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Coming together to strengthen community care across Kent and Medway: Our next steps
After more than two years of joint work, both Boards have agreed the full business case, which sets out why we think we should bring Kent Community Health NHS Foundation Trust and Medway Community Healthcare together as one organisation.
Our plans are clinically-led, system supported and focused on improving outcomes for patients and communities across Kent and Medway.
While the legal form of the transaction is a statutory acquisition of MCH by KCHFT, our clear intent is to take the best of both organisations and remove barriers that limit joined up working.
The proposal will shortly go to NHS England for national review.
Demand for community health services is rising as the population grows older and lives with more complex needs, alongside workforce pressures, financial constraints and persistent health inequalities.
Although our organisations already work closely together, remaining as separate legal entities restricts our ability to deliver consistent, resilient services at scale. Integration provides a planned and proactive response, strengthening accountability, governance and long term sustainability.
For patients and carers, it is important to be clear that there will be no immediate changes to how or where care is delivered. People will continue to receive care from the same teams, in the same places, with services transferring safely as they are now and any future change phased carefully.
For staff, integration offers greater stability, wider career opportunities and improved access to NHS training and development. Colleagues will transfer with full legal protections in place, and staff engagement has been central to shaping this proposal.
We have heard clearly the importance of protecting Medway’s local identity, leadership and partnerships. Integration does not mean centralising care away from Medway or reducing local services. Strong place based leadership will be retained, and resources will continue to be allocated based on population need and commissioning decisions.
The financial case demonstrates that integration is affordable, represents good value for money, can be delivered within existing resources, and does not require additional funding from the wider system.
Both Boards believe this proposal will improve equity, quality and consistency of community care, support our workforce and strengthen neighbourhood care. We remain committed to continued engagement with patients, the public, staff and stakeholders.
John Goulston, Chair
Kent Community Health NHS Foundation Trust
Bruce Potter, Chair
Medway Community Healthcare Community Interest Company (CIC)
Why change is needed
Health and care services in Kent and Medway are under increasing pressure. These pressures are linked and long standing, and they affect how community services are delivered now and in the future.
Taken together, these pressures mean that doing nothing is not an option. Integration is proposed as a planned and proactive response to known challenges, helping create a stronger, more sustainable future for community health services across Kent and Medway.
About our two organisations
Kent Community Health NHS Foundation Trust (KCHFT) and Medway Community Healthcare Community Interest Company (MCH) both provide a wide range of high quality community health services, delivered by skilled and committed staff. The organisations already work closely together and share similar values, but they currently operate as separate legal entities, with different systems and governance arrangements.
| Medway Community Healthcare (MCH) | Kent Community Health NHS Foundation Trust (KCHFT) | |
|---|---|---|
| Organisation type | Community interest company (CIC). 99% of staff are shareholders in the organisation and an elected members forum ensures that the voices of staff and shareholders are heard at meetings of the Board and its committees. | NHS trust. All staff are members of the Foundation Trust with elected public and staff governors acting as ambassadors for the organisation and providing a public and staff voice. |
| Established | 2011 | 2011 |
| Mission | Lead the way in excellent healthcare | Empower adults and children to live well, be the best employer, and work with our partners as one |
| Values | Caring and compassionate, deliver quality and value, work in partnership | Compassionate, aspirational, responsive, excellence |
| Funding | £80 million | £400 million |
| Workforce (WTE) | 1,250 staff | 5,500 staff |
| CQC Rating | Good | Outstanding |
| Strategy |
- Deliver care closer to home - Provide flexible, efficient services - Respect dignity and privacy |
- Putting communities first - Better patient experience - Great place to work - Sustainable care |
| Services | More than 40 community services in Medway and surrounding areas | More than 70 services in Kent, Medway, East Sussex, London |
| Governance | Independent Board with CIC accountability | NHS Trust Board with public accountability |
The future integrated NHS trust
The two organisations will come together as a single NHS foundation trust, retaining the name Kent Community Health NHS Foundation Trust. The integrated organisation will have:
- one Board and executive leadership team, providing clear accountability
- strong place based leadership in Medway, with local visibility, influence and partnership arrangements explicitly preserved
- shared clinical, operational and corporate systems, reducing duplication and supporting consistency
- a larger and more resilient workforce, with improved access to NHS training, development and career pathways
- a single community provider voice within the Kent and Medway system.
Preserving local identity and relationships
Integration does not mean moving care away from local communities. Services will continue to be delivered locally, supported by:
- strong place-based leadership in Medway and across Kent
- ongoing partnerships with local authorities, primary care networks and voluntary sector organisations
- operating arrangements based around neighbourhoods and communities.
Engagement made it clear that preserving Medway’s identity and influence is essential. In response to this, we will:
- retain distinct leadership for Medway as a place
- protect existing local partnerships and system relationships
- ensure local voices continue to shape decisions, where this improves patient care.
Overall, the integrated organisation combines the scale, stability and statutory role of an NHS trust with the local knowledge, relationships and community focus that staff, partners and communities value.
How care will work in the future
For patients, families and carers, there will be no immediate changes to where or how care is delivered as a result of integration. People will continue to receive care from the same teams, in the same places, and services will transfer safely as they are now at go live.
Any future changes will be planned, phased and clinically led, with patient safety, quality and continuity of care as the overriding priorities.
More consistent and joined‑up care
Over time, bringing services together will support:
- more consistent care pathways, based on agreed best practice. For example, people with similar needs can expect clearer and more consistent approaches to assessment, treatment and follow up, wherever they live
- reduced unwarranted variation across Kent and Medway. This helps reduce differences in access or experience that are not explained by clinical need
- better coordination between professionals and services, for example, nurses, therapists and other professionals working more closely around the same person
- smoother transitions between services or stages of care, such as clearer handovers when someone moves from hospital to community support, or between specialist and general services.
Together, this will help make services easier to understand and navigate, improving people’s overall experience of care.
Neighbourhood and preventive models of care
Integration supports national and local ambitions to:
- provide more care closer to home, where appropriate. For example, avoiding unnecessary hospital visits by supporting people in their own homes or local clinics
- strengthen neighbourhood teams and ways of working, so professionals based in the same area can work more closely with GP practices, social care and voluntary organisations
- focus more on prevention and early support, helping people manage long term conditions earlier and stay as well as possible for longer.
Bringing teams together within a single organisation supports multidisciplinary working and clearer clinical leadership across all parts of the NHS.
Digital and information sharing
Being one organisation will, over time, support:
- Better integration of digital systems, where this improves care. Reducing the need for staff to use multiple systems for the same person.
- Safer and more efficient sharing of information between teams. So professionals have access to the right information at the right time.
- Less duplication of records and processes. Reducing the need for people to repeat their story and for staff to recreate information.
This supports better clinical decision-making, improves continuity and helps deliver safer, more coordinated care.
What people told us and how we responded
Patient, public and stakeholder engagement has directly shaped the final proposal.
More than 240 people across Kent and Medway took part in planned engagement activity around the integration, which included:
- an online public survey, to gather views from patients, carers and parents
- two targeted discussion groups with residents from different parts of the county
- a face-to-face public stakeholder information and feedback event, held in Medway.
Participants at the stakeholder event included representatives from voluntary and community sector organisations, local government partners, and NHS colleagues. Together, these methods provided both quantitative insight into experiences of community services and qualitative depth on what matters most to people, their priorities for improvement, and their hopes and concerns about services coming together as one organisation.
Engagement with staff, patients, carers, partners and stakeholders highlighted several key themes:
- strong appreciation for the quality of care provided, alongside frustration about difficulties accessing services
- concerns about long waiting times, poor telephone access and unclear pathways between services
- clear evidence of variation between areas, with people wanting fairer and more consistent services
- a strong desire for joined up, local and easy-to-navigate care, including shared records and smoother transitions
- conditional support for integration, dependent on protecting local services, addressing inequalities and improving access.
We have published frequently asked questions, based on what we heard and how we responded. Here’s some examples:
What this means for patients and communities
For patients, families and carers, integration is designed to deliver clear and tangible benefits over time, while ensuring continuity, safety and quality of care throughout the change. The ambition is not to disrupt existing services, but to strengthen them so people experience care that is more coordinated, consistent and responsive to their needs, regardless of where they live in Kent and Medway.
What people can expect
At the point of integration, people should notice continuity rather than change:
- services will continue to be delivered from the same locations by the same teams
- appointments, referral routes and access points will remain the same initially
- care will continue to be provided locally and, wherever possible, closer to home.
Over time, bringing services into one organisation will make it easier for patients, families and carers to:
- navigate services without being passed between organisations
- experience smoother transitions between different teams and services
- receive more consistent levels of access and quality standards across Kent and Medway.
Improving outcomes, experience and equity
Bringing services together supports improved outcomes and experience through:
- Earlier intervention and prevention, helping people stay well for longer and reducing avoidable hospital admissions. For example, aligning neighbourhood teams and urgent community response services across Kent and Medway makes it easier to provide rapid support at home and prevent unnecessary hospital stays.
- Better coordination for people with complex or long-term needs, with professionals working more closely together across teams and services. For example, integrated community nursing, therapy and specialist input supports smoother community rehabilitation and more joined up care for people with frailty or long-term conditions.
- More consistent care pathways, based on shared standards and best practice. For example, standardising community therapy and rehabilitation pathways reduces unwarranted variation so patients receive the same level of service, regardless of where they live.
The same standard of care for everyone
A single organisation makes it easier to identify variation and health inequalities across Kent and Medway. This allows services to be shaped around the needs of local communities and resources targeted where they can have the greatest impact, supporting fairer access and more equitable outcomes.
A consistent theme raised through engagement was concern that integration could result in resources being taken away from Medway. The Full Business Case is clear that this is not the intention. Funding will continue to be allocated on the basis of population need. There are no proposals in the Full Business Case to remove funding from Medway or reduce local services as a result of integration.
Instead, the purpose of bringing the organisations together is to level up services, reducing unwarranted variation and ensuring people in Medway benefit from the same access to specialist
expertise, workforce resilience and clinical support as elsewhere. Integration also strengthens Medway’s position within a larger organisation by improving financial resilience and enabling investment decisions to be made on the basis of need and outcomes, rather than organisational boundaries. This supports fairer, more equitable services for Medway communities over the long term
Safety, quality and continuity
Keeping people safe and well cared for is the top priority throughout the integration.
Care will continue as normal at the point of integration, with services moving across as they are now. People will keep seeing the same teams and using the same services.
Any changes in the future will be carefully planned and introduced step by step. Clinical leaders will be closely involved to make sure changes are safe and based on what works best for patients.
This approach helps make sure care remains safe, reliable and consistent, without disruption, while improvements are made over time.
What this means for staff
Staff engagement has highlighted concerns about job security, workload and organisational culture. These concerns are understood and have informed the integration plans. Integration is intended to strengthen stability and support staff, while ensuring changes are planned carefully and handled fairly.
Greater job security and stability
Moving to a single NHS trust provides a more stable organisational footing than operating as a smaller standalone organisation. Staff will transfer with legal protections in place, and any future workforce
changes will be subject to engagement and formal consultation.
Wider career opportunities
Being part of a larger organisation creates more opportunities for development without needing to change employer. For example:
- a community nurse in Medway could progress into specialist or leadership roles
- therapists could access broader training and supervision networks
- support staff could develop new skills across a wider range of services.
Stronger, more resilient teams
Small teams can be vulnerable when staff leave or are absent. Integration allows:
- better sharing of cover between teams
- reduced reliance on agency staff over time
- improved peer support, particularly in specialist services.
Fairer access to training and development
As part of an NHS foundation trust, staff will have improved access to national training programmes and professional development
funding. Over time, this supports recruitment, retention and staff wellbeing.
A shared culture built on values
Staff told us that culture matters. Integration creates the opportunity to deliberately build a shared culture, bringing together:
- the scale and stability of an NHS trust
- the local knowledge, relationships and community focus of Medway services.
This work will be shaped with staff and grounded in shared NHS values.
What this means for partners and the wider system
Bringing the two organisations together provides benefits across the Kent and Medway health and care system, including:
- a simpler organisational set-up, making it easier to work together
- clearer accountability, with a single community provider responsible for services
- a stronger and more joined up community provider voice within the wider system.
Partners can expect:
- continued place based relationships, with local services and partnerships remaining central
- better alignment with system priorities
- more effective collaboration across health, care and the voluntary and community sector.
Overall, integration supports shared system goals for prevention, neighbourhood based care and long term sustainability, helping services work together more effectively to improve outcomes for local communities.
Financial case and value for money
The financial case shows that bringing the two organisations together is affordable and makes good use of public money. The integration does not need extra funding from the wider NHS and can be delivered using existing resources, with plans in place to deal with any financial pressures that arise during the change.
Over time, working as one organisation is expected to deliver savings. This isn’t about cutting patient services; it is mainly about working more efficiently together – the majority of benefits come from non pay efficiencies and improved ways of working. This helps create a stronger and more stable financial position for community health services across Kent and Medway.
The benefits come from:
- avoiding duplication in day to day support and administrative work
- simpler and more joined up corporate and support services
- better coordination of staff and services, helping teams support each other
- built in financial contingency, so risks can be managed safely.
Overall, the integration provides a more secure financial base for the future, helping the organisation look after public money responsibly while continuing to focus on safe, high quality care for patients. Any changes that follow integration will be carefully planned and subject to engagement and consultation, with patient care and service continuity remaining the top priorities.
Delivering the change safely
A detailed integration plan and outlines clear governance, defined workstreams, programme management, risk controls and a realistic plan to reach the proposed go-live date of Thursday, 1 October 2026. All legal and regulatory requirements are included. Patient safety, quality and service continuity are embedded throughout the plan.
Following integration:
- the organisation will be accountable as an NHS foundation trust
- regulated by NHS England and other statutory bodies
- overseen by a single Board, with clear responsibilities.
Local accountability will continue through place‑based arrangements and system partnerships.
What happens next
Both Boards agree that becoming one organisation is in the best interests of patients, colleagues, local communities and the wider Kent and Medway system. They recommend progressing with the integration of MCH and KCHFT.
The full business case has been reviewed against NHS England’s key lines of enquiry (KLOEs) and provides strong assurance across all areas. It highlights particular strengths in the strategic case, quality and safety, people and culture, digital planning, the operating model, the financial case and delivery planning.
Key milestones
April 2026
Full business case submitted to NHS England for consideration (our
earlier strategic outline case was well received with advice to continue with our plans).
April 2026
Integration is officially approved by MCH and KCHFT’s Boards.
June 2026
As MCH is a community interest company (CIC), there will be an advisory vote of MCH shareholders.
June 2026
NHS England formally approves.
By October 2026
The transfer of services is planned to be completed, with the goal of making sure the new organisation is ready to deliver safe, effective care from day one.
Our communities and colleagues will be involved throughout this process. Your feedback will help shape how services are delivered. There will be opportunities to ask questions, share concerns and help make the new organisation work for everyone.
How you can stay involved
You can still give us your views:
- email us at kchft.comms@nhs.net
- write to us at:
Communications and Engagement Team
Kent Community Health NHS Foundation Trust
Trinity House
110-120 Upper Pemberton
Eureka Park, Ashford
Kent, TN25 4AZ
Regularly updated frequently asked questions are available on this page.
Frequently asked questions
Alternative formats
If you need communication support or would like this in an alternative format, please contact the KCHFT Communications and Engagement Team.
0300 790 0506
kchft.comms@nhs.net
Write:
Communications and Engagement Team
Kent Community Health NHS Foundation Trust,
Trinity House
110-120 Upper Pemberton
Eureka Park
Ashford
Kent, TN25 4AZ