This report provides an update on the progress of Phase 2 of the Kent and Medway (K&M) population health management (PHM) development programme and the NHS England and Improvement (NHSE/I) place-based development programme.
The Chief Strategy Officer, Integrated Care Board Executive Team, NHS Kent and Medway introduced the update report. The second population health
management (PHM) action learning set was launched in July 2022. It brought together a wide section of partners across the health and care system, to explore ways to utilise knowledge and use different tools to progress the work. The Integrated Care Board had moved onto the next phase of the PHM project. It was working with its partners and building on existing public health programmes, to address health inequality and disparities.
Members then raised a number of questions and comments which included:
Pilot Scheme- in response to a question on how Swale was identified as the best place for the pilot scheme when there were other areas with a greater population that could have been used, in particular in Medway. The Director of Delivery, Medway and Swale Health and Care Partnership said that Medway Central was the first Primary Care Network (PCN) area that was launched, with Sheppey PCN area the second to go live. The PHM action learning set was a small part of the work being done on population health management in Medway. The expertise of the public health team at Medway greatly benefitted the programme as it enabled team working to identify areas of inequality. The first area of the programme that was rolled out in Medway Central, was focussed on childhood obesity and adults with a long-term condition and the second part of the programme was now being rolled out in Sheppey. There were currently a number of initiatives on population health underway in Medway. The voluntary sector had been central to the work being done which had resulted in the development of a framework that all organisations had signed on working and thinking differently and ensuring the community was at the heart of all its work. The voluntary sector now also sat on all the Health and Care Partnership Boards.
Kent Public Health - it was asked what contribution was being made to the PHM programme in Medway Swale by the Kent Public Health team. It was vital that Kent played their part due to the limited capacity of the Medway Public Heath Team. The Director of Delivery, Medway & Swale Health and Care Partnership said that Kent colleague were involved in analysis, data distribution and roll out of programmes.
Challenges - It was commented that being a unitary authority and having previously had a coterminous Clinical Commissioning Group, put Medway in a position where conversations were easier to maintain. The new landscape and new way of working meant that collaborative working may be more challenging. It was important to recognise the difference in population and landscape between Medway and Swale and to continue to ensure that the places selected for pilots continued to be evidence driven. The work that was being done by Medway Public Health team was commendable as well as the work by Kent. It was suggested that going forward, it would be beneficial that some of the work took place in more remote parts of Medway, for example, the peninsula and in areas of Swale where access to services was extremely challenging. It was also important to recognise that post Covid, there were some underlying issues that had yet to materialise. There was a need to build a system that would be able to cope with, and respond adequately to, emerging problems.
The Director of Public Health advised the HWB it was extremely important to collaborate. The Board were reminded of their duty under the Health and Social Care Act 2012 to provide support to NHS partners. Regular meetings took place with Kent officers to share learning and work through any boundary issues as well as resolve any conflicts. The resource issues alluded to were appropriately managed and there was no cause for concern.
Complexity of Organisations - it was commented that any service improvement in Swale, had a knock-on benefit to Medway residents. The successful bid on the diagnostics centre was evidence of this. By putting a hub in Sheppey, there was positive benefit for Medway as it reduced demand at Medway Hospital from people outside of Medway. The pathways being explored were centred on identifying where the biggest impact could be achieved. Additionally, work was underway on a primary care needs assessment with nine PCN’s across Medway and Swale. The aim was to better understand the differences in need in each area and therefore set priorities to benefit the patients and community in different areas.
The Board noted the Update on Population Health Management Report.