Overview of NHS Kent and Medway Integrated Care Board
NHS Kent and Medway Integrated Care Board, established in July 2022, oversees the planning and delivery of integrated health and social care services for the geographically diverse and growing population of Kent and Medway. The board addresses various challenges, including workforce recruitment, service configuration, inequality, and diversity. It aims to streamline functions, improve efficiency, and enhance patient care amidst the ongoing impact of the Covid-19 pandemic.
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1 1 DRAFT WORK IN PROGRESS NHS Kent and Medway NHS Kent and Medway Integrated Care Board organogram
22 NHS Kent and Medway our Integrated Care Board NHS Kent and Medway was established on 1 July 2022. Our integrated care board (ICB) holds responsibility for planning NHS services, including those previously planned by clinical commissioning groups (CCGs). As well as a chair and chief executive, membership of the board includes partner members drawn from local authorities, NHS trusts and general practice. Our ICB makes sure services are in place to deliver the integrated care strategy developed by the Integrated Care Partnership, which principally involves the ICB, Kent County Council and Medway Council. The breadth of responsibilities that our ICB is required to fulfil is wide and includes procuring services, having a statutory duty around quality and safeguarding, a statutory duty around public involvement, leading financial management, leading performance management, leading emergency planning, overseeing primary care at scale, leading workforce planning and developing a one-team people strategy. This is against the backdrop of one of the most challenging periods in NHS history; coping with the continuing impact of the Covid-19 pandemic, an increasingly stretched social care service that is unable to take on patients who could be discharged from hospital, an over stretched ambulance service and a Primary Care service delivering record numbers of patient appointments to cope with the increased demand. Within our ICB there is much continuing work with reorganising our teams following appointment of our executive team, looking at opportunities to streamline our functions and improve efficiency. In addition, we will take into account forthcoming delegation of responsibility for commissioning pharmacy, ophthalmology and dentistry services in 2023, alongside some specialised services and public health functions (such as screening and immunisation) thereafter. Since 1 April 2020, Kent and Medway merged eight CCGs into one organisation.
33 About Kent and Medway Kent and Medway is a large geographical area (1,368 square miles) with a disperse population. Our geography is typified by being coastal, rural and and remote. Bordering London and having a long coastline bring particular challenges in terms of workforce recruitment and retention and configuration of services. The number of people living in Kent and Medway is about 1.9million, which is expected to grow to 2.1million in 2031, faster than the England average. We are one of the larger systems in the country with total health and social care spend amounting to c 4billion per year. We comprise four acute providers, an NHS community provider, two non-NHS community providers, a large NHS mental health trust, a number of wider mental health providers and 200 GP practices. In April 2020, we merged the eight CCGs to become a single CCG and in July 2022, we became NHS Kent and Medway Integrated Care Board. We have two local authorities and 12 borough and district councils. We have a wide range of voluntary sector partners. We have significant inequalities. We have unacceptable differences across Kent and Medway in the underlying drivers of poor health which results in health inequalities. There is a clear link between health inequalities and deprivation and as a system we need to do more to tackle deprivation. Our population is diverse, with the Dartford, Gravesham and Swanley footprint being the most diverse place, where a number of different languages are spoken, including Punjabi, Hindi, Polish, Tamil, Slovak and Urdu. However, the diversity of our population is not reflected in the diversity of our workforce. One of the key barriers is the lack of a voice in senior leadership, with boards that are not typically representative of the staff they employ or of the populations they serve.
44 NHS Kent and Medway Integrated Care Board Board structure Chair Non-executive director roles Executive directors, voting roles only ICS partner member representatives Chief Executive Local authority Kent County Council Local authority Medway Council Community and mental health Primary care Primary care Acute hospitals Chief Medical Officer Chief Finance Officer Chief Delivery Officer Non-exec Director Non-exec Director Non-exec Director Non-exec Director Non-exec Director Chief Nurse
55 NHS Kent and Medway Integrated Care Board Executive leadership structure Chief Executive Executive Director of Corporate Governance Executive Director of Communication and Engagement Chief Digital Transformation Officer Chief Medical Officer Chief Finance Officer Chief People Officer Chief Strategy Officer Chief Nurse Chief Delivery Officer Chief of Staff Executive leadership structure Band/Grade Full time equivalents (FTE) Very senior manager contracts (VSM) 11 Total Cost 2,557,470* * Also includes non-executive board member costs
66 Directorate functions This clinically led directorate is responsible for: development and delivery of long-term clinical strategy for Kent and Medway quality improvement and safety of providers (with Chief Nurse) working with providers on clinical priorities to reduce unwarranted variation, implementing population health and addressing health inequalities medicine optimisation of providers, improving safety and efficiency of medications providing clinical and professional leadership into strategic change programmes clinical leadership of clinical and professional networks leading the development of the clinical and professional workforce (with the Chief Nurse and Chief People Officer). This professionally led directorate is responsible for: population health management development for Kent and Medway ICS Strategy development and implementation of NHS actions NHS Forward View strategy development and implementation ICB strategy development strategy change programmes including large scale change. Chief Strategy Officer directorate Chief Medical Officer directorate This professionally led directorate is responsible for: Kent and Medway People Strategy workforce planning and development workforce programmes for Kent and Medway including primary care strategy clinical and professional workforce networks across Kent and Medway internal HR function. Chief People Officer directorate This clinically led directorate is responsible for: development and delivery of long-term clinical strategy for Kent and Medway quality improvement and safety of providers (with Chief Medical Officer) infection prevention and control oversight of providers safeguarding oversight of providers providing clinical and professional leadership into strategic change programmes leading the development of the clinical and professional workforce (with the Chief Nurse and Chief People Officer) Continuing Health Care a clinical led provider service. This professionally led directorate is responsible for: Kent and Medway Digital and Data strategy digital and data programme delivery GP IT analytics corporate IT. Chief Nursing Officer directorate Chief Digital Transformation Officer directorate This professionally led directorate is responsible for: corporate governance, compliance and risk management Freedom to Speak Up legal services estates emergency planning, resilience and response environmental sustainability. This multi-professionally led directorate is responsible for: operational oversight including the operational control centre operational planning place and provider performance and pathway improvement and redesign commissioning functions including primary care, cancer, elective care, urgent and emergency care, mental health, community care place facing teams supporting localities. Corporate Governance directorate Chief Delivery Officer directorate This professionally led directorate is responsible for: strategic support to the Chief Executive strategic project management office (PMO) coordination function system programme assurance performance monitoring and oversight including system oversight framework metrics. Chief of Staff directorate This professionally led directorate is responsible for: 3.6bn Kent and Medway budget allocation leadership of the Kent and Medway financial strategy and delivery plan contracting and procurement of services and providers capital planning and management of system capital bids contract analysis financial productivity and efficiency internal and external audit internal financial functions. Chief Finance Officer directorate Communication and Engagement directorate This professionally led directorate is responsible for: community and engagement strategy external communications and statutory patient and public engagement internal communications function
77 Budgeted staffing establishment Board including Executive Team 1 10 Comms and engagement Grade Medical Nursing Finance Governance Delivery People Strategy Digital Chief of Staff Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 Chief Executive VSM Chair and Non Executives Band 9 Band 8d Band 8c Band 8b Band 8a Band 7 Band 6 Band 5 Band 4 Band 3 Doctors Clinical Lead Total WTE posts Total Cost 1.27 0 0 0 0 0 0 0 0 0 0 1.27 0 0 0 0 0 1 0 0 0 0 0 0 0 2 4 15 11 13 16 24 6 18 0 2.67 111.67 6,330,322 3 2 7 22 22 34 17 9 23 7 9 2.46 157.46 8,129,629 3 9 4 11 16 8 14 16 14 1 0 0 96 0 3 1 3 1 5 4 5 5 1 0 0 28 8 8 18 28 38 44 13 20 19 4 0 0 200 2 1 5 5 9 3 1 4 2 0 0 0 0 1 1 4 1 7 5 3 1 0 0 0 23 1 4 2 3 2 1 0 4 1 0 0 0 18 1 1 4 9 10 17 8 1 2 1 0 0 54 2 2 3 2 4 3 3 1 1 0 0 0 21 20 33 49 102 114 136 81 87 74 32 9 5.13 754.4 45,364,727 13.27 2,557,470 32 5,505,360 1,520,341 11,895,157 2,104,682 1,301,773 1,181,454 3,372,308 1,466,232
88 Kent and Medway Integrated Care Board Notes: The structure shows the workforce budgeted whole time equivalent (WTE) to run NHS Kent and Medway Integrated Care Board and support system wide improvement programmes on behalf of Kent and Medway. This also includes services, such as continuing healthcare that provide services directly to patients. VSM means managers (clinical and non-clinical) who are on very senior manager contracts this is national pay banding used in our organisation for executives reporting to the chief executive and the chief executive. Grades are based on national Agenda for Change pay scales Funding cost is the total funded cost for the team.
