Agenda and minutes

(1)      There were no apologies for the meeting.

(1)      There were no declarations of interest.

Members are asked to approve the minutes of the following meetings as a correct record:

·         5 July 2018

·         5 September 2018

(1)      RESOLVED that the Minutes of the meeting held on 5 July 2018 and 5 September 2018 are correctly recorded and that they be signed by the Chair.

·         NHS Report (pages 25 - 45)

·         Draft Decision-Making Business Case – unvalidated and as such will be subject to change (pages 47 - 229)

·         Integrated Impact Assessment (pages 231 – 287)

·         South East Clinical Senate Review (pages 289 - 324)

Rachel Jones (Senior Responsible Officer, Kent and Medway Stroke Review), Nicola Smith (Stroke Programme Lead, Kent and Medway Stroke Review), Lucy Readings (Communications and Engagement, Kent and Medway STP), Dr Chris Thom (Consultant Stroke Physician – Maidstone and Tunbridge Wells NHS Trust), Ray Savage (Strategy and Partnerships Manager, South East Coast Ambulance NHS Foundation Trust) were in attendance for this item.

(1)      The Chair welcomed the guests to the Committee.  The Chair emphasised to the Committee that the draft Decision-Making Business Case document was unvalidated and as such was subject to change.  Additionally, the Chair highlighted that information from the group ‘Save Our NHS in Kent’ (SONiK) had been circulated informally to the Committee prior to the commencement of the meeting.

(2)      NHS representatives were invited to update the Committee. Ms Jones began by giving context to the documents provided, accentuating that due diligence had not been completed on the Decision-Making Business Case (DMBC) and that there would be changes to the final version.  She said that it was a strong working draft and given its importance, it made sense to provide this to the Committee to give opportunity for comment.

(3)      Ms Jones said that she had attended the Kent and Medway Joint Health and Wellbeing Board that morning, at which point comments had been received which would also be duly incorporated.  She informed the Committee that the final date for feedback was 21 December 2018 whereupon the final and validated document would be created by 3January 2019.

(4)      Ms Jones emphasised the table within the NHS report which documented feedback received and the associated actions taken.  She highlighted that there were three things still of particular focus beyond what had been raised in feedback - workforce, stroke incidence and detailed finance assumptions. 

(5)      Some Members expressed concern regarding the practices being undertaken that lead to the final decision process.  Changes to information that had emerged in respect of Princess Royal University Hospital (PRUH) led some Members to the conclusion that the decision-making process was unclear.  Ms Jones clarified that the decision had not been made until the documents had been finalised and that the Joint Committee of Clinical Commissioning Groups (JCCCG) would ultimately make the final decision.  She said that the documentation provided enabled the Programme Team to conduct enough work to show understanding of every possible intended and unintended impact and consequence of the option being considered for recommendation and preference.  Ms Jones clarified the stages undertaken; highlighting that the PRUH had never been part of the public consultation but that the impacts on the PRUH were documented in all the of the options.  She highlighted that two other hospitals on the periphery of Kent and Medway were also included.

(6)      Ms Jones informed the Committee that they followed learning and took advice from previous stroke consultation programmes including those in London, Manchester and Northumbria.  In addition, formal feedback was received from a regulator and any changes in national clinical guidance since these changes would be  ...  view the full minutes text for item 13.