The NHS in Kent and Medway is planning an overhaul of health and care services which will mean creating about 42 primary care networks from July 1, each covering 30,000 to 50,000 people.
These will mean GP practices working together in networks with their own funding so they can employ new staff -such as physiotherapists with enhanced skills, who patients can refer themselves to without needing to see the GP first- and provide some services for everyone in their area.
There will also be four integrated care partnerships from April 2020, consisting of hospital, community, mental health, and commissioning organisations and primary care networks. These will be based on how patients currently use hospital services: one each for east Kent; Dartford, Gravesham and Swanley; Medway and Swale; and west Kent.
Each organisation will hold a budget but they will agree together on how funding is spent locally. The Kent and Medway NHS says this will free up staff to work in teams based on skills and patient needs, regardless of which NHS organisation employs them.
There will be one system commissioner for the NHS, which may be formed by the eight existing clinical commissioning groups merging or working as one – the GPs from the CCG membership will decide. The single commissioning organisation for Kent and Medway, led by local doctors, will take a ‘bird’s eye view’ of health priorities for local people and look at where shared challenges, such as cancer and mental health, should be tackled together.
In addition the Kent and Medway integrated care system is also expected to include, by April 2021:
A partnership board, representing commissioners and providers from across health and care organisations, as well as local government, the voluntary and community sector and other stakeholders
Patient and public representatives ensuring patients have a voice within the new arrangements
A clinical and professional board to scrutinise the evidence for change and advise on how best to improve the quality of care
Partnership arrangements with elected members of local authorities through Health and Wellbeing Boards and Health Overview and Scrutiny Committees.
Dr Jihad Malasi, chair of NHS Thanet Commissioning Group (CCG), said: “I and my fellow CCG chairs across Kent and Medway want people to be able to live their best life, and get great treatment, care and support when they need it.
“We are very clear in Thanet about how important it is to work closely together with colleagues from other organisations. This is key to helping people with long term conditions who need health and care from several teams, or who are dealing with non-medical issues, such as problems with housing, employing or benefits, which could have an impact on their health and wellbeing.
“Equally, working with our partners is absolutely key to our being able to deliver high quality, sustainable care that meets people’s needs and makes the best use of NHS staff and resources.
“Over the last three years the CCGs have made real progress by working with the rest of the local NHS, social care and public health as the Kent and Medway Sustainability and Transformation Partnership.
“Now we collectively want to change some things about the way health services are organised. We believe this will unlock improvements in care for patients and help us meet rising demand.”
County and district councillor Karen Constantine said: “I broadly welcome attempts to improve access to health care across Thanet. However the NHS has never been a static organisation, with major service delivery changes now coming every few months, or so it seems. I’m concerned that the introduction of PCNs primary care networks will cause both staff and patients confusion and concern.
“The reorganisation of local staff and services will only be successful if the Government acts urgently to ensure more people see careers in the NHS as desirable. Since the removal of the successful bursary scheme for nurses and midwives we have seen a real decline in the number of people in training for those vital roles.
“I’m worried that patients with complex health requirements, including disabilities and mental health needs could eventually find themselves needing to receive treatment in several different places across Thanet. Additionally I’m concerned about those residents who are on very low budgets, who will struggle to fund bus and taxi fares. That’s of course where public transport is available. Especially in the evenings and on Sundays and Bank holidays. What additional support will be available to those on low incomes?
“I note that the Ash surgrey has been grouped with CARE, Coastal and Rural East Kent. Does that mean that residents from St Peters, Westgate and Broadstairs could find themselves travelling across to Ash? According to google maps that’s 24 minutes by car, that’s if you are lucky enough to own one. I doubt there’s any public transport.
“I shall be raising these matters formally. If people have concerns they can contact me.”
A document setting out full details of the plans, and a summary, has been published today at https://kentandmedway.nhs.uk/workstreams/systemtransformation/.
People are being encouraged to respond to the plans by Friday, August 16 by filling in an online survey or by post or email.
Over coming weeks, every clinical commissioning group in Kent and Medway will be discussing the plan at their governing body meetings and with their member GP practices.
The Kent and Medway NHS says the plans will offer people more support to stay fit and well before things become a problem – including active reminders sent direct and clinical initiatives to, for instance, identify people at higher risk of a stroke, and will include more focus on your physical and mental health and wellbeing
Fill in the survey online at www.kentandmedway.nhs.uk, write to Freepost KENT & MEDWAY NHS, New Hythe Lane, Aylesford, Kent ME20 6WT or email email@example.com
As the elected Thanet representative on the Health Overview and Scrutiny Committee I very much hope to be in attendance.
One day the money wasters management of the NHS will stop wasting money by constantly moving services around and kidding the public that it’s “to improve services” I spent nearly 40 years working in the NHS so I have seen at first hand the endless meetings about meetings on how to fit a quart into a pint pot. In the meantime there are over 40,000 vacancies and staff cannot wait to leave or retire due to the pressures put upon them. The government tells the NHS trust to improve efficiency savings year are year cut cut cut, then after nearly ten years the government lie that they are increasing funding, Lies, they are only giving what they took away. Trust don’t rush to employ more staff they disguise it as so called efficiently saving..
I have no confidence in any of those people on the comittee. They are all a load of NHS money wasters, taking huge somes for introducing more costly alternatives to what was working well before they took over.
These waste of time consultations are another huge waste of money because they will implement what they decide without our input in any case.
The authorities in charge should leave things alone and stop changing it around making services harder to receive for most of the population here in East Kent. But they won’t, we need these people out of their jobs so the NHS can save money and we can receive the services we need.
I want an audit of the money central government get from the nation’s National Insurance contributions – deducted at source &/or charged by HMRC for self the employed – which they’ve withheld from the NGS & Social Care, for the past decade.
Where has the nation’s NI payments gone, if not directly into the NHS – this has the makings of the greatest national scandal in the history of the UK & the history of the NHS.
Using NI contributions for any purposes, other than the nation’s health, must be accounted for by the Treasury & those politicians who have cut the use of our NI contributions for their sole purpose – properly funding our NHS.
The videos were disturbing & at no point cut-to-chase & actually stated precisely what the ‘difficult decisions’ really meant, in terms of NHS services cut due to government abuse & neglect of the nation’s health through failing to spend our NI taxes on our National Health Service.
National insurance is a tax which enables you to build up an entitlement to pension benefits, maternity pay, sick pay etc.
The NHS is separately funded by government.
It seems very strange that the three worst proposals for changes to the NHS services in Kent are not discussed
1. The closure of the Stroke Unit in Margate
2. The removal of Accident and Emergency Services to Canterbury from Margate
3. The proposed removal of GP services in Broadstairs, close to the people who need them , to a central hub to a site on the edge of Westwood Cross, which for many elderly people, mothers with young families and other disadvantaged people is quite difficult and time consuming to reach
Are the administrators really at all interested in our views??
They have already made their minds up, paid by the tories for implementing Tory policies, all about cutting services. How many of them understand the needs of ordinary Thanet people. Shame on them
I was assured by the SONIK group that the decision on the stroke unit is not driven by cost cutting.
I have read the proposal documents and it is unfair of you to suggest it’s all about cutting services. Doing things differently does not necessarily mean cost cutting.
The NHS is often used as a political football, which is wrong.
The argument made by NHS managers who are driving the stroke changes through is that it is not about cost-cutting. That is what they assure us. That is what SONIK will have said – but it doesn’t mean that we believe it!
I can’t belive they’re using the slogan ‘live your best life’! It’s even worse than their use of ‘three vibrant hospitals’!
The meeting held on this topic this Thursday (july 18th) has just 40 hand picked attendees. Many applicants were turned down, including local councillors.
– Many doctors have expressed concerns about Primary Care Networks, and don’t want them to go ahead, as they fear they will drive independent practices to close. The new networks will reduce autonomy for doctors, and the patient doctor relationship and continuity of care is likely to be greatly damaged. GP surgeries will effectively be ‘chains’ – this may make life easier for the top managers, but it seems less likely that it will improve anything for the patients, doctors or other staff. The new PCN system will use receptionist triage, which carries risk. Triage should always be done by a clinician. PCNs will use a lot more staff that have fewer qualifications. New ‘non-doctor’ roles have been created, and people will see physios, nurses etc before they get to see a GP for a diagnosis. This may be appropriate in some cases, but again it carries risk. Some are questioning if it is appropriate to create a system where lots of staff will be operating beyong their competence level.
The removal of the eight local CCGs that we currently have and replacing it with one overarching Kent and Medway CCG is very worrying, potentially meaning a huge loss of local autonomy of budgets, health choices, and spending. Local voices will be lost when trying to be heard by a commissioner that manages health for over 1.8 million people. Some also believe that the new ICSs (integrated Care Partnerships) are simply a placeholder for private firms that are poised to take over management of NHS services in coming years – the new structure will suit private companies much better as it is designed to simplify mangement at the cost of local needs.
Save Our NHS in Kent are asking questions about the implications of these changes. What is happening seems to be a highly controlled public engagament exercise but not a consultation. These are major changes and the current govt have no mandate for it; nor did they mention it before the last election. There has been no public debate on it.
No members of Save Our NHS in Kent have been allowed to attend the NHS meeting on July 18th in Canterbury. Only 40 people, who had to apply, were allowed to attend. Many were rejected.
At this early stage, it is hard to fully understand the implications of these changes, but we suspect it will lead to less patient voice, less local control, less autonomy for local decision making, less autonomy for doctors, and probably further erosion of democracy in health care and effectiveness of and access to healthcare for the already deprived.
Follow @saveournhskent to stay up to date…