Our Case for Change

NHS and social care leaders make ‘case for change’ in Kent and Medway

Leaders from the NHS in Kent and Medway, along with Kent County Council and Medway Council, have today (24 March) published a compelling ‘case for change’ which sets out why services need to change to meet the needs of local people. 

The case for change shows that every day 1,000 people (about 1 in 3 people in hospital at any one time) in Kent and Medway are stuck in hospital beds when they could get the health and social care support they need out of hospital if the right services were available. 

Doctors and social care leaders say this, along with eight other key challenges, are the drivers for new plans being developed that will see more care provided outside of hospitals and NHS and social care services working in a joined-up way. 

They are calling for local people to get involved in helping shape these plans for the future of NHS and social care services in Kent and Medway.

The case for change gives more detail about these challenges and has been published to explain the thinking behind the draft plans in the Kent and Medway Sustainability and Transformation Plan (STP), published in November 2016.

The case for change also shows that:

  • We need to focus more on supporting people so they don’t get ill in the first place: Around 1,600 early deaths each year could have been avoided with the right early help and support for example to help people maintain a healthy weight, stop smoking and drink responsibly.
  • GPs and their teams are understaffed, with vacancies and difficulties recruiting: If staffing in Kent and Medway was in line with the national average there would be 245 more GPs and 37 more practice nurses.
  • Services and outcomes for people with long-term conditions are poor: As many as four in 10 emergency hospital admissions could be avoided if the right care was available outside hospital to help people manage conditions they live with every day and to prevent them getting worse.
  • Some services for seriously ill people in Kent and Medway find it hard to run round-the-clock, and to meet expected standards of care: All stroke patients who are medically suitable should get clot-busting drugs within 60 minutes of arriving at hospital. None of the hospitals in our area currently achieve this for all patients.
  • Planned care – such as going into hospital for a hip operation or having an x-ray – is not as efficient as it could be: There is variation across Kent and Medway in how often people are referred to specialists and variation in the tests and treatments people get once they have been referred.
  • Cancer care does not always meet national standards: waiting times for diagnostic tests, to see a specialist and for treatment, are sometimes longer than national standards.
  • People with mental ill health have poor outcomes: people with a serious mental illness die on average 15 to 20 years earlier than the general population
  • Services could be run more productively: Around £190m of savings could be made if services were run as efficiently as top performing areas in England.

Glenn Douglas, Chief Executive of Maidstone and Tunbridge Wells NHS Trust and Senior Responsible Officer for the Kent and Medway STP, said: “We all want health and social care services that can meet our needs now and in the future. All those who work in NHS and social care services in Kent and Medway do their best to offer safe, compassionate and high quality care. However, we face new challenges that mean we need to change the way we work to improve care and get better value for the money we have available. Our case for change describes the current situation and explains why change is necessary. We now want local people to get involved to help shape and influence good health and social care in their area.”

Dr Peter Maskell, Consultant Geriatrician and Co-Chair of the Kent and Medway STP Clinical Board, said: “As our population grows, and people live longer, the demands on our services are changing and increasing. We can’t carry on having an average of 1000 people in a hospital bed each day who could be more appropriately cared for elsewhere. In my experience, people would rather be at home, or closer to home, with the right care in place, as soon as they are well enough. What’s more those 1000 beds aren’t available for their intended purpose, leading to cancelled operations and long waits for admissions via accident and emergency departments. I, and colleagues from health and social care services, believe the answer is to grow services to meet the needs of this group of patients in our local communities, closer to where people live.”

Dr Sarah Phillips, local GP and Co-Chair of the Kent and Medway Sustainability and Transformation Plan Clinical Board, said: “One in three local people are living with one or more long-term condition. Every day in my surgery I see people with conditions such as heart and lung disease, obesity and high blood pressure, which are often preventable with the right support and information. I also know that the pressure on GP surgeries and community services means we can’t always do as much as we would like to help people stay as well as possible, stay out of hospital and get them home quickly when they are admitted. Our plans for improving local care will start to change this.”

Paul Carter, Leader of Kent County Council, said: “We are starting to make great headway on joining up health and social care services for local people. We are implementing new ways of working that deliver better outcomes and experience of care for people who rely on social care services and the NHS. We need to build on this good work across the whole of Kent and Medway. I would like to see local people signing up to shape future plans. I’d like local people to sign up to the Transforming health and social care newsletter so they can inform themselves, share their views and get involved.”

Cllr Alan Jarrett, Leader of Medway Council, said: “It’s important that we all work together to provide the best possible services for people living in Kent and Medway. Residents deserve to have access to high quality, reliable health care and this case for change clearly highlights what needs to be done to ensure that is delivered. Those wishing to find out more and have their say on plans going forward can join their GP practice’s patient participation group or local clinical commissioning group’s Health Network. We need to think and act as communities to make it possible for everyone to improve their health. Let’s end preventable ill-health in Kent and Medway.”


Media enquiries: For questions and interviews with Dr Peter Maskell, Dr Sarah Phillips, Paul Carter and Alan Jarrett please contact Alex McNally at South East Commissioning Support Unit on 07984 551545

Note to Editors

1.    The Sustainability and Transformation Plan for Kent and Medway was published in November 2016. It is available on our website at www.kentandmedway.nhs.uk/stp

2.    The STP sets out our ambition to put local people at the heart of services, helping people to stay well and independent in their own homes and communities and avoid being admitted to hospital. It describes how we can:

o   improve the health and wellbeing of local people

o   deliver high quality, joined up health and social care

o   offer access to the right care and support in the right place, at the right time

o   make sure NHS and social care staff are not under so much pressure that they can’t deliver the caring ethos of the NHS and social care

o   better meet people’s needs within the funding we have available

o   build health and care services that are sustainable for years to come.

3.    You can sign up for the Transforming Health and Social Care newsletter at www.kentandmedway.nhs.uk/subscribe

4.    The Kent and Medway Sustainability and Transformation Plan is being developed and delivered by a partnership of all the NHS organisations in Kent and Medway, Kent County Council and Medway Council. It is led by Glenn Douglas,

5.    The future plans are being draw up by groups of local doctors and other healthcare professionals, hospital chief executives, patient groups and councils