The Kent and Medway Sustainability and Transformation Partnership Programme Board met on Monday 5 February. This month’s discussion focused on the stroke consultation, system transformation and a proposal for a single strategic commissioner and on capital bids from STP partners.

Launch of stroke services consultation

The Programme Board heard that following a meeting of the Joint Committee of Clinical Commissioning Groups (JCCCG) on 31 January 2018, the formal public consultation on the future of acute stroke services was launched on Friday 2 February.

Extensive engagement work has been taking place with patients, the public, clinicians and stakeholders as part of the Kent and Medway stroke review. Modelling work has led to potential site options being developed for three hyper acute stroke units in Kent and Medway. The JCCCG is composed of the eight Kent and Medway clinical commissioning groups (CCGs) plus Bexley CCG and High Weald, Lewes and Haven CCG and is the key decision-making group for the work, receiving recommendations from the Stroke Programme Board.

The consultation period runs for ten weeks until midnight on Friday 13 April and consultation engagement activity is underway to gather feedback and responses to the proposals from a wide range of stakeholders and audiences. Consultation engagement activity includes:

  • the dissemination of the consultation document in a variety of formats including printed, plain text and ‘easy read’;
  • supporting materials including a slide deck for presentations, an animation outlining the proposals and online and paper versions of the consultation questionnaire;
  • a series of listening events which are being held across the consultation catchment areas (including south east London and East Sussex);
  • research such as telephone polling, focus groups and outreach work;
  • frequently asked questions and responses to queries and questions;
  • ongoing support for key stakeholder meetings and interactions;
  • a proactive and reactive programme of media relations;
  • comprehensive social media activity on Facebook, Twitter and Youtube; and,
  • marketing materials including posters, banners and paid-for advertising to raise awareness of the consultation.

The consultation is on: the case for change; the proposal to introduce hyper acute stroke units into Kent and Medway; the proposal to have three such units; and the five options for the potential location of those units and acute stroke services in the future. A decision on the future shape of urgent stroke care in Kent and Medway will be determined by the Joint Committee of the ten CCGs once they have conducted the formal public consultation and examined responses together with all other available evidence.  It is anticipated that the decision will be made in the autumn this year.

System transformation

The Board heard how Kent and Medway CCGs are discussing proposals to establish a strategic commissioner and to have a shared senior management team. CCGs are looking at options for developing a strategic commissioner function with the aim of strengthening how CCGs work together, where doing so can drive service improvements that patients need and expect.

Making strategic commissioning decisions across multiple CCGs will provide consistency and reduce duplication; both for commissioners and the hospital, community and mental health services they work with. It will help improve services for patients by reducing variation in quality and access to care and will drive up standards across all providers.

A formal proposal to establish a strategic commissioner and share a single senior management team with one accountable officer (chief executive) has been considered by CCG governing bodies at meetings during January and February 2018. Six of the eight CCGs have agreed the proposal. South Kent Coast CCG met with member practices on 22 February to discuss the proposals. Before taking a decision, they wanted more information on the detail of the proposal and the balance between working at scale, where appropriate, and retaining local autonomy. A further meeting is being arranged and we will update on the outcome once known.  Thanet CCG are not pursuing a path to be a part of formal arrangements, however, they will continue to work with the other CCGs on development of the strategic commissioner and on a range of strategic service improvement plans as they recognise that there are functions they currently undertake which could be usefully undertaken at a larger geography. The strategic commissioner will be established in a shadow form from April 2018.

In the coming months CCGs will be working together to design where the different functions of commissioning need to sit and how to ensure the local voice of clinicians and patients is heard at the strategic level. This will include working with staff, member practices and lay-members of the CCGs to consider how current functions should be split across a strategic commissioner and individual CCGs.

The Board heard that a merger of CCGs is one potential option for the longer-term which will be discussed in the coming months, but it is not the only option and no decisions have been made at this stage. A proposal to merge would require all the CCGs involved to seek the support of their membership practices, and NHS England would also have to approve. The Board will receive updates on this work as it progresses.

Capital bids

The Board received an update on capital bid submissions that are being made by STP partner organisations. These bids are for capital investment in local schemes and initiatives – such as the development of local hubs and wellbeing centres and making material changes to estates and facilities – that require additional national funding to bring to fruition.

Submissions for capital bids are made to NHS England and NHS Improvement on a phased basis with announcements on the success of the current wave of submissions expected in the Spring. The STP Programme Office is coordinating these bids on behalf of partner organisations. Further capital bidding rounds are anticipated in the spring and summer of 2018. As part of the bidding process, a comprehensive plan for the estate of STP partner organisations will be developed and published on the STP website in due course.

Chief Executive’s update

Glenn Douglas, STP Chief Executive and Chair of the Programme Board, led colleagues in discussion on the following areas:

  • Workstream progress – an overview of the progress made by individual workstreams including local care, stroke, finance, workforce and productivity.
  • Forward planning – a look ahead at the areas of focus for the partnership over the coming months.