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.