Our integrated care system

“We will work together to make health and wellbeing better than any partner can do alone”

This means we will:

1. Give children the best start in life and work to make sure they are not disadvantaged by where they live or their background, and are free from fear or discrimination.

2. Help the most vulnerable and disadvantaged in society to improve their physical and mental health; with a focus on the social determinants of health and preventing people becoming ill in the first place.

3. Help people to manage their own health and wellbeing and be proactive partners in their care so they can live happy, independent and fulfilling lives; adding years to life and life to years.

4. Support people with multiple health conditions to be part of a team with health and care professionals working compassionately to improve their health and wellbeing.

5. Make sure when people need hospital services, most are available from people’s nearest hospital; while providing centres of excellence for specialist care where that improves quality, safety and sustainability.

6. Make Kent and Medway a great place for our colleagues to live, work and learn.

The integrated care system is a partnership of all parts of the NHS working together with councils and other partners.

Within the NHS there are three key groupings working at different geographies. The terminology used for the three levels is neighbourhood, place and system:

1. Forty two primary care networks across Kent and Medway. A primary care network (PCN) consists of groups of general practices working together, and in partnership with community, mental health, social care, pharmacy, hospital and voluntary services in their local area, to offer more personalised, coordinated health and social care to the people living in their area. 
    
2. Four place based partnerships drawing together all provider NHS organisations in a given area and working more closely with social care. These have previously been called integrated care partnerships.
    
3. A single commissioning group for Kent and Medway, was created in April 2020. Changes proposed in the Health and Care Bill would see the Clinical Commissioning Group replaced by a new NHS statutory body and the creation of a new partnership group.

The ICS partnership board currently includes representatives from:

• Dartford and Gravesham NHS Trust
• East Kent Hospitals University NHS Foundation Trust
• Healthwatch
• Kent and Medway NHS and Social Care Partnership Trust
• Kent Community Health NHS Foundation Trust
• Kent County Council
• Kent Local Medical Committee
• Maidstone and Tunbridge Wells NHS Trust
• Medway Community Healthcare
• Medway Council
• Medway NHS Foundation Trust
• NHS England and NHS Improvement – South East RegionSave
• NHS Kent and Medway
• South East Coast Ambulance Service NHS Foundation Trust

The Health and Care Bill, proposes changes that would replace the current form of this group but there will continue to be a meeting of representatives from all partners in Kent and Medway. 

The system transformation partnership, and now the integrated care system, aims to tackle a range of challenges to improve health and care for residents across Kent and Medway.

The number of people living in Kent and Medway is predicted to rise by almost a quarter by 2031.

We spend just £86m (2 per cent) of our budget supporting people to stay well and prevent illness, compared to £3.4 billion treating ill-health.

Over 528,000 people – that’s almost one in three – live with one or more significant long-term health conditions, including around 12,000 with dementia.

People with a serious mental illness die on average 15 to 20 years earlier than the general population.

If staffing was in line with the national average, there would be 175 more GPs in Kent and Medway. Over half our practice nurses could retire in 10 years.

Evidence shows, every day, about 1,000 people in Kent and Medway are in a hospital bed when they no longer need to be.

In addition to these challenges, which existed before the pandemic, we must now work together as a system to recover from the pandemic and ensure we take the opportunity to address health inequalities which Covid-19 has shone a spotlight on.

These priorities have been agreed with by the Kent and Medway ICS Partnership Board

1. Restart and recover – a systematic approach to restarting services that were disrupted during the first Covid-19 peak and in transforming to the system we want to be. Elements of the programme include: A focus on the enablers and levers for lasting change; addressing the impact of Covid-19 on BAME communities; clinical input to the plans for restarting and recovery; recognising the importance of impact of Covid-19 on staff and the need to support staff resilience; supporting meaningful development of out-of-hospital care for the longer term; preparing for any further surge in Covid-19.

2. System leadership and development – a clear focus on ICS development and approval moving to deeper system working including Integrated Care Partnership (ICP) and Primary Care Network (PCN) development and assurance and effective interactions between the layers of the ICS in terms of accountability, responsibility, support and facilitation.

3. Strategic change

• Starting the process for review of service delivery across Medway, north Kent and west Kent with a focus on development of organisational alliances and clinical networks.
• Progress and deliver the east Kent pre-consultation business case (PCBC) and consultation process.

4. Performance – develop a revised performance improvement approach in challenged organisations with better alignment of energies and activities across CCG/ICS and regulators; system approaches to improvement beyond single organisational boundaries; and incorporation of local system support from other organisations to support improvement.

5. Develop a clear approach to improvement – commitment to, and adoption of, single methodology and philosophy (Quality, Service Improvement and Redesign (QSIR) is currently the predominant model in Kent and Medway); develop capacity and capability at all levels of the ICS; change in culture for increased focus on experimentation and rapid improvement cycles.

6. A focus on key system enablers – strategic attention to digital (including shared data and analytics) and workforce aligned to focused initiatives within priority development areas to make sure this is translated into real change and moves beyond strategic intent.

• More support to stay fit and well before things become a problem.
• Better access to the care you need, when you need it, in a way that suits you: evenings, weekends, over the phone, by video link or face-to-face with a physio, nurse, clinical pharmacist, GP, or support from a non-medical service.
• More focus on your physical and mental health and wellbeing – on what matters to you, not the condition or disease that you may have.
• More care out-of-hospital, with staff working together as a single team across organisations to help people stay as well as possible and get the care they need when they need it.
• Better identification of the issues that need tackling and a real focus on quality services, wherever they are provided.

• Higher job satisfaction as working in teams is less isolated and more rewarding.
• Better work/life balance with each professional able to focus on what they do best.
• Greater resilience and less risk of burnout.
• Greater influence on how resources are used to best effect for patients.