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On 1st July, Integrated Care Systems were formalised as statutory bodies following changes brought about by the 2022 Health and Care Act.

I was informed that our ICS is simply to be called NHS Kent & Medway.

Integrated care systems are partnerships that bring together providers and commissioners of NHS services with local authorities and other local partners to collectively plan health and care services to meet the needs of their population.

This all sounds great to me and I truly wish all involved the very best. I spent my working life promoting 'joined up working' and encouraging cooperation wherever possible.

The central aim of an ICS is to integrate care across different organisations, joining up hospital and community-based services, physical and mental health, and health and social care. The last of those cannot come too soon for me. I remember attending conferences well over a decade ago where we were all calling for the NHS and social care to work closer together for patients and the public.

The integrated care systems have now been given statutory responsibilities and the Kent and Medway Clinical Commissioning Group has been replaced with the NHS Kent and Medway Integrated Care Board.

The website says that 'in Kent and Medway, we are discussing options for additional board roles to ensure effective representation across the area; recognising we are one of the largest Integrated Care Systems in the country with four place based partnerships and two top tier local authorities'.

This is where I would like to make a very positive suggestion:

According to the fourth principle of the NHS constitution 'the patient will be at the heart of everything the NHS does' and the first of the excellent NHS values states 'Patients come first in everything we do'.

I just love that constitution - says it all doesn't it? It's OUR NHS, not simply the business of politicians, managers and professionals.

However, there appears to be a lack of patient representation on the new ICB Board for Kent and Medway - someone to make sure people and communities are at the heart of all Board thinking.

Three years ago lay-members with specific roles covering Patient and Public Engagement sat on all eight of the smaller, more locally focussed CCG boards covering the Kent and Medway area. (At this point I have to declare an interest - I was a lay-member, for the Thanet CCG).

Two years ago, when the eight CCG's were merged into one, covering the whole of Kent and Medway, we were left with just one lay-member for patient and public engagement on the single board. However, common sense prevailed and eventually there was agreement that one person would struggle to reflect the perspective of a population numbering well over 1.5 million.

Consequently, geographically spread associates were appointed to support the lay-member on the board. It wasn't perfect but it did bring together views from across the geography - especially during the pandemic when so much was being dictated from the centre. (Again I declare an interest - I became one of those associates on scaled down duties but performing an advisory role to the K&M board member covering local Thanet issues). In this way the lay member on the board was kept informed of local issues affecting patients and the public right across the Kent and Medway geography.

My concern now is that I see no lay-member appointed to the Kent and Medway Integrated Care Board for Patient and Public Engagement, let alone any system to help reflect potential local variances.

I have heard that belatedly and sadly somewhat as an afterthought, board members with other responsibilities might be approached to 'tag' patient engagement onto their primary roles, but how on earth would it be possible to simply add reflecting the issues of 1.5 million+ people to what might already be quite onerous responsibilities.

I therefore simply suggest that the leadership of the newly created ICB take a very close look at their board membership and act swiftly to appoint someone with a SPECIFIC FOCUS on Patient and Public Engagement - just like the NHS constitution suggests - putting the patient at the heart of EVERYTHING it does, including governance.

Have no fear, this guy wouldn't apply for any such role.

I write purely as a concerned resident.

Done my bit - I'm retired!


Clive Hart
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