After a very busy summer I was pleased to be able to present the following communications and engagement report to today's NHS Thanet CCG Governing Body meeting.

STOP PRESS! I also gave verbal praise to the recent development of a Macmillan Volunteer Coordinator appointed and supported through Social Enterprise Kent, who will be working to raise cancer awareness and prevention across Thanet.

Many thanks to Sara Warner and Rob Hustwayte for compiling the following report:



NHS Thanet Clinical Commissioning Group recognises that listening to and acting on what matters to local people is key to the delivery of our commissioning intentions and plans.

Engaging and communicating with patients and local people to jointly design and

commission services will make them a more active and powerful resource. It will also help us to gain a much better return on the money we invest in local services.

A summary of recent activity is included below.

1.0 Patient and stakeholder engagement

Throughout the summer Clive Hart, the CCG’s lay member for patient and public engagement, has continued to promote and encourage public participation in local health matters. With the extended county and general election periods over, the practical business of patient and public involvement and engagement resumed.

Clive continued to promote the Thanet Health Network online and to chair face-to-face monthly meetings through the Thanet Health Reference Group which continues to go from strength to strength.

Most importantly, Clive was pleased to support our two excellent ‘local care’ Esther Café events held at Trinity Resource Centre in Margate and the Customs House in Ramsgate. Both events were well attended and participants raised very relevant issues.

Clive maintains good working relations with local voluntary and community groups through active attendance at Thanet Adult Strategic Partnership and Thanet Local Children’s Partnership Group. With strong support from Thanet CCG, he is pleased to have achieved the goal of third sector representation at future Thanet Health and Wellbeing Board meetings.

In addition to the East Kent Patient and Public Engagement subcommittee, Clive now also attends regular meetings with east Kent Lay Member colleagues from Ashford, Canterbury and South Kent Coast CCGs, together with east Kent communication and engagement staff. This summer he also started another term on the East Kent Programme Board.

The largest public event of the summer here in Thanet was the Kent and Medway STP Listening Event held at East Kent College’s Yarrow Hotel in Broadstairs and Clive was pleased to help with the smooth running of the event for all those who gave up their valuable time to attend. He sits on the Kent and Medway Patient and Public Advisory Group which works to ensure feedback from all the listening events and other public engagement across the STP footprint is taken into account.

During the summer Clive attended the South East Workshop on Behaviour Change in London and was also delighted to support visits from Helen Stokes-Lampard (Chair of the Royal College of General Practitioners) and Roy Lilley (health policy analyst, writer, broadcaster and commentator on the National Health Service), and to proudly help promote the innovative work taking place and being planned for the future through local health and care services here in Thanet.

Last but not least, Clive also turned 60 this summer and is pleased to report NHS cancer screening ‘kicked in’ automatically and very efficiently just a week after his birthday. He can also confirm receipt of his very first free prescription.

1.2 Local plans for Integrated Accountable Care

The integration of health and social care has been acknowledged as the way forward, as the means of delivering better care and improving quality and outcomes for citizens, as well as efficiencies across the system.

In June we held the first of a series of ESTHER-style café events, where local patients and carers share their first-hand experience of services with staff over tea, and talk about how services could be improved from a patients’ perspective. Two meetings were held in June one in Ramsgate and one in Margate, These will happen regularly over the next year with different services such as mental health and frailty being discussed next.

All of this will help staff to improve the delivery of local services and the Thanet local care model, as well as additional Kent and Medway Sustainability and Transformation Plan (STP)in east Kent. We would like to thank all those who took part, it was a helpful learning environment for everyone involved.

1.3 Managing prescribed items of low priority for NHS funding

NHS Clinical Commissioners (NHSCC) and NHS England have developed a proposal to improve patient care by no longer routinely prescribing medicines which are easily available in pharmacies and shops for minor illnesses and ailments, and tightening prescription guidance on 18 medicines which are either:

• clinically ineffective; unsafe; or not cost effective;

• deemed a low priority for NHS funding.

The prescribing teams across east Kent want their response to the national consultation to be based on local people’s views and those of local clinicians. So we have prepared a local document and survey for members of public based on the national survey. This will run from 4 September to 2 October 2017, and will be analysed at the beginning of October. This will enable the medicines management teams to give an informed response to the consultation, from a local perspective.

We have sent the link to the survey to Thanet’s Health Reference Group and to the Health Network. It is also hoped there will be printed copies which will be distributed to pharmacies and GP practices across Thanet, to ensure we have a broader range of feedback. Please give us your views.

1.4 Strategic plans to transform health and social care in Kent and Medway – Sustainability and Transformation Plan (STP)

Over the summer we have been holding a series of listening events about future plans for health and social care in Kent and Medway to capture people’s feedback on the emerging model of care. This builds upon the earlier listening events and survey to help shape the development and delivery of the Sustainability and Transformation Partnership and the plans for east Kent. Together with the work by clinicians and the enabling work streams we are building a picture of local needs and the pressures on health and social care services and how we might address them.

Broadstairs Listening Event

About 80 people attended the Thanet listening event on 27 July, including patient representatives, members of voluntary and community organisations, health and care staff and members of the public.

Presentations about local care and hospital care were followed by a Q&A session and then round table discussions on mental health, health improvement/self-care, and care in the community through GP practices and the wider team of community nursing and social care, as well as the emerging model for hospital care and the evaluation criteria for finalising options.

All the feedback from the event has been sent to an independent analyst and a report will be written and shared with all partners in preparation for the next steps.

Overall, people are receptive to the new model and an increased focus on local services and care in the community, however, there are concerns about how the model will be delivered in practice. The major concerns are the impact of increased travel, particularly given poor public transport, and whether there are sufficient resources in terms of staff and funding.

Discussions at the tables allowed people time to consider the ideas in more detail and make suggestions on how these issues might be tackled such as the importance of:

  • improved communication between professionals and with the local community;

  • patient education so people know about the services on offer as well as the support in the community to stay well and independent.

People also responded positively to the idea of separating planned hospital care for orthopaedic services from emergency orthopaedic services, meaning fewer planned operations would be cancelled because of emergencies. And they agreed with an emphasis on prevention and early support, rather than treating people once they were ill.

For more details on the presentations and the questions asked at each event you can access the materials on the CCG website. The full report will be shared later once all events are finished and the independent research company DJS has completed its report.

1.5 Kent and Medway Children’s Summit

As part of the STP, there will be a Kent and Medway Children’s Summit held at the end of September. To show real experiences of children services, there will be short films of parents sharing their positive and less positive experiences, to help attendees understand what it’s like to be in a “system”.

Two voluntary and community sector events are planned for September, for full details please use the Kent and Medway website and sign up for the regular bulletin.

1.6 Thanet Health Reference Group (HRG)

The HRG met on 2 August 2017, and a presentation was given by Oena Windibank about the Thanet Integrated Accountable Care Organisation (IACO) and the Esther Model. The group had a lengthy discussion about the number of GP appointments wasted because patients did not attend. Patient Participation Group members came to the meeting and shared with the group the number of patients at their practice who have missed appointments. Andrew Dent from the Prescribing Team also attended and shared the NHS England consultation about Over the Counter medication which closes in October.

Date of next Health Reference Group meeting is Wednesday 4 October, 10am-12noon, at Thanet District Council offices. At this meeting there will be a presentation about the Primary Care Homes Model in Thanet.

1.7 Tiers of Care - Improving care for long term conditions,

More than 70 clinicians (GPs, community specialist nurses and hospital specialists) from across the east Kent are discussing how to improve the care for long term conditions such as cardiology (heart disease), respiratory (lung disease), rheumatology (rheumatic disease such as arthritis) and diabetes (control of blood sugar) as part of the long-term conditions clinical transformation plan.

The new models are based on tiers of care which includes people being equipped with skills to keep themselves well (self-care and self-management).

Tiers of managed care pathways comprise:

  • Tier one –care delivered in GP practices by GPs or practice staff

  • Tier two - care delivered by specialist GPs and advanced practitioners such as nurses and therapists

  • Tier three - consultant led care.

Each clinical specialty has used national evidence of best practice and a skills-based competency framework, setting out what care should be delivered where and by whom. The aim of the work is to make the best use of each tier of care for patients and see how and where improvements can be made to increase the level of support given in Tier one and Tier two, which is generally more convenient for patients, involving less travel and less waiting. It is anticipated that this evidence-based approach will also reduce any unnecessary or wasteful duplication or confusion for staff or patients during the transition to more people being seen away from an acute (main) hospital.

A survey has been developed to find out patients’ views of the existing services, establishing a baseline of how effective the current service is, to support evaluation of the revised service. The survey will be distributed by the NHS providers of each service, such as East Kent Hospitals University NHS Foundation Trust, as appropriate. The survey will also be sent out through the CCG’s Health Reference Group (patient group) and to the Health Network.

Once the new services have been running for six months, a follow up survey will be distributed to seek people’s views on the new services.

1.8 New contracts for eating disorders services and children and young people’s mental health services

Intensive work with children and young people with mental health problems, and people with eating disorders, to get their views about what an effective service would provide, contributed to the procurement of new services.

Both contracts with NHS North East London NHS Foundation Trust (NELFT) went live on 1 September 2017.

We are grateful to everyone who contributed their time and their expertise to shape the specification, and to take part in the procurement process, and to those who are working with NELFT on communications and other issues.

2.0 Urgent care communications

Each CCG has a national requirement to produce a system resilience plan. This is to help manage seasonal pressures.

In advance of winter, we have updated the joint Systems Resilience Communications Strategy for commissioners and the main providers of NHS services in east Kent.

The purpose of this plan is to assist with allaying system pressures by promoting the correct use of NHS resources. This will be achieved by all partners working together to use all their channels to encourage people to self-care and make appropriate use of A&E.

Key elements of the messaging will be promoting Heath Help Now website and app for signposting patients (which also gives access to the Waitless app), promoting the national Stay Well This Winter messages, and promoting the new East Kent Integrated Urgent Care Service.

A key part of our work to help people understand which service to use is Health Help Now, the mobile optimised website and app.

As of 31 August, the Health Help Now web app had been used 298,074 times by people using 249,723 devices (such as smartphones, tablets or computers). Users stay on for over one minute on average. Forty one per cent of users are aged 18 to 34, 25 per cent are 35 to 44, 16 per cent 45 to 54, 10 per cent 55 to 64, and eight per cent 65 plus. Seventy per cent of usage is by women.

The downloadable app, which launched on 9 December 2014, has been used 42,473 times and downloaded 17,525 times. People typically stay on for three and half minutes and look at 11 screens.

2.1 Patient newsletter

The Summer patient newsletter was published in August and is available on the CCG website:

2.2 Digital and social media

The CCG continues to use new technologies to better engage and communicate with patients and stakeholders. There are currently 2,889 Twitter followers of the CCG account @thanethealth. Recent tweets include:

NHS Thanet CCG‏ @ThanetHealth Sep 1


Keep your children healthy with this NHS #BackToSchool toolkit

NHS Thanet CCG‏ @ThanetHealth Sep 2


Did you know that many minor health issues can be dealt with at home or by seeing a pharmacist? #BackToSchool

NHS Thanet CCG‏ @ThanetHealth Aug 12


Look out for our Engagement Team at #Margate Pride!

NHS Thanet CCG‏ @ThanetHealth Jul 27


It’s great to have about 100 people at our listening event in Broadstairs which is just getting underway #kmlistens @KMhealthandcare

NHS Thanet CCG‏ @ThanetHealth Jul 25


Have you booked a place at our summer listening events? Come and have your say on local healthcare #kmlistens

NHS Thanet CCG‏ @ThanetHealth Jul 9


Stay safe in the sun – spend time in the shade, cover up & wear glasses, use at least factor 15 sunscreen #KeepCool #CoverUpMate

2.3 Website

Recent updates to the website include:

  • Back to School campaign

  • Updated Mental Health page, with a new Get Support Now child page

  • Set up new categories as there is a big push towards self-care and self-medication across Kent.

  • Uploading Listening events presentations to Kent websites as well as updating respective news articles.

Around 740 people used the Thanet CCG website in August.

Top 5 most visited pages were:

  • Back to School

  • Home

  • Back to School – Common Childhood Health Issues

  • Back to School – Medicine Cabinet

  • Contact us.

  • Public affairs and stakeholder management

3.1 Health Overview and Scrutiny

Following the Kent County Council elections in May, a new Health Overview and Scrutiny Committee (HOSC) and a new Joint Health Overview and Scrutiny Committee (JHOSC) have been formed.

The new HOSC chair is Councillor Sue Chandler, who represents Sandwich on the county council. The full Committee can be viewed here.

The first meeting of the new committee took place on Friday 14 July.

The agenda included items on the removal of junior doctors from Kent and Canterbury Hospital and the Kent and Medway Sustainability and Transformation Plan (STP).

There was also a written report on east Kent mental health rehabilitation services.

The next meeting takes place on Wednesday 20 September and includes items on the east Kent integrated urgent care service and local care in east Kent.

3.2 Stakeholder Briefings

There have been two requests from the Department of Health for briefings since the last governing body report.

The first related to the procurement of mental health services for children and young people in Kent. The second related to payments to care homes for continuing heath care.


Clive Hart