Overview of Health Changes
in East Sussex
New Health Structures – National Picture
Trust
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Commissioning
CQC
NHS
Commissioning
Board
4 Regions
27 Area
Teams
2014 foundation trusts
23
Commissioning
Support Groups
(to 2016)
GPs, dentists, 212 Clinical
Commissioning
specialist
Groups
services
Public Health
Public
Health
England
Service Users
Health
Watch
England
4 Regions
15 Centres – 8 Knowledge &
(inc. Health Intelligence
Protection
Teams
Upper Tier
Councils
Health and Wellbeing Board
Local Health
Watch
New Health Structures – Local Picture
Trust
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Commissioning
CQC
NHS
Commissioning
Board
South Region
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Service Users
Public
Health
England
Health
Watch
England
South Region
Surrey and
Sussex Area
Team
Trusts including:
•Brighton & Sussex
University Hospitals Trust
•East Sussex Hospitals
•Sussex Partnership Trust
•Maidstone and Tunbridge
Wells
Public Health
Surrey, Sussex
and Kent Centre
CCGs
•High Weald,
Lewes and Havens
•Eastbourne ,
Hailsham &
Seaford
•Hastings & Rother
East Sussex
County Council
Healthwatch
East Sussex
East Sussex Health and Wellbeing Board
Clinical Commissioning
Groups (CCGs)
Health and Wellbeing Board
Members
• 4 members of the County Council
• Director of Public Health
• Director of Adult Social Care
• Director of Children Services
• A representative from each of the three CCGs
• Healthwatch
Observers
• A Member from each of the five Borough and District Councils
• Chief Executive of ESCC
• East Sussex Healthcare NHS Trust
• Partnership NHS Foundation Trust
• SpeakUp
• Sussex Police and Crime Commissioner
• Surrey and Sussex Area Team of the NHS Commissioning Board
Health and Wellbeing Board
Terms of Reference
• To provide strategic influence over commissioning decisions across health,
public health and social care.
• To strengthen democratic legitimacy by involving democratically elected
representatives and patient representatives in commissioning decisions
alongside commissioners across health and social care and provide a forum
for challenge, discussion, and the involvement of local people,
• To bring together clinical commissioning groups and the council to develop
a shared understanding of the health and wellbeing needs of the
community.
• To drive local commissioning of health care, social care and public health
and create a more effective and responsive local health and care system.
Health and Wellbeing Board
Key Tasks
• East Sussex Joint Strategic Needs Assessment;
• Health and Wellbeing Strategy; and
• To provide an annual report to the Full Council on the
work and achievements of the Board.
Healthwatch
The Health and Social Care Act says…
• Provide information and advice
• Promote and support the involvement of people in the monitoring,
commissioning and provision of local care services
• Obtain the views of people about their needs for and experience of
local care services
• Provide access to independent NHS complaints advocacy
• Make reports and recommendations on how services could be
improved
• Make recommendations to Healthwatch England and advise CQC
on areas of concern.
Healthwatch East Sussex
East Sussex Community
Voice Board
Chair and Non
Executives
Executive Director
Advisory
Group
Healthwatch
East Sussex
Staff
Healthwatch
East Sussex
Delivery
Organisations
Volunteer Roles – e.g.
Information Advisers,
Enter and View Teams
What Healthwatch will do?
Supporting
Individuals
Information
&
Signposting
Influencing
Service
Providers &
Commissioners
Local
Healthwatch
Intelligence
& Evidence
Engagement
& Outreach
Engaging with
Communities
Public Health in East Sussex
Cynthia Lyons
Public Health Transferring to Local
Authorities
The Health and Social Care Act 2012 includes
the transfer of responsibilities for Public Health
from NHS Primary Care Trusts to Local
Authorities from 1 April 2013.
In transferring to local government, the NHS
public health team will be bringing with them
specialist knowledge and a set of specialist
skills that include analysis and interpretation of
population data and the local factors that
impact on health.
What is Public Health?
The science and art of promoting and protecting
health and well-being, preventing ill-health and
prolonging life through the organised efforts of
society”
Public Health is concerned with the overall health
and well being of populations and communities. It
involves identifying health risks and developing
plans and programmes to improve and protect the
health of populations as a whole.
Three Key Domains of Public
Health Practice
Health Protection
Improving
Services
Health
Improvement
Local Authority Public Health
Functions and Responsibilities
Mandated Services:
 Sexual health services
 Health protection
 Public health advice service to Clinical
Commissioning Groups
 NHS Health Check Programme
 National Childhood Measurement
Programme
Public Health in the Local Authority
Leadership
and Influence
Mandatory
Support to GP
Commissioners
Portfolio of Public
Health Services
Public Health
in the
LA
Adding Value
Across LA/s
Health Protection
&
Emergencies
Ring-Fenced Public Health Grant
Published on the 10 Jan 2013 by the
Department of Health.
Ring fenced grant for 2 years set, £23.8m for
2013/14 and £24.5m for 2014/15.
The Council had been planning for a worse case
scenario using a figure of £20m (which was
based on the returns made from the 10/11 and
11/12 audited spend, and 12/13 forecast).
Action Taken
• Portfolio Plan agreed through County Council.
• Smooth and safe transition of both public health staff
and commissioned services.
• 3 year comprehensive service review agreed for all
public health areas to maximise best value and
health outcomes and to reflect priorities in the
Council Plan and the Health and Wellbeing Strategy.
• Contingency reserves in place for pandemic
influenza and costs incurred as part of the service
review.
Clinical Commissioning
Groups
Keith Hinkley
CCGs in East Sussex
• Eastbourne, Hailsham and Seaford CCG –
• 22 practices
• 180,000 patients
• estimated budget £231m 2013/13, QIPP c.16m
• Hastings and Rother CCG –
• 32 practices
• 184,000 patients
• estimated 2013/14 budget £258m, QIPP c. £8m
• High Weald Lewes Havens CCG –
• 22 practices
• 164,000 patients
• estimated 2013/14 £202m, QIPP c. £10m
N.B. CCGs have smaller budgets than PCTs because of different
responsibilities
Priorities - Linked to Evidence of need
Health & Wellbeing Strategy
Hastings and Rother
High Weald Lewes Havens
Eastbourne, Hailsham &
Seaford
•The best possible start for all
babies and young children
•Safe, resilient and secure
parenting for all children and
young people
•The best possible start for
babies and young children
•Preventing and reducing falls, •Accidents and falls
accidents and injuries
•Preventing and reducing falls,
accidents and injuries
•Accidents and falls
•Supporting those with special
educational needs, disabilities
and long term conditions
•Long term conditions
•Supporting those with Special
Educational needs and
disabilities
•Chronic diseases
Admission avoidance
Non-elective admission
avoidance
Intermediate care
Enabling people to manage
and maintain their mental
health and wellbeing
High quality and choice of
end of life care.
•Chronic diseases
•Cancer
Mental health
Mental Health with a focus on
A&E admissions and Dementia
Older people
Older people with a focus on
end of life care
End of life care
Enabling people of all ages to Healthy lifestyles
live healthy lives and have
healthy lifestyles;
Providing High quality and
choice of end of life care
Enabling people to manage
and maintain their health and
well being
Reducing the harm caused by
alcohol and tobacco
Planned care
Delivering priorities
• Each priority area will have a communication and engagement
plan
• Lay member for PPI on each CCG board
• CCG participation in regular community networks and forums
• Regular two-way communication with GP practice Patient
Participation Groups
• Series of focus groups and workshops commissioned through
local Councils for Voluntary Services to engage Voluntary and
Community Sector organisations
• Twice yearly stakeholder workshops
Working with the CCGs
• Delivery of whole systems clinical and
financial sustainability
• Whole population needs commissioning
• Managing acute pressures
• Delivery of transformation
• Partnership working and sharing
management capacity