Agenda item

The draft Kent and Medway Health and Social Care Sustainability and Transformation Plan (STP) was published on 23 November 2016.

An STP update was last presented to the Committee in March 2017. The attached paper summarises service models developed through the Sustainability and Transformation Partnership and sets out the Case for Change.

Discussion

The update was introduced by the Accountable Officer for the Kent and Medway STP. The Committee was informed that a traffic light system was being introduced to rank progress made in the development of local STPs. Each STP footprint would also need to create a strategic commissioner.

The role of an STP would be to support local services and deliver the best care possible, maximising the resources available. There was a particular need to deliver procurement efficiencies, which was something that the NHS as a whole had not be able to do well.

The reliance on relatively costly agency staff was a particular problem in Medway and an issue across the whole of Kent and Medway. The aim was to create a medical school in Kent and Medway which would help to reduce this reliance. There also needed to be promotion of the health sector in Kent and Medway as a place to work. This was against a backdrop of falling overseas recruitment, particularly staff from EU countries. It was considered that the size of Kent and Medway made it possible for joint commissioning to maximise cost efficiencies.

In relation to stroke services in Kent and Medway, it was recognised that there was an urgent need to improve provision. This was currently spread across seven acute hospital sites in Kent and Medway, with none of them currently offering full hyper acute stroke treatment.

A Committee Member said that the need for both service improvement and financial savings made it difficult for the public to appreciate that the STP process was about improving services as well as saving money. She was also concerned about the front loading of costs, which she considered was an inevitable part of the STP process and about the need for a strategic commissioner, which would be another layer of bureaucracy. The Member was concerned that the meeting of the Kent and Medway Joint Health Scrutiny Committee (JHOSC), which was due to discuss proposed changes to stroke services, had been delayed. She was, however, pleased to see the accessible ‘Case for Change’ document included in the agenda papers.

The Accountable Officer for the Kent and Medway STP considered that the strategic commissioner may actually reduce bureaucracy given the current fragmented nature of NHS organisations. With regard to the stroke review, it was recognised that the work needed to be progressed quickly, including the commencement for public consultation. However, difficulties in East Kent made going progressing the consultation difficult

Another Committee Member agreed that the stroke review needed to progress at a faster pace. He noted that the review had first been discussed by the Committee in August 2015 and by the Joint HOSC in January 2016. The Accountable Officer agreed that there was a need to go to public consultation as soon as possible so that discussion could be undertaken about which sites in Kent and Medway should provide acute stroke services.

In response to a Member who highlighted the importance of working together in relation to procurement, the Accountable Officer said that significant progress had already been made and that procurement savings made up a significant  part of the overall cost savings process to be delivered as part of the STP.

A Committee Member was concerned that there was a lack of understanding of the specific needs of Medway compared to the rest of Kent. The Accountable Officer said that he understood these concerns but considered that there was a strong case for centralising services on Medway given the large population in the vicinity.

Decision

The Committee considered and commented on the update provided on the Kent and Medway Health and Social Care Sustainability and Transformation Plan and agreed that the next update should be presented to the Committee in December 2017.