being carried out nationally by the CQC. We did however send the views on branding gathered during the last six months to the CQC to pass on to the consultants undertaking this work. CQC did say that all of the points received from East Sussexwere broadly in line with existing discussions.

The gathering of views and experiences to help developHealthWatchEast Sussex continues into the New Year. There is a short onlinesurveyavailable for people to complete. The closing date is Monday 6 February 2012. The responses to the survey will be made available mid February and be used to shape HealthWatch East Sussex.

Contact:

Paul Rideout, Third Sector Policy manager, ESCC.

T: 01273 482911