West Kent Clinical Commissioning Group along with their system partners in the West Kent Improvement Board identified through their Local Care Plan the opportunity to create integrated care through local care hubs across the county. This being in response to and recognition of the local imperative, reflecting the national position, to take positive, and integrated, action in respect of the growing demand faced by health and care services in the coming years; especially, but not exclusively, from the increasing number of older people within an overall growing population.
Tricordant was commissioned via a competitive procurement tender to develop the strategic case on behalf of the system.
The Tricordant Approach
The purpose of the strategic case was to determine the feasibility of local care hubs within west Kent; the service model, the potential number and location of hubs. This stage of the work was to provide the CCG Governing Body with sufficient facts and insights to allow them to decide if the concept should be taken forward for further detailed consideration.
System partners; NHS, District and County Councils, were enthusiastically engaged in the work and provided significant input throughout; participating in interviews, workshops to develop the service model and location criteria, and a range of engagement (including public, council and GP practice) events. All supported by the Improvement Board who gave quality time to the discussions.
Detailed analysis of and projections for activity demand and capacity were undertaken along with a review, with partner organisations, of existing space allocation and utilisation. Geographic mapping was used to determine the potentially optimum localities and likely travel times both by car and public transport; this forming a significant part of the positive public engagement discussions. At this stage no specific locations were selected although along with partner organisations a range of possible sites (including current provision) were identified as part of the initial feasibility work.
Working with the system, we identified four key strategic considerations:
- Can hubs deliver services more effectively, than the current provision, to different groups of patients?
- Can hubs improve the ability of health and care organisations to attract and retain workforce; also allowing for transformation of culture, behaviours and working practices to ensure benefit from integration?
- Can hubs be operated cost effectively, optimising the utilisation of estate and other valuable resources; improving on the current disparate provision?
- Can hubs provide the means for the potential maximisation of future changes to the delivery of health and care, e.g. through technological advances?
Whole system engagement was a critical part of our work to explore the development of local care hubs in west Kent. Tricordant took time to work with the different organisations in our system both individually and collectively; there was no ‘one size fits all’ approach and time was always taken to pick up specific issues around some of the more challenging aspects.
As a CCG we received a bespoke service; Tricordant were accessible and responsive and the right focus was given to the different elements of our project (strategic and technical). Tricordant were careful to select the people with the right skills and approach to partners with us.
The end result was a strategic case that partners had been fully engaged in the development process and that was delivered on time.
The strategic case document was presented to the CCG Governing Body, on the date proposed at the outset of the work, and they unanimously agreed to support the findings and proposals of the work and to move forward to the next stage of development; which will incorporate the outcomes of three other related workstreams reviewing general practice and workforce developments and beds in the community.