Building a first class health and care system for Sussex and East Surrey

We have a bold ambition for the future of the local NHS. We want to make integrated care a reality for Coastal West Susssex.

Integrated care means caring for people as a whole, rather than separating them out into their problems and conditions; it means looking at the health of whole communities rather than just the ‘sick’ people within them, and preventing illness before it takes hold.

Watch our animation to find out more about our priorities for the coming years:

A transcription is available (click to reveal)

As the CCG responsible for commissioning NHS services in the Coastal West Sussex area, It’s our job to make sure that the services we have in place already are working and to help make plans for the future. We help decide which NHS services get funding and how much funding they need to get the best health outcomes for our population.

We want to change how that happens.

I know this sounds like it could be a bit dull... but keep listening because it gets interesting, and if we want a healthy population with easy access to the right healthcare for everyone, it’s also really important.

Right now, service providers (the people who run hospitals and provide services in the community) can feel that they compete with each other for our attention and funding.

Every year, they let us know how much they think they are going to spend.

We discuss with them how many operations they plan on doing, how many medicines prescribed, the number of babies they’ll birth or broken bones they’ll mend, or just the total amount of money they’ll need to keep going for another year.

Each individual unit, specialisation and department is competing for a piece, of our NHS funding pie.

While this is very flattering for us there are some problems with the current system.

Firstly there’s no incentive to be doing less treatments… so no incentive to keep people well.

Secondly, in order to preserve their bit of the budget, departments sometimes argue about whose responsibility a particular patient is. 

Not just within hospitals and primary care, but also in terms of social care where things can get even messier.

We can forget that we are all on the same side and that we all have the same mission: to get and keep people ‘healthy, happy and well’.

For doctors, nurses and other practitioners, this political in-fighting is frustrating; for patients, who don’t know which department deals with their particular needs, finding the right one can be maddening.

Imagine you’re a patient with a mental and a physical illness, perhaps even more than one illness.

You may be rejected from some of the care you need because another one of your other ailments is seen as more urgent.

Or worse, your care may be delayed while departments face confusion over whose responsibility you are.

Having several things wrong with you is something we deal with more and more as our population gets older and, with a predicted funding gap as well as cuts to social care putting more and more pressure on the overall NHS budget, we simply cannot afford to waste time squabbling internally while our patients suffer and their symptoms progress.

To find a better way, we launched the embarrassingly named ‘Let’s Talk’ campaign.

We’ve spent the last three years talking to people, patients and health care professionals.

We’ve found that there has been a movement growing within the NHS towards integrated care.

Integrated care means caring for people as a whole, rather than separating them out into their problems and conditions; it means looking at the health of whole communities rather than just the ‘sick’ people within them. 

It’s about dealing with how one condition impacts another and treating them all at once and how preventing illness before it takes hold is just as important as curing it.

This is sometimes seen as hopelessly idealistic, but we don’t think it is.

We heard about great systems in the United States, in Spain and New Zealand, so in addition to ‘Let’s Talk’, we studied those as well. 

And now, having done our research, we are ready to make a few changes.

What we want to do is work with health-care providers that can show us that they have integrated care in mind; providers willing to work in different ways together, that have shown that they know the specific issues which affect the communities on the Sussex coast, and have a joined up plan to tackle them.

From now until 2020 we are going to be doing this more and more, but in the run up to 2017 our particular focus will be in two key areas: integrating GP care with Community Services, and transforming Urgent Care.

We want to look at patient flow; stripping away organisational barriers so that the entire patient pathway can be covered under a single budget.

We want to provide incentives based on patients getting well, rather than the number of times they are seen, so that each of the departments they pass through is taking some responsibility for their over-all journey.

We’re going to look at what people do when they start to feel ill or have an accident, and how to decide who is the best person to treat them.

Redesigning the front door, to make it easier and faster to get where you need to be so that the utopian dream of each patient getting the right care, in the right place, first time, every time, can take another small step, or one giant leap, towards becoming a reality.

We also want to look at GPs because this is where 90% of patient interaction takes places.

We want to work with GPs who are able to network and partner with existing community services to generate and promote health.

We want to find ways to use new technology to group patients differently and identify and tackle health risks before they become health problems.

We want to work with them to plan and combine individual specialisms into primary-care multidisciplinary teams.

We want to see them partnering with housing associations, mental health provision or charities.

We want to see how working with their communities can counteract the negative effect that social isolation or depression can have on a chronic conditions.

Basically, we want to see a change and It may sound a little daunting, it may be tricky to set up but that's ok. We are prepared to work hard.

For three years we’ve listened to what you want and now we want to give it to you.

We think that by doing this we will save money in the long term. That we will make the lives of health professionals more rewarding, and ultimately lead to much healthier people, living in healthier communities across the West Sussex coast. So If you are interested in working together for one NHS…

Start believing that integrated care can work, because in many places, it's already is.

So if you are involved in local health and care, start working as one now, and together we will make it happen.

Sustainability and Transformation Plan (STP)

The East Surrey and Sussex Sustainability and Transformation Plan (STP) and our local plan 'Coastal Care: inspiring healthier communities together' have been published.

The STP plan will set out how services across the whole Sussex and East Surrey footprint will work together to sustain and improve health and care services for our population.

The plan talks about three place-based plans, which are the local plans that will deliver improved services to local communities. The three place based plans are:

  1. Inspiring Healthier Communities Together, Coastal Care
  2. Central Sussex and East Surrey Alliance
  3. East Sussex Better Together.

Sussex and East Surrey STP update – March 2017

Dena Marshall, Programme Director for the Sussex and East Surrey STP, said:

“The NHS has never been under as much pressure as it is now. Demand for health services continues to increase and in spite of our best efforts to recruit more staff we do not have the workforce we need to respond to all the demands being placed on our services.

“The Sussex and East Surrey Sustainability and Transformation Plan aims to make practical improvements – like making it easier to see a GP, speeding up the diagnosis of cancer and offering help faster to people with mental health illnesses. The STP also aims to encourage the public to take more responsibility for their own health and wellbeing. The STP brings together all organisations involved in delivering health and care services and represents a real shift in the way that the NHS works, with organisations collaborating to respond to the challenges facing local services and communities.

“We have faced our most challenging winter and so we need to ensure that our plan addresses the scale of the challenges we face over the coming years.

“No final decisions have been made about any services and will not be made without our patients and public being given the opportunity to be involved and voice their opinions.”

Coastal Care

Inspiring Healthier Communities, Coastal Care was the place-based plan for the Coastal West Sussex area, submitted as part of the Sussex and East Surrey Sustainability and Transformation Plan in October 2016.

Since its submission, the financial position of the local NHS system has changed considerably and we will need to adapt our plans accordingly.

While the different NHS organisations involved in the process all agree that working together to bring care closer to patients is the right thing to do, more work is needed to understand what formal changes are needed to the way organisations work to achieve this scale of change.

At the time of submission, one option being considered was the formation of a single organisation with one, budget, called an Accountable Care Organisation. However, no formal decisions have been made about this.

Health leaders across the Coastal West Sussex area have agreed that the plan needs to be redrawn in to address the significant financial changes since October and to consider further what organisational changes might be necessary.

That work is on-going and the revised plan will be published in due course when we will seek the views of our public and patients.

Local digital roadmap

To support the Sussex and East Surrey Sustainability and Transformation Plan (STP) it is vital that we look at how we can become more digital across organisations.

This document summarises our work to date to deliver digital enablement to the STP for Sussex and East Surrey through the delivery of digital technologies. It builds on our local digital roadmap (LDR) submissions to NHS England in June and October 2016.

The LDR sets out how we will develop paperless working for the NHS and social care across Sussex and East Surrey by 2020. It also describes how it will enable the development of additional services through the use of digital technologies.

View the local digital roadmap 2017 v1

Our partnership

  • Coastal West Sussex Clinical Commissioning Group, the NHS commissioner for the Coastal population, and its 48 member GP practices
  • Primary Care, 48 GP Practices and over 100 Community Pharmacies
  • Western Sussex Hospitals NHS Foundation Trust, provider of acute health services, with major hospitals in Worthing, Shoreham-by-Sea and Chichester
  • Sussex Community NHS Foundation Trust, provider of community health services across West Sussex, Brighton & Hove and High Weald Lewes Havens
  • Sussex Partnership NHS Foundation Trust, provider of mental health services in West Sussex, East Sussex, Brighton & Hove, Kent and Medway and Hampshire
  • West Sussex County Council, which provide council services to all of West Sussex and which has an aligned approach to Coastal Care.
  • District and Borough Councils – Chichester, Arun, Worthing and Adur and Horsham.

Read the East Surrey and Sussex Sustainability and Transformation Plan (STP).