Northfleet Swanscombe Dartford Gravesend Swanley Greenhithe Bexley South Bean Darenth Longfield Farningham Meopham Snodland West Otford Kingsdown Aylesford Sevenoaks Allington Bearsted West Westerham Hadlow Malling Maidstone Coxheath Lenham Hildenborough Barming Shepway Wateringbury Sutton Yalding Tonbridge Langley Valence Edenbridge Paddock Wood Brenchley Headcorn Pembury Speldhurst Tunbridge Wells Goudhurst Cranbrook Lamberhurst Hawkhurst What’s in this report? Contents p3 Introduction p19 Advice and information for p5 Who we serve patients p5 Who we are p19 Complaints handling p5 What we commission p19 Adherence to Principles for 674,000 p5 Primary Care Remedy people p6 Prevention services p19 Staff satisfaction and p6 Community services engagement p6 Mental health and learning p19 Staff survey 2009 disability services p20 Sickness absence and p7 Acute services stress at work p7 Specialist services p20 Equal Opportunity and p7 Continuing care Diversity Policy p8 What have we achieved? p20 Education, development p8 Improving health and training p8 Acute care p20 Health and safety p8 Creating a seamless service p20 Measuring Performance p9 Creating a fairer service National scrutiny p10 Foundations for the future p22 Local scrutiny and audit p10 Considerable Challenges p22 Performance management p10 Population p22 Clinical governance p10 Lifestyle factors p22 Risk assessment and p10 The ageing population Foreword p10 Long term conditions management p11 Financial situation p22 Incident reporting p11 Political and reputation p23 Information Governance NHS West Kent is responsible for the challenges p23 Data protection healthcare of over 670,000 people living in the area we serve. Our ambition is to ensure p11 Focussing our efforts to p23 Data loss and that they enjoy the best possible health. realise our ambition confidentiality breaches p11 Increasing support p23 Freedom of information Here you will see how we have worked to p13 Helping people take control p23 Environmental Issues and achieve this over the last year, and how we p14 Self-management are striving to realise that ambition in the Sustainability p14 CareCall future. p23 Equality and Human Rights p15 Health Trainers p23 Equality and Human Rights p15 Prevention It’s not just the NHS that deserves credit for Strategy the success we’ve achieved, or that takes p16 Increasing efficiency and p23 Equality Impact responsibility for the improvements we need performance Assessments (EIA) to bring. More than ever before we are p16 Stroke involving you, the public, patients and p24 Corporate Governance p16 Diabetes clinicians in the work we do. You have a p24 PCT Board p16 Opthamology valuable opportunity to help us shape the p25 Directors’ declarations of p17 The next five years future of the health service. interests 2009/10 p18 Pride, pace and purpose p26 Financial Review Welcome to our Annual Report for 2009/10. p19 Statutory and business p33 Independant Auditors information Report NHS West Kent annual report 09/10 03 Steve Daryl Phoenix Robertson Rod Smith Julia Declan Ross O’Neill David Griffiths James Thallon Welcome Harshad Topiwala Julie Hunt Brian Jill Sweetland Barry Ruddock Wilding Rosanne Corben Peter Conway The NHS in West Kent is a wide-ranging network of services all designed to fit together for one aim - to offer the people of West Kent the best possible health. Rather than being a single organisation, it is a family consisting of NHS, local authority, private sector and voluntary sector providers as well as contractors such as dentists, GPs and optical practitioners. The local NHS has unique skills and experience, and is continually learning and developing to do the job better. It also has unique challenges, which doesn’t change our ambition but makes it harder to achieve. NHS West Kent is an organisation known regional networks where services are as a Primary Care Trust (PCT). Our role is better designed covering a larger area. to commission that network of services to achieve outcomes which will bring about We also work with our population, our ambition. In 2009/10 we had a clinicians and local elected officials to budget of £994 million to manage across shape the future of our health services. the health system in West Kent to ensure Our Health Network is a vibrant and ever- the best outcome for the population. We growing collection of members of the do not simply purchase or contract for public who give us the benefit of their services - our role is to provide knowledge and experience in building leadership and support to organisations new services. Many members of the and individuals who provide healthcare, public sit on the PCT’s working groups as well as challenging them to do better and committees to give their unique for the people of West Kent. perspective. We are building services for the community, with the community’s As commissioners, we select the best help. providers for each part of the service, then oversee and work in partnership The population in West Kent is ever with them to get the best from the skills changing, as is the environment the and experience they share. At the same health service operates in. The health time, we work together to mitigate the needs of that population do not stay the ever-changing challenges the NHS faces. same, neither do people’s expectations. We drive the providers we commission to Knowledge and best-practice is improve, and learn from their own developing all the time. NHS West Kent is experiences and those of other committed to negotiate these constantly- providers. We work with other PCTs to shifting factors to deliver the excellent create a more seamless service, benefit standards the people of West Kent from economies of scale and develop deserve. 04 NHS West Kent annual report 09/10 It is important for NHS West Kent to take on board public and patient feedback so the services that are funded are the ones we would choose for ourselves. “ As service users we can give a perspective on quality and what works well that may not be reflected in other “ measures used. My main interest is in mental health and I hope all future engagement with those most affected by mental health issues will have a good result, and that the outcomes do reflect all of our efforts. Alex Williams Alex Williams is one of over 730 Health Network members who play an important role in helping to shape local services and influence commissioning strategies. Since becoming a member more than two years ago, Alex has participated in various consultations and training sessions, provided feedback on documents and strategies, and written for the Health Network newsletter. The 32-year-old has also joined the NHS West Kent Patient Experience Group, which meets every three months with local healthcare providers to share user focused research ideas. NHS West Kent annual report 09/10 05 Who we serve • Population 674,600 • Mix of urban and rural • Significant pockets of deprivation • Proportion of over-65s set to rise West Kent has a population of 674,600 * living in a mix of provided services. West Kent Community Health acts, as rural and urban settings. The population is generally far as possible, like any other NHS body we commission well-off and healthy - 60 per cent of the population is services from. It has its own Board and manages its own made up of groups such as career professionals, budget. younger families in newer homes, and older suburban families, which tend to be relatively affluent and enjoy During 2010-11, we anticipate that NHS West Kent will good health. cease to provide any services directly. We are currently exploring a range of options for the best way to provide However, there are significant areas of deprivation where these community services, and the best shape for an there are greater health problems. These can be found organisation or organisations to deliver them. throughout West Kent - although the greatest concentration of deprived wards can be found in There are a total of 2,358 people working for NHS West Dartford and Gravesham, there are also some highly Kent, in 1,709 full-time equivalent posts. Of these, 508 deprived areas in and around Swanley, Sevenoaks, work in the commissioning part of the organisation in Tonbridge, Tunbridge Wells and Maidstone. 437 full-time posts, and 1,850 work for West Kent Community Health in 1,272 posts. Furthermore, the population is getting older. The over-65 population is set to increase significantly in this decade, and will make up a larger proportion of the population as What we commission well. • GPs, dentists, opticians and pharmacists • Hospitals and specialist care Who we are • Mental health and learning disabilities • Preventative and community services • Commissioning and ‘arm’s-length’ community services • 2,358 people overall Primary Care • 1,709 full-time equivalent posts GPs, dentists, pharmacists and optical practitioners are NHS West Kent is made up of a range of staff and contracted to provide a service to the NHS. These professionals with experience of frontline healthcare, primary care professionals are the first port of call for management, finance and all the skills necessary to most people with health needs. There are 107 GP manage a budget of around £1 billion. The PCT is practices, 104 dental practices, 111 community committed to developing as a commissioning pharmacies, and 76 optometric practices in West Kent. organisation - this means we focus on designing, Currently, 93 per cent of West Kent GP surgeries offer overseeing and managing the health system in West appointments outside the normal 8.30am-5.30pm time Kent but do not provide any services directly. slots. Historically, NHS West Kent has performed both NHS West Kent commissioned a new out-of-hours functions as we commissioned healthcare across the primary care service in 2009/10 from South East Health.