Agenda item

In attendance for this item: Mike Gilbert (Executive Director of Corporate Governance, K&M ICB)

1.         The Chair welcomed Mr Gilbert and asked about the PICU issue raised under the previous item, asking if he was able to comment from the ICB’s perspective. Mr Gilbert offered to confirm the situation outside of the meeting, but his understanding was that the ICB/ ICS did not hold capital money other than for the buildings they were responsible for leasing.

2.         The ICB had been established for 9 months. Decision making and influence were on a much wider scale than they were before the 2022 Act. The Integrated Care System allowed for much easier joint decision making – there were two Local Authority partners on the Board as well as voluntary organisations and GPs/ providers being represented on committees. Stakeholder from across health and social care were also represented. The work carried out to date focused on developing an interim Integrated Care Strategy as well as a Joint Forward Plan for the NHS over the next 5 years. Moving forward there would be a focus on drawing out efficiencies and ensuring funding achieved as much as it could. There was also a need to promote the role of the Health and Care Partnerships, in part by delegating resource and responsibility to them for their local areas. NHS Kent and Medway would be taking on joint additional responsibility for some specialist services during 2023-24, with full responsibility from April 2024.

3.         Mrs Chandler, Cabinet Member for Integrated Children’s Services, asked how the interests of children were represented on the Board. Mr Gilbert explained there was a lead for children services on the ICB as well as a children and younger people’s integrated care board within the system. However, it was recognised that this area needed development, and it was being explored whether a shadow board could be established which would feed directly into the main Board. One of the Strategy’s main priorities was to improve the start in life for young people and it was important that young people were involved in deciding how that would be achieved.

4.         A Member asked how full system integration was possible until patient data could be shared. Mr Gilbert explained that whilst digital transformation was underway, there was a long journey ahead before completing the Kent and Medway Care Record (KMCR). Doctors in A&E could usually see a patient’s GP record but not their social care one, and they were unable to add information to the record. Mr Gilbert would confirm outside of the meeting whether Trusts within Kent could share data – Trusts between counties could not do this. It was recognised that sharing data would have to be compliant with GDPR.

5.         A Member asked how the ICB could ensure technology was fit for purpose, citing instances when systems such as E-Consult failed. Mr Gilbert confirmed the ICB was responsible for commissioning primary care ICT services and that team monitored the performance / looked to resolve issues when required.

6.         The Chair requested a comprehensive briefing on the ICB digital transformation and its direction of travel.

7.         Mr Gilbert offered to provide information outside of the meeting about how the ICB would lead on integrating social prescribing with health provision.

8.         A Member asked how the ICB would work with local planning authorities to ensure there was adequate GP provision. Mr Gilbert explained that a Kent and Medway Estate Plan was in development, and this would be brought to HOSC once complete.

9.         In terms of addressing GP workforce shortages, Mr Gilbert explained that an attraction scheme for GPs and primary care was underway and had already had some success. Whilst there was a national shortage of GPs, Kent was an outlier. There were opportunities to recruit other professionals to reduce the burden on GPs. The Kent Medical School would train GPs (which took 8 years), who then needed to be encouraged to stay in Kent – the Chair commented that Councillors had a role to play in that area.

10.      A Member asked what action was being taken following the closure of Lloyds Pharmacies in Sainsbury’s stores. Mr Gilbert offered to look into this and report back on this after the meeting.

11.      A Member asked how many patients there were per doctor in Thanet. Mr Gilbert offered to confirm this outside of the meeting but recognised that Thanet did have particular issues with its primary care workforce. The Chair requested the GP to patient ratio be provided for areas across Kent, as well as an update on impact of the GP attraction package in Medway, Swale and Thanet.

12.      The importance of preventative action was discussed, in order to keep people away from acute care where possible, and this included partnership working with adult social care. Mr Gilbert said the ICB recognised that social care was a system responsibility and that it was a transitional priority.

13.      Members asked about primary care provision in growth areas, such as Ebbsfleet Garden City, where people were already living despite health provision not being in place. They also asked how decisions were made as to the location of new primary care provision. Mr Gilbert recognised that Dartford was in itself a growth area, not just Ebbsfleet, and that provision was needed throughout the area and not just in the Garden City. That would be picked up in the Strategic Estates Plan. He added that the locations of new primary care facilities would be developed by the relevant Health and Care Partnership through local strategies.

14.      Explaining the use of Section 106 funding for new services, Mr Gilbert said services were phased in once housing was in place. The funding contributed towards, but did not cover, the full cost.

15.      The Chair thanked Mr Gilbert for attending the meeting.

16.      RESOLVED that the Committee note the report.