Agenda item

Jim Loftus (Commissioning Programme Manager, NHS Swale CCG), Patricia Davies (Chief Accountable Officer, NHS Swale CCG and NHS Dartford Gravesham and Swanley CCG), Dr Christopher Markwick (GP Lead, NHS Medway CCG), Zoe McMahon (Commissioning Programme Manager, NHS Dartford Gravesham and Swanley CCG), Ian Ayers (Accountable Officer, NHS West Kent CCG) and Caroline Friday (Commissioning Manager, NHS West Kent CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Mr Loftus began by giving an overview of the proposals to redesign and re-commission an integrated Dermatology service for children and adults in North and West Kent.

(2)       Mr Loftus explained that a significant proportion of patients requiring dermatology services could be treated by a skilled workforce within a community setting. At present 85% of new patients were referred to an acute hospital for their first outpatient appointment; the majority of these appointments took place at Medway NHS Foundation Trust. It was anticipated that 60 – 70% of patients could receive future services within a community setting by a multi-disciplinary team, releasing capacity within the acute trust to treat patients with more complex conditions. He noted that there was rising demand for dermatology services and a need for activity to take place in the community to release acute capacity. Following public engagement, the proposed service specification included the provision of services in a local community setting, with good access in terms of clinic location and clinic times. He reported that there were a number of providers interested in delivering the service.

(3)       The Chairman invited Mr Bowles, local Member for Swale East, to speak. Mr Bowles noted respondents’ preference to be treated locally, in a GP practice or community clinic, in the patient questionnaire. He stated that community based services could lead to a carbon reduction as patients would travel shorter distances.

 (4)      Members of the Committee then proceeded to ask a series of questions and make a number of comments. A question was asked about caseload. Dr Markwick explained that a third of dermatology patients were managed by their GP (Level 1 & 2), a third were seen by acute specialists  (Level 3 & 4); and a third required high level acute specialist services for life threatening conditions (Level 5 & 6). He stated a significant proportion of Level 3 patients could be treated by a skilled workforce within a community setting which would release specialist appointment capacity within the acute service.

(5)       A Member enquired about the shortage of dermatologists. Dr Markwick explained that there was a shortage of dermatology specialists, locally and nationally. The new model was designed to build the capacity of the workforce and deliver the service through a multi-disciplinary team with a range of skill sets. In response to a specific question about a resident dermatologist at Maidstone Hospital, Dr Marwick noted that there was a team of consultant dermatologists who rotated between Medway Maritime Hospital, Maidstone Hospital and Darent Valley Hospital.

(6)       RESOLVED that:

(a)       The Committee do not deem this change to be substantial.

(b)       The guests be thanked for their attendance at the meeting, that they be requested to take note of the comments made by Members during the meeting and that they be invited to submit a report to the Committee in six months.