Agenda item

Gail Arnold (Chief Operating Officer, NHS West Kent CCG) was in attendance for this item.

(1)       The Chairman welcomed Ms Arnold to the Committee. Ms Arnold began by explaining that the paper provided an initial overview of West Kent CCG’s plans to design and implement local care, in line with the CCG’s strategic vision, Mapping the Future, and the Sustainability and Transformation Plan. She stated that the CCG had begun to work with key partners and stakeholders on the proposals. She reported that the delivery of care would be undertaken in two phases. The first phase was the development of a service specification for core cluster level team which would support GP federations to provide services. She reported the likely establishment of eight clusters: Sevenoaks, Tunbridge Wells, Tonbridge, Weald and four clusters covering the Maidstone district which would act as building blocks in developing the local care and training. She noted the importance of having a critical mass of services for an effective hub of care.  She reported that the specification would comprise of four work streams including the provision of mental health and social care. She explained that the service would begin to take effect in 2017/18 in an informal way; in 2018/19 it was expected that the CCG would move towards the multi-speciality community provider model (MCP). The new model of care was expected to be fully established and embedded by March 2019; the CCG was in discussions with providers about how the new model would be delivered and governed.

(2)       Ms Arnold highlighted that the emergence of two GP federations in preparation for local care; the two federations had jointly set up a provider arm and were joint shareholders. It was anticipated that services would be provided by hubs of care with services collocated on the same site. The location of hubs was still to be determined, as part of discussions with local providers, but would need to serve a population of 100,000 to be cost effective and sustainable. It was expected that hubs would provide access to diagnostics and extended opening hours with the potential to include a GP surgery to enhance medical cover on site. Ms Arnold stated that the she was engaging with 61 GP practices over the next 8 – 10 weeks; she noted that national pressures on general practice had begun to impact on the delivery of services in West Kent with a high percentage of surgeries being unable to fill GP vacancies. She acknowledged that GP surgeries were all independent businesses and all had their own plans and aspirations for the next five – 10 years.

(3)       Ms Arnold noted that there had been advance discussions in Edenbridge and Sevenoaks. In Edenbridge, the CCG was looking to combine the current GP surgery, whose building has reached the end of its life, with services at Edenbridge Hospital. The strategic outline case was in the final stages of development and needed to be signed off by NHS England before formal consultation with local people and the Committee. In Sevenoaks discussions were taking place to explore the possibility of collate a GP surgery at the hospital. A stakeholder event was held to look at the wider opportunities and to identify the key work streams which will be needed to take this work forward.

(4)       The Chairman enquired about the involvement of borough & district councils and the local Health & Wellbeing Boards with the proposal. Ms Arnold stated that districts had been involved in all discussions so far; the Chairs of the Patient Participant Groups and League of Friends had also been involved. Local members had been notified in Edenbridge and would be informed in due course in Sevenoaks. 

(5)       A number of comments were made about the availability of workforce, demographic growth in West Kent and the provision of services in Edenbridge & Sevenoaks. Ms Arnold explained that it was hoped that the reorganisation of local care would help to fill staff vacancies. She acknowledged that population growth was a problem but noted the CCG was working collaboratively with Maidstone Borough Council’s planning department who provided advanced warnings on planning developments and sought the CCG’s input. She confirmed that that the plans for Edenbridge and Sevenoaks were distinct from each other; the development of a hub would be for a wider population for 100,000 and part of a wider local care proposals for West Kent.

(6)       Mr Inett highlighted that Healthwatch Kent was keen to be involved with the public engagement work and stated that Ian Ayres and Bob Bowes had given their agreement for Healthwatch Kent to be involved.

(7)       RESOLVED that the report on Local Care in West Kent be noted and NHS West Kent CCG be requested to update the Committee at the appropriate time.