NHS Sussex discusses its Integrated Care Strategy

Stephen Lightfoot addressed sixty members of the public online in the latest public engagement exercise to explain the vision behind the new integrated care strategy from NHS Sussex on Thursday 17 November. The strategy is a long-term, health and care five year plan which will build on existing health and wellbeing strategies in East and West Sussex and Brighton & Hove. Mr Lightfoot is the Chair for NHS Sussex, the Integrated Care Board (ICB) for Sussex covering hospitals, GPs, mental health services, pharmacists and dentists.

In putting the strategy together Mr Lightfoot and his team have taken advice from the Department of Health and other partners including the voluntary sector, social enterprises and the public.

The plan aims to improve the health of the population of Sussex (1.7 million) and reduce inequalities, particularly in access and outcomes. Difficulties with access can be due to geography or due to other demographics such as ethnicity and age.

Sussex Health and Care Assembly with a broad membership will oversee the development and approve the integrated care strategy on 14 December at a public meeting at the University of Brighton.

Mr Lightfoot said there is a growing need and demand for services due largely to a growing and ageing population. Research has shown that the population of Sussex has grown by six percent, however, those aged 65+ has grown by 19 percent while the population under 65 has only grown by three percent. There are 1.7 million people living in Sussex and there are wide geographical disparities. Twenty two percent of the population is over 65 years old.

In Mid Sussex people have a healthy life expectancy until they are 69 years old, in Hastings the age drops to 62. He said research has found the most deprived areas have the worst access to services. Mr Lightfoot said the population with the greatest needs should get the best services. At the moment the opposite is true across Sussex.

Our NHS system is large and complex, comprising 1100 different NHS organisations and locations including GPs, pharmacies and dentists, as well as hospitals. Mr Lightfoot said at the moment, care is disjointed, patients are referred to hospital by GPs which incurs delays.

He said we need to make better use of technology. For 95 percent of the population, technology will help but we do need to be mindful to avoid digital exclusion. NHS Sussex gets £3.6 billion. We need to make the best use of these resources. Every organisation has its own buildings and the NHS estate is ageing. Services should be close to the communities they serve.

Integrated care strategy public engagement has been carried out in 23 cities and towns across Sussex which each have a population of more than 10,000 people.

We agreed the case for change at a meeting in October.

“The Assembly has selected three system-wide priorities for the strategy:

… Development of Integrated Community Teams

… Development and support of our Workforce

… Maximising the use of Digital Technology and data”

Mr Lighfoot said: “Over the last many, many years the NHS has been an incredible organisation but it has been built around organisations. So services have been developed out of hospitals and GP practices almost regardless of where people live…We need to provide health and care services to each of our communities across Sussex and build services around where the population live, rather than where the hospital or GP surgery is based.” To do this, he said, the NHS must better understand need (or demand) for services and integrate services at a local level.

He said the strategy will encourage more local engagement, joined up services and more partnership working. Communities are not just about geography, children and young people are another community. There is a pressing need to address the mental health of the community of children and young people. Then there are cancer survivors and communities of people with different sexual preferences and different religions. He said: “We need to build care around people, not around existing organisations. That’s frankly our big ambition.”

NHS Sussex employs a workforce of 35,000 people and are the biggest single employer in Sussex. We always have vacancies. It’s not an accident that there are three university vice chancellors who sit on the board from Brighton University, Sussex University and Chichester. Rebecca Conroy represents FE colleges in Eastbourne, Hastings and Lewes.

Mr Lightfoot said we need to grow our workforce and retain existing NHS staff. We need to develop attractive career paths for graduates to work in Sussex instead of going to London, Kent or Hampshire. He said NHS Sussex needs to address the cost of living crisis head on. He said: “We can’t renegotiate salaries but we can think about everything else to make one Sussex workforce a reality.”

He said one of the three priorities of the strategy is to develop an integrated digital platform to share information. Mr Lightfoot said patients should share their experience once, not every time they meet a new professional which is not great for the patient experience. The NHS should provide services digitally.

Some people would prefer virtual online discussions, they would prefer telephone appointments and do online research on the internet about health issues. Doctors and nurses still need to see people. “Patients do want to book appointments online, not ring up in the morning, they do want to access blood test results and appointments on their phone instead of getting a letter a week later.”

Fifty percent of the population of Sussex has signed up to the NHS app which provides a better experience and greater access but that is not universal yet. I think we need to get every GP surgery on the NHS app. Mr Lightfoot would like ninety percent to use the NHS app. Digital technology will make us more efficient and give a better experience and provide more access to our services.

This is work in progress, the final strategy has not been fully drafted yet and has not been approved yet by the assembly until 14 December. He said: “What are we going to do about specifically the support and health of children and young people so they can start their lives well? There’s going to have to be services that support people to live well, particularly if they have complex conditions and multiple health issues.

“We’ve got to help people to age well, and I think part of that is to help people to stay healthy and to live independently for as long as they possibly can. So they can get care as close to home as possible rather than always having to go to a hospital for that. We need to address waiting lists so that people get the care they need when they need it in an area that they need it.”

On 14 December the strategy which is the vision will be approved at the assembly as above. From January to March 2023 the Delivery Plan will be developed – who is going to do what and when with what resources. Mr Lightfoot said the NHS Board will approve the delivery plan that sits under the strategy on 05 April next year.

Hove residents join MP for climate change meeting in Poet’s Corner

Hove MP Peter Kyle joined councillors and about 150 local people for a community meeting about practical responses to climate change on Thursday evening (10 November).

They met at Holy Cross church hall, in Poet’s Corner, for presentations about the “climate and nature emergency” and discussion aimed at answering the question: “What can we do in our community?”

The event was organised by a small team including researcher and content strategist Tamsin Bishton.

And several small businesses from the area were represented, including Timeless Toys, in Portland Road, and Harriet’s of Hove, in Blatchington Road.

Katie Eberstein, the Brighton and Hove environmental education officer at Sussex Wildlife Trust, said: “Give young people skills, knowledge and an attitude to tackle climate change.”

The former teacher, who runs the website Our City Our World, works with about half the schools in Brighton and Hove and added: “Adapt the curriculum to discuss climate change. Equip schools to make their structure carbon neutral.”

She said that being in nature inspired young people and said that young people and families should be empowered to take action both individually and collectively.

Katie works with half the schools in Brighton and Hove. She said 97 percent want climate education in schools. Being in nature inspires young people. Katie encouraged parents and pupils to talk to their schools and tell them what they want, tell them that sustainability matters.

Charlie Peverett from Birdsong Academy is a naturalist who has been identifying birds by their song for thirty years. During the pandemic, he founded ‘Up with the birds’ which is a dawn chorus shared on zoom. In Spring 2020 did the birds get louder? He said people had more time to notice what’s around them. He shares the sounds of live birdsong on zoom with the help of crowd funding.

He asked: “Why are birds so hard to find these days? It’s a moment of truth.” Birdsong academy and the dawn chorus are free. He also produces a weekly newsletter from January to June and he runs a ten week online course as well as walking workshops at Stanmer Park. He said: “Tune into what’s already here. It’s essential to the work that we need to do.”

Climate change


Councillor Elaine Hills is a Green Party member for Hanover and Elm Grove who sits on the Environment, Transport and Sustainability Committee. She said we have a target of being carbon neutral in Brighton and hove by 2030.

She said: “We have 200 electric charging points in Brighton and Hove, we reduce, repair and reuse, we recycle. We protect promote and prioritise. But we are facing a biodiversity emergency and extreme weather. We have a circular economy programme. As a city we will move away from wasteful ways of doing things. We have a food partnership project and foodbanks. As a council, we will make more sustainable choices.”

Paul Loman runs the ‘Real Junk Food Project’ that intercepts food before it is sent to landfill or incinerated to help tackle climate change. He said: “One third of food production goes to waste. Many people don’t have enough food. Food is sent to landfill which produces methane and is worse than carbon dioxide. Supermarkets waste food, they take it off the shelves and send it to incinerators or landfill.

“We rescue food and feed people. We have relationships with supermarkets and we go through the front door. We take the food to Bevendean, log it, and send it to pay as you feel cafes at St Luke’s in Hove and Fitzherbert’s in Kemptown. We take donations. One third of food is wasted, cook wisely, freeze, grow food, compost.”

Michael Kennard disrupts food waste and composts it. He said: “There is lots of food waste, tonnes of food in landfill, 600 kilos of carbon, if you compost it, you end up with 9 kilos. We have a market garden and run the Compost Club. Compost is a beautiful life cycle.”

Circular economy to help tackle climate change

Harriet Dean-Orange runs Harriet’s of Hove on Blatchington Road with her husband, Mhiran. The shop is free from single use plastics and provides refills of pasta, lentils and other dry foods. She used to be a nurse and found there was a great disparity between work and home. Customers bring in their own containers and buy by weight. You can buy Daal for £1. She said she is selling behaviour change: “By shopping at Harriet’s of Hove, you are using ethical and sustainable wholesalers. Re-sterilisation. No new plastic. Recycling.”

Susan Luxford owns ‘Timeless toys’ on Portland Road. She said: “Toys are rarely mentioned when discussing climate change. Toys come in unwanted plastic and break easily. Toys are the most intensive plastic industry, 90 percent are unrecyclable. BHF found 1 in 3 parents admit to throwing away toys in the UK every year. They end up in landfill or the ocean. 58 London buses of toys end up in the sea every year. There are toy rental schemes. She asked: Is our legacy to our children, to bury toys we are actually buying for them?”

Home Energy

Tim Beecher from BHESCO, the energy cooperative, reduces the environmental impact of buildings. He was inspired by the natural world to tackle climate change. Twenty four percent of carbon emissions come from our homes. He said we need to: “rescue the street, terraced housing by putting in external wall insulation. We will reduce the cost individually if we come together as a community. Cooperate and collaborate. You can invest in BHESCO and buy shares which will fund renewable energy.”


Councillor Carmen Appich is leader of labour group and sits on the social care and health and wellbeing committees. She said Brighton and Hove has a local walking and cycling plan which is out for consultation at the moment. People should use public transport. She has introduced rounded street corners on Portland Road, there will be a car share project, starting in Hanover with two cars in Westbourne Ward next summer. Then there is the ‘Mini Holland scheme.’ Additional pedestrian crossings, crocodile crossings, school streets, bike share hubs or car hubs. She said the council needs to know what people actually want so get in touch.

Sarah Forbes has been blogging about reducing plastic waste since 2020. She has been helping people feel safer to cycle in the city. She welcomed the Old Shoreham Rd cycle lane. She has a neurological condition which has not stopped her enjoying cycling. Sometimes she uses an E bike. She is a member of Bricycles.

Tamsin Bishton was the organiser of the event. She has lived in Poet’s Corner for 18 years, her children went to Goldstone Primary School and Hove Park. She said her step Grandad fought for something in the war and we need to protect it for the next generation.

Tamsin Bishton
Tamsin Bishton organised the event

Kate and Marianna were at the event representing Extinction rebellion. Marianna spoke, she has a fifteen year old son who sleeps in a bunk bed because he is terrified of the sea level rising. She said: “We are facing a climate and ecological emergency. She mentioned the sister organisation, animal rebellion protecting methane gas. She said becoming vegan was the best thing she has done. And there is money rebellion. East Sussex County Council have divested their pension fund from fossil fuels. Between 14-19 Nov we are targeting Barclays bank. There is a march on Saturday at 12 noon.

Hove MP, Peter Kyle was the last speaker of the evening and he gave a summary of what was happening in Parliament to tackle climate change. He is Shadow Secretary of State for Northern Ireland and a Labour MP.

He said: “I have been actively involved with students since 2021. I have also been talking to Southern Water about the sewage dumped on our beaches. My emphasis is on what they have done, billions poured down the drain. We need water back in the reservoirs.

He said: “We have reached a plateau with food waste and recycling. We need to do much more: green waste and composting. There is an Environment bill. It will impose regulations on every Local Authority. We can’t upgrade the Hollingbury recycling depot until the regulations are published in March. I have frustrations on behalf of our community. All 3 MPs, created a road map for ourselves with different levers to help the council. We all visited Hollingbury and the incinerator in Newhaven.

“I do drive, I choose not to have a car. There was lots of resistance to the Rampion offshore windfarm. Urban areas are not connected to where power comes from and where waste goes to. We need to grow up. We are connected to power now. Labour pledge we will have clean energy in Brighton and Hove by 2030… We need to double the off shore wind farms by 2030. Labour proposes a multi-year green fund to recapitalise our economy. Carbon reduction.”

Hove MP Peter Kyle
Hove MP Peter Kyle

Question and Answer

How sustainable are the prices of public transport? It costs our family of three £15 on the bus and £5 in the car. Ms Appich said: “There are costs to running a car. We bid for money, we were awarded £27m, we have a private bus company with shareholders. There is no national will to fund transport properly. Government doesn’t want to run the bus company, they don’t trust us, they have taken away a lot of money.”

One member of the audience said civil disobedience is important to the freedom movement. Mr Kyle said: “Protest is incredibly important and it has to be legal. Keir Starmer agreed with harsher penalties. I am a gay person, all gay people protest and it’s legal. Do it within the law. Change the law.”

Mr Kyle said: “There is a problem with the new bill. We don’t support the new bill. Certain protests are so counter-productive. (For example, Extinction rebellion.) We don’t support disrupting ambulances. Suella Braverman’s chinook was in breach of the noise regulations in her law when she visited Manston.”

Another member of the audience asked the last question. She lives in Benfield Valley. There are 12 garages near Portslade. She asked: “Why don’t you knock them down and build there rather than on Greenfield sites?” Councillor Appich said the council needed to include some green field sites in the city plan. Nothing will be built without planning applications. Councillors can reject them. Whitehawk Hill. We needed to fulfil the requirement of the planning body.”

Mr Kyle said: “We need green growth, greenhouse emissions fell by 20%, we have more wind turbines than any other country. We are about to enter a recession. High intensity energy, steel, we need clean steel. We have to get the economy moving, buses, public services and the city needs investment, smart investment.”

A shortened version of this article was first published today in Brighton and Hove News.