Agenda item - The Big Conversation - Caring Together in Brighton & Hove (our Sustainability & Transformation Partnership)

Sussex & East Surrey Sustainability & Transformation Partnership (STP): engagement and consultation. Tom Gurney, Associate Director of Communications, Brighton & Hove and High Weald Lewes Havens Clinical Commissioning Groups, will present.

334.1  This item was introduced by Thomas Gurney, Head of Communications, Brighton & Hove Clinical Commissioning Group (CCG) and High Weald Lewes Havens CCG. Mr Gurney gave a presentation on the development of the Sussex and East Surrey (SESA) Sustainability & Transformation Partnership (STP).

334.2  Mr Gurney told members that there was currently no overarching STP-wide plan. There are detailed locality plans (e.g. for Brighton & Hove Caring Together), and there is thematic planning across the footprint (e.g. for mental health and for urgent care), but there is no grand plan as such.

334.3  One of the aims of the STP is to ensure that there is consistent quality of care across the SESA area. However, there may still be inconsistency of care between SESA and other regions: STPs are not intended to introduce standardised care nationally.

334.4  The STP will also seek to make healthcare more patient-focused. In the past, NHS services have often been designed for the convenience of staff rather than patients.

334.5  The STP needs to address really significant quality issues. This is particularly so at Brighton & Sussex University Hospitals Trust (BSUH) which is in Special Measures for both quality and finances, and is consistently failing to hit targets for A&E waiting times, elective Referral to Treatment times (RTT) and cancer waits. East Sussex Healthcare Trust (ESHT), which runs general hospitals in Eastbourne and St Leonards is also in Special Measures. In addition, several local CCGs are struggling, with Horsham & Mid Sussex now under Legal Directions (the CCG equivalent of Special Measures). Brighton & Hove CCG was under Legal Directions, but has recently been up-rated to ‘good’.

334.6  The SESA area is facing increasing demand without the prospect of equivalent funding increases. The financial challenge is very significant, but this is not just about money. It is also about ensuring that the available resources are used as efficiently as possible, that pointless duplication is eliminated and that all local health and care organisations work together effectively.

334.7  STP communications were poorly handled in the early stages of the initiative. This was largely because there was actually very little to report in the early months, but much more should have been done to engage with the public. Now that more concrete ideas are emerging there is the real potential for valuable engagement and this is now being progressed. It should be noted that Brighton CCG is the only CCG in the SESA area that is engaging on the whole STP rather than just its local STP plans. This is in response to local public interest. In terms of formal consultation rather than engagement, there is to date nothing that requires consultation (e.g. no significant service changes have been identified).

334.8  In response to queries about privatisation, Mr Gurney explained that there has been a significant independent sector presence in the NHS for many years (e.g. GP practices, which are profit-making small businesses). NHS procurement laws also mean that it is impossible to rule out any contract being awarded to an independent sector provider. However, the SESA STP is not designed to increase privatisation of local health services. There are specific public worries about Accountable Care models, since these are often associated with the insurance-based American healthcare system. However, the NHS is so complex, and offers so little remuneration for providers, that it is really not an attractive proposition for private healthcare concerns. Similarly, although in theory Multi-Disciplinary Community Provider (MCP) contracts could be awarded to independent sector providers, the MCP initiative is not designed to increase private sector presence in the local health economy.

334.9  The Chair thanked Mr Gurney for attending the meeting.