Agenda and draft minutes

An apology for absence was received from Leanne Trotter (Healthwatch Medway). 

To approve the record of the meeting held on 12 March 2026.

The record of the meeting held on 12 March 2026 was agreed by the Committee and signed by the Chairperson as correct. 

The Chairperson will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

There were none. 

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct. Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

The Chairperson, on behalf of the Committee, expressed its deepest sympathies of the recent loss of a colleague from NHS Kent and Medway Integrated Care Board. They had been highly regarded and respected across the system and the Committee sent its deepest sympathies to the individual’s family, friends and colleagues.

The Chairperson also informed the Committee that he had been requested to alter the order of the agenda and with the Committee’s agreement, items 8 and then 7 were taken first, before returning to item 5.

Attached to this report is a paper from the Integrated Care Board (ICB) which provides information on a proposed pathway redesign within mental health services, which would include the decommissioning of Bedgebury Ward in Maidstone. It explains that the core aim is to improve patient experience by supporting people to move from secure inpatient care directly into appropriate community-based support wherever clinically safe to do so.

Estimated time: 35 minutes

Discussion:

Representatives from both NHS Kent and Medway Integrated Care Board (ICB) and the Kent and Medway Mental Health NHS Trust (KMMH) introduced the report which proposed a mental health pathway redesign that had been developed between both the commissioner (ICB) and the provider (KMMH) and aimed to redirect resource to a more proactive, assertive outreach model. It was explained that the in-patient service at Bedgebury was an outdated model developed prior to forensic outreach and community based support, which was now sufficiently established to support patients, complemented by assertive outreach treatment. As a result, admissions to Bedgebury Ward had been paused and the remaining five in-patients were expected to leave between September 2026 and January 2027, when the ward would close.

Members then raised a number of questions and comments, which included:

·         Timeframes – in response to a question about when decisions were taken to pause admissions, it was confirmed that discussions between the ICB and KMMH had taken place in early 2026 when it was decided to pause admissions while the proposals were considered. Members were reassured that no patient care plans had been accelerated as a result of the timeframes for closure of Bedgebury Ward.

·         Public safety – in response to concerns around public safety when people with complex mental ill health were treated in the community, it was explained that patients were not discharged into community based provision without support and many were subject to Ministry of Justice Restriction Orders, providing legal requirements of how patients were monitored and supported. If a patient relapsed, they were admitted to the acute setting and where patients improved, they were moved to the Community Mental Health Team. It was added that some patients were known to be difficult to engage and discharge between the forensic outreach service and community mental health services and therefore the assertive outreach treatment would bridge the gap between the two teams and improve patient care and public protection outcomes.

·         Reduction in mental health beds – concern was raised that there would be an overall reduction of beds across the mental health service within Kent and Medway. In response it was explained that Bedgebury Ward was contained within a medium secure forensic site so had very specific limitations. In addition, the increased utilisation of community based support had reduced reliance on mental health beds.

·         Case study – the point was made that a case study to demonstrate the care between the two pathway models would have been beneficial in understanding of the rationale provided. In response, an offer to provide more detail on the step down from the in-patient forensic unit was made and would be shared with Members outside of the meeting.

·         Funding resource – clarification was sought on the resourcing for the service and whether all funding from the closure of Bedgebury Ward would be repurposed into the Assertive Outreach pathway. The ICB confirmed that the funding would be redirected into the new model, with additional investment, anticipated to be at least double  ...  view the full minutes text for item 76.

This report sets out an overview from NHS Kent and Medway Integrated Care Board on the changes made to the NHS Funded IVF fertility treatment offer for Kent and Medway residents, which took effect from 1 April 2026.

Estimated time: 45 minutes

Discussion:

The Chief Executive (CE) of NHS Kent and Medway Integrated Care Board (ICB) introduced the report and apologised for failures in the process of engagement around the fertility services review, acknowledging that both Medway HASC (this Committee) and the Kent Health Overview and Scrutiny Committee (HOSC) should have been consulted at the beginning of the process. The ICB had therefore taken the decision to re-instate the previous IVF offer, backdating that decision to the 1 April 2026, and would re-open dialogue and consultation in relation to the proposal. He also wanted to use the opportunity to work with other ICBs across the South-East to potentially create more parity and fairness across the landscape in terms of the eligibility criteria, which differed across the region. He also emphasised the financial difficulties and the £200m deficit the ICB was trying to address, hence the need to make difficult decisions.

The Deputy Chief Medical Officer explained that in the climate of limited funding, the proposals had been developed to maximise successful outcomes. He also explained that of the 28 women that had been accepted for fertility treatment in the year 2025-26, had those changes been in place during that period, six would have no longer been eligible. 

Members then raised a number of questions and comments, which included:

·         Mitigations for future engagement – in response to what mitigations had been put in place to avoid a future error in the engagement process, the ICB CE described the broader organisational issues inherited since he joined the ICB in 2025, including cultural issues, a major headcount reduction, the significant financial deficit position and a need to reset commissioning processes.

·         Commissioning intentions – the ICB CE explained that he intended to share with the Committee in the summer, the ICB’s commissioning intentions which would outline its considerations for commissioning decisions that the Committee could then have early sight of and comment on. He also referred to the Memorandum of Understanding between the Committee and NHS bodies which was being developed, which would help to reaffirm expectations of relationships.

·         Lack of detail – Members expressed their frustration of the lack of information within the report, including financial modelling. It was explained that estimated average savings from the changes had been approximately £900k by reducing the number of cycles from 2 to 1 and approximately £480k by reducing the upper age limit from 40 to 38.

·         Retrospective eligibility - Concern was raised about how many women had been denied treatment since 1 April, who would now be eligible and how they would be notified, along with women less easy to identify, who had not been in the formal system but may have been working to prepare for it, such as losing weight in preparedness and had not pursued an application because they had believed they were no longer eligible under the new criteria. In response the ICB confirmed this was their immediate priority. They did not believe at this stage that anyone had been directly impacted by  ...  view the full minutes text for item 77.

The South East Coast Ambulance Service NHS Foundation Trust (SECAmb) will be providing a presentation, which as attached as an appendix to this report), to update Members on progress with the plans to create a Group Model with South Central Ambulance Service NHS Foundation Trust (SCAS).

Estimated time: 25 minutes

Discussion:

The Divisional Director of Operations Kent, at the South East Coast Ambulance NHS Trust (SECAmb) introduced the report which provided an update on the group model between SECAmb and the South Central Ambulance Services (SCAS). He explained that the move towards a group model was still at an early stage and that a new Group Chair had been appointed, with a new Group Chief Executive expected in the autumn. He emphasised that there would be no immediate impact on Medway residents in the short term and impact in the medium term was unlikely.

Members then raised a number of questions and comments, which included:

·         Future resourcing – in response to a concern raised that the group model would result in a reduction in ambulances or stations, it was explained that the rationale was about sharing learning and improving resilience between the organisations, rather than reducing services in Medway.

·         Virtual care – The shift in the health and care demands was referenced, particularly in the context of an aging population, which was causing the trust to change how it served residents. There was a growth in managing people with less urgent need and assisting them in navigating the health and care system, providing virtual care and so development of pathways and exploring how to best use the frontline work force, whilst ensuring ambulances were sent to those that need them most was underway. This shift was enabling paramedics to make more use of their clinical skills in a virtual setting.

• Safeguarding – reference was made to safeguarding in the context of the group model. It was confirmed that safeguarding practices was a strength of SECAmb who had robust procedures in place and was a strength that the trust brought to the Group model.

Decision:

The Committee noted the report.

This report provides an update on the proposed integration between Kent Community Health NHS Foundation Trust (KCHFT) and Medway Community Healthcare CIC (MCH). The proposal involves the transfer of MCH staff and services into KCHFT, forming a single NHS Foundation Trust to deliver more sustainable, integrated community services across Kent and Medway. Attached to the report is a completed substantial variation assessment for the Committee to consider.

Estimated time: 40 minutes

Discussion:

Representatives from both Kent Community Healthcare NHS Foundation Trust (KCHFT) and Medway Community Healthcare Community Interest Company (MCH) introduced the report which provided an update on plans to integrate the two organisations which would involve the transfer of MCH staff and services into KCHFT. During the tender process for Community Services provision across Kent and Medway, the two organisations had provided a collective and collaborative bid, which was successful. The integration was to strengthen that further by improving access to community services; reducing duplication; strengthening neighbourhood-based care; improving consistency across Kent and Medway; making better use of digital and data and increasing resilience for smaller, specialist teams. The Boards of both organisations had therefore decided to progress with integration in April 2026.

Members then raised a number of questions and comments, which included:

·         Local services – the point was raised that historically MCH was seen to provide a better, more local service to meet the specific needs of Medway, and it was asked why that position had now shifted. In response it was explained that the health and care landscape had significantly changed and the collaboration in the context of community services would be less sustainable if MCH remained as a separate, small organisation. The integration would enable more resilient services and more opportunities for workforce. Assurance was sought around whether services would continue to be provided from exis ting premises in Medway. It was confirmed that no immediate changes were proposed and therefore services would continue to run as they currently were when they formally transfer to KCHFT on 1 October 2026. The likely longer term impact was that more services would be delivered in Medway as a neighbourhood health area, with an ambition to deliver services in a modern estate that was fit for purpose.

·         Staff survey – reference was made to the outcome of the MCH staff survey, which resulted in 88.6% of respondents being in favour of the reintegration. The survey was in addition to a number of staff engagement events where the organisation was able to hear and respond to staff views. It was added that of around 1700 MCH staff, approximately 250 had responded to the survey.

·         Key performance measures – In order to measure the benefits for Medway residents, it was asked whether the Committee could be given current baseline figures for Medway services so there was something to compare data with going forward. MCH undertook to provide that. In addition, it was asked what measurable performance indicators there would be to hold KCHFT to account on the proposed benefits going forward and KCHFT confirmed they would share data for key measures. The point was also made that one of the key longer-term outcomes anticipated from the integration was improved health outcomes for residents.

·         Governance and oversight – in response to a question about how the wider organisation would work and who would lead the services in Medway, it was explained that the Deputy Chief Operating Officer at KCHFT was also the  ...  view the full minutes text for item 79.

This report is intended to update the Committee on the background, procurement process and new framework for Residential and Nursing Care for Older People (Aged 65+), as approved by Cabinet on 5 May 2026.

Estimated time: 30 minutes

Discussion:

The Programme Lead for Accommodation and Registered Services introduced the report which provided the Committee with an update on the recent procurement exercise for residential and nursing care in Medway.  The key changes to the new contract were that bandings were linked to need rather than a formal dementia diagnosis and a fifth band had been created for highly specialist care due to the increase in complexity of need for some individuals. In addition, there was a robust key performance indicator framework to which all providers were required to submit monthly, quarterly and annual data to enable the commissioning team to ensure quality of service and performance. In terms of the tender process, 36 providers applied and 18 were accepted onto the framework, representing 29 care homes. This had been lower than had been desired and therefore the tender would be reopened in the summer to encourage additional providers to apply/re-apply.

Members then raised a number of questions and comments, which included:

·         Supporting smaller businesses – the point was made that larger organisations would have access to staff or consultants who specialise in tender bids, whilst smaller businesses would be less equipped and may need support. This was acknowledged by officers who would be looking to support such providers as best they could within the confinements of procurement legislation.

·         Number of bed – information on the number of beds available across the 29 homes in the contract was requested and would be shared with Members outside the meeting.

·         Fees – in response to a question about fees and how they compared with other areas, officers confirmed that the team engaged with the market daily and rates was a common theme of discussions. The Council benchmarked with other local authorities as much as was possible. There had been no direct feedback to commissioning officers that rates had dissuaded providers from bidding.

• Encouraging engagement – it was asked how the service would be encouraging more providers to bid when the tender process was reopened. It was explained that there would be a significant campaign to demonstrate the benefits of working with the Council, such as the strong relationships that compared well to other authorise due to the significant offer of collaboration through monthly forums and fortnightly newsletters. Officers were also working with Category Management to mitigate the issues for those that were not successful last time due to technicalities rather than concerns in standards of service provision

Decision:

The Committee noted the report and requested additional information on the total number of beds covered and the relationship between framework capacity and local demand.

The One Medway Council Plan (OMCP) 2024/28 sets out the Council’s priorities and the performance indicators used to monitor performance. This report and appendices summarise how we performed in Quarter 4 on the delivery of these priorities. This report also presents the Quarter 4 2025/26 review of strategic risks.

Estimated time: 15 minutes

Discussion:

The Director of People and Deputy Chief Executive introduced the report which outlined how the Council had performed in Quarter 4 on the delivery of the Council’s priorities, based on the areas covered by the remit of the Committee. She highlighted two indicators in particular; 1.15 (page 147) which stated that by 2027/28 the proportion of closed safeguarding enquiries where risk is reduced or removed is better than the national percentage, and 1.22 (page 154) which stated that by 2027/28, the proportion of long-term clients receiving support via a Direct Payment is similar to or better than the national percentage.  She referred the Committee to the narrative for both indicators and reassured the Committee that these were both areas of focus for her to improve performance on.

Decision:

The Committee noted the progress of performance in Q4 as set out at Appendix 1 and the strategic risk summary set out at Appendix 2.

This item advises Members of the current work programme and allows the Committee to adjust it in the light of latest priorities, issues and circumstances. It gives Members the opportunity to shape and direct the Committee’s activities over the year. 

Estimated time: 5 minutes

Discussion:

The Principal Democratic Services Officer introduced the report which set out the Committee’s work programme. She highlighted the Committee’s informal development session that was taking place on 23 June 2026 where it was hoped a draft version of the Memorandum of Understanding between the Committee and the NHS would also be shared for early discussion, but she would keep Members informed.

Decision:

The Committee noted the report and agreed the work programme as set out at Appendix 1 to the report, subject to accepting the proposed changes, outlined in italic text on Appendix 1.