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