Agenda item

(a)        Review of Work Programme (following third facilitated session) – Councillor Paul Watkins, Leader of Dover District Council (attached)

(b)        Joint Integrated Commissioning Strategy and Plan  – Mark Lobban, Director of Strategic Commissioning, Kent County Council (attached)

(c)        Project brief for Intermediate Care Services – James Lampert, Commissioning Manager, Kent County Council and Karen Benbow, Chief Operating Officer, NHS South Kent Coast CCG (attached)

(d)        South Kent Coast CCG Community Engagement Strategy – Hazel Carpenter, Accountable Officer, NHS South Kent Coast CCG (to follow)

(e)        Public Health Projects Update – Jess Mookherjee, Assistant Director of Public Health at NHS Kent and Medway (verbal update)

(f)         'Patient Knows Best' Update on pilots in South Kent Coast CCG area – Dr Joe Chaudhuri (attached)

(1)          Review of Work Programme

The Leadership Support and Corporate Communications Manager advised that following the third facilitated session two additional items were added to the work programme.  These were:

·                         To maintain awareness and input, if necessary and required, to the Canterbury C4 CCG work programme to ensure 'whole population' links; and

·                         Evidence base for intermediate care beds in Dover (with the potential to lead to a Full Business Case)

In addition, health inequalities would be added to the District/CCG action plan.

It was agreed:

              That the Strategic Business Advisor (Kent County Council) and Leadership Support and Corporate Communications Manager (Dover District Council) would work to ensure that the work streams of for the Kent Health and Wellbeing Board and the Dover and Shepway Health and Wellbeing Board were co-ordinated wherever possible.

(2)          Joint Integrated Commissioning Strategy and Plan

The Director of Strategic Commissioning (Kent County Council) informed the Board that a Virtual Integrated Commissioning Group had been established to develop a strategy, plan and toolkit for undertaking integrated commissioning.  The Group comprised of the South Kent Coast CCG, Dover District Council, Kent County Council and Shepway District Council and had identified four key areas of commissioning activity which supported the delivery of the partners shared objectives.  There were:

(a)          Preventative services;

(b)          Short term care (including a focus on local Intermediate Care and Enablement services);

(c)          Management of Long Term Conditions (including accommodation needs); and

(d)          End of life care

The recent facilitated meeting of the Board had had expressed support for the Commissioning Strategy being developed.  The Board was advised that the plan was still in development and further work had to be undertaken to clarify the governance arrangements as the final commissioning decisions still rested with individual partner organisations, as well as the detail of how resources were to be allocated.  As part of this work was being undertaken to understand how activity, spend and outcome in commissioning were linked.

The process would also be reported in Thanet and the C4G CCG group area so that sufficient information could be compiled to enable meaningful engagement with the acute health sector.

The Director of Strategic Commissioning informed the Board that less than £2 million out of £10 million countywide was being spent in East Kent on mental health services in response to a question from Councillor P A Watkins on the difficulty on finding out information on the level of mental health service expenditure in East Kent.

The problem of patients being charged to mental health services who actually had other issues such as pain management was raised as well as the importance of the strategy including dementia care needs.  The majority of dementia care beds for Dover and Shepway residents were provided in either Thanet or Canterbury.

The need for close co-operation between the county council and district council's was identified in respect of the provision of extra care housing and the support that was needed to make it successful.

It was agreed:

(a)      That mental health services would be included within the plan.

(b)      That the focus of the Integrated Commissioning Plan, subject to the above amendment, be endorsed.

(3)          Project Brief for Intermediate Care Services

The Board was advised that an East Kent Intermediate Care Review had been commissioned from NHS Kent and Medway by the CCG's covering Ashford, Canterbury, South Kent Coast and Thanet.  In particular there was concern that Dover was under-served in regard to some community health and social care facilities.  The initial findings of the report were expected by the end of October 2012.

Councillor P A Watkins reminded the Board that East Kent Hospitals was expected to make a decision on the business case for Buckland Hospital soon and of the strength of local feeling in respect of the provision of beds at Buckland.

It was agreed:

(a)      That the Board would await the outcome of the East Kent Review of Intermediate Care report prior to progressing further with new local work on the matter.

(b)      That the Virtual Integrated Commissioning Group be requested to analyse the East Kent Review of Intermediate Care in respect of how it related to local need with a view to producing a business case and options appraisal for intermediate care/enablement services for the South Kent Coast Area.

(4)          South Kent Coast CCG Community Engagement Strategy

The Chief Operating Officer (NHS South Kent Coast CCG) advised that the Community Engagement Strategy under development would link to the activity of the Dover and Shepway Health and Wellbeing Board.  The CCG's would still have the same consultation responsibilities as the current Primary Care Trusts.

It was suggested that Dover and Shepway District Council's and Kent County Council's experience in community engagement could be fed into the CCG work under development.

It was agreed:

              That the South Kent Coast CCG Community Engagement Strategy be added to the agenda for the December 2012 meeting of the Board.

(5)          Public Health Projects Update

The Assistant Director of Public Health (NHS Kent and Medway) advised that the steering group for the Healthy Living Pharmacy Project had met twice and had reported very positive engagement with local pharmacies.

The 'World Cafe' event on 30 October 2012 was the next step in the project where pharmacies would come together to discuss the project.  It was planned that the eight pharmacies elsewhere in Kent already certified as Healthy Living Pharmacies would mentor local pharmacies participating in the project.

Councillor S S Chandler advised that once a venue had been found a youth nutrition project would be launched.

It was agreed:

              That an update be given to the next meeting of the Board on the project.

(6)          Patient Knows Best – Update on pilots in South Coast Kent CCG Area

Dr J Chaudhuri presented a paper on the roll out of the 'Patient Knows Best' (PKB) pilots.  It was expected that the pilots would commence at the end of November 2012 and a training plan had been agreed with health and social care providers to ensure sufficient capacity existed in time for the start of the pilots.  The Proactive Care cohorts of patients would be the first group to participate in PKB as these were patients already identified as actively wishing to be involved in the management of their Long Term Conditions.

It was agreed:

            That the update be noted.