Agenda item

1.            The Cabinet Member for Adult Social Care and Public Health, Mrs C Bell, gave a verbal update on the following public health issues:-

20 August - Visited Kent Community Health Foundation Trust (KCHFT) Services at Tonbridge Cottage Hospital to see services and meet staff and members of the multi-disciplinary team (MDT). She also accompanied a health visitor on her rounds and visited a baby clinic to see an infant feeding session. This visit had shown how well services were working. The Trust had subsequently been awarded an ‘outstanding’ rating. 

17 September - Kent and Medway Joint Health and Wellbeing Board Workshop. This had discussed the role of the Joint Board. Work would continue on the case for change, which would be published in autumn 2019, and the priority areas of work for the Joint Board would be drawn from the case for change. A primary school teacher had recently spoken about young children not being ready for school, in terms of toilet training and speech development.  This lack of preparedness could be due to lack of access to a health visitor or GP. 

World Mental Health Day on 10 October – Ms Marsh outlined the events taking place at County Hall to mark the day and undertook to send out to Members the details of events.  A series of summits was to take place to raise public awareness of mental health issues and the first of these had recently taken place in Margate. This had been very well attended by a range of participants.  Contributions made by public participants at these summits would be used to draft an action plan.  The Sustainability and Transformation Partnership (STP) had allocated £600,000 to establish four ‘safe havens’ which could offer out-of-hours help for people with mental health problems and their carers, and additional funding would be made available for staff training in dealing with mental health issues. A new crisis café had been established, run by volunteers. 

2.            The Leader and Cabinet Member for Health Reform, Mr P B Carter, gave a verbal update on the following issues:-

Sustainability and Transformation Programme

Mr Carter said that he had received much good feedback from Members about the usefulness of the presentations by the panel of NHS clinicians and senior officers at the committee’s June meeting, setting out the Government’s changed arrangements and local implementation plans.

He had stated that, when he stood down as Leader, he hoped to continue in a role of promoting the local care vision, not just in Kent but nationally, to see how integrated care was being delivered in other parts of the country and ensure that local government could continue to play a role, alongside NHS colleagues, in the delivery of good community health and social care services. Part of the work that he hoped to pursue at a national level was to influence Government to achieve a greater proportion of NHS funding going into primary care, community care and preventative care, to reverse the reduction made to this proportion over the last 8 – 10 years. Just 1 - 2% more of the NHS budget being directed there would have a large impact on the recruitment of district nurses, health visitors and occupational therapists, especially considering the ageing population with increasingly complex needs.

It would be interesting to compare what Kent and Medway was doing with what was happening elsewhere in the country, how local government was being involved with NHS colleagues and how others were embedding structural change. 

He was confident that the approach being taken by Kent and Medway was right and was pleased with the progress made over the last 12 months.  The groundwork was done and what was needed now was to find the right resource to build a suitable workforce to develop it.  

At the last meeting of the STP, the Kent Medical School was debated. He was pleased that an additional £2m had been made available to contribute to help develop the new campus at the University of Kent at Canterbury and Canterbury Christ Church University sites. There were many hurdles still to overcome and much work still to do but he was sure that all County Council Members would support the delivery of the medical school.

He had received much correspondence from Kent GPs about the need to improve the physical assets available to deliver GP hubs around the county and there was general acceptance that GPs needed to work together in larger hubs, with sufficient appropriate technology to support their new way of working. This was something the County Council could support by work on the health estate.  The County Council’s new housing strategy was about to be launched, including scoping of the need for increased nursing and residential care and a move towards the provision of more extra care housing to allow elderly and vulnerable people to live in their own homes for as long as possible. It had been estimated that more than 1,000 additional units of extra care housing would be needed in the next few years.

Much work was still going on around a potential new hospital in Canterbury, and he would continue to take an interest in this and how services at it and the other two hospitals in East Kent – the Queen Elizabeth the Queen Mother and the William Harvey hospitals - would be configured.  He hoped to see a new hospital being built in Canterbury as the existing hospital site was no longer fit for purpose, was very expensive to maintain and difficult to recruit to.  

3.            Mr Carter then responded to questions and comments from the committee, including the following:-

a)    Mr Carter was thanked for his work as Leader in advancing the health reform and local care agenda, and for the help and support he had given to opposition Members and new Members in helping them to understand the issues involved;

b)    a good and sufficient workforce was vital to develop the programme, and to go forward without this would mean the new arrangements would fail.  Mr Carter agreed that recruitment was a significant issue and said that he hoped Britain leaving the European Union would not make it difficult to recruit overseas staff. The suggested minimum salary level requirement (yet to be confirmed by the Home Office) for overseas workers to come and work in the UK might make many healthcare posts more difficult to recruit to;

c)    the absence of positive progress around a new Canterbury hospital and the effect of this upon recruitment was a great concern for local people, who hoped to hear a confirmed decision soon.  Mr Carter said that much work was going on to facilitate the building of a new hospital but it was not a simple process and it was unclear as yet how services would be reconfigured and physical assets used. The aim was to provide the very best treatment and facilities as close to the local community as possible;

d)    spending on the NHS was compared to spending on projects such as HS2 and frustration expressed about why it was so difficult to put money into building a new hospital. Mr Carter acknowledged the frustration at the uncertainty and advised that the Minister for Health had highlighted the need to look at innovative ways of providing money for infrastructure; and

e)    similar work around preventative and early interventions had been done in the field of adult social care and had shown that it was most cost effective to provide services to patients early to save them from developing more complex and costly needs later. Primary care was the area in which spending could be directed most effectively.    

4.            The Director of Public Health, Mr A Scott-Clark, then gave a verbal update on the following public health issues:-

Suicide Rates for 2018 recently published – these had shown a small reduction, which was good, but a change to the way in which the Coroner was required to assess suspected suicides may lead to a future increase in the number of cases being recorded.  a more detailed assessment of the 2018 figures would be presented to a future meeting.

Spending Review Settlement for Local Authority Public Health – this had shown an increase in funding.  Mr Scott-Clark would meet with the other regional Director of Public Health and with Duncan Selbie, the Chief Executive of Public Health England, to gain more information on the impact of this.  The net increase may not be as large as first appeared as it was following on from cuts made in previous years.

5.            Mr Carter referred to a recent thinktank which had considered the concept of using a ‘patient premium’, comparable to the pupil premium, to help address health inequalities. He referenced a recent paper on the issue and undertook to provide Members with the title of this paper outside the meeting.

6.            It was RESOLVED that the updates be noted, with thanks.