I spent Tuesday afternoon on the parliamentary estate with representatives from clinical commissioning groups (CCGs) and public health bodies. They agreed that our health services work best when they cover the same geographical area as local authorities. I was, therefore, disturbed to read in Thanet Extra about proposals to combine Kent and Medway’s eight CCGs into four integrated care partnerships with just one of these new partnerships spanning the whole of East Kent.
Few people would argue that Thanet CCG is successfully representing the needs of our area or fulfilling its duty to tackle health inequalities. Thanet CCG was complicit in the decision to close the stroke unit at QEQM hospital, apparently guided by the need to make huge savings across the county. Every week, new evidence emerges of failures in our mental health services, which is most apparent in the shocking and preventable rise in suicides. Service for children and adolescents have been decimated, and Thanet consistently misses Government targets for counselling and therapy. In-patient services are underfunded and unable to cope with local demand. Save Our NHS in Kent has collected personal accounts of people who have been failed by the Beacon Community Mental Health Service, which make for distressing reading.
The projected rise in severe mental illness in Thanet is 3.8% by 2020; in mild to moderate mental illness, it is 5%. Thanet CCG’s Clinical Chair, Dr Jihad Malasi, argues in Thanet Extra that the proposed merger would ‘unlock improvements in care for patients and help us meet rising demand’. But it is difficult to see how these improvements would be made if decisions are taken by people with little experience of the reality on the ground.
One in five people visit their GP for non-medical reasons ranging from social isolation to money worries. NHS England’s drive towards social prescribing will increasingly see people being referred to advice, arts, exercise and educational activities in the community. The Local Government Association is responding to the opportunity this represents for the cultural, leisure and public health arms of councils to play an active part in improving population health and overcoming inequalities. This is a unique moment for a locally based movement to address the generational challenges facing our society. This would surely work best if Thanet CCG is working closely with Thanet District Council to respond to local need in a joined-up way.
You can read more about the plans to merge health services here.