Agenda item

This report provides an update on the proposed integration between Kent Community Health NHS Foundation Trust (KCHFT) and Medway Community Healthcare CIC (MCH). The proposal involves the transfer of MCH staff and services into KCHFT, forming a single NHS Foundation Trust to deliver more sustainable, integrated community services across Kent and Medway. Attached to the report is a completed substantial variation assessment for the Committee to consider.

Estimated time: 40 minutes

Discussion:

Representatives from both Kent Community Healthcare NHS Foundation Trust (KCHFT) and Medway Community Healthcare Community Interest Company (MCH) introduced the report which provided an update on plans to integrate the two organisations which would involve the transfer of MCH staff and services into KCHFT. During the tender process for Community Services provision across Kent and Medway, the two organisations had provided a collective and collaborative bid, which was successful. The integration was to strengthen that further by improving access to community services; reducing duplication; strengthening neighbourhood-based care; improving consistency across Kent and Medway; making better use of digital and data and increasing resilience for smaller, specialist teams. The Boards of both organisations had therefore decided to progress with integration in April 2026.

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

·         Local services – the point was raised that historically MCH was seen to provide a better, more local service to meet the specific needs of Medway, and it was asked why that position had now shifted. In response it was explained that the health and care landscape had significantly changed and the collaboration in the context of community services would be less sustainable if MCH remained as a separate, small organisation. The integration would enable more resilient services and more opportunities for workforce. Assurance was sought around whether services would continue to be provided from exis ting premises in Medway. It was confirmed that no immediate changes were proposed and therefore services would continue to run as they currently were when they formally transfer to KCHFT on 1 October 2026. The likely longer term impact was that more services would be delivered in Medway as a neighbourhood health area, with an ambition to deliver services in a modern estate that was fit for purpose.

·         Staff survey – reference was made to the outcome of the MCH staff survey, which resulted in 88.6% of respondents being in favour of the reintegration. The survey was in addition to a number of staff engagement events where the organisation was able to hear and respond to staff views. It was added that of around 1700 MCH staff, approximately 250 had responded to the survey.

·         Key performance measures – In order to measure the benefits for Medway residents, it was asked whether the Committee could be given current baseline figures for Medway services so there was something to compare data with going forward. MCH undertook to provide that. In addition, it was asked what measurable performance indicators there would be to hold KCHFT to account on the proposed benefits going forward and KCHFT confirmed they would share data for key measures. The point was also made that one of the key longer-term outcomes anticipated from the integration was improved health outcomes for residents.

·         Governance and oversight – in response to a question about how the wider organisation would work and who would lead the services in Medway, it was explained that the Deputy Chief Operating Officer at KCHFT was also the Interim Chief Operating Officer at MCH so was working across both organisations to understand how MCH worked and how to manage the move across of MCH staff and services. It was reiterated that staff would move over and continue to deliver the same services in the same teams at the start of the contract, with transformation towards neighbourhood health ambitions overtime. The importance of Executive Team presence in overseeing the transfer and bedding the service and staff in was also acknowledged.

·         Strength of integration – Frailty was provided as an example of a service that would benefit from the integration. Across Kent and Medway there was an aging population and many had complex health and care needs. Investment in frailty services in Medway had historically been low compared to other areas and the integration and transformations towards neighbourhood health would benefit older people in Medway who would be better supported to receive treatment at home and remain at home where safe to do so. It was also felt that the innovation and opportunities that would be brought by the transformation would assist in the attraction of GPs to Medway, which had historically been under-resourced compared to other areas.

·         MCH Executive Team – reference was made to the fact that none of the Executive Team from MCH would be transferring to KCHFT, but it was explained that this had been through personal choice, due to their own decisions around retirement, secondments or other opportunities in other organisations. This was a disappointment for KCHFT as some of the MCH organisational memory would be lost but the dual-hatted member of staff currently working across both organisations would mitigate risks around lack of continuity.

• Ongoing engagement – it was confirmed that engagement for staff, patients and the wider community was ongoing and the importance of this to continue was emphasised by the Committee, including its own involvement in ongoing engagement.

Decision:

The Committee noted the update on the proposed integration of KCHFT and MCH and the SV assessment attached at Appendix 1 and determined that the proposal did constitute a substantial variation or development in the provision of health services in Medway because there had not been sufficient engagement and this would result in significant deviation of contract through transformation.