Members are asked to declare the existence and nature of any Disclosable Pecuniary Interests in respect of any item of business to be considered at the meeting.

Declarations of Interest

Councillor Liz Frost MSc FCOptom, Other Interest: Councillor Liz Frost declared her current employment in NHS England could be said to be considered a pecuniary interest under the council’s local code of conduct for members. However, the council’s standards committee has discussed this, and would not consider this a risk to public confidence, and that she has been given dispensation to speak on matters relating to health.

Daniel Elkeles, Chief Executive, Epsom & St. Helier University Hospitals NHS Trust.

A Guide to understanding the NHS is attached for Members’ information.

Introduction of Daniel Elkeles and Andrew Demetriades.

There was a briefing given on the programme for Improving Healthcare Together.

There was an acknowledgement of the progress made on the business case, with the 3 CCGs (Surrey Downs, Merton and Sutton) having worked closely with Epsom & St Helier.

Andrew Demetriades advised on the business case for change:

·                     Clinical

·                     Building / Estates

·                     Financial

The proposal was to bring all acute, clinical services together under ‘one roof’. The clinical senate has endorsed the proposal.

The Integrated Impact Assessment (IIA) is on-going with further research and analysis required. The draft IIA is available on the IHT website.

The proposal will then need to go to the ‘National Scrutiny Board’ and there is a requirement to have financial approval before the proposal can move to public consultation.

Cllr Dalton asked for confirmation of timelines and also offered a reflection that some participants of the focus group were not satisfied with the work undertaken as part of the IIA.

Andrew Demetriades advised that the aim is to move to public consultation by Autumn 2019.

Daniel Elkeles advised that the consultants undertaking the IIA are completely independent of the NHS and that a significant amount of work has been done in undertaking a complex analysis of the needs of all groups identified, inclusive of travel time by method, times and days of the week, and clinical need. Early findings are that deprived communities of Merton and Sutton maybe adversely impacted by an Epsom based site; whilst the older population of Surrey Downs may be adversely impacted by a Sutton based site.

Further questions posed re: work-force relocation, the likelihood of the finances being secured, the risks of Brexit and the ‘plan B’ should the application be declined.

Daniel Elkeles and Andrew Demetriades advised that:

·                     The workforce were very keen to re-locate to one specialist site. 100% of nurses and 91% of consultants were prepared to relocate.

·                     NHS England had received 9 applications and Epsom & Ewell were high on list.

·                     Brexit will remain a risk to current transformation bids however there is no ‘plan B’.

Daniel Elkeles went on to provide an overview of current improvement on the Epsom Hospital site, and provided on up-date on the planning application approval of the multi-story car park. Due for completion Dec 2020.

Dr Hilary Floyd, GP Health Lead and Board Member of Surrey Downs Health and Care Partnership

Dr Hliary Floyd presented on the newly formed Surrey Downs and Health & Care Partnership.

·                     The partnership ensures a whole system/pathway approach.

·                     The partnership is GP led.

Of recent and on-going success, is the rehabilitation of 60% of people within their own homes, and the impact of Croft Ward which continues to provide in-patient rehab to complex cases.

Cllr Nash raised the question of social prescription and how this can be utilised.

Dr Floyd advised that there was opportunity for social prescription and that Primary Care Networks are being proactive in provision of social prescription within each PCN; they is an acknowledgement of the wider determinants.

Further questions pertaining to provision of rehab bed spaces via Legal and General following land sale, as well as the organisational structure of the partnership and how our residents understand this, and the relationship between the partnership and EEBC Hospital-to-Home service.

Daniel Elkeles confirmed that Legal and General are committed to providing self-contained rehab units; some will be costed. In some cases, NHS will secure these.

In respect of communicating services, the Care Coordinators and Community Matrons are getting the message ‘out there’. All agree a ‘roadmap’ of services may be useful and that their needs to be a further conversation about how Hospital-to-Home fit in.

Rod Brown will take this forward.

Dr Floyd confirmed that all staff are employed by their respective organisation and commented on the significant benefits of the partnership in respect of referral routes (incl. of self-referral) to targeted, clinical interventions i.e. physio. This is already showing to be reducing pressure on the GP practices.

Rod Brown – Head of Housing & Community Epsom and Ewell Borough Council Rachel Kundasamy – Health & Wellbeing Officer Epsom and Ewell Borough                   

Discussion on the emerging theme of the Health and Wellbeing Strategy

Rachel Kundasamy advised on history and context of the Health and Wellbeing Strategy currently being produced, advising further on the influence of Surrey Heartlands Integrated Care System, and the work of the Integrated Care Partnerships, of which EEBC is represented.

Rachel Kundasamy advised that the Health & Wellbeing priorities for the Borough need to align to the wider priorities, whilst being pertinent to the needs of the residents.

Rachel Kundasamy advised that desk top reviews had been conducted, as well as engaging with our community and voluntary providers to identify the following (emerging) themes:

·                     Our ageing population

·                     Our hidden communities

·                     Our carers

·                     Our residents experiencing domestic abuse

·                     Our general population for which weight, female participation in sport, alcohol use and conditions such as diabetes and hypertension are emerging as a need.

More work is required in respect of further engagement with partners, and in ensuring that Future40 is central to the strategic direction. Rachel Kundasamy advised that member engagement was also required.

Cllr Dalton stated how important she felt this work to be and was in full support of the Council in moving this work forward.

Rod Brown added that much of the work needed is in regards to the wider determinant of health.

Question were raised in respect of the councils intent to engage schools, how the Council envisage ensuring initiatives that arise from the strategy are taken to the correct committee, and how the Council intends to address substance misuse issues on some of its estates.

Rachel Kundasamy advised that consideration would need to be given to those policies/projects that supersede, as to ensure consideration at appropriate panel. Rod Brown advised that all projects sit under Housing & Community.

Rachel Kundasamy advised that there was an intention to engage with schools and that due to the work of Leisure Developments in delivering the Surrey Youth Games, EEBC has established positive working relationships.

Rachel Kundasamy advised that in respect of substance misuse, she is yet to meet i-access. However, the statistics available are likely to under-represent the scale of the issue and as such, local intelligence is required. Rachel Kundasamy advised that in respect of how to address this, an approach could be taken whereby services are made available to all, however we target a few as to help reduce stigma and encourage disclosures.

All members would welcome being kept up-date via member’s briefings.