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The power of community

Our summary annual report 2023 to 2024

Our year in numbers

This year we delivered

2.2 million

patient contacts:

Satisfaction icon

With a 94%

patient satisfaction.

Children's services icon

570,000

were in children's services.

Our urgent treatment centres and minor injury units treated more than

185,000 people

reducing pressure on A&Es across Kent and Medway.

Urgent treatment icon

2,133

people were treated as inpatients in our community hospitals.

Our sexual health services provided treatment and advice to

59,000 people

Almost a quarter of a million

vaccinations were given to school-age children.

Vaccinations icon

1,704 flu and 1,477 Covid

booster vaccines were given to staff.

1,740 people

were seen aboard our public health bus,

Public health bus icon

with almost

400 health checks, 200 immunisations and 73 health MOTs

delivered, along with many health conversations and signposting to other services.

In this report
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    Our reports

    Read our full 23/24 annual report, or see our other reports.
    Our reports

    We care – the progress we’ve made in our first year

    We care strategy graphic

    The launch of our new We care strategy in April last year signalled a new focus for the way ahead and four big ambitions for the future – to make KCHFT a great place to work for our colleagues, to put our communities first, to provide a better patient experience and deliver sustainable care.

    Designed to focus on making the biggest breakthroughs to patient care and the working lives of our colleagues, it is shaped by what the public, patients and clients, colleagues and our stakeholders told us really matters to them.

    Driven by data, we have taken a continuous quality improvement approach, learning along the way. But before we dive into year two of our strategy, we thought it was important we reflected and shared some of our progress.

    Nothing we have accomplished this year, happens without the dedication and professionalism of our 5,300 amazing colleagues, who delivered more than 70 different services to communities across Kent and Medway, East Sussex and parts of London.

    As you will see in this impact report, which shows just a snapshot of the work we achieved, we’re pleased with the progress #TeamKCHFT made in our first year and excited about where we go next.

    A great place to work

    Our colleagues are valued, feel heard and make changes easily to deliver better care.

    We want our colleagues to enjoy work, feel like their voice is heard and feel they can change things to make their job more rewarding – this is about our culture and what it feels like to be part of #TeamKCHFT.

    Key areas of focus were centred around recruitment and retention, maximising staff voice and wellbeing with the introduction of a new staff voice model, improving culture and ways of working, making sure ‘nobody is left behind’ and leadership, devolving authority and succession planning.

    Breakthrough targets

    • We increase our staff engagement score by 0.2, as measured by the NHS Staff Survey, from 7.31.
    • We increase our staff morale score by 0.2, as measured by the NHS Staff Survey, from 6.23.

    Staff health and wellbeing

    • Our annual staff fitness challenge, flo fit big 50, encouraged colleagues to complete the most steps in 50 days. This year, 113 teams and 425 colleagues took part, clocking up 174,074,985 steps in total.
    • We celebrated NHS75 by taking part in the Parkrun for the NHS events in July. Colleagues represented #TeamKCHFT at seven Parkruns across the south east, from Margate to Maidstone.
    • Our free fast-track MSK physio service received almost 1,500 referrals from colleagues this year, helping with a range of back and neck issues.
    • We continued to promote and support our KCH FC football team, offering all colleagues the opportunity to train and compete in match fixtures throughout the year.
    KCHFT Football team
    • The KCHFT choir continues to go from strength-to-strength, with sessions now available at five locations across Kent and East Sussex.
    • As part of the NHS People Plan, our network of health and wellbeing champions almost doubled this year, with more than 200 colleagues signing up to become a champion.
    • Our staff counselling service provided support to almost 500 colleagues this year.
    • Our new-look staff health and wellbeing bulletin, Youmail, launched in July. The monthly newsletter promotes all aspects of health and wellness through video, animations and articles.

    Making sure people feel valued after appraisals

    Making sure people feel valued after appraisals graphicQuality appraisal metric increases to 50 per cent (33 per cent in 2022/23)

    Appraisals are a key part of creating a culture where our colleagues feel listened to, valued, safe and part of a team.

    We streamlined appraisal documentation and ran a large internal comms campaign, where we took every opportunity to encourage people to focus on the quality of their conversations and provide a listening space for colleagues.

    This video (below) was part of the campaign.

    Staff survey 2023: Increasing our response rate

    Staff survey 2023 increasing our response rate graphic

    Our targeted NHS Staff Survey campaign in 2023 saw us receive our highest response rate ever, with 70 per cent of our colleagues responding and ensured that even more voices were heard, exceeding our breakthrough objective.

    Read more about our staff survey results

    We have a voice that counts – Staff voice, a new way of listening

    Target: Increase ‘we have a voice that counts’ score in NHS Staff Survey from 7.26 to 7.46

    We dedicated time this year to co-design a new staff voice model, which will help us improve how we listen and make sure all colleagues feel heard. The model not only builds on what we already do, but proposes a new staff council. Our staff survey score was 7.2 but we hope this will increase once the new model has had time to establish itself. 

    We have a voice that counts – Staff voice, a new way of listening graphic

    Equity, diversity and inclusion (EDI): Nobody left behind

    Equity, diversity and inclusion (EDI) Nobody left behind graphic

    Target: Less than two times more likely to be appointed if white than Black, Asian and minority ethnic groups compared with 2022/23 (2.34 times in 2022/23). Target achieved (1.93), but we know there is more to do. 

    More than 97 per cent of colleagues have not personally experienced discrimination from colleagues compared with 2022/23 (94.8 per cent).

    We recognise continued work is required to make sure our recruitment activities are equitable and fair for all applicants. The Board has approved a culture-influencing programme which will directly address any areas of bias or discriminatory behaviours in the recruitment and selection process.

    Apprentices

    Our newest home-grown community nurses took the next step in their careers as they came to the end of their four-year apprenticeships. They are the second cohort to successfully complete their nursing training. Since the academy was established in 2019, we have supported 36 registered nurses to complete their training.

    The course involved degree-level study through the Open University, with student placements in a variety of KCHFT services combined with a work-based paid role.

    Win-win for health sector careers in Kent as apprentices graduate

    “My advice to anyone who is at the start of the journey is, don’t be afraid to ask questions. It is hard work, but at the end, not only do you have a qualification but you have the experience and skills to take into your dream job.” Lauren Shaba Registered Nurse Apprentice.

    Read more about our apprentices

    Putting communities first

    Everyone has the same chance to lead a healthy life, no matter who they are or where they live.

    Our communities first ambition encourages us to think about those people we deliver care to, not just as service users and patients, but as people. People who lived in the most deprived communities, people who live in groups who don’t instantly understand how the NHS works or have others challenges which means that they have lesser access, outcomes and experience than the majority – this ambition aims to reduce those differences in experiences.

    Here you can read some of the examples of where we have made a difference by increasing ethnicity reporting so we can better understand these differences and support them better, and the number of missed appointment so people get their care quicker and waiting lists reduce.

    Breakthrough targets

    • There is no significant difference in did not attend (DNA) or ‘was not brought’ rates, between patients living in the most and least deprived areas or ethnic group by April 2026.
    • The number of people who wait longer than 12 weeks to be seen is reduced by 50 per cent compared with March 2023.

    Ethnicity recording

    We know people from some minority ethnic groups do not always receive equitable access, experience and outcomes from NHS care. To identify areas for improvement, we need to make sure we are accurately recording people’s ethnicity and other protected characteristics.

    Watch our animation to find out more about health inequalities 

    In 2023/24 our recording reached 78.8 per cent, with more than 20 services reaching the 80 per cent internal target.

    We are now able to use this data to identify areas for action, including increasing the uptake of school-aged immunisations from our communities from eastern Europe and making sure people from ethnic groups get access to care at the right time, by reducing missed appointments and disengaging with care.

    Public health bus

    Our public health bus provided healthcare interventions to 1,760 people in 2023-24. NHS health checks have been delivered at Maidstone market, people who are homeless have accessed podiatry care and baby checks have been carried out for traveller communities.

    Our School-age Immunisations Service used the bus to deliver almost 200 vaccinations, including measles, mumps and rubella (MMR). Our Sexual Health Service took the bus to Pride events across the county to deliver advice and support.

    Health visiting clinics for Roma families in Cliftonville

    Our Health Visiting Service set up a new project to help Roma families stay well and get vital health advice through specialist drop-in sessions in Cliftonville, Margate.

    Read more about building trust and helping families

    Helping homeless people to access healthcare

    Hundreds of homeless people are now benefiting from essential foot and dental care.

    Read more about the Rough Sleeper Service

    Reducing did not attend (DNA) rates

    80 per cent of all contacts have their ethnicity recorded on electronic patient records by March 2024.

    Reducing did not attend (DNA) rates graphic 1

    We reduce the total DNA rate for patients from deprived localities by 25 per cent by October 2024.

    Reducing did not attend (DNA) rates graphic 2

    We are focussed on reducing the number appointments which were missed by people living in the 20 per cent most deprived areas of the county, our target is to reduce from DNAs 6.2 per cent to 4.7 per cent, by October 2024. We hit our target early, in March 2024 it was 4.3 per cent.

    Our Health Visiting Service has acted to reduce missed appointments, including sending reminder text messages, making appointments over the phone for people in target areas and sourcing more accessible locations for clinics.

    They have seen a significant reduction in their DNA rates, with 7,000 fewer appointments missed during 23/24 compared to 22/23. Two thousand were people living in the most deprived areas.

    Watch this short film to see how our public health services, including school health and health visiting, are working with families to reduce missed appointments.

    Reducing DNA rates in health visiting

    Every month in Kent, a staggering 2,500 health visiting appointments are missed – and a chance is lost to help a family who might need us.

    Read more about reducing DNA rates

    Reducing waiting times

    Reducing waiting times graphic

    The number of people who wait longer than 12 weeks to be seen is reduced by 50 per cent compared by March 2027.

    All services with waiting times of more than 12 weeks have a plan in place by October 2023

    All services were asked to develop action plan to reduce their waiting lists. These have all been completed and they are being monitored through KCHFT’s internal governance systems. This work is being supported by workstreams focused on estates and improving data definitions.

    Referral to treatment targets (RTT)

    Eighteen of our services are required to report against the national 12-week RTT. At the end of March 2024, eight services were meeting the national 92 per cent target and the 87 per cent breakthrough target. The other 10 are under the 87 per cent.

    Adult Neurodiversity Service

    The Adult Neurodiversity Service has agreed a new triage process, which has been tested and suggests around 60 per cent of those on a waiting list would require a diagnosis, with remaining signposted to self‐manage or supported help.

    We have extensively developed, refined and improved information on the KCHFT website to support people on the waiting list to ‘wait well’.

    Community Paediatrics service

    The Community Paediatrics service is experiencing long waiting times for initial assessments. A nurse-led assessment (NLA) quality improvement project was set up in 2023, with the aim to reduce the number of children waiting over 52 weeks.

    The pilot saw more than 580 children with the longest wait, with all 385 remaining children waiting over 52 weeks now booked to all be seen by June 2024. From June, the team will focus on those waiting 36‐52 weeks to prevent children breeching 52 weeks in future.

    Kent family website

    In September 2023 we launched our Kent Family website, which provides advice, support and signposting for families with children aged nought to 19 on all aspects of parenting, from potty training, to immunisations and how to cope with teenage anxiety. The site provides all the advice parents can expect from our health visiting and school health services, helping to manage demand on the service and provide families with round-the-clock, trusted NHS advice. The site was visited more than 680,000 times from September to March 2024.

    Adult health improvement programmes

    Adult programmes information

    Better patient experience

    Our conversations focus on what matters to the patient, so they get the right care, in the right place.

    We know people spend too long in a hospital bed when they don’t need to and we want to make sure people get the right care, in the right place. This year, we’ve worked closer than ever before across health and social care to improve this and give our patients a better patient experience. We opened new beds to trial new approaches and made good progress developing integrated neighbourhood teams to focus on delivering proactive care to the most vulnerable patients and keep them well and out of hospital.

    Breakthrough targets

    • No more than 30 patients a day are waiting in an acute bed for care, when they are fit and well enough to come home, during winter 2024/2025.
    • We are involved in developing integrated neighbourhood teams in 15 primary care networks or neighbourhoods in east and west Kent by March 2025.

    New stroke rehabilitation unit for east Kent

    Caring for patients the Westbrook way

    A new 15-bedded specialist stroke rehabilitation unit at Westbrook House in Margate opened in July to help people on the road to recovery and independence, with a daily programme of therapy tailored to their needs.

    Read more about the Westbrook way

    Thank you for the music: How our stroke ward helps people like Paul to live again

    Abba musicals, pie and mash and jokes round the dinner table – the Westbrook House Stroke Rehabilitation Unit doesn’t feel like your average hospital ward.

    Read more about the stroke ward helping Paul

    Clinical coordination hubs in west and east Kent

    Clinical hubs benefitting patients and reducing demand on A&E

    The trust’s frailty consultants played a major role in two clinical virtual hub trials, which saw 1,800 people diverted away from hospital between November 2023 and January 2024.

    Read more about clinical hubs

    New home first roles to keep well at home

    In November 2023, new-joint health and social care roles were launched to keep people safe and well at home, thanks to a partnership between KCHT and Kent County Council.

    Home first support workers were recruited to teams across Canterbury and Thanet to provide support at home to people on discharge from hospital, or who are at risk of being admitted. The roles also provide local entry-level jobs into health and social care.

    Staffing has increased from four people daily in November to eight daily in March.

    In March, the team saw their 100th patient and the programme is being rolled out to other areas.

    Hayley Oakley, Home First Team Assessor, said: “We are a one-stop-shop to bring in different sources of help – including health, social care and the voluntary sector, such as Age UK. Offering my time to listen to their story is my first move. I make a cup of tea, pop myself down on the sofa and have a chat to find out what they need to get better and what’s important to them. It really works.”

    Winter improvement wards test our future ambition

    Over the winter months, KCHFT worked with Kent County Council to set up 30 specialist rehabilitation beds across Westbrook House in Margate and West View Integrated Care Centre in Tenterden.

    The wards tested our ambition to rethink how we deliver rehabilitation, recovery and reablement in our community hospitals, by providing an integrated model.

    Nine out of 10 people who were treated on the wards were able to return home with reduced care needs.

    Almost half returned home with no external support at all.

    Staff feedback: “We’re making a difference, I really think so. All patients are improving, for example fewer bed sores, more walking. It’s person-centred care through enablement.”

    'I wasn’t just being cared for – I felt like I mattered'

    Rosemary Crouch, 80, shares how a three-week stay at West View Integrated Care Centre didn’t just help her to walk again, but gave her the confidence to get back to living her life.

    Read more about winter improvement wards

    Virtual wards

    KCHFT stepped up the drive to keep people at home increasing the capacity of virtual wards.

    East Kent saw a 68 per cent increase in activity, between April 2023 and 2024, largely thanks to the work of our Frailty Home Treatment Service, which saw 8,500 people.

    In west Kent, more than 4,000 people received treatment on a frailty virtual ward, with another 1,000 admitted to the Hospital at Home Team. KCHFT is working with East Kent Hospitals NHS Foundation Trust (EKHUFT) to deliver respiratory virtual wards.

    Alan’s stay on a virtual ward

    Integrated Neighbourhood Teams

    Four pioneering integrated neighbourhood teams in east Kent are making strides in supporting people to manage their own health and wellbeing and we are playing a key role in their development. This includes our adult community services supporting projects in Canterbury North and South PCN areas, working to develop a home and care home multi-disciplinary team visiting service and our public health services are involved in work in the Marsh PCN to support the prevention of cancer, by increasing the provision of smokefree support in the area.

    In west Kent, Tonbridge PCN set up a frailty multidisciplinary team (MDT) involving KCHFT and are now expanding to have a children's MDT, including KCHFT health visiting staff. The Weald PCN have focussed on a mental health MDT and has contacted KCHFT to be part of their PCN board. They are looking to set up a frailty MDT, with involvement from our Frailty Service.

    Sevenoaks PCN has focussed their work on a wider health and wellbeing offer, connected to services being delivered from the new Edenbridge Memorial Health Centre, which also has services delivered by KCHFT including health visiting.

    Tunbridge Wells PCN has developed and piloted a digital solution to improve demand and access to primary care. The next steps will involve KCHFT and may act as a triage and referral source in conjunction with our LRU.

    We have secured funds from NHSE south east, with the aim to co-produce the first draft of an Integrated Neighbourhood Team Development Framework. This piece of work will be carried out from February to June 2024.

    A new approach to rehabilitation and recovery in our hospitals

    In 2023, we started the conversation about changing our approach to rehabilitation and recovery in our community hospitals.

    We want to make sure people can retain their independence and live healthier lives, for longer.

    Community hospital rehabilitation and recovery

    Read more about the background to the new approach and why we think we need to change.

    Read more about rehab and recovery

    Sustainable care

    We will live within our means to deliver outstanding care, in the right buildings, supported by technology, and reduce our carbon footprint.

    Our sustainable care ambition is about living within our means.

    We want our people to have everything they need to do their job well now and in the future.

    We want to support them with technology so they can spend more time on things that directly improve patient care and this year, we had success in trailing a voice notes saving clinicians 33 per cent.

    It’s also important we operate from good quality buildings that support our people to provide the very best care and are accessible for our patients and this year we started the review of our estate.

    Underpinning all this work is our constant quest to build on our skills to continuing improve the quality of care we provide.

    A huge thank you not only to #TeamKCHT colleagues, but to our Board, governors, volunteers and partners for everything we achieved in 2023-24.

    Breakthrough targets

    • Staff spend 50 per cent less time on admin processes that don’t add value to patient care by March 2027.
    • We reduce the emissions we can control by 80 per cent by 2028.

    Staff spend 50 per cent less time on admin processes

    20 per cent reduction in time completing RiO through reduction of input and automation by March 2024.

    Progress notes voice recognition trial resulted in a 33% admin time reduction.

    Voice-recording of patient progress notes to reduce admin time

    Voice-recording of patient progress notes was trialled in two Maidstone Primary Care Network (PCN) teams for three months at the end of 2023.

    The trial successfully reduced the time spent on patient notes by 41 minutes per clinician per day on average, meaning colleagues found it easier to take breaks, get home on time, or spend longer with their patients.

    Colleagues completed progress notes quicker and more efficiently in patients’ homes, or in their car, ready for the next appointment.

    Roll-out to the rest of the trust is planned for 2024. Watch:

    We reduce the emissions we can control by 80 per cent by 2028.

    We identify and report on KCHFT’s carbon footprint based on non-pay spend and the true emissions from staff travel that all budget holders understand and use by March 2024.

    16 per cent reduction in controlled emissions
    when compared to 2019/20 and 2021/22.

    Our carbon footprint and emissions

    We have a system to measure our carbon output and have reduced our controlled emissions by 16 per cent. All electricity used by the trust is backed by Renewable Energy Guarantee of Origin (REGO), which shows that a given share or quantity of energy was produced by renewable sources.

    One of the biggest areas of emissions for KCHFT as a community provider is staff travel, which is necessary to provide care for patients in their own homes. This is mitigated through the promotion of electric lease cars and electric vehicle charging points at five of our trust sites.

    Finance Team win award for commitment to sustainability

    The Finance Team has won an award for their commitment to environmental sustainability at the Healthcare Financial Management Association (HFMA) Kent, Surrey and Sussex Branch Awards.

    Read more about the award win

    Shirley's scheme to recycle crutches wins national acclaim

    An innovative recycling scheme where patients receive elbow crutches quicker, has resulted in occupational therapist Shirley Rashid being shortlisted for a national award.

    Read more about Shirley's scheme for crutches

    Community nursing demand and capacity

    We worked on several programmes to reduce demand on our community nursing teams and improve skill mix to deliver patient care, which will make our services more sustainable in the long term.

    Lisa RalfThis has helped us to adopt a new approach to staffing and skills in some areas. We have seen progress on helping patients, reducing pressure on teams and providing new creative career pathways for people.

    In east Kent, Lisa Ralf and Naomi Meakins, specialist diabetes nurses for Thanet and south Kent coast, transformed how we work with patients living with diabetes. They have combined hands-on patient care with leadership roles, providing annual treatment reviews for complex patients, prescribing and deprescribing, and providing training for care home staff and our own colleagues to streamline the diabetes caseload and reduce pressure on the community nursing teams.

    Stuart’s specialist skills

    Stuart Watts is a band seven nurse specialising in end-of-life care in Thanet.

    Stuart Watts nurse end of life care

    In this challenging field, Stuart has pioneered new ways of working with the local hospice, GPs and SECAmb to make sure people nearing the end of their lives can do so in comfort and without pain, keeping them at home if possible. Stuart said: “I carry out out prescribing and deprescribing, supporting more junior team members with upskilling and taking a lead with complex or more difficult to manage patients. This approach frees up my colleagues to help more patients on our general caseload.”

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