Better wellbeing and health for all
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Health is a complex area for scrutiny. Therefore, overseeing and scrutinising everything undertaken by local NHS organisations is not realistic within the resources available. Therefore, the HOSC defined its programme of work in three ways:

  1. - work that the HOSC must do - this is responding to 'substantial variations or development' of local NHS services and referring, when necessary, contested proposals to the Secretary of State;
  2. - selected reviews of NHS services which can directly influence or improve service delivery;
  3. - managing referrals from East Sussex Local Involvement Network (LINk) and other partners.

HOSC agenda topics coming up - click here

Progress review of current HOSC work- click here

Summary of HOSC completed projects - click here

Work plans for 2009 include:

Maternity services in East Sussex - HOSC continues to monitor the implementation of the maternity strategy which is to maintain two consultant led maternity units in Eastbourne DGH and Conquest Hospital at Hastings. (For history on Fit for the Future in East Sussex click here )

Nutrition, hydration and feeding in hospitals scrutiny review - underway. Click here

NHS dentistry in East Sussex - HOSC continues to monitor developments.

Mental Capacity Act - Power of Attorney - a review on how much support is available to people who wish to make arrangements for someone to take over their own decisions in the event they lose mental capacity. Report was published in July 2009. Click here. HOSC is monitoring response to the review's recommendations.

Stroke care scrutiny review - review report published March 2009 click here. HOSC is monitoring progress on the review's recommendations.

Joint HOSC with Brighton and Hove City Council, East Sussex CC, Hampshire CC, Portsmouth City Council, Surrey CC and West Sussex CC on NHS West Sussex Fit for the Future proposals has been wound-up. This follows the PCT's decision to abandon its plans to centralise three major services: inpatient paediatrics, consultant-led inpatient maternity services and emergency surgery. The Joint HOSC had been formed to scrutinise these plans. The committee referred the original proposals to the Secretary of State for Health and, as the bases for this referral no longer apply, the referral has been with drawn.

Joint HOSC website - click here

Work approach

Regular quarterly meetings of the full HOSC - receiving amongst other matters, presentations on local health services - are supplemented by:

  1. - project boards undertaking reviews;
  2. - special board meetings responding to major changes in health services;
  3. - members attending NHS trust and primary care trust consultation meetings on service changes.

Clear links for information-sharing have been established with the chief executives of the primary care trusts and NHS trusts. These links enhanced the developing working relationships.


Treatment and services for people living with long term conditions

5% of NHS patients have long term conditions e.g. diabetes, heart failure, respiratory disease, dementia, stroke and utilise some 42% of NHS resources. HOSC recognised that there is scope to apply care management principles and support for self care to this group of patients.

HOSC reviewed the treatment and services for people who live with a long term condition. It found that the Transforming Chronic Care Programme being undertaken by all 15 PCTs across Surrey and Sussex is comprehensive and is designed to improve care and reduce dependence on NHS resources.

To download the review report click here (96k pdf file) March 2006

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Carers review

The review investigated the following areas:

  1. - the effectiveness and extent of carers' assessment;
  2. - hospital discharge issues around carers and the people they care for;
  3. - GPs' recognition of carers

To download the review report click here (137k pdf file) April 2005


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Health Local Delivery Plan review

HOSC wanted the speed of change and modernisation in health services to accelerate. The changes, outlined in the East Sussex 2003/2004 Health Local Delivery Plan, will see a shift away from hospital based care to providing health services in the community. Although HOSC is happy to support this strategy, it believes that investment in community health services should be speed up. It also wanted the commitment by health partners in achieving the plan to be realised.

The review of the plan found it had unclear targets and had little accountability or a clear timescale. HOSC concluded that the plan was over ambitious and that health partners needed to ensure that the plan's services could be financed.

As a result of its findings, HOSC called for more rigorous monitoring and greater emphasis on achieving investment in community health services in the 2005/2008 Local Delivery Plan. HOSC also wanted the plans better explained to the public and more evidence of partnership working between all health and social care delivery services.

To download the review, click here (100k PDF file) Paper copies available from Sam White on 01273 481581 or by writing to him at HOSC, C6F County Hall, Lewes BN7 1SW

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Substance misuse

Alcohol and substance misuse is one of the key health concerns in East Sussex. The review examined the effectiveness of strategies and policies in place around the county to combat alcohol, tobacco, drugs and substance misuse. It found that there are some very good strategies in place across the county and good partnership working arrangements to tackle substance misuse. However, it is critical of the lack of action being taken on:

  1. - smoking in public places;
  2. - licensees ensuring they apply their duty of care;
  3. - providing support to children whose parent/s need to access treatment services;
  4. - the need to make government funding of schemes long term rather than short term;
  5. - improving funding to reduce alcohol and substance misuse.

HOSC lobbied the relevant authorities and organisations to highlight the positive benefits of tackling these issues and make them a priority.

To download the report click here (pdf file) October 2004

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Patients' choice

The scope of this review was to:

  1. - identify the extent to which patientsŐ choices are taken into account in their health care provision;
  2. - examine whether the first place a person goes to with a health problem is easily accessible;
  3. - examine whether there is integration of services with private and voluntary sector provision.

The preliminary report of initial findings into this complex area of primary care found a mixed picture in which the following areas were being tackled by primary care trusts, but needed sustained action:

  1. - carers and their relatives being registered at the same general practitioner (GP);
  2. - more pro-active opportunities for health promotion by GPs;
  3. - careful monitoring of the 'Out of Hours' service to ensure patients receive a good service;
  4. - extension of patient transport into primary care;
  5. - appointment systems;
  6. - improvements to community pharmacy services and a review of the repeat prescription process;
  7. - compliance with the Disabilities Discrimination Act;
  8. - improved consultation with local authorities with regard to health needs in new housing areas.

Aspects of this review were followed through by the HOSC in partnership with the Patients and Public Involvement Forums which carried out a survey of GP practices.

To download the report click here (pdf file) October 2004

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Closure of All Saints Hospital, Eastbourne and monitoring of re-provisioning plans

When HOSC discovered, by chance, in January 2004 that action had been taken to stop admissions to All Saints Hospital and that it was to close on 31 March 2004, it undertook further investigations. These revealed that there was public concern, and some confusion, around the issue of whether or not formal public consultation had taken place. HOSC decided at its January 2004 meeting to hold the Eastbourne Downs Primary Care Trust and the East Sussex Hospitals NHS Trust to account for their non-compliance with the statutory requirement to consult health overview and scrutiny about proposed changes to services and their re-provisioning. In part, these services had previously been provided from All Saints Hospital.

At the HOSC meeting, which was held in public on 4 February 2004, the Chief Executive of Eastbourne Downs Primary Care Trust and the Chief Executive of East Sussex Hospitals NHS Trust apologised for not consulting the committee on the closure of All Saints.

HOSC gave a cautious welcome to the way in which the re-provisioning plans for the closure of All Saints Hospital had been implemented. In its final report, the HOSC described the closure as being managed 'with sensitivity and thoroughness'. However, the report also stressed that a lot of work is still to be done to ensure that patients receive a high quality of care.

HOSC were involved in the re-provisioning plans following the closure of All Saints Hospital and expressed concerns about the sustainability and capacity of the services put in place.

The events relating to All Saints Hospital demonstrated how the committee can help ensure that residents - and the quality of available services - remain everybody's top priority.

To download the final report click here (47k pdf file) June 2004

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Relationship with Local Involvement Network (LINk)

East Sussex Local Involvement Network (LINk) was established in April 2008 and replaced the Patient and Public Involvement Forums (PPI Forums). Organisational support is provided by East Sussex Sussex Disability Association (ESDA). The LINk's operation is based on a core group and a number of issue focussed and task orientated sub-groups, with various ways for LINk participants get involved.

Janet Colvert, Chair LINk Core Group is the LINk repesentative on HOSC.

The LINk has the right to refer matters to the HOSC and a protocol has been agreed.

For further information on LINk - click here

HOSC worked on a number of projects with the Patient and Public Involvement Forums.

Projects with PPI Forums

Eastbourne Downs Primary Care Trust PPI Forum and East Sussex Hospitals NHS Trust PPI Forum supported HOSC's monitoring of the All Saints re-provisioning plans. Members of the PPI Forums visited and reported on arrangements for patients at Hailsham 2, Eastbourne District General Hospital and Firwood House.

East Sussex County Healthcare PPI Forum worked with HOSC on the Carers' Review and produced a complementary report 'Day for Carers' which was distributed with the HOSC report.

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Substantial Variation

The NHS has a duty to carry out public consultation when there are any 'substantial variations or developments' to services they provide. One element of any public consultation requires matters to be discussed with HOSC. During this first year, HOSC and local NHS organisations engaged in discussions about the definition of 'substantial variation'. HOSC took into account a number of key factors in matters of service changes in the NHS. These are:

  1. - evidence that the NHS organisations considered the views and interests of the public and key stakeholders and responded appropriately;
  2. - how much service users, the public and other key stakeholders contributed to the planning and delivery of the service in question. Where appropriate, particular regard will be given to the involvement of 'hard to reach groups';
  3. - that changes to services are based on best practice and there is sound evidence of service improvement for patients;
  4. - impact of the proposal on other services and on the wider community. This may include consideration of issues such as economic impact, transport issues and regeneration.

Whilst it is for HOSC to determine how it wishes to respond to formal consultation, weight is given to the way the NHS organisation discharged its statutory duty to involve and consult all key stakeholders under Section 11 of the Health and Social Care Act.

HOSC agreed a protocol with local NHS organisations. The protocol sets down a model for addressing consultation with the HOSC around 'substantial variations and developments' to services.

To download the report click here (260k pdf file) October 2004

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Reference group

HOSC established an innovative reference group made up of people who have worked in the NHS or associated services and who have recent and relevant experience, but do not have a conflict of interest. Operating as a 'virtual' group, members are called upon to give advice, information and specialist expertise on particular areas of health and health matters that may be put before the committee.

If you are interested in joining the HOSC Reference Group please contact Claire Lee on telephone 01273 481327 or email:

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Joint HOSC working

East Sussex HOSC is working with neighbouring authorities on a number of joint projects involving changes to health services.

HOSC is also part of the South East Regional Group which was established in 2005. The Group shares good practice and supports health scrutiny. The HOSC Chairmen meet on a regular basis.

Fit for the Future

Joint HOSC on West Sussex and Brighton & Hove PCTs' health plans under the Fit for the Future banner - click here

Best Care, Best Place (superceded by Fit for the Future)

Proposed service changes at the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital in Haywards Heath would affect residents over a wide area including the western half of East Sussex. These changes - under the banner Best Care, Best Place - prompted the organisation of a committee of HOSC representatives from the East Sussex, Brighton & Hove and West Sussex HOSCs to develop a joint response.

Response of Joint Committee on NHS consultation on Best Care, Best Place - click here (41k pdf file) March 2005

A number of allegations were made about the constitution. protocal and conduct of the Joint Committee and its review of the Best Care, Best Place consultation proposals following the publication of the report. Click here for the March 2006 press statement issued in response to these allegations which the committee refutes.

Future of services for women and children in the South of West Kent

During 2004 and 2005, East Sussex HOSC worked with Kent County Council's HOSC on developing a joint response to health service changes proposed for the South of West Kent.

Reports available to download:

The future of services for women and children in the South of West Kent - executive summary click here (238k pdf file) - full report click here (417k pdf file) December 2004

The future of local orthopaedic services in the South of West Kent - executive summary click here (334k PDF pdf file) - full report click here (483k pdf file) April 2005


Briefs and responses

HOSC responds to consultation on configuration of Primary Care Trusts, Strategic Health Authority, Ambulance Trust - 21 March 2006

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