Agenda item

Glenn Douglas (Chief Executive, Maidstone and Tunbridge Wells NHS Trust), Dr Chris Thom (Urgent Medical and Ambulatory Unit Clinical Lead / Lead Physician, Maidstone and Tunbridge Wells NHS Trust), Mr Akbar Soorma (A&E Consultant / Clinical Director for Acute & Emergency Medicine, Maidstone and Tunbridge Wells NHS Trust),Felicity Cox (Chief Executive, NHS Kent and Medway), and Ian Ayres (Accountable Officer, NHS West Kent CCG) were in attendance for this item.

(a)       The Chief Executive of Maidstone and Tunbridge Wells NHS Trust (MTW) introduced the item by explaining that he was present to explain changes to Maidstone Hospital which were underway and so concrete, not just aspiration. It was an opportunity to close the loop on the Trust’s reconfiguration when a lot of focus in recent years had been on the new Tunbridge Wells Hospital at Pembury. Several Members commented how please they were to see Maidstone Hospital had such a vibrant future.

(b)       One negative aspect was raised by Members regarding the appointment system, with the specific example given of being unable to change an appointment due to the absence that day of a particular member of staff. The Chief Executive of MTW responded to the specific example by saying it was clearly unacceptable but acknowledged that the appointments formed a high proportion of the complaints received by the Trust. Improvements had been made and would continue to be so.

(c)        One recent change was the opening of the new Urgent Medical and Ambulatory Unit (UMAU). This replaced the previous Medical Assessment Unit (MAU) and worked differently. The UMAU was designed to deal with patients for 24 hours only. After this time they would be discharged or admitted to the ward for the appropriate clinical specialty. The intention was to get as much of the necessary assessment and diagnostics done in the first 6-8 hours. There were two routes to the UMAU. Firstly, GPs could refer patients to it directly; patients passed through accident and emergency (A&E) where a nurse would be able to assess whether any treatment needed to be given immediately as the patient transited. Secondly, patients would arrive in A&E as usual and would be moved to the UMAU where appropriate after triage. Previously, all patients went through A&E.

(d)       There was also a new cardiac service. Cardiac services were a long established part of what Maidstone Hospital offered, but what was new was a very specific treatment for the most common form of the heart short-circuiting, ablation. This was currently only available in London and Maidstone was the only place in Kent which offered the service. This was a technology which did not exist 15 years ago and the service was likely to grow.

(e)       The new community ward, Romney Ward, was also discussed. It was explained that this was not the same as the old Boxley Ward. In part the new community ward was an ad hoc response to winter pressures and was more like a community hospital. Maidstone does not have a separate community hospital. The length of stay of patients on this ward was 7-8 days when the ward was initially operational, but these patients had been transferred from other wards in the hospital. The average length of stay was around 2-3 weeks now, although the service had not been operating long enough to make definitive statements.

(f)         It was explained that the trend was to reduce admission to hospital where possible. There was a growing demand for medical care, and an ageing population. It was often better for patients if admission could be avoided and the trend was towards more ambulatory care where patients were admitted or discharged with a treatment plan, sometimes returning for tests at a later date. The changes were not unique to Maidstone, but the specific configuration was.

(g)       The renovation and redesign of the hospital was welcomed, and the role wider spaces between beds played in reducing infections was commented on. It was explained that the Trust had the lowest backlog maintenance bill in Kent but was not complacent. The building was in a series of cruciform sections and it was possible to work through the hospital systematically, stripping each section down to the bare frame.  Some maintenance work, like boiler replacement, would need to be done separately.

(h)        The Trust also explained that it was seeking 120 additional parking spaces. In response to a comment from a Member, the Chief Executive undertook to look at the size of the spaces used in the standard template. The majority of people arrived at hospital by car and Maidstone Hospital was fortunate in being positioned in a comparatively flat area. The question was asked about building a multi-storey car park. There was nothing forbidding a multi-storey car park, although it might not be able to be higher than the hospital. One Member suggested this may be to ensure helicopter clearance. The barrier was cost. Each level of a multi-storey car park cost around ten times more than having a simple car park on one level, although the design used at Medway Hospital was slightly cheaper.

(i)         The Chairman proposed the following recommendation:

·        That the Committee thanks its guests for their explanations, notes the report and looks forward to updates in the future.

(j)         AGREED that the Committee thanks its guest for their explanations, notes the report and looks forward to updates in the future.