Agenda item

This report provides an overview of Medway Community Healthcare’s (MCH) current position of community health services provision.

Discussion:

Members considered a report which provided an overview of Medway Community Healthcare’s (MCH) current position of community health services provision.

The following issues were discussed:

·       Cardiology – in response to whether there was the capacity to cope with the increase in referrals, Members were advised this would be one of the first areas to be focused on in the transformation programme. If there were any issues about capacity, MCH would discuss extra support with primary care colleagues.

·       Pay awards – MCH were congratulated on funding the 2022/23 pay award, at a cost of £2.5m. Disappointment was expressed that this had not been funded centrally and that MCH had needed to take out a loan to cover this cost. The Managing Director of MCH advised that the judicial review to pursue equitable treatment had been paused as the Treasury would fund this pressure if MCH met certain criteria. MCH were optimistic the pay award would be funded by the Government.

·       Type 3 performance – regarding the causes of the breaches of this target which related to the time it took patients to get from the Emergency Department to MedOCC, the Managing Director advised that MCH was working closely with the hospital and was looking to change the urgent care pathway.

·       Discharge – in response to how MCH would ensure patients were discharged on time, Members were advised MCH was working with partners to introduce a new discharge model. Lessons were being learned from failed discharges.

·       Continuing Health Care End of Lifecarers – what percentage of hours had been reduced to remain within funding was questioned and a written response was promised.

·       Doctors’ pay award – in terms of the reasons for thedelay in funding being received, Members were advised that MCH’s status as a community interest company affected access to funding routes. A Member noted this would impact on recruitment and retention.

·       eConsult – Members were advised this had been very successful and was popular with patients.

·       Integrated Care Board – a Member asked what key issues MCH would like to see resolved in relation to the Integrated Care Board and the Managing Director advised this would be clarity about future plans and services.

·       Continence service – it was clarified that the self-referral process also involved structured telephone calls to patients.

·       Medway and Swale Health Hub – in response to a query about the proportion of GPs involved in this scheme and how easily it could be scaled up, the Head of Transformation advised seven practices were involved and while it was a scalable service this would require sustainable funding.

·       Community Services procurement process – MCH were asked if they had concerns about the future of the organisation given this procurement process. The Managing Director responded this was a concern and clarity about impacts and timescales was important. The uncertainty involved had the potential to impact on staff morale and retention. Funding for all service providers was a challenge and there was a need to find efficiencies and streamline processes across the system.

·       Urgent Treatment Centre Provision – a Member commented that this procurement had only been notified to the Committee the day before by the ICB but had been considered at Kent’s Health Scrutiny Committee.

·       Transient Ischaemic Attack (TIA) service – the MCH Managing Director clarified that once the MCH staff who provided this service became aware of the decision that the specialist service would no longer be at the hospital, they had decided to leave.

Decision:

The Committee agreed to:

a)      note the report.

b)      request a briefing note regarding Continuing Health Care End of Life carers, specifically what percentage of hours had been reduced to remain within funding.