Activity planning

KMPT’s activity planning is based on historic activity plus an expected growth percentage linked to increases in demographic changes aligned to the contractual discussion with all Commissioners. The forecast position will be jointly agreed with the commissioners of Kent and Medway as part of the contract negotiations for the 2019/20 financial year and will be based on the planning guidance for 2019/20.

We have identified increases in referrals within community services especially within Older People’s Mental Health (OPMH) and will be working with commissioning leads to understand the impact of these and how they are reflected within the current block contract arrangements. In year we have been working with social care leads as part of their transformation process to clearly separate health and social care activity into their respective areas. We anticipate that this clarity will have an impact on the reported demand levels in year and are planning to review demand and associated capacity levels within these teams.

Our inpatient capacity has been extensively reviewed as part of operational plans in year to plan for changes within the current bed base. We have been working with key stakeholders to implement community based services to support these changes and ensure that it continues to remain within the commissioned bed base. Over recent years we have successfully reduced the number of patients placed out of area (OOA), with no younger adult or older person being placed out of area in 2018/19. Our plans support this reduction and are designed to maintain low of out of area bed usage. An exception is PICU beds for women; see section 3 on Quality for details of proposed actions to address this OOA usage. We are working with commissioning leads to address the small number of female PICU patients that are still being placed out of area.

The Trust is also working with commissioning leads to progress the deliverables identified in the NHS Long term plan published in January 2019, these include:-

• Ensuring that spend on mental health services achieves a year on year increase in accordance with the Mental Health Investment Standard.
• Enhancing 24/7 community based mental health crisis services so that home treatment can be further offered as an alternative to acute hospital admissions by 2020/21
• Building upon the wave one mental health liaison service allocations in order that 50% of services within Kent and Medway meet the core 24 service standards by 2020/21.
• Maintaining and improving upon the Early Intervention in Psychosis response times standards which have been met throughout 2018/19, the Trust plans reflect the increased target of 56% starting treatment within two weeks. Further work is ongoing in relation to achieving the NICE standards for EIP.
• Maintaining the reduction in out of area placed activity and, as above, develop services to help reduce the female PICU placed activity in line with the NHS Plan requirement.
• Working alongside commissioning leads and primary care to support the expected increases in physical healthcare checks in line with the outlined increase by 2023/24.
• Building upon the perinatal developments seen in 2018/19 so that there is an increase in evidence based care for women with moderate to severe perinatal mental health difficulties and a personality disorder, working towards the anticipated increase by 2023/24.

The Trust will continue to play a leading role in the provision of Specialist Mental Health services working alongside its partners in Surrey & Sussex as part of the New Care Models initiative. From April 2019 the recently awarded Criminal Justice Liaison and Diversion service, which provides specialist mental health support to patients in custody, will expand.