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  • Agenda item
  • Agenda item

    Transforming Health and Care in East Kent

    Minutes:

    Louise Dineley (East Kent Programme Director, Kent & Medway STP), Liz Shutler (Deputy Chief Executive & Director of Strategic Development and Capital Planning, East Kent Hospitals University NHS Foundation Trust), Michael Ridgwell (Programme Director, Kent and Medway STP), Matt Jones (Consultant Anaesthetist, East Kent Hospitals), Upaasna Garharran (Consultant Geriatrician and Acting Medical Director for Urgent Care, East Kent Hospitals) were in attendance for this item.

     

    (1)   The Chair welcomed the guests to the Committee.  Mr Ridgwell briefly introduced the paper and summarised progress to date. He reported that  NHS England had updated the assurance process that applied to reconfiguration programmes involving changes to bed numbers and schemes requiring capital investment; capital sources needed to be identified before public consultation to ensure that they were implementable.

     

    (2)   He stated that the first draft of the pre-consultation business case is due to be presented to NHS England in October and November which will, once signed off, proceed to consultation.  Senior colleagues from NHS England have visited to see the challenges being faced in East Kent. 

     

    (3)   Mr Ridgwell informed the Committee, that a further report will be presented on patient in-flows to East Kent.  He noted that whilst services in East Kent largely supported the East Kent population; for some residents in  East Sussex, their main hospital services were provided in East Kent  in addition to  more specialist services, such as coronary care, which were provided to the wider population. He noted that a Joint HOSC with neighbouring authorities may be required.  The Chair welcomed a discussion on this as soon as possible.

     

    (4)   A Member enquired about the establishment and membership of a Joint HOSC, engagement with community and voluntary groups and a major trauma centre. The Chair confirmed that the creation of a new committee was a decision for the local authorities involved and the power to make a referral to the Secretary of State would remain with the Kent HOSC.

     

    (5)   Mr Ridgwell welcomed the opportunity to discuss engagement with community and voluntary sectors outside of the meeting. He noted the importance of the sector particularly in supporting local care. Dr Jones explained that the major Trauma Centre for Kent was King’s College Hospital and there were no plans for a Major Trauma Centre in East Kent as  it would not meet the national designation criteria set by NHS England. 

     

    (6)   A Member asked about the financial position, public consultation and implication on KCC’s budget.   Mr Ridgwell noted that a  planning submission has been made to NHS England which  outlined the costs of the East Kent reconfiguration; all forms of capital opportunities were being explored. He stated that the NHS England assurance process would determine the start of public consultation.  He anticipated that the delivery of local care, through the integration of and investment in health and social care, would have a cost implication to KCC.

     

    (7)   In response to specific question about PFI, Mr Ridgwell stated that whilst there was preference for public capital, main objective was for better care which required better estate.

     

    (8)    A Member expressed concerns about the length of the process and local care.  Mr Ridgwell noted the importance of the process reaching of a conclusion and the delivery of local care as close to where patients live.  He highlighted the ability of Encompass Vanguard in Whitstable to attract workforce; staff were attracted to the provision of modern services in modern facilities.

     

    (9)   Dr Garharran concurred stating that she has been a Geriatrician for 6 years and had seen a lot of progress in that time with access now being available in the community with functioning care pathways.  She added that there was enthusiasm to deliver service models akin to those at Encompass more widely.

     

    (10)       In relation to questions on the scale of GP federations and accessibility, Ms Shutler informed the committee that it was inaccurate to assume that GPs would be in a single building, but rather that practices would be placed for easy accessibility, making sure that practices were fit for purpose, giving Whitstable as an example.  Dr Garharran said that she has been talking to GPs and providers whilst looking at social mobility, identifying patients that need to access services in a different way through risk stratification.  To reassure the committee Ms Garharran confirmed that this was high on everyone’s agenda.

     

    (11)       There was a discussion around ensuring that the final options that went to public consultation would be deliverable and NHS representatives explained that there were a series of assurance processes to look at this, particularly more complex options such as Option 2 which has more elements to it. This was underpinned by the new NHS England assurance process outlined earlier in the meeting.

     

    (12)       A Member asked that reassurance was given to the public on the continuation of the GP-patient relationship as primary care hubs develop. NHS representatives explained that, depending on patients conditions, the planned developments would enable GPs and senior clinicians to have the named relationship that complex condition patients require and deliver a more appropriate service.

     

    (13)       The Chair welcomed the engagement of primary care in the services as described in the paper and noted  GPs appeared to be positive about the changes that are going to be made.  She welcomed the clinicians presenting to the committee as they had made a difference to the discussions.

     

    (14)       RESOLVED that:

    (a)   the report on Transforming Health and Care in East Kent be noted;

     

    (b)   East Kent CCGs be requested to provide an update in September, with the risks articulated on finance and timetables specifically addressed in the update;

     

    (c)    A report detailing the patient inflow to East Kent to be presented to the Committee in September.

     

    Supporting documents: