Download Mapping the Future background information briefing document

Background information on
organisations involved in the
project
August 2013
MAPPING THE FUTURE Background information on organisations involved in the project | 1
Introduction
To provide some context to the Mapping the Future project, this document sets out
information on:

What the National Health Service (NHS) is

Changes to the NHS

What a Clinical Commissioning Group (CCG) is

Key statistics for west Kent

Explanation of the organisations involved in the Mapping the Future project

Glossary of terms.
What is the National Health Service?
The NHS is the UK’s publically funded healthcare system. Created in 1948, the NHS
provides a range of health services, the majority of which are free at the point of use for UK
residents.
Funding for the NHS comes directly from taxation and is granted to the Department of
Health by Parliament.
Changes to the NHS
The Health and Social Care Act 2012 led to an extensive re-organisation of the NHS. As
part of the changes, NHS Primary Care Trusts (PCTs) were abolished and replaced with
Clinical Commissioning Groups (CCGs). CCGs ‘shadowed’ PCTs for a number of months
before becoming fully authorised organisations in April 2013.
What is a Clinical Commissioning Group?
Every area in England is now covered by one of the 211 CCGs who are responsible for
£65billion of the £95billion NHS commissioning budget.
CCGs are statutory organisations made up of, and led by, GPs from a local area. The idea
is that as GPs are closest to patients, they will be able to identify and tailor services to the
needs of their local community most effectively.
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Each CCG has a governing body which is made up of elected clinicians and lay members
who ‘run’ the CCG on behalf of general practices.
CCGs are responsible for commissioning (buying and planning) the majority of healthcare
services for patients in their area. This includes:

Urgent and emergency care (including 111, accident and emergency and
ambulance services)

Out-of-hours GP services

Planned hospital care (operations and other treatments that can be planned in
advance)

Community health services (such as community nurses, speech and language
therapy, continence services, wheelchair services, and home oxygen services)

Rehabilitation services (for example, physiotherapy after an accident or stroke)

Maternity and newborn services (excluding neonatal intensive care)

Children’s healthcare services (mental and physical health)

Services for people with learning disabilities

Mental health services (including psychological therapies)

Infertility services

Continuing healthcare

Medication.
They are also responsible for making sure these services offer patients high-quality care.
This is done by monitoring patient experience, assessing clinical effectiveness and the
safety of services. Where necessary, CCGs will work with an organisation providing care to
deal with any failings.
CCGs do not have responsibility for health improvement services (such as sexual health,
stop smoking services or healthy weight services) or commissioning primary care (GP
surgeries, dentists, pharmacies and optometrists) or specialised health services.
Health and wellbeing boards
As part of the 2012 reforms Health and Wellbeing Boards were established as a forum for
key leaders from the health and care system to work together on improving the health and
wellbeing of their local population and reduce health inequalities.
Each top tier and unitary authority has a health and wellbeing board. Kent County Council
covers the west Kent area.
The Kent Health and Wellbeing Board brings together clinical commissioning groups and
councils to develop a shared understanding of the health and wellbeing needs of the
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community. They have undertaken a Joint Strategic Needs Assessment (JSNA) and joint
strategy for how these needs can be best addressed.
The board is made up of councillors, GPs from the NHS West Kent CCG and a
representative from Healthwatch.
Healthwatch is a new ‘consumer champion’ for health and social care. Healthwatch,
operates at a local level (local Healthwatch) and national level (Healthwatch England).
Local Health and Wellbeing boards also take place at CCG level.
Key statistics for west Kent
When we talk about ‘west Kent’ we are referring to the boroughs of Tonbridge and Malling,
Tunbridge Wells, Maidstone, and most of the Sevenoaks district.
Some key statistics for this area are as follows:

463,730 residents

62 GP practices

Average life expectancy ranges from 75 – 82 years

In the next 20 years, the number of people aged 65+ is projected to grow 57 per
cent and number of people aged 85+ by 127 per cent.
NHS West Kent Clinical Commissioning
Group
NHS West Kent CCG has a budget of approximately £471 million per year to spend on
healthcare services in the west Kent area. This equates to around £1,015 per person.
Some of NHS West Kent CCG’s priorities for 2012/13 include improving:

Planned care (with a particular emphasis on helping people with diabetes and heart
failure)

Integrated commissioning (providing joined-up care, earlier diagnosis of dementia,
more support for care homes)

Urgent care (encouraging people to use their GP and minor injuries units more)

Localities (improving diagnosis of long-term conditions, supporting people to live
healthy lives, reviewing the mediation people are prescribed)
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
Children and maternity (improving ante-natal and post-natal care)

Mental health (greater support for people with mental health illness).
The Mapping the Future project is being coordinated and led by NHS West Kent CCG.
For more information on NHS West Kent CCG, visit: www.westkentccg.nhs.uk.
Kent County Council
Kent County Council (KCC) is an upper-tier local authority that governs the county of Kent.
It is made up of 84 county councillors that represent the wards of Kent. It is responsible for
public services such as education, transport, strategic planning, social services and waste
disposal.
From April 2013, KCC took on the responsibility for Public Health. This includes:

Improving the health of Kent residents – especially the most disadvantaged.

Informing and advising other relevant organisations on health protection issues. For
example, making sure the police, local nursing homes and health services know
when there is severe weather or an outbreak of an infectious disease.

Providing advice to CCGs and all those who commission health and social care
services.
For more information on KCC, visit: www.kent.gov.uk.
Maidstone and Tunbridge Wells NHS
Trust
Maidstone and Tunbridge Wells NHS Trust (MTW) is a large acute hospital trust. It
provides a full range of general hospital services to around 500,000 people living in the
south of west Kent and parts of north east Sussex.
The majority of people that use MTW live in the Maidstone and Tunbridge Wells area. In
addition, the Trust provides specialist cancer services, through its flagship cancer centre at
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Maidstone and unit at Kent and Canterbury Hospital, for the whole of Kent, Hastings and
Rother (about 1.8 million people).
MTW is at the forefront of developments in minimally invasive laparoscopic surgery in the
NHS and is increasing the range of other highly specialised services available locally to
patients, including centres of expertise in trauma (emergency surgery), maternity,
paediatrics (children’s inpatient care), orthopedics and planned complex surgery.
The Trust primarily works from two main clinical sites: Maidstone Hospital and the new
Tunbridge Wells Hospital at Pembury. It employs approximately 4,750 full time equivalent
staff and on average has 84,000 inpatients and 387,500 outpatients per year.
For more information on MTW visit: www.mtw.nhs.uk.
Integrated Care 24
Integrated Care 24 (IC24), formerly known as South East Health Ltd, is a major ‘not for
profit’ social enterprise company. It provides a range of innovative primary care services
designed to deliver quality and affordability. IC24 is a solution based company providing a
comprehensive portfolio of primary care services aimed at improving access and reducing
the demand on secondary care services.
IC24’s vision is to provide: ‘Easier and faster access to services and information for our
patients about their health, illness and the NHS services which enables more independent
care.’
IC24 provides services to more than four million patients through a range of services which
include:

GP out of hours primary medical services

NHS 111

Primary care support services

Secondary Care Support

Offender Healthcare Services (prisons and custodial services)

Telecare and Telehealth – long-term conditions management

IT Solutions

Pharmacy and Medicines Management

Contact Centre Services.
For further information on IC24, visit: www.ic24.org.uk.
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Kent Community Health NHS Trust
Kent Community Health NHS Trust provides community healthcare for patients in their own
homes and in other community settings. The Trust’s health and wellbeing services support
people to make positive lifestyle choices.
The Trust also provides services for children and adults to manage their long-term health
conditions, help them avoid going into hospital and, when they have needed to be in
hospital, help them to get home quickly. Staff deliver services in locations including GP
surgeries, nursing homes, health clinics, community hospitals, minor injury units and
children’s centres. They include doctors, community nurses, dieticians, health visitors,
dentists, podiatrists, occupational therapists, physiotherapists, family therapists, clinical
psychologists, speech and language therapists, radiographers, pharmacists, health
trainers, health improvement specialists and many more.
The Trust works closely with patients’ GPs, social services, other NHS providers and
commissioners to provide healthcare that meets people’s needs.
The Trust has a rapid response service which runs 24 hours a day, seven days a week
where experienced nurses, following a request from a GP or other health professional, will
assess a patient’s needs within two hours and put a package of care in place to enable the
patient to stay at home rather than attend hospital.
More complex care for people who otherwise would have needed to go into hospital, called
“step-up” care, is also provided in the county’s 12 community hospitals. If people do need
in-patient care in an acute hospital, for example while recovering from an illness, staff
support people to get back home by providing rehabilitation at home and in community
hospitals.
For more information about the Trust and its full range of services please visit
www.kentcht.nhs.uk.
South East Coast Ambulance Service NHS
Foundation Trust
South East Coast Ambulance Service (SECAmb) was formed on 1 July 2006, following the
merger of Kent, Surrey and Sussex ambulance trusts and is one of 11 ambulance services
operating in England. It covers an area of 3,600 square miles and a resident population of
approximately 4.5 million across East and West Sussex, Brighton and Hove, Kent and
Medway and Surrey.
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The trust responds to 999 calls from the public, immediate and urgent calls from health
professionals. SECAmb is also the lead provider of the new NHS 111 service in
partnership with Harmoni across the Kent, Medway, Surrey and Sussex region. It employs
more than 3,000 staff across approximately 60 sites, more than half of whom are
paramedics and ambulance technicians.
For further information on SECAmb, visit: www.secamb.nhs.uk.
Kent and Medway NHS Social Care
Partnership Trust
Kent and Medway NHS and Social Care Partnership Trust (KMPT) was formed in 2006
after East Kent NHS and Social Care Partnership Trust and West Kent NHS and Social
Care Trust merged.
KMPT provides mental health, learning disability, substance misuse and other specialist
services for 1.6 million people across Kent and Medway. The Trust prides itself on
providing high-quality clinical services, innovation and partnership working.
It is one of the largest NHS Trusts covering an area of 1,450 square miles, employing over
3,600 staff and operating from over 170 buildings across Kent and Medway.
The demand for mental health services is increasing at a higher rate than that of the
general population. It is currently estimated that one in 100 people suffer from a severe
mental illness, but this is rising. There has been a huge increase in mental health clients
over recent years and by 2016 it is estimated there will be more than 1,700 extra people
known to KMPT with a severe mental illness.
The CCGs across Kent and Medway, Kent County Council, and Medway Council all
commission services from KMPT.
For further information on KMPT, visit: www.kmpt.nhs.uk.
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Glossary of terms
A&E
Accident and Emergency Department
Acute Care
Care provided by the larger general hospitals
Acute Hospital
A hospital which provides a range of care that normally takes a
short time to complete – e.g. accident and emergency,
maternity, surgery, medical, x-ray, radiotherapy, and so on
Acute Services
Medical and surgical treatment provided mainly in hospitals
Admissions
When a patient is admitted to hospital
Ambulatory Care
Services where people do not stay in hospital overnight e.g.
outpatients, x-ray, day surgery and medical diagnostics
AO
Accountable Officer
Bed blocking
(Also known as delayed discharge) where patients that are fit
for discharge remain in acute hospital beds when other more
suitable forms of care are not provided
Booked
Admissions
The NHS national booked admissions scheme is a style of
booking system which enables patients to arrange convenient
out-patient and in-patient admission dates, leading to fewer
cancelled operations, less bureaucracy and more efficient use
of NHS time and resources
C&B
Choose and Book - a national electronic referral service which
gives patients a choice of place, date and time for their first
outpatient appointment in a hospital or clinic
Caldicott Guardian
All NHS organisations are required to appoint a Caldicott
Guardian – a person who has a responsibility for policies that
safeguard the confidentiality of patient information
Caldicott Standards
These are a set of standards that regulate the use of patient
information throughout the NHS
CAMHS
Child and Adolescent Mental Health Services
Care Management
A system of organising care to vulnerable adults by local
authority social services departments. It involves assessing
needs, care planning, the organisation of care packages within
available resources, monitoring and review and close
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involvement with service users and carers
Care Pathways
The route that a patient will take from their first contact with an
NHS member of staff (usually their GP), through referral, to the
completion of their treatment. You can think of it as a timeline,
on which every event relating to treatment can be entered
CCG
Clinical Commissioning Group
CCU
Coronary Care Unit. Dedicated unit for specialist coronary care
CHD
Chronic Heart Disease
CMHT
Community Mental Health Team
Clinical Negligence
A breach of duty by healthcare practitioners in the performance
of their duties
Clinical Team
A clinical team may comprise doctors, nurses and other health
staff who provide services of a particular type, for example
audiology
Clinician
A health professional who is directly involved in the care and
treatment of patients, for example, nurses, doctors, therapists
Commission/
Commissioning
Process in which the health service identifies local needs for
services and assesses them against the available public and
private sector provision. Priorities are decided and services are
purchased from the most appropriate providers through
contracts and service agreements. As part of the
commissioning process services are subject to regular
evaluation
Community Care
A network of services provided by social service departments
of local authorities in conjunction with the NHS and volunteers.
It supports old people, people who have mental health
problems, or people who have learning disabilities, who might
previously have been in a long stay hospital. Not to be
confused with community health services
Community Health
Services
Care provided locally designed to keep people out of hospital
and providing treatment in or near their homes. It is normally
given by district nurses, health visitors, community midwives,
and community psychiatric nurses, attached to general practice
surgeries
COPD
Chronic Obstructive Pulmonary Disease
Corporate
Governance
The rules and regulations within which an organisation works to
ensure probity and accountability
CQC
Care Quality Commission – health and social care inspectorate
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which replaced the Healthcare Commission in April 2009
CQUIN
Commissioning for Quality and Innovation - the CQUIN
payment framework enables commissioners to reward
excellence, by linking a proportion of English healthcare
providers' income to the achievement of local quality
improvement goals
CSU
Commissioning Support Unit
Day case
admission
Day case patients are admitted for care or treatment which can
be completed in a few hours and does not require a hospital
bed overnight
Delayed discharge
rate
The proportion of patients occupying a hospital bed and are
ready for discharge
DoH
Department of Health. Government body responsible for
delivering a fast, fair, convenient and high quality health and
social care service in England
Elective Care
Care that is planned in advance as a day case or inpatient
Elective admission
A patient who is admitted from the waiting list
Emergency
admission
A patient admitted to hospital at short notice because of clinical
need or because alternative care is not available
FHS
Family Health Services. Services provided in the community
through GPs, dentists, pharmacists
Foundation Trust
NHS Foundation Trusts have been established as new public
interest organisations accountable to local people and free from
Whitehall control. Drawing on models from co-operative
societies, mutual organisations and charities in Britain and
abroad, NHS Foundation Trusts work for NHS patients and
wide public benefit. Each NHS Foundation Trust has a Board of
Governors, including governors elected by members of the
local community and NHS staff, to provide accountability to
stakeholders
GP
General Practitioner - doctor who usually with colleagues in
partnership, works at a local surgery and provides medical
advice and treatment to patients, and takes a leading role in the
management and provision of local health care through their
influence on the primary care trusts. Their surgeries, general
practices, often have a Practice Manager, and are now staffed
by specialist nurses and therapists, and many accommodate
dentists, opticians, and pharmacists
GPwSI
GPs with Special Interests
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Health Community,
or Health Economy
A term used to embrace all the organisations, NHS and others,
whose activities have an effect on people’s health in a local
area. It can include local authority function such as services,
environmental health and transport, and housing associations,
water suppliers, and voluntary organisations
Health Inequality
The term used to describe the fact that people living in deprived
areas usually have poorer health than people living in more
affluent areas. This can also apply to differences in the health
of the people of various ethnic groups
Integrated Care
Pathway
Improving the patient’s route for treatment through different
health and social care systems by combining resources and coordinating working methods to prevent hold-ups and jams
In-patient
A patient who has been admitted to hospital for treatment and
is occupying a hospital bed
ITU
Intensive Care Treatment Unit. Dedicated unit for intensive
care of patients Also known as high dependency unit
Intermediate Care
Health care for patients who are not ill enough to be in an acute
hospital and not well enough to be at home unsupported
JSNA
Joint Strategic Needs Assessment – covering health and social
care, the purpose of a JSNA is to pull together in a single,
ongoing process all the information which is available on the
needs of the local population and to analyse them in detail to
identify:
a) the major issues to be addressed regarding health and wellbeing,
b) the actions that will be taken to address those issues
KCC
Kent County Council
KCHT
Kent Community Health NHS Trust
KMPT
Kent and Medway NHS and Social Care Partnership Trust
KMCS
Kent and Medway Commissioning Support
LA
Local Authority
LACS
Looked After Children’s Services. Service for children who are
either in care (subject to a care order) or accommodated by a
local authority
LTC
Long Term Conditions - conditions that cannot, at present, be
cured, but can be controlled by medication and other therapies.
They include diabetes, asthma, and chronic obstructive
pulmonary disease
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MDT
Multi disciplinary Team. This is a team of professionals drawn
from various disciplines within the Trust that combine their
expertise to the benefit of patients
MIU
Minor Injuries Unit
MTW
Maidstone and Tunbridge Wells NHS Trust – acute provider
NHS
National Health Service
NHS England
A national body that has been created under the Health and
Social Care Act, whose role includes supporting, developing
and holding to account the system of clinical commissioning
groups, as well as being directly responsible for some specialist
commissioning
NICE
National Institute for Health and Clinical Excellence - guides
NHS staff about new health technologies including medicines,
medical devices, techniques and procedures
Nursing Home
A residential home that has qualified nursing staff to provide
nursing care
OOH
Out of Hours – primary care services normally provided by GPs
in hours
Ordinary admission
An admission, including one that is an emergency, where the
patient is expected to remain in hospital for at least one night
Out-patient
A patient who attends hospital for treatment, consultation and
advice but does not require a stay in hospital
Palliative Care
The care of patients whose disease is no longer curable,for
example cancer and motor-neurone disease. It takes into
account the physical, psychological, social and spiritual aspects
of care of patients, with the aim of providing the best quality of
life for them
Patients
People who are currently using or waiting for health services
QIPP
Quality, Innovation, Productivity and Prevention - a large scale
transformational programme for the NHS, involving all NHS
staff, clinicians, patients and the voluntary sector to improve the
quality of care the NHS delivers whilst making up to £20billion
of efficiency savings by 2014/15, which will be reinvested in
frontline care
Secondary Care
Patients whose needs are too complex to be managed in
primary care are referred to more specialist services.
Secondary care includes local hospitals and treatment given
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away from the hospital setting, such as mental health services,
learning disability services and help for older people.
Social Care
Social care services are normally run by local councils,
sometimes in conjunction with local NHS providers and
organisations. Most of us are likely to become clients of social
care services at one time or another but some of the main
groups using the services include children or families who are
under stress, people with disabilities, people with emotional or
psychological difficulties, people with financial or housing
problems and older people who need help with daily living
activities
Tertiary Care
Service provided by specialist hospitals which have diagnostic
and treatment facilities not available at general hospitals, or
given by doctors who are uniquely qualified to treat unusual
disorders that do not respond to therapy available at acute
hospitals. It can also include hospice care for people who are
terminally ill
Therapy services
These are provided by ‘allied health professionals’ who include
dieticians, hearing therapists, occupational therapists,
physiotherapists, podiatrists (chiropodists) and speech and
language therapists.
Whole System
Approach
Term for a strategic, integrated approach to planning and
delivering services. A local whole system of care covers all
local health and social service provision and any other service
that impacts upon health and social care
WIC
Walk-in Centres. Nurse-led drop-in centres managed by the
NHS that provide minor treatments, self-help advice and
information on the NHS, social services and other local
healthcare organisations
ENDS