Agenda item

A presentation will be given on delivering the Five Year Forward View incorporating an update on the development of the Kent and Medway Sustainability and Transformation Plan.

Discussion:

The Sustainability and Transformation Plan (STP) Director gave a presentation on Delivering the Five Year Forward View.  It incorporated an update on the development of the Kent and Medway Sustainability and Transformation Plan.  Key issues within the presentation included:

·         The national planning context which required a five year STP together with a one year operational plan.

·         How the STP would improve health and wellbeing, transform quality of care delivery, deliver sustainable finances and establish more robust system leadership.

·         The anticipated allocation of place based funding and also sustainability and transformation funds.

·         The challenges for Kent and Medway including population change, housing development, unacceptable health inequalities, recruitment concerns, reshaping service delivery to provide more out of hospital services and to concentrate on preventative support and managing the deficit budget.

·         The performance against targets where particular attention was drawn to poor performance in the following areas: the estimated diagnosis rate for people with dementia; the four hour target for A&E.

·         Population characteristics including highlighting special concerns around higher levels than average in Medway of obesity, smoking prevalence and related illnesses.

·         Improving the governance.

·         The need to concentrate on four main themes: increasing self care and prevention; strengthening primary care and integrated out of hospital care; developing a clearer acute hospital strategy focusing on an East Kent Strategy Board, the A21/A229 corridor and pan Kent and Medway services for example in stroke and vascular services; and cost reductions.

Members of the Board raised a number of issues which were responded to, including:

·         What steps were being taken to ensure “total place” financial models could work in terms of delivering savings? It was noted that this continued to be a complex issue which was being explored at a national level. Very different mechanisms were needed for a joined up single budget.

·         Whether significant additional finance would be available to the NHS following the EU referendum. It was concluded that it would be a matter of having to await developments although additional funding would not have a significant impact without an increased workforce.

·         The timing of a review of acute services. The Board was advised that more detailed modelling was required to establish the baseline position;  The review was due for completion in March 2017.

·         The importance of engagement which would include further reports to the Board and concern about this being led by NHS England. The Board was assured that there was a significant level of involvement from Medway health partners which had resulted in the current version of the Plan better reflecting Medway’s needs. The STP steering group included several Health and Wellbeing Board members and a wide range of stakeholders would be invited to workshop events.

·         Concern that the per capita financial settlement disadvantaged Medway residents.

·         It was vital to concentrate on core requirements rather than what might be seen as “vanity projects”.

·         It was vital to demonstrate that existing resources were being properly and efficiently applied in order to persuade the Government that additional finance was necessary. It was noted that lack of trained personnel and poor infrastructure were challenges that needed to be addressed in transforming the way in which healthcare was delivered.

·         Ensuring that expectations of support service savings were realistic and that all opportunities for joint working were pursued.

Decision:

The Board:

(a)       noted the presentation; and

(b)       agreed that a summary of the final Plan should be supplied to Board members.