As we look back on 75 years of our National Health Service, Paul Bentley, Chief Executive of NHS Kent and Medway, talks about plans for its future here in the county
After World War Two thoughts turned to post-war reconstruction under a new Labour Government, with Minister of Health, Aneurin ‘Nye’ Bevan, introducing the revolutionary NHS. On July 5 1948 the Government assumed responsibility for all medical services, with free diagnoses and treatment. The principle (which still holds) of healthcare free at the point of delivery and based on need not wealth was established. It was the first universal healthcare system available on this basis and is still revered by many Britons.
There has been pressure on the NHS for as long as most of us can remember, particularly over winter, but the recent COVID-19 pandemic took these pressures to a new and critical level. The NHS now faces a massive backlog of millions of cases, augmented by a growing and ageing population. The NHS will do its best - it always does - treating 1.3 million people a day in England alone. The organisation adapts constantly as the needs of our people and the nature of illness evolve.
The NHS was responsible for the world’s first liver, heart and lung transplants, as well as developing pioneering new treatments such as bionic eyes, and using robotic systems to help prostate-cancer sufferers, and drones to deliver chemo drugs. Large scale vaccination programmes were introduced, the most recent during the COVID pandemic. This saw the NHS researching on an unprecedented scale, enabling the world’s first effective treatment, then putting jabs into arms in a rollout that was both miraculous and urgent: in the single month of January 2021, there were 100,000 hospital admissions with the virus. Every single person in the NHS matters, but in a year of 75th anniversaries it is perhaps worth paying special tribute to those from ethnic minorities, who today make up 42 per cent of medical staff working within the NHS. It was in June 1948, the month before the NHS’s launch, that the Empire Windrush docked at Tilbury.
To obtain an insight into Kent’s NHS, I spoke to Paul Bentley, Chief Executive of NHS Kent and Medway, a new organisation dating to July 2022 that covers the whole of Kent and Medway, a wide-ranging and diverse set of communities totalling 1.9 million people.
'It’s an integrated care board where we recognise that to make people well and keep them well it’s important to work with other partners, including NHS trusts, primary care including General Practitioners, the voluntary sector and colleagues in local government. That integration is important: we see ourselves as the glue in the system, pulling the various parts together. We have a budget of £3.9 billion of taxpayers’ money and commission all parts of the NHS to deliver the services the public needs from the NHS.
'Our health and wellbeing are affected by many factors. Kent and Medway is a fascinating place. It’s possible to drive from top to bottom or side to side in less than 90 minutes yet life expectancy varies by up to 18 years depending on where you live. We have significant variations with areas in the highest 20 per cent of affluence in the country but also areas falling in the lowest 20 per cent of affluence. There are real areas of poverty in our coastal communities, which have a direct impact on health and wellbeing. We want to create opportunities for everyone to hopefully lift people out of these circumstances, so we positively affect and reduce this disparity. We’re responsible for those 1.9 million who can have multiple interactions with the NHS. The overall numbers are staggering when you consider GP appointments, hospital appointments and the other ways that people interact with our NHS. There are significant variations in Kent and Medway when we compare the numbers of GPs per head of population and regrettably the lowest numbers are most frequently in the areas of highest deprivation.
'Like every other part of the world, we’re still in the pandemic’s recovery phase. When COVID-19 hit our country in 2020 we turned all our NHS attention and capacity against it, and I still believe that was the correct choice. But there have been consequences. Too many people are now waiting for elective operations, although we are making headway and the wait time is reducing. We now have a handful of patients waiting 78 weeks but this is coming down and we are now setting our goal to reduce the waiting time further in the year ahead. The effort to improve this situation continues and so it should. If a person is awaiting an op there’s every chance they will experience pain, the condition worsening due to the wait, then demands on GPs and emergency departments rise. We’re seeing increased demand for GP appointments. We have increased the number of appointments in GP surgeries but we’re also still seeing people finding it hard to get these appointments in a timely fashion. We need to grow the primary care workforce so there is a better balance between the number of people who need the services and those who provide them.
'The public is proud of its NHS, which we want to be responsive and accessible. We need to change and adapt to reflect the world we live in which is quite different from that into which the NHS was born. Advances have been enormous with life-changing technological progress and we need to keep responding to these changes and adapt. We won’t make the mistake though of thinking one size fits all. We live in a digital age but access is not universal. Some people favour a telephone appointment or video call as less disruptive but what works for young adults won’t necessarily suit older generations. We need a more responsive, individualised service and that is the challenge facing myself and other leaders, to adapt the way the service works. We can do these things while at the same time we all need to take personal responsibility, to look after our health and wellbeing and enhance our own lives, for example, some people began exercising more during the pandemic and kept it up. It’s also good we’re talking more openly now about mental health.
'We have an incredibly skilled staff in Kent and Medway across multiple disciplines. We must look after them and recruit and retain more. The official opening of the Kent Medical School in Canterbury in April 2023 is highly significant, as people tend to stay in the area they’re trained. We can now train our own people. The school was open for students three years ago and is very significant as we have students from Kent and Medway and elsewhere, but there will be an emphasis on drawing as many as possible from local schools. I’ve worked in Kent and Medway for 13 years and feel a real connection to the area. There’s a great deal we do really well in Kent and Medway NHS but we must strive to get that quality in every patient interaction. We’re not quite there so there is that ambition to achieve that all the time, but in a more personal and accessible way. We’re certainly building from a strong base. The 30,000-plus people delivering in Kent and Medway are doing a remarkable job and their efforts are genuinely life-changing.
'I feel lucky and privileged to have this role, the best, most enjoyable role I’ve ever had. Being a Chief Executive in the NHS is a really privileged position; something that feels very precious. I’m proud of the NHS. Our NHS is reaching the point of being a national treasure and my role is to steward it to the next era and into its next 75 years. I ask myself each day ‘Did I make a difference?’ Whatever the answer personally, I know the NHS will have done so each day in Kent and Medway”.
Kent's NHS voices
A look at local NHS staff, past and present, improving our lives every day
Lynne Holmes - Dispatch team leader at South East Coast Ambulance Service
Lynne’s served the county for over 40 years, joining Kent Ambulance Service in 1980 as a civilian call taker. She celebrated the NHS’ 50th Anniversary when representing the Trust at a Queen’s Garden Party at Buckingham Palace.
Lynne says she’s seen the service come a long way: ‘In the early days there were no computers – it was all on paper. In 1987, our current Emergency Operation Centre opened, and we had a computerised system for the first time. This was the year of the Townsend Thoresen Herald of Free Enterprise disaster and the Great Storm, both of which I was on duty for. I’ve always had such a high regard for all my colleagues, including our operational crews. There is a true sense of belonging to such a huge family.’
Karen Brewer – Practice development nurse for East Kent Hospitals
It's never too late to follow your dreams, believes Karen Brewer, who'd wanted to be a nurse since childhood. Karen, a mum of five, was 41 when she began working for the NHS, 48 when she started her university nursing course and 51 when she qualified. Afterwards, she spent six years working in wards, before joining the Workplace Development and Education team. Last year she became the lead for healthcare support workers.
‘My healthcare support worker experience has been the backbone of my training,' she says. 'I don’t know if I would have been ready to start a nursing course sooner than I did, but it’s fantastic to finally be wearing the uniform and even better that I can help others on their own career pathways,’
Dr Aylur Rajasri – Consultant obstetrician and gynaecologist at East Kent Hospitals
Dr Aylur Rajasri helped to establish the pre-birth clinic team at the QEQM in Margate and the William Harvey Hospital in Ashford. The dedicated team provides a range of services to help those at risk of premature birth arrive safely. Since its conception two years ago, the clinic has helped hundreds of families to welcome healthy babies into the world.
‘It’s a real privilege to be able to make a difference to so many families,’ Dr Rajasri says. ‘I’m very grateful to my team, whose dedicated support allows the service to run effectively. We can save babies’ lives and there is nothing more important than that.’
Tracey Twyman – Matron for neonates at the QEQM
Tracey has been honoured with The British Citizen Award after she helped to care for critically ill adult adults during the coronavirus pandemic. At the time, Tracey was ward manager of the Special Care Baby Unit at the QEQM Hospital before she volunteered to care for Covid-positive patients in the Adult Intensive Care Unit. Tracey, alongside six other members of her team, spent three months working additional shifts during the first wave.
She was one of almost 50 Trust staff to receive the award, which recognises individuals that have done extraordinary things for the good of the country. She insists it was a team effort, adding: ‘I felt like I took the award on behalf of everyone. The pandemic changed a lot of things, but it has also helped build our teams up in many ways and reinforced why we do what we do.’
Helen Finlayson, retired General Nurse
Helen trained in Dartford and worked for over 40 years in Kent and London, latterly specialising in Infection Prevention and Control. She now leads regular tours around the Call the Midwife Experience at Chatham Dockyard
‘I’ve seen incredible progress during my career, and in so many areas,’ reflects Helen. ‘Back in the 1950s and 60s, a midwife wouldn’t only have cared for pregnant women, she’d have acted as a community nurse, too, treating all sorts of issues. These days, those roles are separate, and certainly the rise of specialisms has meant better-focused care. But the need to engage people remains key to any nurse’s role and the chance to do so is something I’d really missed since retiring. That’s why I’m so glad to be working with the public again via tour-leading – and of course there’s always plenty of discussion with visitors about the NHS then and now.’
Dr David Chesover
Now retired, David worked in Kent for the NHS for over 30 years, as a GP, Community Surgeon and Mental Health Clinical Lead in the county. A former chair of Kent Armed Forces Network, he is a trustee of Great Comp Garden near Sevenoaks and came up with the idea of creating a bamboo garden there as a therapeutic endeavour for former servicemen who were struggling with life after retiring from the services. It opened at Great Comp in 2022. ‘The NHS is currently under great pressure; nevertheless some excellent charity initiatives, supported by the NHS, are springing up around the county to help those with health issues, mental and physical,’ he says. ‘A preventative approach to illness has never been more important, so to stay well it’s essential to eat as healthy a diet as possible, to get out and about to meet people so you don’t feel lonely and for gentle exercise, and to stay in touch with friends and relatives, remembering that simply talking can often be an effective way of resolving issues.’
KCHFT Health Checks Team
Delivering NHS health checks to fishermen in Ramsgate was just one of the initiatives that earned Kent Community Health NHS Foundation Trust (KCHFT) three Healthwatch Recognition Awards earlier this year. The awards recognise outstanding work from health and social care organisations that champion the involvement of patients in improving and delivering services.
NHS Health Checks Programme Manager Kimberley Lloyd says, ‘We know for people like the fishermen we met in Ramsgate, who have very busy and demanding jobs, we have to think differently and not expect them to come to us. So we took our service to them. If you want to meet a fisherman, head to the harbour, so that is where we delivered our health “pub crawl”.’
Sarah Agyemang, Head Chef, Hawkhurst Hospital
Sarah is the woman behind the development of the kitchen garden at Hawkhurst Community Hospital, working with a team of volunteers to grow vegetables and herbs for patients and using whatever is produced – from tomatoes and strawberries to courgettes and potatoes - in fresh, nutritious meals, tailored to their needs. Moreover, the patients can visit the garden, helping to boost their sense of wellbeing.
Sarah’s passion for the project, for ensuring patients receive a choice of home-cooked healthy foods and her role as a positive ambassador for wellbeing and mental health have certainly helped improve the patient experience, earning her an award from KCHFT too. She is described as, ‘respected and popular for her tireless dedication, excellence and commitment to her profession.’
