Agenda item

(1)  The Chair welcomed the CCG guests and invited them to update Members on progress made since their last attendance in January 2019.

(2)  Ms Adler explained that the CCG had been carrying out pre-consultation engagement, with over 4,000 stakeholders participating and briefings for MPs and Councillors. The pre-consultation business case had been completed and scrutinised by Healthwatch.

(3)  The Committee had been presented with the Public Consultation Communications and Engagement Plan (published with the agenda) and the next step was for a public consultation which was planned to run for 12 weeks from 29 July – 21 October 2019. The consultation would be on the two site options for the Urgent Treatment Centre.

(4)  Ms Adler articulated that the changes around Urgent Care were not proposed in isolation but were part of a wider network of developments such as improved access to primary care, extended access to GPs and the introduction of Primary Care Networks. To support local care (i.e. care received in the home or community), £4.2m was being invested over the next two years.

(5)  There were two, very different, proposed options for the location of an Urgent Treatment Centre: Gravesham Community Hospital and Darent Valley Hospital. Each would involve adjusting current services, and these were set out in the agenda paper.

(6)  It was noted that the changes proposed affected neighbouring authorities.

(7)  A Member asked which MPs had been consulted and what their views were. Ms Adler explained that three Kent MPs had been briefed: Adam Holloway, Michael Fallon and Gareth Johnson. Overall, they agreed with the proposals but did have concerns, mainly around access and parking.

(8)  Dr Lauren Sullivan, local member for Gravesham, addressed the Committee with the permission of the Chair. She spoke on behalf of residents that the Labour group had engaged, and one of their main issues was around access to GPs. Concerns raised included:

a)    The removal of local Minor Injury Clinics would eventually contribute to the closure of the Gravesham Community Hospital.

b)    The need to pay for parking at Darent Valley Hospital, considering current local provision did not charge.

c)    The ability to reach Darent Valley Hospital by public transport.

d)    The closure in 2020 of the walk-in centre at White Horse Surgery (which had merged with the Forge Surgery and was located on the Fleet Health Campus) would lead to confusion over how residents accessed local care.

(9)  With the above in mind, Dr Sullivan sought confirmation from the CCG that there would be no gap in provision of local care. She requested clearer language be used to inform residents about how they could access healthcare. She suggested the CCG consult parents at the school gates, as access to healthcare for their children was so important. She also requested the closed questions in the consultation document be amended to be more open. Ms Adler agreed to take Dr Sullivan’s points back to the CCG.

(10)               Members discussed the plans and raised a number of concerns around:

a)    The impact on transport;

b)    The price of paying for parking;

c)    The sustainability of Gravesham Community Hospital if the Minor Injuries Unit moved to Darent Valley Hospital.

d)    The population served by DGS CCG was forecast to grow and yet the proposals seemed to reduce access to local healthcare services.

e)    The shortage of GPs in the workforce.

f)     The communication around different categories of healthcare should be reviewed.

(11)               In response, the CCG highlighted these points:

a)    NHS England supported the development of Urgent Care Centres and the model was already in place in other locations, such as Medway.

b)    Transport always presented a challenge but the CCG was undertaking traffic modelling to better understand and mitigate the risks. They were engaging bus operators.

c)    Urgent care services treated illnesses and injuries that were not life-threatening but that needed urgent assessment. Residents would still have access to local GPs as well as urgent-care centres.

d)    Evidence showed that urgent care centres were being used for primary care needs and this was not sustainable.

e)    Gravesham residents currently accessed Darent Valley Hospital for out-of-hours urgent care.

f)     There were no plans to reduce further services at Gravesham Community Hospital.

g)    An Urgent Treatment Centre may attract those staff wishing to straddle primary and secondary care, and therefore boost the workforce.

(12)               Mr Inett explained Healthwatch Kent’s role in the process so far. They had scrutinised the Outline Business Case and paid specific attention to the level of engagement and its reach. They were content with the process so far. He recognised the limited role of Healthwatch in the area of transport, and suggested a strategic view was needed, which perhaps may be led by HOSC. The Chair noted his comments.

(13)               Summarising the next steps, Ms Adler explained that after the consultation and associated review, a final decision would be presented to the CCG Governing Body in early 2020 with implementation in July 2020.

(14)               The Chair noted that Bexley residents could also be impacted by the proposed changes. If the London Borough of Bexley’s Overview and Scrutiny Committee deemed the change a substantial variation, there would be a need to form a Joint Health Overview and Scrutiny Committee (JHOSC).

(15)               RESOLVED that:

a)    The report be noted;

b)    The CCG be invited back to HOSC after the consultation had finished but before the final recommendation was taken to the CCG Governing Body;

c)    The CCG provide a full transport plan around the site options when they return to the Committee.