Agenda item

In attendance for this item: Gerrie Adler (Director of Strategic Transformation), Dr Sarah MacDermott (Clinical Chair), Gail Arnold (Deputy Managing Director), Angela Basoah (Head of Communications and Engagement), Dr Nigel Sewell (Clinical Lead for Urgent Care) from NHS Dartford, Gravesham and Swanley CCG

1)    Dr MacDermott and Ms Adler introduced the item, highlighting the positive response to the 12-week consultation period held in 2019.

2)    The consultation demonstrated overwhelming support for Option 1 – an Urgent Treatment Centre (UTC) at Gravesham Community Hospital.

3)    Four key themes emerged from the consultation:

a.    Proximity to the service

b.    Traffic

c.    Public Transport

d.    Parking

4)    Following in-depth analysis, the CCG determined that a single site solution was unlikely to address public concern and meet the needs of residents. The CCG’s Decision Making Business Case (DMBC) therefore recommended a networked urgent care services model with two linked Urgent Treatment Centres, one at Gravesham Community Hospital and one co-located at Darent Valley Hospital. 

5)    The benefits of the recommended model included:

a.    Delivery of urgent care services in a town centre location with good transport links;

b.    A UTC co-located with an A&E Department would offer local residents benefit and avoid additional footfall.

6)    Both UTCs would be closely integrated with the GP Out of Hours Service and accompanied by a robust communication plan to ensure residents understood how best to access services. There would be a phased approach to implementation.

7)    The CCG Governing Body meeting was held on 16 January 2020 and they agreed the mitigated model of care.

8)    Members supported the development of a communication plan, which would clearly set out how to navigate the various NHS services. Particular attention would first be paid to those accessing the soon to close White Horse walk-in centre, so they understood where they needed to go.

9)    The importance of primary care and GP surgeries was discussed. Ms Arnold spoke of the importance of all residents registering with a GP, and not relying on secondary care services for illnesses which should be addressed by their primary care provider. The CCG were looking into options for enhancing access to primary care services, such as extending hours, to match the accessibility of the walk-in centre.

10)The proposed mitigation model was estimated to cost £85m compared to the projected cost of the current urgent care service provision of £84m. This excluded the potential impact of void estate charges at Fleet Health Campus.

11)Members questioned the potential gap in provision whilst providers and contracts were arranged. Ms Arnold explained that nothing had been agreed at that time, because the Governing Body decision had only recently been made. The CCG would commence discussions with current providers imminently, looking into options for extending contracts or going out to tender.

12)A Bexley councillor described how Darent Valley Hospital was the local hospital for many Bexley residents, and whilst they may reside in Bexley, there was no physical border to separate them.

13)Steve Inett from Healthwatch Kent spoke of a perceived challenge around the public having confidence in public consultations. He acknowledged that this was an example of people being listened to and decisions being changed accordingly.

14)The Chair supported Mr Inett’s statement and thanked for the CCG for running such a successful consultation and then designing a solution that was favourable to everybody.

15)Dr MacDermott explained that a key finding of the public consultation was the difficulty for Dartford, Gravesham and Swanley residents to access public transport. She spoke of her desire for the relevant organisations involved in providing and commissioning public transport to work together to improve this for local residents.

16)Members acknowledged and supported Dr MacDermott’s statement and requested that the relevant data the CCG had gathered be shared with them in order to support discussions with transport providers. Suitable meetings to raise this issue included the Borough Council’s Joint Transportation Board and KCC’s Environment and Transport Cabinet Committee.

17)The Chair thanked the CCG for their hard work and continuous engagement with the relevant scrutiny committees.

18) RESOLVED that the Bexley and Kent Urgent Care Review Joint Health Overview and Scrutiny Committee support the decision of the Dartford, Gravesham and Swanley CCG Governing Body.