Agenda item

To note the progress being made to establish a Growth and Infrastructure Framework for Kent and Medway and provide comment on how best to engage with the health sector in debates about growth; about future health provision; and funding for health

(1)       The chairman welcomed Barbara Cooper (Corporate Director for Growth, Environment and Transport), Paul Crick (Director of Environment Planning and Enforcement), Mike Gilbert (Assistant Accountable Officer – Dartford Gravesham and Swanley CCG) and Dr Su Xavier (Consultant in Public Health Medicine – Dartford and Gravesham CCG) to the meeting. 

(2)       Mr Crick gave a presentation (available on-line as an appendix to these minutes) which outlined the projection for population growth across the county for the next 30 years and the funding required for the associated infrastructure.  He said the Office of National Statistics projected a population increase of 305,000 by 2031 and KCC’s projection was 293,000 based on district local development plans bringing the total population of Kent and Medway to just over 2 million.  The infrastructure to support this increase in population would require £6.5 billion investment of which 67% had been secured leaving a funding gap of just over £2 billion. He concluded by referring to alternative service delivery models, the need to test and review such models and have a robust and informed discussion with Government.

(3)       Mr Gilbert and Dr Xavier gave a presentation on the development of Ebbsfleet Garden City and wider housing development in north Kent with particular reference to the impact on health care services (available on-line as an appendix to these minutes).  Mr Gilbert referred to the work to date and outlined the proposed development areas and the predicted growth in population.

(4)       Dr Xavier drew attention to the impact of demographic changes on health servicesand said there was a once in a life time opportunity to influence the wider determinants of health such as environmental surroundings, transport to health services, leisure facilities and other services.  She also said that even before the proposed Paramount development was considered there were concerns about GP capacity, the growing demands on A&E, mental health and community services as well as the importance of planning to meet future needs. 

(5)       Mr Gilbert said CCGs did not receive capital funding, funding for GPs was based on patient registrations and there was, on average, a 2-3 year lag between registration and receipt of funding.  He also said that work being done to assess the impact of the Ebbsfleet development at a high, strategic level, had identified a significant gap in both revenue and capital funding. Further more detailed work was planned for the summer.

(6)       The chairman thanked the presenters and said the Dartford Gravesham and Swanley Health and Wellbeing Board had considered these issues at a meeting the previous month where concerns about the adequacy of funding, the challenges and opportunities for new models of care and the opportunity to plan for health and healthy lifestyles had been identified.

(7)       During discussion the value of the work being undertaken to assess the implications of growth was acknowledged.  The need to engage in early and well-evidenced debate with central government and to lobby for some up front funding and assistance to meet the anticipated shortfall of over £2 billion was recognised.  The particular urgency to resolve these issues in relation to north Kent was also acknowledged.

(8)       It was generally agreed that health and care services were currently under pressure particularly in relation to GP capacity, increasing demands on community services as a result of the increase in the numbers of frail elderly  and growing demands on A&E, hospital beds and mental health services.  It was also agreed that the Office of National Statistics’ projections for population growth were useful at the whole Kent and Medway level but the detailed implications of growth needed to be considered at a local level.

(9)       An offer from NHS England to provide information about GPs and descriptions of practices was welcomed.

(10)     Resolved that:         

(a)       Following a review and challenge of the assumptions about  the health and social care elements of planned growth for Kent and Medway a further report be considered at a Health Wellbeing Board meeting in six months;

(b)       Appropriate engagement with partner organisations be facilitated;

(c)        The local health and wellbeing boards be invited to engage in the discussion and consider the implications of growth for their local areas: