Agenda and minutes

(1)       RESOLVED that the Minutes of the meeting held on 4 August are correctly recorded and that they be signed by the Chairman.

Oena Windibank (Programme Director, Kent & Medway Vascular and Stroke Services Reviews), James Thallon (Medical Director, NHS England South and Senior Responsible Officer, Kent & Medway Vascular Review), Rachel Jones (Director of Strategy, East Kent Hospitals University Foundation NHS Trust), Noel Wilson (Vascular Services Clinical Lead and Consultant Surgeon, East Kent Hospitals University Foundation NHS Trust and Clinical Lead for the Kent & Medway Vascular Network), Ben Stevens (Director of Clinical Operations, Co-ordinated Surgical Directorate, Medway Foundation Trust) and Anil Madhven (Interventional Radiologist Consultant, Medway Foundation Trust and Deputy Clinical Lead, Kent & Medway Vascular Network) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Dr Thallon began providing an update to the Committee about the Vascular Services Review; he explained that East Kent Hospitals University NHS Foundation Trust (EKHUFT) and Medway NHS Foundation Group (MFT) had established a Network to deliver vascular services jointly in East and Mid Kent. He noted that the Committee had requested NHS England to present an update on the engagement events; he explained that these had been delayed until the early next year.

(2)       Following a change of membership at the previous meeting, the Chairman asked for a description of vascular services. Dr Wilson explained that vascular diseases related to disorders of the arteries and veins but excluded the heart and cardiothoracic diseases. He stated that vascular services included interventions to remove interruptions to arterial blood supply in the limbs, neck and abdomen to prevent stroke and repair aneurisms. He noted that aneurisms particularly affected men and common vein conditions included varicose veins and ulceration.

(3)       Dr Wilson stated that he was the Vascular Services Clinical Lead and Consultant Surgeon at EKHUFT and was the lead for the Kent & Medway Vascular Screening Programme which screened 11,000 – 12,000 men a year for Abdominal Aortic Aneurysm. He also worked with Public Health England to peer review vascular services across the country and was currently working with NICE to review the vascular guidelines. He explained that resulting from the vascular services review in Kent and Medway, a collaboration between EKHUFT and MFT had developed the Kent & Medway Vascular Network. He noted that the pathway to London for specialist tertiary treatment would continue. He reported that a Network Board had been established, by the Chief Executives of the two Trusts, to move the service forward; Dr Wilson had been appointed as the Clinical Lead and Dr Madhven had been appointed as the Deputy Clinical Lead. He explained that the Network Board was working to develop and build the best service for patients and their families and was very optimistic about its future. He stated that he attended a patient and family engagement event which had given him a greater understanding of patients and their families’ priorities for vascular services.

(4)       Dr Madhven explained that he was an Interventional Radiologist Consultant at MFT and provided minimally invasive specialist procedures for vascular patients. He highlighted that, although he was not a vascular surgeon, he provided specialist treatment  ...  view the full minutes text for item 22.

Oena Windibank (Programme Director, Kent & Medway Vascular and Stroke Services Reviews), Patricia Davies (Accountable Officer, NHS Dartford Gravesham and Swanley CCG and NHS Swale CCG and Senior Responsible Officer, Kent & Medway Stroke Review) and Lorraine Denoris (Public Affairs and Strategic Communications Adviser, NHS Dartford, Gravesham and Swanley CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Ms Davies began by outlining the review. She stated that the review began 18 months ago with the formation of the Stroke Review Programme Board to develop a new model of care which would meet the national standards; the Board was made up of representatives from the eight Kent & Medway CCGs, the Stroke Association, clinical experts and patient representatives. She noted that the process was overseen by Professor Tony Rudd, the National Clinical Lead for Stroke. She explained that since the last JHOSC, the clinical data had been reviewed again and a series of engagement events were held which JHOSC members were invited too; the feedback from patients at these events was that patients felt cared for but recognised that the current model was not meeting national standards. She noted at the last Stroke Review Programme Board on 24 November, a three site option was agreed to be the optimum model for stroke services as detailed in the supplementary paper. She stressed that the locations of the three sites had not been determined and would depend on the output from the Kent & Medway Sustainability and Transformation Plan (STP) as a number of other services needed to be collocated on the site including a major A&E and trauma units. She stated that the original 27 configurations had been reduced to nine and each of those configurations met the 45 minute travel time and 120 minute call to needle standard.

(2)       Ms Windibank stated that the feedback from the recent engagement events, about workforce, travel time and rehabilitation, was similar to previous events and would be used to inform and influence detailed modelling. She noted that an initial gap analysis on the out of hospital pathway had been undertaken and services were variable across the county; a more detailed analysis would be carried out. She explained that a wider clinical and stakeholder engagement event was planned for early 2017 which would be used to test and validate a three site option.  Ms Denoris highlighted that the recent engagement events brought together patients, carers, stroke survivors alongside clinicians to look at the emerging options, challenges and solutions.

(3)       Members of the Committee then proceeded to ask a series of questions and make a number of comments. A number of comments were made about rehabilitation services. Ms Davies acknowledged that community rehabilitation services were variable in Kent & Medway and there was no definitive specialist rehabilitation service for stroke which was recognised by clinicians at the recent Review Programme Board. She highlighted that a specialist stroke rehabilitation pathway was being developed as part of the modelling for a three site option  ...  view the full minutes text for item 23.