Agenda item

This report updates the Committee on the Medway and Swale Interim Estates Strategy being developed through the Health and Care Partnership, Healthy Living Centres and Community Diagnostic Centres.

Discussion:

The Director of Health and Care Integration and Improvement, Medway & Swale Health and Care Partnership and the Director for Corporate Governance (and Strategic Estate), NHS Kent & Medway Integrated Care Board (ICB), introduced the report which set out the Medway and Swale Interim Estates Strategy being developed through the Health and Care Partnership, Healthy Living Centres and Community Diagnostic Centres.  It was explained that the document remained interim and would not be finalised until the Medway and Swale Local Plans had been adopted. There was a priority to optimise the One Public Estate programme and work was ongoing in developing a framework in relation to developer contributions to improve this activity and ensure that infrastructure was provided alongside new development. In relation to Healthy Living Centres (HLCs), it was confirmed that void space within HLCs varied from 9-22% and dynamic solutions were being explored to address this and ensure their use was maximised by the NHS and partners, including the community and voluntary sector (CVS).

Members then raised a number of questions and comments, which included:

·        Resourcing – in response to a question about resourcing available, both within the NHS and amongst partners to assist in this work, the ICB representative confirmed they worked closely with Public Health in terms of data collection and were working with the Planning team. A particular issue was that the NHS received revenue funding based on individual GP registrations but when there was inward migration, the funding was delayed on average 2-3 years after individuals moved into area and was not retrospectively applied.  As such, large new developments would put additional significant pressure on NHS resources. This was a national issue but exacerbated in Kent and Medway and the South East where large developments and inward migration was high.

·        Use of developer contribution funding (s106) – in response to how s106 funding was used to provide health services, it was confirmed this was done in a dynamic and strategic way.  The NHS had access to planning tools which took into account existing clinical services, deprivation, population health etc when a new development was planned and would map out the level of investment needed and where to direct it. Sometimes, funding from multiple developments was pooled together to optimise the funding to meet need.

·        Community Diagnostic Centre – reference was made to the helpful visit that took place before the last local election and it was suggested that a visit be reorganised, particularly for the benefit of newer Members of the Committee.

·        Void spaces in HLCs – reference was made to how these could be used, including by CVS organisations.  It was confirmed that the HCP worked closely with CVS in terms of how they used NHS space and vice versa.  A survey of almost 2000 people from harder to reach communities had demonstrated that their needs in relation to improving their health and wellbeing were not clinical interventions but instead related to alternative support services, such as cost of living support and services that could provide wrap around support for people. It was added that work was ongoing in making renting of void spaces more affordable and attractive to help improve usage.

·        Rationalisation of disused property – concern was raised that services would be stopped from properties that were not used frequently enough.  Reassurance was provided that that there would be no closure or relocation of services without full consultation and that this would largely relate to very under used properties or those in bad disrepair. Community provision in Medway was flexible and agile to respond to changes needed.

·        Integrated Neighbourhood Teams (INTs) – reference was made to INTs and how valuable they were and it was asked what was being done to attract and retain staff to the roles within these services.  It was confirmed that close work took place with the local universities and Medway colleges, along with the School of Pharmacy, to encourage individuals to work in Medway. The HCP was also engaged in an apprenticeship programme to assist in recruitment, supporting young people with an alternative route into the profession.  It was confirmed that INTs were a key priority and that much of the workforce modelling was to ensure that people had access to the right member of staff to meet their need.  It was noted that staff turnover from the current community provider was not significantly high.

·        Green vehicles – it was commented that clinicians in the community would benefit from having access to green vehicles to be able to access the community easily and in a sustainable way, without relying on clinicians having to use their own vehicles.

·        Children’s self harm ­– it was asked why this had significantly worsened. It was explained that the reason was not known but that Medway was a national outlier.  This could not be contributed to Covid as that had been an issue impacting all areas and the deterioration in this issue was instead Medway specific. It was a key pathway area for development and work was ongoing with partners, such as Healthwatch Medway and others, to help understand the cause for the decline and to identify ways of tackling that.

Decision:

The Committee noted the report and requested the following:

• That a site visit to the Community Diagnostic Centre in Rochester be arranged for Committee members.
• That an update on Healthy Living Centres and their utilisation be provided to the Committee in six months.
• That a report on Integrated Neighbourhood Teams be provided to the Committee at a future meeting.