Agenda and minutes

Councillor Michael Lyons declared a personal interest in the Agenda as a Governor of East Kent Hospitals University NHS Foundation Trust.

RESOLVED that the Minutes of the meeting held on 20 July 2012 are correctly recorded and that they be signed as by the Chairman.

Marion Dinwoodie (Chief Executive, Kent Community Health NHS Trust), Lesley Strong  (Deputy Chief Executive / Director of Operations Adults (Kent Community Health NHS Trust), Isabel Woodroffe (Head of Governor and Member Recruitment, Kent Community Health NHS Trust), Natalie Yost  (Assistant Director, Communications, Engagement and Public Affairs, Kent Community Health NHS Trust) were in attendance for this item.

(1)       The Chairman welcomed the representatives from the Kent Community NHS Trust and invited Mrs Dinwoodie to introduce the item.

(2)       Mrs Dinwoodie set out the context, their five strategic goals and the consultation process for the Foundations Trust Application and referred to the papers on their journey to become a Foundation Trust which had been circulated with the agenda.

(3)       A general question was raised about the impact of Private Finance Initiatives (PFIs) on the finances of local hospitals. Although this did not affect Kent Community Health NHS Trust directly, it was explained that local PFI hospitals were looking at getting into a stable and mature position and had a 5 year plan to get full money back into the area by year 6. 

(4)       Members requested some clarification around which properties were run by the Trust. Mrs Dinwoodie confirmed that the Kent Community Health NHS Trust FT ran services in the 12 Community Hospitals around Kent, but that there was not an equitable distribution across the county as they tended to be positioned around the perimeter of the county. These were used as step down facilities from an acute setting. She stated that there needed to be a better balance between this and step up facilities from respite. The future of the community estate was currently being considered and it was likely a new body, The NHS Property Company, would take ownership of them. Most services were provided by the Trust outside of fixed locations, in the community. This contributed to a sense in which community services were like “dark matter” in the health economy in that they held everything together but were not visible. In the future, the Trust would be asset light which would improve its flexibility.

(5)       In response to a question about information to patients on about what to expect following an operation with an example given by a Member,   Ms Strong stated that the trust would be working on care pathways to ensure that this situation patients were given this information prior to discharge.  She undertook to discuss the specific matter further with the Member outside of the meeting. She explained that the normal process was to facilitate discharge into Community Services if appropriate.  With long term conditions part of the Trust’s work was supporting self management to help the client to manage the condition themselves.

(6)       In response to a question on how the difference made by the Trust would be seen on the ground, Mrs Dinwoodie and her colleagues stated that they believed that the Trust engaged with and listened to the patient now, but there will be a greater transparency  ...  view the full minutes text for item 3.

Nicky Bentley, Associate Director (South of England Specialised Commissioning Group, NHS Kent and Medway) was in attendance for this item.

(1)       The Chairman introduced the item and explained that it was for the Committee to consider whether the changes were a substantial variation. Medway Council’s Health and Adult Social Care Overview and Scrutiny Committee had considered this and asked for further information before deciding whether this was a substantial variation.  If both Health Overview and Scrutiny Committees decided that this was a substantial variation then it would be considered at a Joint Health Overview and Scrutiny Committee.

(2)       Ms Benton presented the paper on the Kent and Medway NHS vascular review which included an outline of the proposal with reasons for the changes and the timescale.  The Trust had to report to the Strategic Health Authority by the next financial year that they had a plan in place.

(3)       Members expressed their appreciation to the Trust for coming to the Committee at this early stage; they welcomed the review and the holistic and long term approach taken.  The comment was made that it would be helpful to know the costings and estimated savings from these proposals. Confirmation was sought that this review was more to do with clinical excellence than achieving savings. Ms Benton explained that the proposal was related to Consultant training and Junior Doctors, there was a need for a critical mass of expertise for this service and she did not believe that it was possible to achieve this on two sites. 

(4)       Information was sought on the impact that travelling a greater distance for surgery would have on the outcome for the patient.  Ms Benton stated that this was not available yet but that they would need to have this information for the review.

(5)       Responding to a question about screening it was confirmed that it was already in place in GP surgeries in Canterbury. It was reported that this had been very successful and was being rolled out across Kent and Medway.

(6)       As only data for 2011/12 had been supplied, a Member asked if this was indicative of previous years. Ms Benton explained that data was available for previous years and would be supplied for as part of the full review.

(7)       Ms Benton confirmed that patients would still have the option of being treated at Kings College Hospital.

(8)       In relation to a question on the impact of the European Working Time Directive on achieving 24/7 cover, Ms Benton stated that part of the impact was physically having the right number of people, with the right skills in the right place at the right time.

(9)       RESOLVED that:

(1)       the Committee considers that the proposed changes to Vascular Services are a substantial variation and that, subject to the view of Medway Council, further consideration will be given to them by either the Kent Health Overview and Scrutiny Committee or the Joint Health Overview and Scrutiny Committee with Medway Council, and

(2)       an  ...  view the full minutes text for item 4.

Evelyn White (Associate Director Integrated Commissioning, NHS Kent and Medway), Linda Caldwell ( Senior Commissioning Manager Carers and Older People East Kent, NHS Kent and Medway), Dr Kanagasooriam (GP Commissioning Lead for Older Peoples Mental Health), Dr Karen White (Executive Medical Director), Dr Barbara Beats (Assistant Medical Director – Older Adults), Justine Leonard (OPMHN and Specialist Service Line Director, KMP), Su Brown  (Head of Operations, Communications and Engagement, NHS Kent and Medway) were in attendance for this item.

(1)       The Chairman welcomed Health Service colleagues and invited them to introduce their preliminary paper on Older Persons Mental Health Services in East Kent.

(2)       Ms White presented the paper which set out the outcomes of the formal consultation which would be presented to the NHS Kent and Medway Board in later in the month. Ms White confirmed that the Trust were part of a bid for national funding to make the implementation of improvements faster for those with dementia, this was an important work stream and there was partnership working with social care colleagues in relation to this important piece of work.  The Trust was aware of the recommendations of the KCC Select Committee on Dementia.

(3)       Ms Leonard confirmed that there were two options for the proposed provision at St Martins, these were either to build a new unit or to convert an existing facility but this would not be a ward in the older part of the hospital.

(4)       Ms White explained that one of the pieces of work that was going on across the County was to ensure that support staff see the individual and not the dementia. There were dementia champions at each of the Acute Trusts. This was not part of the process being reported to the Committee today but was part of a wider agenda.

(5)       In response to the reference to the patient safety aspect of the options, Dr White explained that option one would mean it was necessary to rota across three sites and it would be more likely that locum staff would need to be used.  Whereas with option two, it would only be necessary to have a rota across two sites which would be easier to cover with Trust staff.

(6)       In relation to a question on the increased prevalence of dementia within an aging population and the proposals ability to cope with this, Dr White stated that an increase in the number of people with dementia did not necessary mean that there was a need for an increased number of inpatient beds, what was needed was support in the community to enable better management of the condition and improved individual care in the persons own home. There should be more investment in crisis treatment and care in the community which would result in a reduced need for acute beds.  There was a need to work closely with local authority colleagues to provide a joined up service and to be confident that the commissioning of beds met the needs now  ...  view the full minutes text for item 5.

Meradin Peachey (Director of Public Health, KCC) and Julie Van Ruyckevelt, (Interim Head of Citizen Engagement for Health, KCC) were in attendance for this item.

(1)       The Chairman asked that, due to the lack of time to fully consider this item, Members email Ms Peachey with their comments on this first draft of the Joint Health and Wellbeing Strategy prior to consideration at the next meeting of the Committee.

(2)       RESOLVED that consideration of the Joint Health and Wellbeing Strategy be deferred until the meeting of the Committee on 12 October 2012.

(1)       The Committee considered a letter on the integration between Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust dated 22 August 2012 from the Trusts’ Chief Executives.

(2)       RESOLVED that the update be noted and the suggested new name “North Kent NHS Foundation Trust” be supported.

(Mr Adrian Crowther declared a personal interest in the Agenda as a Governor of Medway NHS Foundation Trust).