Well before COVID-19, the NHS locally was in the throes of change. Services and organisations who are involved in health and care in Medway and Swale (Sittingbourne and Sheppey) were joining forces as an Integrated Care Partnership (ICP), in line with national direction.
This is a long term change, it's not happening overnight, and there was an unavoidable pause during the height of the pandemic. But we're pleased to say that the Medway and Swale ICP is able to gather pace again.
As with all new ICPs, the ambition is to break down barriers that may exist between the different parts of the system, to make it easier for patients to receive care and for staff to deliver it more effectively. We want to provide quality services by making the best possible use of the resources available to us.
The ICP is part of a national programme of change across the NHS, with the NHS Long Term Plan at its heart, focusing on developing new ways of working to improve the health and wellbeing of local people, aiming for better outcomes and experiences along the journey of health and care.
The Medway and Swale ICP will serve a population of around 412,000 people and play a key role in promoting preventative services, such as helping you stop smoking or lose weight, to reduce your risk of developing long term, potentially more serious conditions such as diabetes or emphysema. We also want to reduce health inequalities, which means we want everybody to have the same opportunity to access health services and live a long and healthy life, regardless of where they live.
All health and social care organisations are also signed up to a commitment to help people and families stay independent in their own homes for as long as possible, to receive treatment closer to home and to avoid being admitted to hospital.
Find out more about NHS changes across Kent and Medway
Practice staff and GPs changed the way they worked - in some cases literally overnight - embracing new technology to deliver consultations virtually; introduce or step up telephone triage systems; implement tougher infection control processes; work remotely and make changes to the waiting and clinical areas.
These measures were necessary to ensure that patients who needed to see their GP or a practice nurse for routine care - such as appointments, or to access repeat prescriptions and immunisations - could continue to do so safely.
The biggest change that patients may have seen has been the way in which primary care consultations have been taking place. Most surgeries are now operating telephone triage and the majority of appointments are now carried out by phone or online unless there is a need for a face-to-face consultation.
Before the pandemic, approximately 25 per cent of GP practices in Kent and Medway routinely carried out online or virtual consultations - now around 75 per cent are doing so. Between March and May, 28,000 consultations have taken place online and 25,500 have been carried out via a secure video link.
Primary Care Networks– which are groups of GP practices working together in a geographical area - restructured services so that patients with suspected or confirmed COVID-19 were treated at designated Primary Care Treatment Centres. As the number of COVID-19 cases continues to fall, NHS Kent and Medway Clinical Commissioning Group continue to review the future use of these centres, which take patients who have been referred by NHS 111 or their own GP.
Patients with routine needs continue to be seen by their regular GP as other practices were able to see patients that were not showing symptoms of COVID-19 - but changes had to be made rapidly to the physical environment and standard ways of working.
Restarting routine and elective services at Medway Hospital
Following the national directive from NHS England in March, we had to take the very difficult step to postpone and cancel some services at the Trust in order to be able to manage the surge in emergency requirements, additional critical care services and other services related to the COVID-19 pandemic.
During this time, we continued to treat patients who required urgent care and patients receiving cancer treatment, and we were able to offer many outpatient appointments via telephone or video call. Unfortunately, we had to postpone planned surgeries and were unable to accept many routine referrals for diagnostic tests.
At the beginning of May, we began plans to restart our routine surgeries, outpatients and diagnostic services safely, while continuing to manage the COVID-19 challenge. We restarted our non-emergency surgery service on 29th June and we are now in the position to be able to offer surgery dates for patients who unfortunately had their procedures cancelled.
We also began to increase the number of face to face outpatient appointments on-site to 70 per cent of our pre-pandemic capacity. The reduced capacity is due to rules around social distancing, and the remaining 30 per cent of patients continue to be offered virtual appointments, which worked successfully during the peak of the pandemic.
Going forwards patients may be offered a face to face outpatient appointment or the option of a virtual appointment by phone or video if appropriate. We are continuing to work with our colleagues in the community and GP practices to ensure the option of a virtual appointment can be offered. We are also now able to accept referrals from GP's for diagnostic tests such as X-ray, ECG and audiology.
We know how upsetting it is to have operations and appointments cancelled, especially for those who are worried or in pain and we would like to thank our local community for their patience during this time. We are working hard to bring all our services back to full capacity, as far as the current situation allows, and to ensure that those waiting for an appointment or surgery are seen as quickly as possible.
Medway mental health services have moved
The following services are now based at Medway Hub, Britton House, Britton Farm, High Street, Gillingham, Kent ME7 1AL:
Medway community mental health service for older people
Medway community mental health team
Early intervention in psychosis
Mental health of learning disability
Mental health primary care nurses
Mother and infant mental health service crisis resolution and home treatment team will move at a later date.
To contact any Medway service, call: 0300 303 3189
Patients and service users in Sittingbourne and Sheppey are not affected by these moves and can access services on the usual numbers - details here: www.kmpt.nhs.uk/our-services