Agenda item

Simon Perks (Accountable Officer, NHS Canterbury and Coastal CCG), Andrew Bowles (Leader of Swale Borough Council and KCC Member for Swale East) and Tom Gates (KCC Member for Faversham) were in attendance for this item.

(1)       The Chairman welcomed Mr Perks and asked him to introduce the item. Mr Perks began by updating the Committee on progress. At the November meeting, the Committee raised a number of serious and legitimate concerns about the procurement and lack of engagement with stakeholders. The Committee asked the CCG to set aside the decision to close the Minor Injuries Unit (MIU) and rethink the proposals. Mr Perks reported that the governing body had actioned the Committee’s recommendation and secured an extension of the contract until September 2014.

(2)      Fresh engagement work began in December with a number of public meetings; in January a steering group chaired by the Mayor of Faversham was established with local stakeholders. Stakeholders included a retired PCT Finance Director and three Faversham GPs. Through the steering group, the CCG had been able to share information regarding finance and activity forecast with a much wider stakeholder group. At the last steering group meeting, it was acknowledged that putting together a specification which was accessible and to the required standard with the money available would be incredibly challenging. Further, if the specification was not right, it would not be viable to put out to tender. The CCG and steering group were looking at other service elements which would make it affordable and viable to the provider. The original specification with the x-ray facility had made the previous tender unviable. The eight options for the Faversham MIU would be discussed at the next meeting of the steering group on 15 April; the most likely model for the unit is access Monday to Friday between 08.00 – 18.00 with an x-ray facility. It was also proposed that there would be direct access for GPs to make a referral for an x-ray.

(3)      The Chairman invited Mr Gates and Mr Bowles to speak. Mr Gates thanked the Committee for their recommendation; full consultation with the people of Faversham had now been carried out as a result. Mr Gates highlighted that the MIU covered a larger area than just Faversham; it included 17 parishes and a large number of tourists in the high season. Mr Gates enquired about the proposed models for the service.

(4)      Mr Perks explained that proposed models included options for different opening hours and running with and without an x-ray service. Through engagement activities, it was found that most people currently use the service Monday to Friday between 08.00 – 18.00; rather than the weekends and evenings which had been anticipated by the CCG. It was important that the unit met the needs of the community to be viable as the smallest MIU in Kent. The CCG were hoping to attract users who had previously attended the Estuary View Medical Centre and the Kent and Canterbury Hospital. The CCG had also examined the Edenbridge model as part of the option development.

(5)       Mr Bowles also expressed his gratitude to the Committee, in particular to Mr Chard and Miss Harrison, for championing this issue on behalf of the people of Faversham and Swale East. He believed that Mr Perks had learnt a lot from this experience and that the CCG were moving in the right direction; the original process would have been successful if the CCG had been more inclusive. Mr Bowles enquired if the steering group’s recommendations would be reported back to the CCG governing board and asked for an assurance that if the service was continued it would be fully advertised.

(6)      Mr Perks explained that in the old and new specification, the CCG required the provider to appropriately signpost people to the unit. The profile of the unit had been raised following the closure announcement in November. Mr Perks stated that he and his staff had learnt a lot from this process especially in making use of local knowledge and skills. This knowledge had been used in the review of community services which would be discussed at the Committee’s June meeting; the CCG had been actively engaging with the local community about the future development of community hubs. Mr Perks gave assurance that the recommendations from the steering group would be taken to the CCG governing body and to the Canterbury Health and Wellbeing Board.

(7)      Members of the Committee then proceeded to ask a series of questions and make a number of comments. Several Members commended the CCG for their honesty about the learning which had taken place since November.

(8)      A question was asked about the approximate population of Faversham and number of MIU users per month in comparison to Edenbridge. It was explained that Faversham had a population of 25,000; in comparison to Edenbridge which had 8,000 residents. On average, there were 550 visits to Edenbridge MIU and 450 visits to Faversham MIU per month despite the larger population in Faversham. Mr Perks explained that the steering group had been cautious with the numbers; if patients were not well signposted to the service or had heard about the threat of closure they were unlikely to use the service.

(9)      A number of comments were made about the importance of moving services out of hospitals into the community and the value of these services to local communities. 

(10)    Mr Inett noted that he had attended the steering group meeting and it had been positive. Healthwatch Kent would be visiting Faversham MIU the following day to further gather patients’ views. Healthwatch Kent was keen to facilitate an event with commissioners to develop best practice public engagement; they would like to use Faversham MIU as a positive example of community engagement. Mr Inett observed that people often stepped forward when there was the threat of closure, especially hospitals, but it was much harder to engage with hard-to-reach groups or motivate the community when services were not easily defined.

(11)    A Member suggested, following a number of agenda items at the meeting which had highlighted weaknesses with procurement and commissioning, that an invitation to Member training on commissioning should be extended to CCGs.

(12)     RESOLVED that it’s guests be thanked for  their attendance and contributions to the meeting  along with their answers to the Committee’s questions, and that they return to the Committee  within three months to give an update on the consultation and final outcome of the steering group review before a final decision is made by the CCG governing body.