Agenda and minutes

(1)  Michael Lyons was no longer a Member of HOSC. There was therefore currently one vacancy in the Borough/District representation.

(2)  Nigel Collor had left the Committee; Diane Marsh had joined the Committee.

(1)  Mr Ian Thomas gave his apologies as he was already committed to attend Kent and Essex Inshore Fisheries and Conservation Authority; he was substituted at the meeting by Mrs Rosalind Binks.

(2)  Mr Nick Chard and Councillor Joe Howes sent their apologies.

(1)  Ms Constantine declared an interest due to her involvement in a campaign to seek a Judicial Review against the siting of stroke units in Kent and Medway. She explained she had received advice from KCC’s Monitoring Officer on this issue. She stated this interest was not a disclosable pecuniary interest and had no conflict of interest in taking part in the debate and vote.

(2)  Mr Lake declared an interest in that he used to be a non-executive Director of the Kent and Medway NHS and Social Care Partnership Trust.

RESOLVED that the Committee agreed that the minutes from 1 and 22 March 2019 were correctly recorded, and that they be signed by the Chairman.

Glenn Douglas (Chief Executive, Kent and Medway STP and Accountable Officer for Kent and Medway CCGs), Rachel Jones (Director of Acute Strategy, Kent and Medway STP), Dr Steve Fenlon (Medical Director, Dartford and Gravesham NHS Trust), Dr David Sulch (Stroke Consultant, Medway Foundation Trust), Dr Chris Thom (Stroke Consultant, Maidstone and Tunbridge Wells NHS Trust), Steph Hood (Communications and Engagement Lead for the Stroke Review), Nicola Smith (Acute Strategy Programme Lead, Kent and Medway STP), Ray Savage (Strategy and Partnerships Manager, South East Coast Ambulance Service NHS Foundation Trust (SECAmb) were in attendance for this item.

(1)  The Chair welcomed the guests to the Committee and invited them to deliver a presentation. The presentation is appended to the minutes.

(2)  The salient points from the presentation were:

·         Stroke services across Kent and Medway were not performing consistently well. This was supported by data from the Sentinel Stroke National Audit Programme (SSNAP).

·         National targets for activity thresholds and workforce numbers were not being met by all stroke unit sites across Kent and Medway.

·         Other areas that have reconfigured their stroke services had seen marked improvements in the number of patients receiving high quality specialist care.

(3)  Members asked a series of questions about the reasoning for having three Hyper-Acute Stroke Units (HASUs).

(4)  Dr Sulch and Dr Thom explained that six specialist consultants were needed to run a full-time rota at a HASU. This would require a workforce of 18 such consultants across three HASUs. Kent and Medway employed 10 consultants currently. NHS representatives stated that employing an additional 14 consultants on top of this number to adequately staff four HASUs would not be feasible due to the challenges around recruitment.

(5)  NHS representatives added that the service would be under continuous review, and that should demographics change in the future then the need for an additional HASU would be revisited (considering both activity levels and workforce capacity). An undertaking was made that the Committee would continue to be engaged, with performance data being shared regularly.

(6)  Another area of questioning by Members was around the decision to remove stroke services from the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate

(7)  NHS representatives explained that the number and location of the HASUs had been subject to robust research, discussion and scrutiny. This was an opinion echoed by the Healthwatch representative present at the meeting. An NHS representative compared the consolidation of services to that of trauma services, in which trauma patients were now taken to William Harvey Hospital instead of QEQM as they were prior to the changes to trauma services. Performance data showed a higher quality of service and improved mortality since the centralisation.

(8)  Ms Jones assured Members that QEQM was not eliminated from the decision-making process early on. The thousands of site combinations were gradually shortlisted by applying an evaluative matrix. QEQM was in several of the final 13 options. It was only at this stage that the criteria used meant that none of  ...  view the full minutes text for item 129.

(1)  The item took place after a short adjournment due to disruption from the public gallery.

(2)  RESOLVED that the Committee considered and agreed the work programme.