Agenda item

This report provides an update on the establishment of the Strategic Commissioner for Kent and Medway and what this means for the wider system and development of an Integrated Care System and Integrated Care Partnerships across Kent and Medway.

Discussion:

The Accountable Officer for the Kent and Medway CCGs and the Kent and Medway STP Chief Executive provided an update on the establishment of a Strategic Commissioner for Kent and Medway and provided details on the expected implications for the wider system and the development of an Integrated Care System and Integrated Care Partnerships across Kent and Medway.

It was explained that there was an expectation that within the next iteration of the NHS 5 Year Plan, Sustainability and Transformation Partnerships (STPs) would transform into Integrated Care Systems (ICSs). In most cases it was expected that these ICSs would follow the existing boundaries of their STPs, however, not in all cases, for example Frimley. Nationally, there had been a debate on how ICSs could incorporate provision and regulatory functions and the thoughts were further developing.

The Joint Board was advised that the Strategic Commissioner would operate at a Kent and Medway level, facilitating commissioning at scale of core services. It was explained that at present discussions were ongoing regarding how to achieve cooperation for commissioning across Kent and Medway and what functions would be retained at a local level or transferred to the strategic Kent and Medway level. It was noted that it had been agreed that one of the first remits of the Strategic Commissioner function would be cancer care. It was added that in the longer term the Strategic Commissioner may also have regulatory functions as well as commissioning functions, as the NHS landscape changes. It was noted that the Strategic Commissioner would commission outcomes.

These outcome based procurements would be commissioned from Integrated Care Partnerships (ICPs), a group of providers who respond to a required outcome as specified by the Commissioner. It was noted that across Kent and Medway these partnerships had already started to emerge through the utilisation of aligned incentive contracts. West Kent was considered the most advanced. The Joint Board was advised that East Kent had not yet utilised these types of contract but the CCG and providers were working together and it was considered that the next steps would be enter into some form of aligned incentive contract. With respect to Medway and Swale, the Joint Board was advised that providers in both areas were working together and that the current assumption was that these two areas were likely to form a partnership, although there was some further thought to be given to this, as there was some merit for Swale joining with West Kent.

The last tier in the emerging arrangements would be Primary and Local Care Networks, which were set out in further detail at paragraph 4.3.4 of the report.

With respect to Local Authority engagement, the Accountable Officer for the Kent and Medway CCGs and the Kent and Medway STP Chief Executive expressed a view that Upper Tier Local Authorities should be engaged at all levels of the new arrangements. It was noted that lessons could be learnt from Local Authority commissioning.

It was added that the Kent and Medway Joint Health and Wellbeing Board was well placed to be fully integrated into the governance of the arrangements.

A Member welcomed the opportunity to connect NHS and Local Authority commissioning. However, he expressed concern in relation to emergency planning and sought assurances that the NHS had plans in place to manage emergencies, such as a no deal Brexit. In response, the Joint Board was advised that a new member of staff was transferring to Kent who was well placed to take this forward and the Joint Board was asked to consider whether emergency planning should be added to the Board’s work programme.

Decision:

The Kent and Medway Joint Health and Wellbeing Board:

a)    noted the update on establishing the Strategic Commissioner and the development of the Integrated Care System in Kent and Medway; and

b)    agreed that emergency planning be added to the Joint Board’s work programme within the standing agenda item ‘Update on Kent and Medway Strategic Commissioner and Engagement with Upper Tier Authorities’.