East Sussex Health Overview and Scrutiny Committee (HOSC) Agenda item 10
Work programme 2006 / 2007 Version 7: 30/11/06
Work item Issues Action
1 Dentistry This item remains from an original list of potential topics generated by HOSC in October 2003. HOSC: 22 September
considered a report on
Full details of the new provisions are available on the Department of Health website: What you
the impacts of the new
need to know about changes to NHS dentistry in England.
HOSC: 23 June 2006 –highlighted concerns and requested further report.
22 September 2006 HOSC view: The new dental contract has not helped NHS dentistry services
in East Sussex. HOSC remains concerned that some of the most vulnerable people may not be
receiving dental treatment and health inequalities are not being addressed adequately. HOSC
noted that the PCTs are carrying out a review on the impact of the new contract. Finish date to
In November 2006 HOSCs the PCTs will be questioned on:
• Resolving issues around the lack of NHS dentists in Uckfield and elsewhere (eg. Rye)
including transport costs
• The consequential impact of the changes on the community dental service and the
emergency dental service; an alleged 7 month waiting time for appointments at the
community dental service
• Additional referrals to the community dental service because of lack of disabled access to
local dentists HOSC: 30 November:
• Improving communications with the public about NHS dentists. further action to be
• Meeting the un-met needs of people who never visit a dentist. agreed. PCT update.
2 Creating an NHS This consultation is about developing the strategy for improving health care in Surrey and
fit for the future Sussex. Proposed ideas for East Sussex are:
Urgent & emergency care: keeping A&E or hospital services for those in most need; improving
Older people: providing more services at home and in community settings, especially those with
Work item Issues Action
long term conditions
Surgery/planned care: more community services
Diagnostics (eg. x-rays and scans): more local services.
Efficiency: swift admissions for those who need it, ensure stays are no longer than necessary
Medicines: better value for money
Improving health, reducing inequalities: working with other local services to improve health, life
expectancy and overall well-being.
23 June 2006: Debbie Bamford, East Sussex Transitional Lead Chief Executive questioned.
August 2006: HOSC has not received draft sustainability plans despite repeated requests from
the PCT who say that the SHA has to give approval for the release of any interim document. Draft
plans have been provided to Executive members at ESCC.
22 September 2006 – HOSC was advised by Nick Yeo, Chief Executive, East Sussex PCTs, that HOSC: 30 November
key considerations the Trust will use when drawing up options for consultation are: affordability; 2006 – update from
clinical standards and safety; the right level of care. The final decision on where each service will PCTs
be located is the responsibility of the PCTs. HOSC will monitor carefully the extent to which the
Trust takes on board the public’s view.
3 Burns services Regional proposals are awaited on the provision of burns services affecting East Sussex. Lead HOSC: when proposals
HOSC member: Cllr Philip Howson. Member visit to Queen Victoria Hospital, East Grinstead received
took place on 13 July 2006.
4 Shaping the The Sussex Partnership NHS was formed on 1 April 2006 covering East Sussex, Brighton &
future of mental Hove and West Sussex. East Sussex HOSC will retain an independent scrutiny of mental health
health, learning and learning disability with issues being referred to neighbouring HOSCs only when a joint
disability and approach is required (17 March 2006 HOSC).
March 2006: HOSC commented on the consultation leading up to the formation of the new Trust.
Issues to take forward are:
• Ensuring effective access to services in rural areas;
• Emergency and out-of-hours access to services.
• Level of co-operation with other health and social care bodies particularly Adult Social
Care /Children’s Services and acute care services: progress with data records sharing
and joint commissioning
Work item Issues Action
• GPs – are they equipped with the expertise to deal with early diagnosis of mental health
problems and provide an immediate response?
• Is it clear who is responsible for people with learning disabilities – the Trust or social care
• Day hospital, Eastbourne Road, Seaford: current and future use – raising the wider
question about the best uses of NHS assets.
• Homefield Place: history and future plans (if substantial variation of service is planned).
• Impact on the service of delayed transfers of care, choose and book and “fit for the future”
• Handling long term conditions / relation with the Transforming Chronic Care programme
• Impact on front line service provision of the decision to stop training for Continual
Professional Development and Vocational training to local PCTs. There are also concerns
with the quality of cascade training as a method of delivery and the impact this may have
on resources in local teams.
22 September 2006 HOSC: Lorraine Reid, Executive Director for East Sussex Locality,
Sussex Partnership Trust briefed HOSC briefed HOSC on organisation of services. The
Trust and service commissioners are working together to reduce out-of-are treatment and to
give service users greater choice in their treatment. The drive is toward treating people
earlier and trying to reduce the number of patients who develop acute conditions. HOSC
identified the following outstanding concerns:
• High percentage of prisoners and war veterans with mental health problems
• Negative perception that older people have about hospital stays and the level of
communication required to change these perceptions and to reduce their anxieties
around this area.
• Future use and plans for Seaford Day Hospital and Homefield Place.
5 Closure of All All Saints Hospital closed in April 2004. Monitoring centred on the sustainability and capacity of
Saints Hospital, the services put in place.
17 March 23 June 2006 HOSC requested and is awaiting further information on how the
Work item Issues Action
proceeds of the sale have been used.
22 September 2006 – East Sussex Hospitals NHS Trust reported that All Saints Hospital site was
sold by theTrust in 2005 for £5.75 million. The money was not earmarked for a particular purpose
and provided a one-off in-year benefit. Revenue savings from the closure were £4 million, of
which £3 million was invested in services provided by Hailsham 2 ward, Firwood House and in Ongoing monitoring.
developing community services, with the remaining £1 million taken as a saving by the Trust.
6 Carers’ Review The review examined range of issues around supporting carers including attitude of GPs towards
(March 2005) carers, strengths and weaknesses of the carers’ assessment process and experience of carers in
30 November 2006 –
hospital admission and discharge.
HOSC to be updated on
September 2005: HOSC reviewed the action plan and reaffirmed the importance of this review. progress on
23 June 2006: HOSC concluded the review but to assess the extent to which it needed to
become involved with a review of support to young carers carried out by Children’s Services in
Young Carers’ Review.
7 Best Care, Best March 2005: The Joint Committee commented on NHS proposals to make substantial changes to
Place –Joint health services in the Brighton and central Sussex area. (The committee comprised three
health overview members each from the HOSCs of East Sussex, West Sussex and Brighton and Hove. The three
and scrutiny East Sussex HOSC members are Councillor Philip Howson, Councillor David Rogers and Mr
committee with Ralph Chapman).
August 2006: The Joint Committee will reconvene to consider progress with implementation. The
Joint Committee will consider:
and Hove City • recruitment of Advanced Neonatal Nurse Practitioners (ANNPs)
Council (March • the current status of the business case for neurology and neurosciences, to ensure that all
2005) the options (including building the new department on the Hurstwood Park site) are
properly considered before a final decision is taken
• any proposals for alternative uses for the Brighton General Hospital site
• investment, financial and transport issues
• any proposals affecting routine surgery, by individual speciality
• any proposals to develop services outside hospital via primary and community services.
17 March and 23 June 2006: HOSC expressed concerns about the short term and long term
Work item Issues Action
future of Newhaven Rehabilitation Centre.
28 September 2006 – the reconvened Committee are investigating:
• A&E waiting times and on ambulance journey times, service modelling and protocols.
• Staffing numbers and any recruitment gaps in children’s inpatient medical services at Royal
Alexandra Children’s Hospital in Brighton.
• The draft business case for the re-provision of the Hurstwood Park Neuroscience Unit at 30 November 2006 –
Princess Royal Hospital. The unit will not be progressed further until ‘Fit for the Future’ HOSC to be updated on
consultation has been issued. The delay is not having an impact on service. review progress from
• Update on transition to community and intermediate provision. Joint Board members.
• Addressing transport provision. Some progress noted but more needs to be made.
• Audiology waiting times January 2007 – Joint
Committee to consider
• The committee has concerns on the future sustainability of two-site provision of maternity reports on outstanding
services. It also has concerns on the effectiveness of Brighton and Sussex University issues.
Hospitals NHS Trust communications.
8 Review of HOSC (17 March 06) endorsed the scrutiny review recommendation that the Transforming
services to Chronic Care Programme (TCCP) public forum should facilitate wider coverage in East Sussex.
people with long The scrutiny review will continue to meet to maintain a watching brief on:
• Information sharing and patient pathways for people with long term conditions
• related health inequality issues.
HOSC: feedback on
September 2006 – HOSC continues to monitor the programme’s progress. progress in March 2007
9 Patient and HOSC members “buddy” with individual PPIFs and maintain a relationship by attending some of HOSC: all meetings from
Public the PPIF public meetings and then reporting activity between HOSC and PPIFs. June 2005
July 2006: Department of Health published A Stronger Local Voice for information and comment.
The proposals include:
A stronger local
• The abolition of PPIFs and the Commission for Patient and Public Involvement in Health.
Work item Issues Action
consultation • Local Involvement Networks (LINks) to be established by every local authority (supported
with additional funding) with social services responsibilities; LINks will “build on the work
of PPIFs by creating a strengthened system of user involvement and will promote public
accountability in health and social care through open and transparent communication with
commissioners and providers”
• LINks to have special relationship with HOSCs and the power to refer matters to them
• HOSCs in future to be encouraged to focus on the commissioning of services.
September 2006: PPIFs in East Sussex reconfiguring to match new PCT structure. One PPIF per
PCT but each with possibly several working groups mirroring current arrangements. HOSC will
decide how to continue its relationship with the PPIFs for the next year – in effect whether to
continue to ‘buddy’ with each PPIF and/or its working groups.
22 September 2006: HOSC noted that Department of Health intends to replace PPI Forums with
local involvement networks (LINKs). HOSC criticised proposals which would see public and HOSC: 30 November
patient representatives lose their right to inspect hospitals and other NHS institutions. However, 2006 – update on
HOSC welcomes proposals to enhance the scope of HOSCs under the new arrangements. response to HOSC’s
Press release issued. HOSC also relays its views to SHA and Department of Health. lobbying.
10 Review of HOSC to comment on each of the East Sussex PCTs, East Sussex Hospitals NHS Trust, Sussex
Healthcare Partnership Trust, South East Coast Ambulance Service NHS Trust and Brighton & Sussex
Commission University Hospitals NHS Trust.
The April 06 regional HOSC Chairmen’s meeting suggested that HOSCs identify their own “core
standards” against which they would request health trusts to report on. East Sussex HOSC will
each local NHS
therefore summarise its key findings and perceptions gathered over the year to form the basis of
its submission for each health trust. This process will also have a practical benefit of helping to
identify priorities for HOSC in 2007/08.
12 October 2006: Healthcare Commission 2005/2006 assessment and ratings for the NHS in HOSC: January and
East Sussex published. Detailed information: www.healthcarecommission.org.uk March 2007
11 Choose and 1 December 2005: HOSC agreed to maintain a watching brief on ‘Choose and Book’ to address HOSC: 22 September
Book particular concerns that appear to be hindering full and effective implementation. 2006 – Terri Agnew,
Choose and Book Co-
August 2006: Preliminary indication – performance data for East Sussex has been particularly
Work item Issues Action
hard to get. Nationally the number of referrals via Choose and Book is increasing and averages at ordinator update HOSC.
21%. The South East Coast SHA is achieving 11%. East Sussex is scoring approximately 5%
against a planned 35%. Within Surrey and Sussex, East Sussex is currently the worst performing
22 September 2006: HOSC critical of ‘disappointing’ roll out across the county. Terri Agnew,
Choose and Book Co-ordinator, admitted that take up had been particularly slow. She blamed HOSC 30 November
lack of progress partly on technical problems and on the fact that important data had yet to be 2006 –Terri Agnew will
uploaded to the system by the acute trust. HOSC requested the financial implications for the slow update HOSC on
take-up to be assessed. progress
12 PCT / SHA / HOSC commented on proposals in March 2006 as part of the consultation on reconfiguration of
Ambulance health services in East Sussex.
Announcement 16 May 2006: two primary care trusts (PCT’s) in East Sussex: East Sussex
Downs and Weald PCT and Hastings and Rother PCT from 1 October 2006.
The three ambulance trusts covering Kent, Surrey and Sussex will be merged to form the South
East Coast Ambulance Service NHS Trust from 1 July 2006.
The South East Coast Strategic Health Authority (SHA) established on 1 July 2006 to replace the
current SHAs for Surrey and Sussex and Kent and Medway.
13 Delayed 3 March 2006: Special HOSC noted that East Sussex has worst performance on DTCs for the
transfers of care three years to March 2006. HOSC questioned Kim Hodgson (Chief Executive of East Sussex
(DTCs) Hospitals NHS Trust) on actions being taken by the trust to alleviate the problem. Recognising
the multi-agency nature of the problem, HOSC will take evidence from PCTs and Adult Social
Care later in 2006.
22 September 2006: HOSC noted consistently improving performance by Adult Social Care over
the last year, but a worsening position for other reasons for delayed transfers of care. DTCs show
a sustained improvement in East Sussex but HOSC is still concerned at the comparatively high
level of cases. In the last 4 months, DTCs in East Sussex Hospitals NHS Trust have reduced
from an average of 78 to 55 per week. There has been a significant decrease in Social Services
DTCs in the last 6 months. Throughout the same period, ‘non-Social Services’ delays do not
appear to have shown any consistent reduction.
The emphasis is on preventative services and reducing the number of people admitted to
Work item Issues Action
East Sussex County Council paid almost £1.4 million in fines in 2005/06 to East Sussex Hospitals
Trust for DTCs.
Further updates as
HOSC is keeping a watching brief on progress. It does not believe the DTC position is required
Item Issue Completed
1 Framework for Worked in partnership with local NHS trusts and established a local definition of Completed December 2004.
substantial variation substantial variation and produced a consultation guide. (HOSC to review in December
2 Hospital discharge Fact finding exercise on current actions being taken to improve hospital discharge Completed December 2004.
arrangements in East arrangements completed.
3 Alcohol, tobacco and Examining East Sussex Primary Care Trusts’ “misuse” policies and effectiveness; Completed September 2004.
substance misuse review scrutiny of a sample of agencies.
4 Patients’ choice review Examined GP appointment systems; access targets; out of hours services in East Completed March 2004
Sussex. First phase completed.
5 Scrutiny of East Sussex Examination of the effectiveness of the local delivery plan in addressing the health June 2005.
NHS local delivery plan needs of the people of East Sussex and the robustness of the financial recovery
and financial recovery plan and ability to meet the financial resourcing of the delivery plan. Also, the
plan review examined the ability of the financial plan to achieve recovery from the
Initial report completed in March 2005.
6 PCT / SHA / Ambulance HOSC commented on proposals in March 2006 as part of the consultation on 17 Mar 06: HOSC submitted
Trust reconfiguration reconfiguration of health services in East Sussex. Announcement 16 May 2006: comments to SHA on
two primary care trusts (PCT’s) in East Sussex: East Sussex Downs and Weald consultation documents.
PCT and Hastings and Rother PCT; established 1 October 2006. A team, headed
by Debbie Bamford, will manage the transition. The two PCTs will have one Chief
Executive and one integrated management team but each PCT will have its own
professional executive arrangements including Chair and Board.
The three ambulance trusts covering Kent, Surrey and Sussex will be merged to
form the South East Coast Ambulance Service NHS Trust; established 1 July
Item Issue Completed
The South East Coast Strategic Health Authority (SHA) will be established on 1
July 2006 and the current SHAs for Surrey and Sussex and Kent and Medway will
7 Sustainability in health A best value review of sustainable communities by East Sussex County Council Issues of sustainability to be
service provision requested that HOSC investigate issues of sustainability, particularly around the addressed specifically as part
provision of accident and emergency, GP and dental services, in the context of an of all HOSC investigations.
ageing population in East Sussex, as part of its future programme. The review
identified issues around accessibility in terms of: transport links and rural isolation.
8 Designed for Health – Consultation from 27 February until 22 May 2006 on: March – May 2006. Lead
consultation on primary HOSC members are Cllrs
• Creating primary care facilities in Hastings and St Leonards to offer a wider
care centres by Hastings John Wilson and Eve Martin
range of accessible services
and St Leonards PCT. with Rosemary Iddenden.
• Develop three purpose built centres
• Create facilities for specialist staff, GPs, nurses and therapists.
15 South West Kent Response to Priority 2 completed – Children and Women’s services. Trauma & Completed March 2005.
Health Community Orthopaedics. Joint review with Kent HOSC.
June 2005: Report on final
Consultation on Priority 3: changes to trauma and orthopaedic services draft.
commenced in October 2004. Joint review with Kent HOSC. (Cllrs Tony Slack and
Diane Phillips represented ESCC HOSC on the joint committee) with Cllr Michael
Bigg (Hastings Borough Council). 20 July 2006: Kent HOSC.
Kent HOSC: Review of joint work on Women and Children’s Services and Trauma
and Orthopaedics. Cllr Diane Phillips represented East Sussex HOSC.
Paul Dean, Scrutiny Lead Officer
Tel: 01273 481327 E-mail: firstname.lastname@example.org
Sam White, Scrutiny Support Officer
Tel: 01273 481581 E-mail: email@example.com
East Sussex Health Overview and Scrutiny Committee, County Hall, East Sussex BN7 1SW
Tel: 01273 481581 Fax: 01273 481485
East Sussex HOSC website: www.eastsussexhealth.org
NHS South East Coast website: www.southeastcoast.nhs.uk
Department of Health website: www.dh.gov.uk