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Edenbridge project update – July 2018

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You said we did: Maternity services choice and personalisation

Posted by Daniel Harper at 20/03/2018 16:06:58

Thank you to everyone who took part in an engagement project in west Kent about choice and personalisation in maternity services.

From March to November 2017, women and their families in west Kent who were booked at Maidstone and Tunbridge Wells NHS Trust (MTW) were being asked to comment on the choices they were offered throughout the maternity pathway. 

WKCCG and MTW were looking at ways of improving choice and personalisation within maternity services, ensuring women have sufficient information to make informed choices for them and their families. A pilot project ran in west Kent in partnership with MTW from March to July 2017 in two community midwifery teams. This pilot project aimed to give women and their families more information about the services and the support available to them, including services in other areas by introducing a maternity choices booklet.

495 women attending Maidstone Birth Centre and Crowborough Birthing Centre completed a baseline survey.

82 women also shared more in depth thoughts about the choices booklet of which 66 percent found the choices booklet useful.

20 women felt that reading the booklet had made them re-think their decision about the sort of birth that they wanted.

“Lots more choice than first thought”

Overall, participating women thought that the booklet would be most useful for first time parents and would be effective if linked to the Birth Centre websites.

Following on from this pilot project WKCCG in partnership with MTW have rolled the choices booklet out across the entire patch and it is also available to view on both the CCG website and MTW website.

Read our engagement report

Edenbridge Health Services Update

Posted by Daniel Harper at 12/01/2018 08:34:09

Since the decision in July to progress the development of a modern, purpose-built combined hospital and GP surgery for Edenbridge, we have been busy working hard behind the scenes. 

We have established a programme board to oversee the development of the new combined hospital and surgery, ensuring it meets the needs of the people of Edenbridge and surrounding villages. The board will also make sure resources are used effectively.

It is jointly chaired on a rotating basis by the chief operating officer from NHS West Kent Clinical Commissioning Group (CCG) and the corporate services director from Kent Community Health NHS Foundation Trust (KCHFT). Members include the lead GP and the business manager from Edenbridge Medical Practice, the clinical services director from KCHFT, and a full-time programme and project manager, who has been specifically appointed to this project.  

The first meeting saw these pieces of work kick-started:

  • Clinical model: This is a priority – representatives from the GP practice, KCHFT and the CCG are looking at how staff from different organisations can work together most effectively in the new building and integrate the care they provide. This is so that patients get a more joined-up service, which helps to keep them well and to support them when their health takes a downturn. This will clarify what space is needed in the new building and how it should function, which is crucial for the other pieces of work. 
  • Communications and engagement: A strategy detailing plans for communicating with the many organisations and representatives interested in the project has been developed for review this month (January), when the board will also consider opportunities for public and patient engagement. 
  • Planning and location workstream: This will identify the best location for the building, and oversee its planning and design. 
  • Financial model workstream: A range of financial models will need to be developed to assess the best way forward. 

The following design principles were also set at the meeting:

  • Integration – creating shared spaces and working practices - the physical space needs to be very well used. 
  • Flexibility –  the ability to change and adapt as new services or legislation require, which can be summed up as ‘long life, loose fit’. 
  • Value proposition (more for the same). The NHS will not support a scheme that does not deliver enhanced benefits and value for money. 
  • Innovation – we are keen to look at technologies and new ways of working in health and social care that are forward-looking and innovative to help us meet the current and future needs of the people of Edenbridge and surrounding villages. 
  • Sustainability – we need to achieve the most environmentally sensitive facility possible, with assistance from the best architecture and engineering teams.  

There is a lot more work to do and, in the coming months, we will be asking for help and seeking involvement from many people, young and old. Keep an eye out for our regular announcements and news.

For further background information about the project, click here or e-mail nelcsu.engagement@nhs.net

Stroke review update

Posted by Daniel Harper at 08/01/2018 08:29:37

Health commissioners from the eight clinical commissioning groups (CCGs) in Kent and Medway are preparing for a formal public consultation on stroke services, following detailed engagement and consideration of a wide number of options. 

The Stroke Programme Board, which is leading the review of acute stroke services, is currently looking at a number of possible models and expects to make an announcement on the list of options it will consult on early this year. The shortlist is likely to include a number of options, each involving three specialist hyper acute stroke centres at existing acute hospitals.

The board has reviewed stroke services in response to national evidence, requirements and recommendations, particularly the need for patients to have access to a specialist stroke unit seven days a week.

Since 2014, commissioners have been talking to the public and clinicians across the county about acute stroke services with a view to improving clinical outcomes for patients. National and international evidence is clear that when stroke care is managed within specialist stroke centres then survival rates significantly improve and disability from a stroke is significantly reduced. 

Following further detailed engagement with stroke survivors and carers at events across the county in the summer, the Stroke Programme Board is ready to apply the evaluation criteria which will reduce a large number of potential three site options to a shortlist. This shortlist will then be presented to a joint committee of clinical commissioners, independently chaired, who will make the final decision on the shortlist for consultation.

The CCGs have been working in partnership on a review of acute stroke services since late 2014.The stroke review now sits under the Sustainability and Transformation Partnership programme.

You said we did: routine prescriptions of over the counter medicines in west Kent

Posted by Daniel Harper at 15/12/2017 14:09:56

Thank you to everyone who took part in targeted engagement work in west Kent about possible changes to the prescribing of medicines which can be bought over the counter, without a prescription.

From 15 December 2017, GPs in west Kent are being asked to discuss with their patients whether short-term courses of over the counter medicines might be something they could buy rather than have prescribed.

These include, but are not limited to, cough and cold remedies, eyedrops, hayfever medicine, and treatments for diarrhoea and constipation. Painkillers are not included.  

There is no change for people who need repeat prescriptions for over the counter items.

There is also no change for people who would be unable to buy them over the counter.

This might be because of their age (for instance, some medicines are not available for young children without a prescription), or because they are pregnant or breastfeeding.

It might also be because they are housebound, disabled or in a care home, or because the amount of medicine they require is only available on prescription.

The decision to request GPs to have these discussions with patients about some over the counter medicines was taken by NHS West Kent Clinical Commissioning Group’s Governing Body at our meeting on 31 October 2017.

With a limited budget and an increasing demand for services, we at NHS West Kent CCG are evaluating every service we pay for and making decisions about the best value for all our patients. It is the statutory duty of the CCG to do the best we can for the whole of our population with the money we have available.

This year, without change, we face spending about £2.1million on medicines that could be bought from pharmacies, supermarkets, petrol stations and other retail outlets.

If patients with a short-term minor ailment decided to buy over the counter medication, it would potentially free up £300,000 a year to spend on other health services in west Kent.

We also anticipate it saving some GP appointments, freeing up time for other people to be seen, and encouraging people to make better use of the knowledge and advice offered by pharmacists.

Advice about a range of illnesses, including everyday illnesses such as tummy bugs and coughs and colds, is available at www.nhs.uk.

There is also a Pharmacy First scheme in west Kent, which offers free over the counter medicines for many common illnesses to people who don’t usually pay for their prescriptions.

Our decision follows a careful examination of the evidence by the CCG’s Medicines Optimisation Group, which is led by GPs and includes pharmacists.

It also follows targeted discussions with the public in three areas of west Kent which identified that:

  • 85 per cent of people surveyed who were currently receiving free prescriptions for over the counter medicine would buy items from a pharmacy if their GP asked them
  • 15 per cent of people said that, if one or more of the medicines listed were no longer available on prescription, it would be a problem for them
  • 45 per cent of people felt that the NHS should provide only the most effective drugs and treatment, regardless of what they cost
  • 68 per cent of people felt that none of the listed medicines discussed with them needed to remain on prescription.

Sixty-four per cent of the 274 people who contributed to the discussions, in rural Tunbridge Wells, Park Wood and Shepway South wards in Maidstone, and Sevenoaks, were getting free prescriptions.

Because of the unprecedented savings needing to be made by the CCG in the current financial year, we have taken the decision to ask GPs to start having these discussions now, while the Department of Health is carrying out its own consultation on the prescribing of over the counter medicines, which started on 30 November 2017. We will, of course, take any national guidance on this matter into account, as and when it becomes available.


New reports published on listening and engagement events

Posted by Paul Davey at 13/12/2017 12:19:57

During the summer and autumn we held a series of listening events about future plans for health and social care in Kent and Medway. We asked for your feedback to help shape the development and delivery of these plans and the results have been published in a report out today. The report from independent analysts DJS Research shows the results and key themes emerging from the events and they will continue to work with us and analyse results from future events, too.

Also during the summer, we commissioned Engage Kent to talk to seldom-heard groups about plans for east Kent. This report highlights the headlines heard during the outreach engagement activities. Their report is also now available.

These reports will be considered widely by all our partners and workstreams and the findings are influencing our plans. We are currently preparing another report on how we are responding to these and earlier research findings and this will also be published.

Find out more about how we are working to transform health and social care in Kent and Medway

You said we did: Gluten-free food prescriptions

Posted by Paul Davey at 06/12/2017 16:15:15

Routine prescriptions for gluten-free food in west Kent

We would like to thank everyone who took part in our consultation over the winter about our proposal to stop routine prescribing of gluten-free food.

At our Governing Body meeting on 25 July, NHS West Kent Clinical Commissioning Group (CCG) decided that, from 1 September 2017, gluten-free food will no longer be routinely prescribed for people with coeliac disease and other gluten-sensitive illnesses in west Kent.

NHS funding will continue for gluten-free products for people with Phenylketonuria (PKU) who need specific low protein food.

We know this will be disappointing to many of the people in west Kent with coeliac disease and we would like to assure you that ending the prescribing of gluten-free food is not a decision we took lightly.

When making our decision, we weighed up whether the money spent on gluten-free prescriptions can be spent on other services without having a significant impact on the health of those affected, and took into account people’s views gathered through consultation.

We were also very aware that it is our statutory duty to do the best we can for the whole of our population with the money we have available. With a limited budget and an increasing demand for services, we at NHS West Kent CCG are evaluating every service we pay for and making decisions about the best value for all our patients.

An assessment carried out by the CCG showed that the top users of NHS prescriptions for gluten-free foods are those people with coeliac disease who are in the most affluent ten per cent of our population. The least affluent ten per cent get the fewest prescriptions.

About one per cent of the population of the UK has coeliac disease. This works out at about 4,600 people in west Kent. Of the total number with coeliac disease, it is estimated that about a quarter have a clinical diagnosis. This indicates that about 1,150 people may currently be eligible for gluten-free food on prescription in west Kent.

The gluten-free items currently available on prescription in west Kent are fresh and long-life bread, flour mix, plain savoury crackers, pasta and pure oats breakfast cereal.

Between January 2016 and December 2016, 10,026 gluten-free prescription items were prescribed by the 61 GP practices in west Kent at a total cost of £137,343.


The NHS started prescribing gluten-free food such as bread and flour for patients 30 years ago, when such products were not readily available in the shops in the way they are now.

There are also several conditions which require specialist diets as part of the treatment (for example, lactose intolerance or nut allergies). Coeliac disease and gluten-sensitive illnesses are the only ones to routinely receive specialist diet foods on prescription.

West Kent consultation

A two month consultation was undertaken from 29 November 2016 to 29 January 2017. It comprised a survey, a public meeting, attendance at two local Coeliac UK coffee mornings and stands at five public roadshows in shopping centres across the west Kent area. It was broadly promoted through a press release, which led to coverage on BBC Radio Kent, and emails  to Health Network members, Healthwatch Kent, and printed materials at children's centres, care homes, children's clubs, community centres, councillors, education contacts, faith groups, churches, Gypsy and traveller sites, leisure centres, libraries, MPs, opticians, parish councils, community pharmacies and PPG chairs. A poster promoting the consultation was sent to local government Gateways, GP practices and hospital waiting rooms.

During the consultation process, NHS West Kent CCG received 505 responses through the online or paper survey. Another 41 people were engaged with at the public roadshows, one public meeting and two local Coeliac UK coffee mornings. Three letters and emails were received from the public and three from organisations.

The consultation document outlined the proposed changes and the rationale for the change. It asked a series of questions about the level of support for the proposal and if any exemptions should be made if the proposal is accepted by NHS Went Kent CCG. It also explored whether those respondents with coeliac disease or caring for those with coeliac disease would have problems affording and accessing gluten-free products if prescriptions were to cease.

Of the 505 people (patients, carers and the public) who responded to the online survey for our consultation, 59 per cent had coeliac disease or were carers for someone with coeliac disease.

Overall, 55 per cent of those who responded agreed at least in part with the CCG’s proposal to stop the routine provision of gluten-free products on prescription:  29 per cent agreed routine prescriptions should be stopped completely; 26 per cent thought there should be some exemptions if they were stopped; and 46 per cent thought routine prescribing should continue. (Numbers do not add up to 100 per cent because of rounding.)

National consultation

The Department of Health is currently evaluating the results of its own consultation on the availability of gluten-free foods on prescription, which closed on 22 June 2017. Because of the unprecedented savings needing to be made by the CCG in the current financial year, we have taken our decision before the outcome of the national consultation is known. We will, of course, take any national guidance on this matter into account, as and when it becomes available.

As with any CCG decision, health professionals can make individual funding requests on behalf of patients whose case is clinically exceptional.

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