Agenda item

This item was taken after item 5.

In attendance for this item: Vincent Badu (Chief Strategy Officer, K&M ICB) and Ellen Schwartz (Deputy Director of Public Health, KCC – virtual)

1.         Mr Badu introduced the item, explaining that the interim strategy was developed in partnership with local councils and set out how the local population’s needs would be met and how health inequalities would be reduced. It was a statutory duty to have a Strategy in place, but it was recognised that the 12-week turnaround had not allowed for significant engagement, which was now commencing. The Strategy was predicated on working together to focus on the wider determinants of health, including the prevention of poor health. Part on ongoing engagement was seeking input around how the strategy should be prioritised in local places, acknowledging that areas had different needs. A clear logic model was being followed for measuring impacts and identifying improvements achieved.

2.         The ICB was investing an annual budget of £5.4m to reduce health inequalities. The money would be delegated to Health and Care Partnerships to support the delivery of those parts of the strategy at a local level.

3.         Ms Schwartz spoke of upstream prevention throughout the life course of an individual. This involved identifying groups of people and understanding their needs and how to address any inequalities.

4.         A Member questioned whether the Strategy conflicted with KCC’s Community Services consultation. Mr Badu had not been closely involved in that programme but recognised that across the public sector there were challenges with resources. He said it was right to prioritise focus and use resources differently, whilst recognising that supporting preventative services reduced people’s need to access secondary care. A whole system approach was needed.

5.         A Member asked how the Committee could best support the strategy. They thought having a debate around priority areas could offer constructive outcomes. Mr Badu supported the idea of focussed discussions at HOSC.

6.         The Chair spoke of the importance of early engagement with HOSC about upcoming changes, whether that be an informal briefing or formal presentation at committee.

7.         Mr Badu expected the final strategy to be published in Autumn 2023. Public Health were leading on the related Local Health and Wellbeing Board plan.

8.         Dr Rickard from the Local Medical Committee raised several points:

a.         Housing developments such as Otterpool Park were referenced in the Strategy, but it was not set out how General Practice would be provided.

b.         She did not feel the Strategy adequately reflected capacity and workforce constraints, nor how those challenges would be addressed.

c.         Patient flow was mentioned in the Strategy, particularly around demand on Emergency Departments exacerbated by Primary Care and inappropriate referrals leading to full hospitals. Dr Rickard did not feel this was entirely accurate as there were capacity issues across the healthcare system, with elective backlogs and a workforce crisis all contributing. She hoped to see more detailed projections on how the Kent Medical School would alleviate workforce issues.

9.         Mr Badu responded to say the Strategy was pitched at an overarching level across Kent & Medway. There were representatives from primary care on the Health & Care Partnerships and planning at place level was vital. He felt the best place to address those concerns was at those place level meetings. The Strategy needed to sit alongside other documents, such as the Primary Care Strategy that was in development.

10.      The Strategy set out the intention to have a single social prescribing platform. A Member asked what evidence was available to support that decision. Mr Badu explained that the Public Health team were central to pulling together the evidence and using it to inform the Joint Strategic Needs Assessment (JSNA) along with their wider work. Ms Schwartz reflected that lots of work around social prescribing was underway, but it was not joined up which was what the Strategy aspired to accomplish. Impacts on wider determinants of health were the core business of Public Health.

11.      Mr Badu’s department was leading on the development of a population health management system, part of which was looking at how segmentation outcomes were used and how the population could be stratified to identify the most vulnerable, leading to targeted interventions.

12.      The Chair recognised the close links with the Public Health & Health Reform Cabinet Committee and suggested that holding joint briefings might be an effective use of resource.

13.      Concerned about continued workforce and capacity issues, and the impact of ongoing pay disputes, Mr Camkpin proposed the following motion:

“That the Committee write to the Prime Minister to engage in a meaningful way with the relevant trade unions.”

14.      There was no seconder, the motion fell.

15.      Mr Badu acknowledged the concerns around workforce and said he would return to the Committee about the Primary Care Strategy in due course.

16.      Asked about the role of the voluntary organisations, Mr Badu expressed how vital that sector was to realising the aims of the Strategy. Their role was often around prevention and engagement, which did not always need to be carried out by highly trained clinicians. The voluntary sector could also carry out activities at a pace the NHS could not.

17.      Over the course of the Strategy, there was an aim to reduce people’s need for requiring secondary care services by providing more support downstream. Part of this would be signposting to wellbeing support. Mr Badu confirmed voluntary organisations would be engaged about planning and also how they were resourced.

18.      The Chair thanked Mr Badu and Ms Schwartz for their time. Looking to the recommendations in the paper, Members were keen that the plan around the new way of working would be an iterative process and develop over time.

RESOLVED that the Committee:

i)             note the contents of the Kent and Medway Interim Integrated Care Strategy

ii)            delegate authority to the Clerk, in consultation with the Chair of the Committee, to develop a future way of working, that will be shared with Committee Members for comment ahead of implementation.