This report outlines the requirement for the development of an NHS Joint Forward Plan (JFP) in response to the Kent and Medway Interim Integrated Care Strategy. The draft JFP has been developed in partnership between NHS Kent and Medway Integrated Care Board and its partner NHS trusts and foundation trusts, as required by national guidance. The draft JFP is being shared with Medway Health and Wellbeing Board as part of our consultation across the Integrated Care System, specifically to seek views on whether the plan takes proper account of the Medway Joint Local Health and Wellbeing Strategy.
The Chief Strategy Officer, NHS Kent & Medway ICB, introduced the report and informed the Board that this paper was being brought before the Board as part of a consultation to set out how they would deliver actions. The Draft Plan sets out NHS plans for delivery of the Kent & Medway Integrated Care Strategy. Based on the six shared outcomes where work will be undertaken it will be necessary to work collaboratively, with a focus on prevention and tackling the wider determinants of health inequalities. It was important to note that there were various other plans with their own Strategies that would run alongside this Draft NHS Forward Plan.
Members then raised a number of comments and questions which included:
The opportunity to work closer together was welcomed as no one agency was able to tackle the issues of inequality in health alone. It was vital that all steps be taken to improve health outcomes for residents of Medway. A centre of excellence was needed in Medway Maritime Hospital and there had been £460million investment for East Kent Hospital but it was disappointing that Medway Maritime Hospital had not received the same investment.
In recent years there had been increased focus and funding for Children’s Services, and this was also now needed in Adults’ Services to ensure that adults were receiving the care and support needed and to minimise tensions between services.
It was vital that all services take account the views of the Community, the Health and Wellbeing Board and Health and Social Care Overview and Scrutiny Committee to ensure that the voice of the residents was being captured and considered in all decision making.
· GP Access – it was commented that a lack of access to GP services remained a challenge and it was asked how other services could play their part. The Chief Strategy Officer, NHS Kent & Medway ICB, acknowledged that this was a plan to work together collaboratively and that improving access to primary care services would continue to be a local priority. The NHS could not, however solely deliver outcomes as in the longer term working together around prevention and increasing their collective focus on health and wellbeing and wider determinants of health would also deliver sustainable improvements. There was a challenge for the entire system in attracting, recruitment and retention of the right workforce to serve the local population. There had been some significant progress made through the GP programme to attract people to train and remain in Medway after their training, in order for this to be successful, other factors such as affordable housing would be key, and it was important that the Council worked closely in partnership with the NHS for the aspirations to be realised.
Despite the issues with access to GP services, NHS Kent and Medway remained committed to working with partners through utilising the healthy living centres in a way that was affordable and best use of the collective resources that were currently available.
· Development of the Kent and Medway Draft Joint Forward Plan - in response to questions on how the Health and Wellbeing Board would contribute to the development and monitor the Plan, the Chief Strategy Officer, NHS Kent & Medway, ICB, said that the draft plan was brought before the Board today in order to seek feedback. The feedback received from various avenues such as clinical leaders and community health would be fed back into the Plan in order to inform the final version due for publication in June 2023. It was proposed that The NHS Joint Forward Plan would be refreshed on an annual basis and would give flexibility for focus and direction to be altered if needed and deemed appropriate, The Medway Joint Local Health and Well Being Plan which would run alongside this could be used as a monitoring vehicle for this Kent & Medway NHS Joint Forward Plan.
· Innovation and Centre of Excellence – prior to the Covid Pandemic, the acute team had the best systems and processes in place for safe hospital discharge if patients did not need to be in hospital and it was asked what the current process was now. The Assistant Director Adult Social Care said that prior to the Pandemic, Medway Council working with Medway Community Health and Medway NHS Foundation Trust were a centre of excellence with hospital discharge. As a result of financial constraints when the Covid funding ended, they had to rethink the way they worked, and rethink how patients were assessed prior to hospital discharge. It was important to note that whilst the new way of working was not preferable, the assessment process did not cause delay or impact hospital discharge. The issues experienced were with availability in the care market and moving patients on from hospital care. There was s an aspiration to move back to the previous model through creation of a community discharge team and a project on this was currently underway.
· Medway Maritime Hospital - in response to a question on what role the hospital played, the Chief Executive Medway NHS Foundation Trust gave assurance that they were invested in working collaboratively, wanted to be at the forefront of working together to do things differently and were already exploring this through the clinical strategy. A clinical strategy was underway which was looking into all the services provided by working across health and care partnership and this would improve access for patients. Medway Maritime Hospital was a busy hospital with many services on site and the work underway would help to identify how best to contribute and respond to needs in a more effective way. It was vital to move forward by utilising and working with others such as healthy living centres to deliver services to the community.
The Chief Strategy Officer, NHS Kent & Medway ICB added that there was a large demand for primary care services and the ICB role in terms of leadership and innovation was to explore and support opportunities that could be developed or provided by other means such as digital and telephony. Improvement of access through multiple channels and investments in digital elements to support the changes that needed to be made to the current systems.
The Director of Public Health provided reassurance that the ICB and other sub committees would address and pick up various themes and would link with other colleagues such as housing as it was fundamental that all partners contributed as required. There would be an annual refresh of the Plan and the Joint Local Health and Wellbeing strategy would prioritise local issues and feed into the Kent and Medway Draft Joint Forward Plan.
The Board noted the report and support the Kent and Medway Draft NHS Joint Forward Plan as a plan that takes proper account of the Kent and Medway Interim Integrated Care Strategy and the Medway Joint Health and Wellbeing Strategy.