The draft Kent and Medway Health and Social Care Sustainability and Transformation Plan (STP) was published on 23 November 2016.
An STP update was presented to the Board at the last meeting in April 2017. This included the screening of a video in relation to the Medway Model and an overview of the Case for Change document. Due to concerns with regard to the purdah period ahead of the general election, a proposed presentation on service models was deferred until the next Board meeting.
The update on the Kent and Medway Sustainability and Transformation Plan (STP) was introduced by the Accountable Officer of NHS Medway Clinical Commissioning Group (CCG). A presentation was given to the Board, the key points of which were as follows:
· An increasing population would increase demand for health and social care provision. Residential and nursing home provision was a challenge although provision was improving.
· Many individuals treated in hospital beds could be better cared for elsewhere if suitable provision was available.
· Health and social care was facing significant financial pressures and also had to contend with an ageing workforce and workforce shortage in key areas e.g. GPs.
· Transformation would take place around four key themes – prevention, system leadership, productivity and enablers.
· Public engagement was due to take place over the summer in relation to plans for the transformation of local care.
· Local care transformation would include increasing the emphasis on self care and enabling more people to be treated locally. There was an initial focus on the complex elderly frail as care for this group was not as good as it could be. This group represented 12% of the population but utilised 32% of resources.
· Other focus areas would be younger adults and children with complex needs.
· There were eight different local care interventions which were embedded in the Medway Model, with engagement taking place to establish how a single point of access to care in Medway could operate.
· GP practices would be encouraged to work in clusters serving between 30,000 and 50,000 people in order to improve GP availability.
· Text message appointment reminders were freeing up 800 GP appointments each month.
· Stroke services in Kent and Medway were currently too fragmented with services being delivered at too many sites for care to be delivered as effectively as possible. Less than 50% of stroke patients were currently receiving thrombolysis within 60 minutes of calling for professional help.
· A seven day consultant led specialist stroke service was due to be in place by autumn 2017. There was a need to provide services at fewer sites, to bring together different types of stroke provision and to ensure that ambulances were able to transport patients directly to stroke units. A consultation was due to take place regarding proposed changes to stroke services.
· The Medway, north and west Kent areas were working together to develop a hospital strategy.
The Board raised a number of points and questions which were responded to as follows:
Third Party Service Provision – Providers of third party care services were commissioned by the Council. Each one had a service specification, with a range of quality control measures being utilised. It was suggested that this be discussed further following the meeting.
Incontinence – The ‘I can’t wait card’ did not have any official status but it would be useful for awareness of it to be promoted. The Clinical Chair, Medway NHS CCG undertook to find out how people could obtain the card and how many people currently had one.
Use of out of area mental health beds – In response to a Board Member who had seen a news report stating that Medway was the worst performing local authority area in the country for placing mental health patients in out of area beds, the CCG Chief Operating Officer said that a significant number of patients had been placed outside Medway in the previous year but that this had now been virtually eliminated. A Member said that mental health provision for Medway residents should be provided within Medway.
Work was taking place on the development of a Medway Mental Health Strategy and it was anticipated that this would be presented to the Board at the September 2017 meeting.
A range of care professionals provided mental health care with communication between these professionals being important. Specialist geriatricians and care co-ordinators had a role to play in improving patient care. The CCG had invested to support the rollout of the EMIS information system to all local GP practices. This facilitated the sharing of patient records between practices. The healthy living centres would provides access to a range of professionals in a single place, with it being anticipated that specialist dementia staff would be available in the future.
GP appointments/Local Care Model – A Board Member said that the reductions in the number of missed GP appointments achieved through the text messaging reminder service was a good achievement and that this should be promoted to raise awareness of the issue. The Member also considered that the local care model outlined in the presentation could lead to some people being provided with either too little or too much support. The CCG Accountable Officer emphasised the need for medical professionals to work together in extended practices and said that system change was needed regardless of the STP process.
The Board noted the update provided on the Kent and Medway Health and Social Care Sustainability and Transformation Plan and commented on the presentation given at the meeting.