Agenda item

To discuss and endorse the following commissioning plans

Ashford and Canterbury & Coastal CCG

Dartford Gravesham and Swanley CCG

South Kent Coast CCG

Thanet CCG

Swale CCG

West Kent CCG

NHS England

Public Health

(1)       Dr N Kumta introduced the commissioning plans for Ashford and Canterbury CCGs.  He referred in particular to the need to dissolve traditional boundaries between primary care, community services, hospitals, social care and other services in order to meet patients’ needs and expectations. He said Ashford and Canterbury CCGs were well placed to deliver against these expectations and drew the Board’s attention to the “Strategic Plan on a Page” set out on page 13 of the agenda papers.

(2)       Dr D Cocker introduced the South Kent Coast CCG’s commissioning plan.  He said the plan was building on a solid foundation from 2014/15 and that it included £6.3m savings, prioritised mental health and parity of esteem, aimed to consolidate early work on out of hospital services and to support the hospital trust with the development of strategies for improving cancer diagnosis and treatment times and musculo-skeletal and integrated dermatology pathways. He explained the links between the commissioning plan and the Kent Health and Wellbeing Strategy and set out the structure of integrated care in the South Kent Coast CCG area.

(3)       Dr T Martin introduced Thanet CCG’s commissioning plan by setting out the vision for Thanet and the priority areas for 2015/15.  He said the priorities for 2015/16 were to ensure patients received: high quality, equitable and integrated GP services and out of hospital care; timely, clinically appropriate and high quality care in hospital; high quality mental health care in the most appropriate setting; and to ensure high quality children’s services.  

(4)       Mr Carter said he thought the East Kent CCGs had received a poor financial settlement both for growth and basic need.  If this was the case across the county he suggested that collective representations were made to redress this.  He also said that the County Councils’ Network had commissioned a report looking at the capitation allocations across the country against demographic and relative needs.

(5)       It was suggested that in about 12 months’ time the board considers the impact of initiatives in Thanet to address health inequalities and the impact of the development of community hubs (multi-speciality community provider (MCP) model).  It was also suggested that safeguarding aims should be as specific as possible and should include appropriate references to child sexual exploitation which now had “national threat” status.

(6)       Mr Ayres introduced the West Kent Plan by saying it was year 2 of a five-year plan and much of year 1 had been spent unpacking inherited contracts, getting quality systems in place and building leadership and organisational capacity. He said the West Kent Vision and plans were similar to the recently published NHS Five Year Forward View and referred to a number of initiatives already underway or planned in West Kent including: coaching clinical micro systems, the integration of GP out of hours services with home care services, building teams based around practices, the purchase of software to assist care plan management and secondary care referrals, work with Maidstone and Tunbridge Wells NHS Trust to develop a clinical strategy, new models for contracting, the development of treatment pathways, total place budgets and workforce training particularly in relation to the training of doctors and nurses.

(7)       Mr Jones and Dr Lunt gave a presentation on the commissioning plans for Dartford, Gravesham and Swanley CCG and Swale CCG.  Mr Jones said that, in addition to the aims set out in the presentation, it was intended to build on the previous year’s successes such as the integrated discharge teams at the Darent Valley and Medway Maritime hospitals and the integrated primary care teams developed around groups of GP practices. 

(8)       He drew attention to the “plans on a page” and said that 11,000 new homes by 2030 were planned for Ebbsfleet resulting in a population increase of 27,000 over and above the normal projected growth of 21,000.  He said the CCG was working with NHS England to highlight the potential shortfall in funding and had made submissions for funding for infrastructure to the DCLG and the Urban Development Corporation.  He said the development of the Paramount Theme Park would attract 5,000 construction workers and 40,000 visitors per day by 2020 but as this population would be considered to be transient additional demand was unlikely to be funded. 

(9)       Mr Jones also referred to the Better Care Fund, the North Kent Education, Research and Innovation Hub and initiatives with further education colleges to develop courses and qualifications to provide opportunities for local people to qualify in health and social care.

(10)     Dr Lunt drew particular attention to the commissioning intentions in relation to urgent care and long term conditions; a new community dermatology service; the implementation of an emotional and wellbeing service with KCC; the emphasis on reducing health inequalities in primary care as well as plans to review the neurodevelopmental pathway for autism/ADHD across Kent and to review services for disabled children with KCC.

(11)     During the discussion there was general support for: the prominence being given to dealing with health inequalities; the emergence of innovation hubs in North and West Kent; and the plans for emotional health and wellbeing and autism services.  It was suggested that workforce development initiative with further education colleges in North Kent be shared more widely. 

(12)     In response to a question about supporting and motivating patient participation groups to enable them to contribute to the resolution of challenges being faced by GPs, Ms Carpenter offered to share a recent report produced in the South Kent Coast area. It was also suggested that more work might need to done to understand more fully how patient participation groups and GP practices could work together.

(13)     The Board was told that Ian Dodge, National Director of Commissioning Strategy at NHS England, was visiting Kent on Friday 27 March and the key message to him would be that adequate resources were required to ensure innovation continued at pace and scale regardless of whether sites had achieved Vanguard status or not.

(14)     Mr Scott-Clark introduced the Public Health Commissioning Plan.  He said much of the last year had been spent dealing with issues arising from the transfer of the public health service from the NHS, there had been no growth in the budget and there were growth pressures from NICE Technology Appraisals, implementing obesity pathways and increasing the number of health checks.  He said that better ways of commissioning lifestyle behaviour programmes were being investigated to avoid unnecessary handovers between programmes.  Mr Scott-Clark said the Public Health Commissioning Plan had been structured into three areas: starting well; living well and ageing well.  He referred in particular to: programmes to reduce obesity in children; provide emotional health and wellbeing services for 0-25 years; reduce premature deaths from vascular disease or poor lifestyles by promoting health checks; support people to remain well and in their own homes, prevent falls and reduce the above average number of neck of femur fractures.

(15)     In response to a question about falls and actions following the Kent Fire and Rescue Services presentation to the HWB on 16 July 2014 it was confirmed that: Public Health was working with the KFRS and social landlords to reduce falls and fires; local health and wellbeing boards had been asked to take this forward and efforts were being made to include data from the KFRS in the Year of Care report.

(16)     Resolved that: 

(a)       The CCGs’ Commissioning Plans and the Public Health Commissioning Plan be noted;

(b)       A report be received at a future meeting of the HWB providing an update on actions taken by local health and wellbeing boards as a result of the KFRS’ presentation.