Agenda item

Helen Buckingham (Deputy Chief Executive and Director of Whole Systems Commissioning, NHS Kent and Medway), Ian Ayres (Accountable Officer, NHS West Kent CCG) were in attendance for this item.

(a)       The Chairman introduced the item explaining that it had been discussed at the meeting of 7 September, at which he had not been present, but there had been a request to bring it back as there were some outstanding issues. The question revolved around whether the NHS had fallen short of their duties to consult the Committee on the change of use of 12 beds at Tonbridge Cottage Hospital. This issue had been ongoing since 2004 with the location of a stroke rehabilitation unit connected to the new Pembury Hospital initially being planned for Sevenoaks Hospital before the plans changed and it was finally placed in Tonbridge Cottage Hospital. The Chairman could not speak for the Committee as a whole as to whether this would have been classed as a substantial variation of service had it come to the Committee at the appropriate time, but for him there was no question that it was a substantial variation of service. The point was that the Committee did not have the opportunity to determine whether or not it was a substantial variation of service.

(b)       In response, NHS representatives explained that there was no definition of substantial variation of service. The broader changes had come to HOSC, but this specific one had not. The decision was made at the time by the NHS that this particular change did not classify as a substantial variation of service. As it is for the HOSC to make that determination it was acknowledged that this did not happen and apologies were given. A meeting between the League of Friends and Clinical Commissioning Group had taken place the preceding week.

(c)        An explanation was then given of the impact of NHS Property Services (Propco) taking on the ownership of Tonbridge Cottage Hospital. This did not mean any uncertainty about the future of the Hospital. Propco would have no ability to declare the Hospital surplus to requirements. The decisions on its usage would be determined locally and even if local commissioners decided it would no longer be used, which would require consultation, the site would then be offered to other NHS bodies first. In this way the system would be a lot like the current one.

(d)       The CCG representative explained that a close examination had been made of general rehabilitation bed use at Tonbridge Cottage Hospital. It was found that there was an even split between people from the local area accessing these beds and those from outside the area. This had meant some people from Tonbridge being placed in rehabilitation beds elsewhere in the county. As a result of work between the CCG, Kent County Council, Kent Community Health NHS Trust and Maidstone and Tunbridge Wells NHS Trust, in the next few weeks a pilot scheme on the grounds of Maidstone Hospital was being commenced. This would provide 26 community rehabilitation beds for patients who were not under the care of a consultant. Consultants would do fortnightly rounds to ensure the case mix was appropriate. This would allow for patients from Tonbridge to be repatriated closer to home. This project would run until March and the offer was made to share the results of the evaluation with the Committee. One Member expressed the hope that intermediate beds in East Kent were also being evaluated.

(e)       The NHS explained that lessons had been learnt and the sentiment expressed that it was an appropriate time to draw a line. A Member of the Committee expressed the view that it would be useful to set up a triage system for future issues to prevent this kind of situation occurring in the future while acknowledging that the Committee could not consider every change. The Chairman explained this would be looked at.

(f)         The Chairman proposed the following recommendation:

·        This Committee acknowledges and accepts the apology offered about the lack of consultation in the past, believes the proposals put forward offer a positive way forward and looks forward to considering the findings of their evaluation in the near future.

(g)       AGREED that this Committee acknowledges and accepts the apology offered about the lack of consultation in the past, believes the proposals put forward offer a positive way forward and looks forward to considering the findings of their evaluation in the near future.