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Overview

Summary :: Our programmes and services :: Overview

The programmes and services designed to improve the health and well-being of people in Medway can be broadly divided into two categories. The first concerns population based measures which aim to influence patterns of behaviour as well as improve the environmental conditions and risks to which people are exposed. The second category involves direct contact with people and can be provided in one of three forms comprising one-off or infrequent interventions which produce long-lasting positive effects, counselling and health education programmes and lastly ongoing interventions with vulnerable people as well as those who have complex needs.

Before discussing these in more detail it is helpful to also consider the impact of socio-economic factors on health and well-being. Low income and educational attainment combined with unequal opportunities and access to services combine to worsen the standard of living for people within society. The kinds of measures which can tackle these issues involve coordination of policy at a national, regional and local level and can take generations to take effect. However, improvements in this area are arguably the most effective of all [1]. For further information please see the 'Our Health Inequalities' section of this document.

The primary data sources used for this section are the background chapters written by topic leads available in the appendices section, the A Better Medway website and Medway Council website.

Summary of commissioned services

Primary care (as at October 2015)

• 231 GPs in 54 practices [2]
• 33 NHS dental practices[3]
• 58 community pharmacies[3]
• 19 Optical practices that deliver NHS sight testing[3]

Six of the above dental practices offer IMOS (Intermediate Minor Oral Surgery) services at various locations within Medway. IMOS, a Kent & Medway wide intiative, is a service which treats patients that have been triaged as needing oral surgery which is above the capability of the referring dentist but not deemed difficult enough to warrant a referral to hospital. This is a relatively new service which has been extended to 31/03/2016 following an agreement to renew the contract.

There is one specialist orthodontic practice, one home-visiting dentist (treatment limited to predominantly making dentures and scale & polish), the emergency out of hours dental service (DentaLine) and special needs dentistry provided via three dental clinics based in Medway (managed by Medway Community Healthcare).

Only those contractors holding an General Opthalmic Services (GOS) contract can deliver NHS sight tests. Domicilary NHS sight testing is available for those patients unable to attend a high street optician.

Community care


• Medway Community Healthcare (38 services including district nursing, health visiting, speech and language therapy, podiatry, occupational therapy, nutrition and dietetics, physiotherapy, continence, blood tests, help with breathing problems, diabetes, heart or stroke problems, assessing difficulties with muscles or bones, end-of-life care and equipment loans)
• Kent Community Health (newborn hearing screening, care management and secure placement services for people with learning disabilities, plus contraception and sexual health services)
• Kent and Medway NHS and Social Care Partnership Trust (wheelchair services)

Health improvement


• Joint NHS Medway / Medway Council Directorate (Stop Smoking support, healthy weight advice and programmes, co-ordination of infant feeding strategy, sexual health advice, Chlamydia testing, co-ordination of teenage pregnancy strategy, tobacco control programme, and alcohol strategy).
• The Sunlight Development Trust run a number of projects with the local community including the Well-being cafe, Dementia family support service and the 'Men in Sheds' programme.

Acute care


• Any hospital of people's choice for most treatments so long as it offers care to NHS standards for NHS prices. (Mental health services, urgent care and very specialised care are excluded).

In practice, most people choose to have their care in Medway or at other providers in Kent — including at Medway Maritime Hospital (run by Medway NHS Foundation Trust), the Will Adams NHS Treatment Centre and the Spire Alexandra Hospital.

Mental health


• Kent and Medway NHS and Social Care Partnership Trust
• Independent organisations offering provision from psychological therapies to secure accommodation

Prisons


• GP, dental, optical and pharmacy services for offenders at Rochester and Cookham Wood Young Offenders' Institutions
• Mental health services including Child and Adolescent Mental Health Services and substance misuse services
• Pharmacy services for all ten prisons in Kent and Medway


References

[1]   Marmot M. Fair Society, Healthy lives 2010; Strategic Review of Health Inequalities in England post-2010. http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review .
[2]   Primary Care Information System.
[3]   NHS England. NHS Organisation data