Agenda item

Mr Roger Gough (Cabinet Member for Education and Health Reform, Kent County Council) and Mr Tristan Godfrey (Policy Manager (Health), Kent County Council) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Mr Gough introduced the item and proceeded to give a presentation which covered the following key points:

·         The 2015 Challenge Declaration - NHS Confederation

·         The Initial Health & Wellbeing Strategy

·         The Refreshed Health & Wellbeing Strategy

·         Communication and Engagement Plan

·         Local Health and Wellbeing Boards

·         The complexity of the Kent landscape

·         Integration Pioneer programme

·         Better Care Fund

(2)       At the 6 June meeting, a Member of the Committee requested an update on the local Health and Wellbeing Boards' relationship with the Kent Health and Wellbeing Board and the input of local Boards into the Kent Health and Wellbeing Strategy as part of Mr Gough’s presentation. Mr Gough gave an overview of the local Health and Wellbeing Boards in Kent. He explained that there was a distinctive set up in Kent with seven CCGs running across 12 local authority boundaries and three health economies. He highlighted the proposed merger between NHS Ashford CCG and NHS Canterbury & Coastal CCG.

(3)       Mr Gough explained that there was a developing relationship between the Kent Health and Wellbeing Board and the local Health and Wellbeing Boards. There was a mandate for local Health and Wellbeing Boards to look at national issues or particular areas such as falls and develop local strategies. The Kent Fire & Rescue Service presented to the Kent Health and Wellbeing Board in July about their contribution to health and wellbeing of Kent which would be taken forward by local boards.

(4)       Mr Gough explained that Local Health and Wellbeing Board were key stakeholders in the development of the refreshed strategy. As part of the communication and engagement plan, the local Health and Wellbeing Boards would be engaging with their local populations and reporting back to Kent Health and Wellbeing Board in November 2014. A number of local Health and Wellbeing Boards inputted into the Better Care Fund and reviewed local commissioning plans. Local Health and Wellbeing Boards had mixed economies with Chairs ranging from KCC Cabinet Members, District Council Leaders and CCG Chairs.

(5)       The Chairman invited Mr Bowles, a guest of the Committee, to speak. As the Chair of the Swale Health and Wellbeing Board, he raised concerns about financial and staffing pressures on the borough council to facilitate the local Health and Wellbeing Board in particular attendance at additional meetings and leading on public consultation. Mr Gough acknowledged the difficulties Swale faced in covering two CCG areas. He explained that he did not expect borough and districts to lead on consultations. It was for the CCGs to consult on their commissioning plans and the communication and engagement for the refreshed Health and Wellbeing Strategy was being led by KCC.

(6)       Members of the Committee then proceeded to ask a series of questions and made a number of comments. A Member raised a concern about the ownership and redesign of NHS estate. Mr Gough explained that NHS estate was owned by NHS Property Services. It would be a significant player in reconfiguration as it could match and mirror changes to services. Mr Ridgwell commented that there was a large amount of NHS estate available to utilise with the redesign of services.

(7)       A number of comments were made about ‘hospitals without walls’ and community services. Mr Gough explained that ‘hospital without walls’ was the concept of acute services coming out into the community enabling patients to have a shorter stay in hospital and receiving care in the most appropriate location such as at home or in a community setting. He highlighted Simon Stevens’, Chief Executive of NHS England, support of community hospitals. He noted that the KCC Accommodation Strategy was looking to establish community capacity and ensuring the correct mix of accommodation was available.

(8)       A specific question was asked about the Assurance Framework’s fit with the Better Care Fund. Mr Gough explained that the Assurance Framework had been developed over the last year with elements of the Better Care Fund being anticipated and incorporated. The Assurance Framework fitted well with six Better Care Fund indicators. He noted the Better Care Fund’s greater focus on reducing hospital admission.

(9)       A Member enquired about devolved budgets. Mr Gough explained that CCGs were responsible for their own budget. Social care budgets would be moving towards the CCG structure and there was a desire to bring the public health funding closer to the local CCG areas. He acknowledged that some public health services would continue to be commissioned county wide. He stated that he would be happy to discuss the issue further with the Member.

(10)     A Member highlighted SEN funding and provision. Mr Gough explained that there was a large special school capacity in Kent. There were huge pressures on autism, speech & language and behavioural & emotional services. KCC had invested heavily in reducing out of county placements and had developed six new primary schools with specialised units in areas of need. There would be further integration between KCC as the education authority and the health service with the introduction of the Children and Families Act.

(11)     A number of comments were made about CAMHS, statistical variances in the report and the utilisation of libraries and gateways. Mr Gough explained that The Rt Hon Greg Clark MP had suggested the countywide target for improvements to CAMHS. Mr Gough stated that he would need to check the differences in the statistics and would provide additional information on the utilisation of libraries and gateways.

(12)     A Member made a comment about the number of people in Kent who could be potentially affected by the Assisted Dying Bill. Mr Gough stated that he was unable to provide a definitive answer as the Bill was going through its parliamentary passage.

(13)     RESOLVED that Mr Gough be thanked for his attendance at the meeting, and that he be requested to take note of the comments made by Members during the meeting and he be invited to attend a meeting of the Committee in nine months’ time.