Agenda Item No. 6b

Lower Ground Floor West Green Drive Crawley RH11 7DH Tel: 01293 600300 (ext. 4255) Email: [email protected]

Dear Mr Turner and Dr Walsh,

Thank you for your letter dated 13th December and the opportunity to respond.

As you are aware we are committed to transforming our community services to deliver an integrated service model in collaboration with all our partners across Crawley, and Mid Sussex CCG areas. The work we have been progressing throughout 15/16 has laid the foundations for improving the preferred model of ‘home first’ principles.

The current programme of work includes:

• increased focus on delivering the principles of an integrated discharge team across our acute hospital sites at East Surrey Hospital and Princess Royal Hospital

• developing an enhanced responsive service model that transforms the current separate community services/teams offering admission avoidance and step down from an acute admission, into a cohesive service offer across the patient pathway from proactive care, crisis intervention and maintenance with access to specialist support at each stage where the need has been identified

• Working with West Sussex County Council to align and move towards an integrated joint community rehabilitation service offer that will include access to re ablement home care support

• developing a local clinical navigation hub that will enable patients and professionals to access advice/support from urgent care services to meet their needs first time and avoid multiple referrals and confusing signposting

We welcome the Boards recommendation for further improvements to the current level of information sharing and a shared understanding of pressures across Health and Social Care. The CCGs are seeking to better understand the financial and workforce pressures across health and social care for our geographic footprints, to better inform future planning for integrated pathways, which will improve the current delays in accessing onward care and support that are experienced by our local populations.

The most recent report by the Health and Social Care Executive Lead highlights the challenge our CCG areas are facing. The level of delayed transfers of care across the County varies, with the highest levels being seen in Brighton Sussex University Hospital (BSUH) in relation to delays from Princess Royal Hospital in .

Crawley Clinical Commissioning Group Horsham and Mid Sussex Clinical Commissioning Group

The next highest are from East Surrey Hospital and then from Worthing and St. Richards. The higher number of delayed transfers from Princess Royal Hospital correlates to where there are significant market challenges with provision of care to meet the levels of demand, particularly with finding packages of care for people in their own home.

We are working closely with the County Council, under the programmes identified above, to improve the delays experienced by patients across these . We are beginning to see improvements with medically ready for discharge delays at East Surrey hospital with a continuing downward trend being reported since October 2016. We believe this is a result of the collaborative work that is happening as part of the Integrated Discharge Team. There is still a lot more that we need to do. We welcome the recent recruitment drives and promotion of career opportunities that West Sussex County Council have run across the mid Sussex areas, who face some of the most challenging market areas for home care and care home providers.

We are working with Sussex Community Foundation Trust and West Sussex County Council to investigate alternative ways to provide services to meet peoples needs where there is a recognised challenge in the market.

We will work with our County Council colleagues to provide a more detailed briefing for your March meeting.

Yours Sincerely

Geraldine Hoban (Accountable Officer NHS Horsham & Mid Sussex CCG) David King (Chief Operating Officer NHS Crawley CCG)