Agenda item

Dr Mike Gogarty, Strategic Lead for Public Health, was in attendance for this item.

1.    Dr Mike Gogarty introduced the report on the development of the Kent Neighbourhood Health Plan and welcomed the Department of Health and Social Care's recognition of Health and Wellbeing Boards as the key bodies responsible for leading the development and delivery of local approaches to improving health and wellbeing. He advised that this presented both an opportunity and a challenge for the Board.

2.    He noted that the current Kent Joint Health and Wellbeing Strategy was aligned with the Kent and Medway Integrated Care Strategy and remained the principal strategic framework for addressing health and wellbeing challenges across Kent. Whilst those challenges had remained largely unchanged, Dr Gogarty highlighted the need to incorporate emerging NHS requirements and develop an approach that balanced national priorities, county-wide challenges and local needs. He emphasised the importance of addressing the wider determinants of health, including socioeconomic, environmental, lifestyle and access-related factors.

3.    Dr Gogarty explained that the original neighbourhood health model had been driven largely by the need to reduce avoidable hospital admissions and support people more effectively within community settings. He noted that the national Neighbourhood Health Framework had since broadened in scope to encompass prevention, improved access to primary care, reduced waiting times, population health improvement and action on health inequalities. He highlighted the importance of ensuring that mental health, children, young people and families remained a strong focus within local delivery arrangements.

4.    The Board was advised that NHS partners were reorganising services to support more proactive and preventative models of care, identifying those at greatest risk of ill health and intervening earlier to avoid hospital admissions. Dr Gogarty emphasised that the focus on admission avoidance remained central to NHS priorities and aligned closely with the County Council's ambition to support independence and reduce reliance on residential care. He noted that achieving these objectives would require close alignment between health and social care services.

5.    Dr Gogarty advised that the Kent Neighbourhood Health Plan, which was required to be in place by April 2027, would set out how the NHS reform priorities of prevention, community-based care and improved access to services would be delivered alongside local priorities relating to health inequalities and wider determinants of health. The Plan would align with the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy, include arrangements for the Better Care Fund, and set out the contribution of partners including district councils, housing providers, voluntary and community sector organisations and family hubs.

6.    He noted that the proposed multi-neighbourhood geographies had been developed prior to local government reorganisation and may require further review as future arrangements became clearer. He also advised that engagement was underway with Health Alliances, district partners, housing organisations and the voluntary and community sector to ensure local priorities informed the development of the Plan.

7.    In concluding, Dr Gogarty stressed the importance of progressing the Plan at pace despite local government reorganisation. He advised that the Plan should be concise, practical and focused on delivery, providing a sustainable framework for improving health and wellbeing outcomes whilst remaining sufficiently flexible to operate effectively through future system changes.

8.    Further to questions and comments from Members the discussion included the following:

(a)  In response concerns regarding the achievability of delivery by April, given the anticipated September establishment of the Health and Wellbeing Board and the limited implementation period thereafter, Mr Gogarty confirmed that the timetable remained achievable.

(b)  With regard to capacity implications for officers in the context of Local Government Reorganisation, Dr Ghosh acknowledged those concerns and provided reassurance that established neighbourhood health governance arrangements, including a delivery group and steering board, were already in place and would continue to progress work between formal Board meetings. He further noted that additional Health and Wellbeing Board meetings could be held to support delivery of the Plan.

(c)  Mr Waller, Deputy Chief Executive and Chief Strategic Commissioning Officer, emphasised that success should be measured by the extent to which outcomes for people receiving services had improved, rather than by the quality of the Plan document itself. He noted that Kent and Medway had become the first area in England to utilise provisions within the GP contract to commission a new model of intervention for complex care cohorts, securing participation from all GP practices across the area. This approach was expected to provide more proactive support for approximately 90,000 residents, helping to improve health outcomes, reduce avoidable hospital admissions, and enable more people to remain living independently at home.

(d)  Concern was raised that, whilst the document stated that health needs had not changed, there was evidence of increasing demand for mental health interventions linked to factors including the cost of living, loneliness and digital isolation. It was suggested that these issues were not sufficiently reflected in the document, and clarification was sought on how wider determinants and external influences affecting people's health and wellbeing would be captured. In response, Dr Ghosh acknowledged that health needs had changed and advised that any suggestion in the document that they were static was unintended.

(e)  Support was expressed for the Plan as a foundation for developing the neighbourhood model. However, it was suggested that greater emphasis should be placed on non-statutory factors affecting people's lives, including debt and housing, and on how agencies providing these services would be involved. It was noted that influencing outcomes such as hospital admissions and entries into care homes began well before individuals came into contact with statutory health or social care services.

(f)   Mr Henderson (Chair)noted that Ashford Borough Council, alongside Kent County Council through the No Use Empty programme, was supporting the creation of housing within town centres to enable residents to live closer to local services and community facilities. He advised that this work aligned with the objectives of the Plan and stated that all relevant portfolios would be ready to support its delivery.

9.    It was RESOLVED that the Kent Health and Wellbeing Board commented on and agreed the outlined approach to the development of the Kent Neighbourhood Health Plan.