Agenda item

Clare Thomas, Community Services Director, Kent Community Health Foundation Trust (KCHFT), and Louise Ward, Assistant Director, Community Hospitals, KCHFT, were in attendance for this item. 

1)    Ms Thomas and Ms Ward provided an overview of the rehabilitation, recovery and reablement work underway in community hospitals in east and west Kent. KCHFT were looking at the whole pathway with the intention of improving patient outcomes, by reducing length of stay and strengthening independence. The focus would be on reablement and rehabilitation rather than nursing care. It was noted that integration and partnership working were central to the success of the new model. The Trust were considering how this could be achieved within community hospitals, looking at opening times as well as co-design of care pathways.

2)    Currently services were provided out of Westbrook House (Margate) and West View Integrated Care Centre (Tenterden), by both the NHS and KCC. Historically, the number of beds provided during winter was increased to reflect wider system pressures. During winter 2023 a pilot would see those additional beds being staffed jointly by KCHFT (for technical rehabilitation) and KCC (for reablement and independence support). Ms Thomas summarised three areas of context:

a)    East Kent KCHFT were an intermediate care frontrunner for NHS England which meant they were actively reviewing all short-term pathways to assess their effectiveness and ability to be flexible to the needs of individual patients.

b)    KCHFT were working much more closely with KCC and East Kent Hospitals, working towards a provider collaborative model which was nationally mandated, with the aim of further integration in the delivery of short-term pathways.     

c)    The Trust had recently opened a new stroke rehabilitation unit in Westbrook house which focussed on 7-day rehabilitation, a ‘what matters to me’ approach and getting patients as independent as possible. The lessons learnt were informing the winter pilot.

3)    Ms Thomas recognised the programme was still at an early stage and evaluation would be used to shape plans for how to deliver care going forward by engaging with several stakeholders including patients. Feedback and engagement were a key aspect of the pilot. As the pilot progressed it would be reported back to the committee. 

4)    A Member welcomed the pilot and the shift to intermediate care but was concerned about the accessibility of the locations and noted that transport would be a barrier. Ms Thomas said that the concern about the locations was valid but that the buildings and the facilities were of a high standard. If the pilot was successful there would be a review of the locations to ensure accessibility. It was also noted that the beds would be open to patients from both East and West Kent, and patients were placed in the best bed for their needs even if it was not closest to home.

5)    A Member if there would be financial support for friends and family who wanted to visit relatives as this would aid the social side of rehabilitation. Ms Thomas said that support for taxi costs was considered on a case-by-case basis and that they would look into partnerships with voluntary driver schemes to support this. As part of the pilot, this area would be investigated further. 

6)    In response to a question about how patients were chosen for the pilot, Ms Thomas said that beds were allocated based on need and their potential for reablement to support independence at home. It was noted that a team of nurses and therapists assessed the best location for a patient once they had finished their treatment at an acute hospital, though a small number of referrals were made from community care.  

7)    RESOLVED that the Committee considered and noted the report and invited KCHFT to provide an update at the appropriate time.