Keeping in the loop

Stakeholders update

The NHS in East Sussex needs to make sure it is providing the best and most appropriate care, and the best value for money to ensure health services will be viable in the long-term. The key challenges facing the local NHS are:

An increasing and ageing population

Health inequalities

A rising incidence of long-term ill-health

An underlying financial deficit

A slowdown of funding from 2008

Poorly developed community services

Reducing waiting times to 18 weeks

Partnership working

Workforce.

Discussion Phase - Introduction

As part of the process of planning health care, a discussion document was published in May entitled creating an NHS fit for the future. It explains why change is needed and describes the potential benefits for patients if some services were organised and delivered differently.

The document has been widely distributed to stakeholders in East Sussex, including NHS staff, primary health care teams, patient and public involvement forums, statutory and voluntary organisations.

Meetings are being held with a wide range of partners, and over 400 invitations were sent out for three recent stakeholder events at Eastbourne (14 June), Cooden Beach and Uckfield (both 21 June).

These facilitated events followed the same programme - an introduction and overview of the issues, including the challenges faced by the NHS in East Sussex, and work groups to discuss how to:

improve access to services

make the best use of staff skills

make the most of new technology

get better value for money.

A second workshop session covered:

health promotion and illness prevention

urgent and emergency care

planned care

continuing and longterm care.

Comments and questions at the three events were recorded and are being considered as part of the next phase of the programme to develop proposals.

Key issues discussed at the stakeholder events

Improve access to services

There is wide support for more and better services closer to people's homes. These include services in primary care and health centres/clinics, for minor surgery, minor injuries, support for people with long-term conditions and rehabilitation.

However, it is recognised that services close ton and in people's homes will need considerable investment in staff, training, information technology, facilities and premises.

Uckfield Event "Services must be linked to good transport and parking. Local transport difficulties even to GP surgery. Need more transport schemes. Need to consider access to pharmacists/medicines, including home deliveries."

Make the best use of staff skills

There was concern that some health care staff areas are not provided with sufficient information to enable them to sign-post patients to more appropriate services. This included GPs, where lack of knowledge on local services can mean a patient is missing out. It is important, therefore, that accurate and timely information is shared appropriately to enable patients to gain full benefit from local services.

There is a general interest in what type of services could be provided in GPs' surgeries and in local health centres rather than in the hospital.

Eastbourne Event: "GPs not aware enough of carers support, and other services."

Make the most of new technology There is a view computer systems could be used to help people by:

Providing electronic information systems

Providing support in people's homes

Providing remote access to patient information, saving a patient time and money by not having to travel distances for consultations.

There is a belief integrating technology systems could save money.

Cooden Event: "We do need to change, otherwise we never improve."

Get better value for money

Integration was generally considered a good way of getting value for money, by working in partnership, sharing budgets and resources with a single assessment process and good discharge processes with links to social care.

Eastbourne Event: "Money saved on acute care should be transferred to community care."

Health promotion and illness prevention There is wide-spread recognition and support for a greater focus on health prevention and promotion. Work targeting children and young people is considered a priority. However, it is also recognised that there needs to be a major cultural shift from a 'sickness service' to a 'health service'. Investment in promotion and prevention in terms of improved health and savings may not be realised for many years.

Uckfield Event: "Health promotion and prevention when younger, delivered by appropriate health professionals to save NHS money later in life - healthy lifestyles."

Urgent and emergency care

There was agreement that there needs to be more appropriate use of emergency departments and that other services, such as GP out-of-hours, paramedics, minor injuries units could be used for cases that are not 'emergencies'.

Eastbourne Event: "Urgent/emergency care needs to be better defined."

Planned care

The choice, time and location of treatment highlights the need for more community based services, without cancellations.

Cooden Event: "Community matrons good - but also other support for less high risk patients are needed."

Continuing and longterm care

There is a consensus that there should be clarity and transparency about the criteria for continuing and social care with a quicker process and faster decisions. There is also consensus for more support and services to keep people as independent as possible for as long as possible. But there is also a need to listen to what users/families and carers want and act upon it.

Cooden Event: "Age is not an illness but older people may need support."

Key local issues/concerns

There were different key issues at the three events, as follows:

Eastbourne Downs

'Save the DGH' Campaign - there is considerable local concern about East Sussex Hospitals NHS Trust's review of maternity and paediatric services alongside leaked information about possible options for A&E, and possible options for hospital specialisation as in the 'fit for the future' discussion document, coupled with financial challenges of the local NHS.

Recent closure of All Saints Hospital and previous closures has given a public perception that there are insufficient services/support available in the community.

The needs of older residents and their carers need to be considered; including fair funding for these services, rehabilitation, intermediate care, and respite care. However, there is also a seasonal impact of visitors, numbers of students and the development of new homes.

There is a lack of services in Seaford.

Rother and Hastings

'Save the Conquest' Campaign - with similar concerns to those shared in Eastbourne.

Concern why PCTs in the east of East Sussex, who are financially balanced, are having to 'bail out' other local PCTs with overspends.

Acknowledgement that there is deprivation/health inequalities in Hastings.

There are a high number of older people in Rother leading to implications for access (including hearing tests), medicines, intermediate care and respite care and end of life care.

There is low car ownership especially among older people, and in Hastings.

Poor road links, poor public transport.

Sussex Downs and Weald

There are no acute hospitals in the Sussex Downs and Weald area. Patients are referred to Eastbourne, Princess Royal Hospital, Royal Sussex County and Kent and Sussex hospitals, depending where they live.

There are Community hospitals in Crowborough, Uckfield and Lewes, which provide a range of outpatient services, including minor injuries, and in-patient services. These hospitals could develop to provide a more local service.

Different issues in rural, inland areas to those in the coastal towns.

Uckfield Event: "Clinical viability inevitably takes precedence over geographic location."

Continuing the debate

Debbie Bamford, Interim Chief Executive of Eastbourne Downs Primary Care Trust, is leading the discussion and development of proposals locally.

No decisions have been made.

If the discussion leads to proposals for significant change to the ways in which health care is provided, such proposals will be subject to full public consultation and there will be opportunities for people to give their views.

For further information about how you can be involved, copies of the discussion document or to request a speaker for a future meeting, contact Angela Paice:
tel. 01323 747710
email angela.paice@eastbournedownspct.nhs.uk

For more information please visit:

www.surreysussexfitforthefuture.nhs.uk

Please note: This newsletter was sent to Sussex Mad to circulate, Sussex Mad may or may not agree with the contents.