The Chairman welcomed Bob Cook, the Head of Strategy & System Integration at Maidstone & Tunbridge Wells NHS Trust and Dartford Gravesham & Swanley (DGS), Sue Braysher – Director of System Transformation & DGS Integrated Care Partnership (ICP) Programme Director to the meeting who gave a presentation which updated Members on the work of the NHS Kent & Medway Clinical Commissioning Group (CCG) to development ICP in DGS and West Kent.

The new CCG created in 2020 was a merger of eight smaller CCGs and has developed four ICPs across Kent bringing together all health related organisations to collaborate together in local areas to work as one. ICPs were the vehicle for planning, co-ordinating and delivering health and care services at a local level within a defined geography and patient population groups.  Integrating health and social care was currently seen as the way to deal with an ageing population, which  was a priority given with increasing levels of frailty.  It aimed to focus on directing resources where it could deliver the best return on investment for the population. In the long term it was envisioned capitated budgets, directed at holistic need identified by joined up data sets would support better care, outcomes and population health improvements.

Members were advised of the key aspects of the Kent & Medway Integrated Care Strategy (ICS) draft principles, draft purpose, governance, initial priorities prior to COVID19 and areas where development was made.

In response to a question regarding advances in computer technology, Members were advised that it was important services were designed that reflected local community needs.  A West Kent Stakeholder Advisory Group had been set up to look at areas of care with partners and how these were then delivered, for the majority of people and other vulnerable groups.  Coronavirus had resulted in a shift of ways of working and meetings, with the reduction in face to face appointments, but still being able to offer appointments on the phone or face to face as needed. 

In response to further questions, Members were advised that data was generated through public health teams and local population health needs around Primary Care Network (PCN) footprints. Core services would be provided, but in line with local priorities there would be variants to meet these needs. It was important that the ICPs worked together to avoid a service postcode lottery. The data would be a live data monitoring system on an ongoing basis, which would be reflected with population growth. In addition, Members were advised that the ICPs were designed around the locations of acute hospital services and in each ICP there were variants. In the Dartford and Gravesham part of DGS, it was the most ethnically diverse area in Kent and Medway and therefore a focus of resources was on Covid-19 for this group, due to the high risk factors for high risk conditions. The ICP met once a month to share work plans and ensure a close connectivity to ensure similar work was undertaken.

Sue Brashyer addressed the Board, giving details of the DGS ICP focus. This included supporting the system to continue to remain Covid-19 ready; supporting the systems to restart programmes of clinically urgent services and to support the 4 health improvement programmes. The improvement programmes included: Developing & implementing a Frailty Model; Supporting & implementing the Kent & Medway Urgent & Emergency Care Programme; Post Covid-19 Mental Health & Wellbeing of staff, survivors & the bereaved; and targeting those at risk of long term conditions. The Governance structure, including the Partnership Board and Advisory Board was explained.

In response to questions, Members were advised that ICP’s gave an opportunity to have conversations with KCC and other local authorities, and in light of Covid-19 there was more awareness of risks and lifestyles. Members were advised that it was important that there was a balance in GPs surgeries for urgent care and routine appointments, and would take back Members comments.

In terms of finances, there was a block contract being worked on with NHS to access additional funding. Reviews were taking place, to look at the opportunity to provide services in the community differently. 

In response to further questions, Members were advised that health tended to look at isolated issues. Therefore it was important that patient experience was taken into account when commissioning services and take into account the wider views. The Elected Members Forum was vital, as the Members were the ones who knew the residents and users of the service in better detail, in comparison to the few occasions when a GP may see someone. The sharing of this knowledge would help develop better services in line with local needs.

Members were advised that before further role out of the pod prescribing services, a business case was being developed, and this would take into account how the services is currently run and any improvements that need to be made, by looking at complaints and other information. Members were advised that additional information on the services roll out would be provided to the Head of Housing and Health.

Members thanked the Head of Strategy & System Integration at Maidstone & Tunbridge Wells NHS Trust and Dartford Gravesham & Swanley and Director of System Transformation & DGS ICP Programme Director for their attendance at the meeting.

Resolved: That the report be noted.