Agenda item

This paper provides details of the NHS Kent and Medway Local Area Team commissioning plans 2013/2014 and 2015/2016 for the Board to consider and comment.

Discussion:

The Local Area Team Director, NHS Kent and Medway introduced the NHS England (Kent and Medway) Commissioning Plan 2014/2015 and 2015/2016 and responded to Board Members’ questions.

She pointed out that commissioning for military health was being undertaken by the Area Team in Bath, Swindon, Wiltshire and Gloucester for the south of England and stated that she would welcome the Board’s views on the tailoring of services locally.  She also recognised the need to align the plans with the Joint Health and Wellbeing Strategy.

Referring to page 29 of the agenda it was pointed out that responsibility for the health visiting service and Family Nurse Partnership would be passed to the Council from October 2015.  She also undertook to provide more detail when the plans are brought back to the Board and agreed to send round the next iteration via the Democratic Services Officer.

The Director of Public Health emphasised that the APMS practices had been commissioned to improve access to primary care in underserved areas and that this important factor in reducing health inequalities should be considered when the contracts were reviewed.  The also encouraged close working between the Local Area Team and the Senior Public Health Manager in relation to the roll out of health living pharmacies and welcomed the extension of delivery of flu vaccinations in community pharmacies to help boost take up of the vaccine amongst at risk patients as uptake rates were not meeting targets.  She also queried whether a Health Equity Audit had been undertaken in relation to diabetic retinal screening to inform procurement.

The Deputy Director, Children and Adults Services suggested that there would be opportunities to collaborate across the Council and NHS to seek service user views.

Following a series of questions the Local Area Team Director, NHS Kent and Medway responded as follows:

·        It was confirmed that the reference on page 34 to ‘cost neutral’ in relation to re-procurement of clinical element of substance misuse service did not equate to cuts to the service

·        In relation to page 20 the reference to choice of GP practice and how this would work still needed to be thought through.  In relation to page 21 the changes to dementia diagnosis meant that professional judgment would be applied in some instances where it was in the patient’s interest not to be formally diagnosed as suffering from dementia.  (The Deputy Director, Children and Adults welcomed the possibility of engaging with the views of service users in regards to the diagnosis and care for people with dementia in order that there could be shared intelligence)

·        The re-procurement of the Kent Sexual Assault Referral Centre (SARC) (page 32) would be for a new service based in Kent

·        The Healthwatch Medway representative welcomed the fact that the patient voice would be heard in Local Area Team’s commissioning as referenced on page 18.  He also said he would welcome working in partnership with the Local Area Team and also with adult social care in relation to commissioning.  He also referred to developments within Healthwatch Medway to attract volunteers to a Healthwatch Academy to work in all areas of wellbeing which he undertook to report back on in the future

·        With reference to page 21 it was stated that the Local Area Team would need to work with the Clinical Commissioning Group (CCG) in relation to changes to alcohol screening service as this seemed to be only relating to newly registered patients at present.  The Chief Clinical Officer, NHS Medway CCG stated that an audit on retinal screening was being carried out to ensure that people were not missed

·        The point was made that the commissioning plans needed to be more Medway-focussed

·        In response to a request from the Chairman it was agreed that the changing face of Medway in relation to primary care should be brought to the Health and Wellbeing Board, particularly in relation to the fact that a large number of GP practices were single-handed and many coming up for retirement.  The Local Area Team Director suggested that this report, when it comes forward, should be a joint one with NHS Medway CCG as there were ongoing discussions regarding merging of some practices and federations being formed

During discussion it was pointed out for clarification that the legal implications in the report should have related to Section 116B of the Local Government and Public Health Involvement Act 2007 rather than the Health and Social Care Act 2012.

Decision: 

The Board:

(a)   noted the commissioning plans for NHS Kent and Medway Local Area Team for 2013/2014 and 2015/2016 and agreed to receive updated plans at the next meeting (with an interim update to be circulated by the Democratic Services Officer);

(b)   noted that a joint report between the Local Area Team, NHS Kent and Medway and the NHS Medway CCG would be brought to a future meeting on the changing face of Medway’s primary care arrangements on a date to be agreed.