Agenda item

Angela McNab (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust) and Bob Deans (Consultant Executive Director, Kent and Medway NHS and Social Care Partnership Trust) were in attendance for this item.

(1)       The Chairman introduced the item and welcomed the two guests attending from Kent and Medway NHS and Social Care Partnership Trust (KMPT). This was the start of the organisation’s engagement with HOSC on this specific issue and that it was a topic which would be returned to as KMPT’s Foundation Trust (FT) application progressed.

(2)       Angela McNab introduced herself and explained that she was the new Chief Executive of KMPT and had taken up her new position the week before. Bob Deans, who had been interim Chief Executive over the previous year and was now Consultant Executive Director, provided an overview of the Trust’s plans, connected to a print out of a presentation which had been placed on Members’ desks for the start of the meeting.

(3)       It was explained that the original consultation around KMPT’s FT application ran in 2008, and the Trust had come to HOSC on that occasion. In October of last year the Strategic Health Authority had approved the plans for the current engagement process with a view to the Trust being authorised in 2013. The Trust was working on a business plan and was looking to the Committee for suggestions of what to include. In response to a specific question, the Trust offered to share the draft business plan when it was ready. An open offer was also made to arrange visits to the Trust for Members. 

(4)       The focus of the Trust’s plans was an ambitious clinical strategy. This was built around Service Line Management arrangements which meant there were a series of clinically led business units such as Community Access and Recovery. They also provided specialised and complex services like forensic services. Trust representatives reported that they performed well against nationally set targets. An engagement process had led to a clear set of values and an ambitious vision being set out and used language from the staff, at least 10% of whom were involved. The Trust aimed towards being able to deliver integrated mental and physical health services and supported the personalisation agenda and wanted everyone to have a care plan. This was backed up by a clear staff development programme.

(5)       KMPT was currently a Partnership Trust, with 300 Kent County Council staff seconded to it. They wished to remain as a partnership with others and an agreement had been reached with KCC’s Cabinet.

(6)       The FT application had to be seen in the context of broader changes in the health economy. There was a more commercial focus with patient choice becoming more of a factor and Trust representatives spoke of wishing to be akin to a ‘blue chip’ organisation that would be the best choice for people. Increasingly services were being tendered, and an example was given of a joint tender bid for community child and adolescent mental health services (CAMHS) that had been put together with Kent Community Health NHS Trust, with academic input from St. George’s. In response to a specific question, it was explained that St. George’s was not the closest academic mental health Trust but did have a particular research expertise in CAMHS.

(7)       Another specific range of services discussed was telehealth and telecare, with the services available in Kent very well regarded and being developed in line with worldwide best practice. Some ways of delivering this were relatively simple methods like providing psychological help and advice via email. In response to a specific question, it was reported that patients did not have to pay for equipment used to deliver healthcare, though some had their own equipment.

(8)       Capital investment in improving inpatient facilities was also highlighted as an ongoing area of work, with the St. Martin’s development specifically referred to. Other specialised inpatient centres of excellence were being developed. On the issue of estates and accountability, it was explained that a Foundation Trust was able to sell off assets and keep the capital receipts to reinvest but that a business case would have to be produced and be approved by the Trust Board and Monitor. More broadly, Members raised specific queries about how accountability would work in practice. It was clarified that the Trust’s Council of Governors would involve services users and carers and they were already involved in the current shadow Council.

(9)       A range of specific comments were made by Members about the presentation of the Trust’s case. Some questions related directly to the presentation, and the lack of clarity about the map. The Trust explained that the presentation had tried to cover a lot, but took on board the comments that a different approach would be needed for different audiences. Borough/City/District Councils were amongst the stakeholders who would be involved in the ongoing engagement process.

(10)     There was a strong vein of scepticism running through a number of Members’ comments about the difference that FT status would make. While it was acknowledged that achieving FT status was Government policy, it was unclear that it would achieve anything more than a change of name. Attention was drawn to the vision, with the comment made that there were so many variables in the health economy it was difficult to see how it could be realised. One Member expressed concern that it was all about organisation, not patient services. Reference was made to past concerns expressed about KMPT and the long-term viability of KMPT; however, it was accepted that the Trust needed to try. Trust representatives took on board the comments Members made and stressed that they saw FT status as just that, a change of status rather than a cosmetic change of name, but knew they would have to demonstrate past problems had been overcome. It was acknowledged by Trust representatives that reputation and perception was important, and made clear that there were no current issues which had been raised by the Care Quality Commission, and there had been none for 6-7 months. The clinical strategy and quality of patient care was at the heart of their plans because patient care was their business. Therefore demonstrating financial sense came from delivering excellent care was central to the ongoing work.  It was accepted that planning for innovation was difficult so the plans needed to build in wriggle room and there was a continual process of horizon scanning; but it was also pointed out that innovation often saved money and reduced costs.

(11)     The Chairman thanked the guests and explained that the Committee looked forward to receiving further updates in the future.

(12)     RESOLVED that the guests be thanked for their contributions and that the Committee looks forward to receiving further updates in the future.