The Kent and Medway Sustainability and Transformation Partnership Programme Board met on 14 August 2017.  The Board assessed a highlight report on how the ten workstreams are progressing.  Three workstreams were considered in more detail later in the agenda: productivity; hospital care and local care.

Medway, North and West Kent (MNWK) Delivery Board
The MNWK Delivery Board has met three times and has an agreed terms of reference and workplan.  The main focus of the workplan is the continued development and delivery of the clinical strategy. Jim Lusby is leading on this.

East Kent Delivery Board
At the East Kent Delivery Board meeting on 10 August there was discussion about the current timeline for formal consultation on hospital changes, especially on ensuring that we develop a timeline that is deliverable. There is continuing work with the Governing Bodies of the Clinical Commissioning Groups to ensure their proper scrutiny and support of the plans for east Kent hospital services.

Work continues to establish a joint committee of the CCGs to consider hospital changes, with the next task being the appointment of an independent chair. The first meeting of the joint committee is likely to be in September.  (Note: at a Kent and Medway level work is taking place across the eight CCGs, and with CCGs in neighbouring areas, to set up a further joint committee to consider stroke changes).

Productivity workstream
The Board received an update on the productivity workstream. The workstream has 10 areas of focus. The non-clinical areas are: corporate and back office support; temporary staffing; pathology; medicines; supplies and services. The clinical areas are: trauma and orthopaedics; care of the elderly; community paediatrics; urgent and emergency care; obstetrics and gynaecology.

Each area has a work group that are looking particularly at potential savings that can be achieved by standardising processes and procurement.

Hospital care
The Board received an update on the work on stroke services for Kent and Medway and on plans for urgent and emergency care services in east Kent.

Work has been ongoing over several years to improve stroke services. The process requires all options to be evaluated using agreed criteria. The criteria have been signed off by clinicians with wide input from other stakeholders, including the national team, and the process of evaluation of the options is underway.

Public engagement has been ongoing during this time. Most feedback from stroke patients shows that they are in favour of moving from the existing provision of seven units to three highly-specialist units.

For the East Kent changes, there has also been public, clinical and stakeholder engagement on the criteria that will be used to evaluate the options.  The three-stage process of evaluation is underway, with data being gathered to enable this.  The workstream is also awaiting the outcome of the work being done to scrutinise the offer of a new hospital ‘shell’ in Canterbury from a housing developer, as, if this is deemed viable it needs to be evaluated alongside the other options.

Local Care Investment Case
The board received an update on the Local Care Investment Case. The case spells out the vision for local care, the potential impact on activity for our first target group – frail, elderly people – and the financial impact of various scenarios, benchmarked against a ‘do nothing’ option. After wide discussion and the Board was asked to take away the figures for further scrutiny.

National assessment of STPs
NHS England published ratings of the STPs across the country on a four-point scale, with one being best. Kent and Medway was rated in category three ‘making progress’. The ratings are based on performance measures.  For Kent and Medway A&E performance, finance and cancer indicators are the main concerns.

System transformation
Work is underway to look at how the health and care system across Kent and Medway should be developed for the future.  A survey has been finished and a series of workshops have been set up for health and social care representatives to analyse the survey results and discuss and agree the way forward.

Meeting structure
The programme board will, in future, have a meeting structure that allows for occasional ‘deep dives’ – lengthier discussion and scrutiny of key subjects.  Productivity will be among the first subjects for a deep dive.

The recruitment of the programme management office is progressing well, some postholders have started already.  The post of PMO Lead needs to be re-recruited.