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Programme

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.

For detailed work programme - click here

Work plans for 2008 include:

Maternity services changes - the Independent Reconfiguration Panel (IRP), after carrying out a review, has submitted its report to the Secretary of State. This follows on from HOSC's decision in January 2008 to refer the PCTs decision to single site maternity services to the Secretary of State. The minister is expected to announce his decision on the proposals in late September/early October 2008.

For latest on Fit for the Future click here

HOSC's report on the PCTs' proposals for maternity services were published October 2007. Click here for a copy.

The IRP intend to submit their report to the Secretary of State by 31st July 2008 and the minister is expected to announce his decision by October 2008.

Ongoing Joint HOSC with Brighton and Hove City Council, East Sussex CC, Hampshire CC, Portsmouth City Council, Surrey CC and West Sussex CC on West Sussex and Brighton & Hove City PCTs' Fit for the Future proposals. The PCT's proposals have been referred to the Secretary of State. Joint HOSC website - click here

Stroke care scrutiny review - this is now underway and is expected to be completed by March 2009.

NHS dentistry - HOSC continues to monitor developments.

 

 

Work programme

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.

Reviews

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. HOSC will monitor the programme's progress with particular regard to information sharing, patient pathways and health inequalities.

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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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.

The HOSC is now lobbying 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 are being followed through by the HOSC in partnership with the Patients and Public Involvement Forums which are carrying 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 the 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. The 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.

The 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.

The HOSC continues to be involved in the re-provisioning plans following the closure of All Saints Hospital and has recently 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. The HOSC remains committed to overseeing the re-provisioning plans and it continues to play a vital role in ensuring that first class services for older people are delivered across the whole region.

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 replaces the Patient and Public Involvement Forums (PPI Forums). Organisational support is provided by East Sussex Sussex Disability Association (ESDA). The LINk's operation will be based on a core group and a number of issue focussed and task orientated sub-groups, with various ways for LINk participants to get involved. The LINk has nominated an 'interim core group' to work with ESDA to develop the governance arrangements, policies and procedures necessary for the LINk to get up and running. Janet Colvert has been elected as Chair of this group. Janet 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 the 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 the HOSC. During this first year, the HOSC and local NHS organisations engaged in discussions about the definition of 'substantial variation'. Currently, the HOSC is seeking to take 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 the 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.

The HOSC has 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. This represents a major step forward in the working relationship between the HOSC and the NHS organisations locally.

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

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Reference group

The HOSC has 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: claire.lee@eastsussex.gov.uk

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Joint HOSC working

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

Best Care, Best Place

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

Go to West Sussex County Council website for latest information on the review - minutes of Review Board meetings etc. Link to West Sussex

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 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

The 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

The HOSC is also part of the South East Regional Group which was established earlier this year with the aim of sharing good practice and supporting health scrutiny. The HOSC Chairmen meet on a regular basis.

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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