Agenda and draft minutes

Apologies were received from Mr Paul Bentley, representative of the Integrated Care Board. Ms Malti Varshney was in attendance.

Ms Varshney declared that she was a non-executive Director in one of the voluntary sector organisations in Maidstone.

RESOLVED that the minutes of the meeting held on 25 April 2024 were an accurate record and that they be signed by the Chairman

1. Dr Ghosh provided a verbal update on the following:

(a)  Kent County Council had been awarded a Public Health Grant of £81,469 for 2025-26 which was the second highest grant in the country, with Birmingham receiving the largest allocation and Lancashire receiving the third highest. However, in terms of allocation per head in terms of size of population, there was a level of discrepancy with Birmingham receiving £92.48 per head, Lancashire approximately £65 per head, and Kent £49 per head. However, the allocation and early announcement would ensure earlier planning compared to previous years.

(b)  The 9^th March was the Covid Day of Reflection and marked the 5^th year of the start of the Covid pandemic. A number of events were set to take place across Kent, with the locally adopted theme focussed on Healing and Hope. KCC would also be launching a virtual remembrance wall for staff and members to share experiences.

(c)  KCC’s public health priorities had been developed for 2025-26, these were as follows:

1.    Three priorities which were set to continue from the previous year:

-       delivery of the integrated care strategy

-       public health service transformation program

-       prevention program, really putting a rocket booster under prevention, although everything that public health does in a way is prevention, but this is specifically looking at how we can prevent, reduce, and delay the use of adult social care strategy services through the adult social care prevention framework that we're working very closely with adult social care colleagues on

2.    Family hubs and Start For Life Programme

3.    Stop Smoking Services and vaping

4.    Tackling health inequalities across Kent through the Marmot Coastal Region, the Work and Health Strategy and the Housing Strategy.

5.    Mental health and the reimagining of mental health services to create better integration between children’s and adults

(d)  The strategic work underway was set to be delivered through the Integrated Care Strategy’s Delivery Plan which featured as an agenda item.

(e)  Coastal Kent would be the first region in the UK to call itself a Marmot Coastal Region. KCC Public Health has commissioned the UCL Institute of Health Equity (IHE) for a period of two years from October 2024 to October 2026 to support the initial stages of the programme. The plan for Kent was to adopt a layered approach starting with two of the eight Marmot principles, ‘skills for work’ and ‘work and employment’ which focussed on tackling health inequalities by improving deprivation through jobs, which was one of the most important sustainable wider determinants of health. The six areas are Swale, Canterbury, Thanet, Dover, Folkestone and Hythe, and Ashford. The senior leadership of all these districts and boroughs had endorsed the programme and committed to support it. Kent Marmot Coastal Region Programme

(f)   The consultation on Kent and Medway’s Work and Health Strategy was due to close on 20^th March 2025. This strategy had been designed to support employers in creating healthier workplaces and to support people with  ...  view the full minutes text for item 51.

Abraham George, Consultant in Public Health was in attendance for this item

1.    Mr George introduced the 2025 Kent Joint Strategic Needs Assessment (JSNA) exception report which highlighted the health needs assessments, reports and analyses completed in 2024, as well as key population health figures. The JSNA allowed both the Board and the Kent and Medway Integrated Care Partnership to be aware of the relevant issues and trends which needed to be addressed and reflected in the key priorities and outcomes of the Integrated Care Strategy and district local plans. Mr George highlighted that there had been a total of 12 needs assessments completed over the last year (highlighted throughout the report) by the KCC Public Health team and other partners organisations . Where available, final reports were published on the Kent Health Observatory (KPHO) website . Mr George highlighted the key findings from the report and welcomed questions.

2.    In response to comments and questions from Members of the Board, it was noted:

(a)  In response to members interest regarding the Kent and Medway Care Record (KMCR) and its promising application, Mr George explained that the KMCR which had been developed over several years as part of the NHS's national digital and data infrastructure program, was a shared care record contracted to GraphNet. Initially intended for direct care planning, its use expanded during COVID to include population health intelligence, aiding JSNI-related work. Despite its benefits, Mr George highlighted the need for a strategy to incorporate non-social care NHS datasets to better understand the broader at-risk population. Efforts were underway, particularly in West Kent Health and Care Partnerships (HCP), to explore data integration from local councils and voluntary organisations. The record's risk stratification tools had been useful for profiling high-risk patients

(b)  Members expressed appreciation for the data available and noted its usefulness in addressing inequalities, with specific reference made to  Tunbridge Wells. A request was made that the maps from the KPHO were better labelled to help focus on communities with problems. Mr George agreed to further discuss the suggested improvements offline.

(c)  With regard to A&E admissions for children and whether there was any assessment of other influencing factors, such as primary care availability or temporary housing conditions, which identified commonality of need; Mr George explained that the current public health data sets were high-level and did not allow for detailed analysis. However, with the Kent care record, there was potential to link multiple data sets to better understand these risk factors. He emphasised the need to collaborate with NHS healthcare partnership colleagues to ensure accurate interpretation of the analysis.

(d)  In response to the healthy weight statistics for children and whether local efforts had made an impact on trends becoming more static as opposed to worse, Dr Ghosh emphasised the importance of looking beyond Kent and comparing its data with similar areas like Hampshire or Surrey, but with caution. He acknowledged that maintaining current obesity levels ("standing still") might have seemed counterintuitive, but it  ...  view the full minutes text for item 52.

Oluwatoyin Sosanya MPH, MRPharmS, Public Health Pharmacy and Quality Lead) was in attendance for this item

1.    Dr Ghosh introduced the report which set out the plan to update the Pharmaceutical Needs Assessment (PNA) and proposed sign-off process to ensure 2025 PNA was published according to legislative requirements. The current Kent PNA was published in September 2022 and was due to be revised by October 2025. A specialist provider called Soar Beyond Limited had been commissioned, via a competitive tender process, to support delivery of the 2025 PNA. The PNA was a key document used by the National Health Service (NHS) and Kent County Council (KCC), to support commissioning decisions; including, but not limited to, approving applications to open new pharmacies and commissioning services through pharmacies based on population health needs. Dr Ghosh advised that due to the scheduled 2025 Health and Wellbeing Board meetings and local Kent election, approval was sought from the Health and Wellbeing Board to delegate authority to the Director of Public Health, in consultation with the Chair of the Health and Wellbeing Board, to draft and approve the first iteration of the PNA to go out to statutory consultation.

2.    Ms Sosanya added that the PNA would assess the current pharmaceutical services in Kent, including pharmacies, dispensing doctors, and appliance contractors. The goal was to identify gaps and make recommendations for improvement across the county. The current PNA was published in September 2022, and a revised version must be published within three years.

3.    The process of refreshing the PNA began in September last year, and a steering group had been established. Members include representatives from Kent County Council engagement, the Kent Public Health Observatory, the local medical committee, the local pharmaceutical committee, Health Watch, and the ICB. The steering group had met twice and completed several activities, including data collection, stakeholder engagement via questionnaires, validation of the current pharmaceutical list, mapping exercises, and drafting the health needs chapter based on the Joint Strategic Needs Assessment (JSNA). The information was being triangulated, and the first draft was scheduled to be ready by the end of March or beginning of April. Once approved, it would go to consultation for 60 days. The final draft would be brought to members at the September Health and Wellbeing Board for approval and publication before October.

4.    In response to comments and questions from Members of the Board, it was noted:

(a)  In response to whether online pharmaceutical providers are captured within the needs assessment, Ms Sosanya clarified that online pharmacies within the health and wellbeing board boundary would be included in the pharmaceutical list, and that they had the capability to supply medicines nationwide.

(b)  With regard to whether the assessment focused solely on providers based in the area rather than accessibility. Ms Sosanya confirmed that online pharmacies were counted as providers within the Kent boundary, although essential services such as picking up prescriptions required physical pharmacies. Ms Sosanya clarified that the scope of the pharmaceutical needs assessment  ...  view the full minutes text for item 53.

Author Dr Mike Gogarty, Interim Strategic Lead for Public Health, was in attendance for this item

1.    Dr Ghosh and Dr Gogarty introduced the report which provided members of the Board with a overview of the Kent County Council Integrated Care Strategy (ICS) Delivery Plan. The plan and priority actions were endorsed by the Health Reform and Public Health Cabinet Committee on 21st January, and approved by Cabinet on 30th January. The Kent Health and Wellbeing Board were asked to endorse the ICS Delivery Plan in its role as the delivery plan for Kent’s Joint Local Health and Wellbeing Strategy. Dr Gogarty advised that the Delivery Plan was one facet of the work needed to shift health and wellbeing. Concurrently, work was being done at the district level to develop district plans, supported by the Kent Association of Local Councils. Collaborative work was also underway with the NHS, particularly through the acute trust, to deliver health and wellbeing. Dr Gogarty thanked colleagues within Kent County Council for their hard work and enthusiasm despite conflicting priorities. The Plan captured ongoing work and also defined new priorities and actions for the next one to three years to improve the population's health. It was recognised that this work would need to be done against a challenging financial background, with many options being low or no cost. Credit was given to the Director of Public Health and Mr Watkins (Chair of the Kent Health and Wellbeing Board and Cabinet Member for Adults Social Care and Public Health) for their leadership.

2.    In response to comments and questions from Members of the Board, it was noted:

(a)  Members commented on the path-breaking approach for the Council in its  commitment to the level of detail in delivering the Integrated Care Strategy (ICS). Whilst recognising that there were initial questions about the substance of the ICS, the actions of the Council and other partners had brought real practical meaning to it, demonstrating its trackable delivery.

(b)  In response to the level of accountability that would be placed on individuals within the public health system, Dr Ghosh advised that multiple stakeholders, including KCC and NHS trusts in Kent, were involved and were keen to contribute. Direct conversations had also been held with the executives of NHS trusts who were eager to be involved. Dr Gogarty’s work over the next year involved working with NHS trusts and internally within KCC’s directorates to embed and hardwire the initiatives. KCC’s directorates were jointly accountable for the strategy, and work was underway to develop mechanisms for implementation, monitoring, and accountability. The collaborative approach aimed to capitalise on the momentum and intentions of all partners involved.

(c)  With regard to targets and how these would be measured and reported, Dr Ghosh confirmed that the Integrated Care Partnership (ICP) was ultimately accountable for delivery, along with the Health and Wellbeing Board. There was also a log frame that linked with the JSNA work, which contained a set of indicators developed to provide a sense  ...  view the full minutes text for item 54.