Agenda item

Julia Ross, Director of Civic Engagement, Barrie Collins, Director of Nursing & Professional Development, Sharon Jones, Director of Community Services and Debbie Lyndon-Taylor, Assistant Director Adult Services, West Kent PCT will be in attendance for this item.

(Julia Ross, Director of Civic Engagement, Barrie Collins, Director of Nursing & Professional Development, Sharon Jones, Director of Community Services and Debbie Lyndon-Taylor, Assistant Director Adult Services, West Kent PCT were in attendance for this item)

(1)       The following Members made declaration of interest:-

·        Mr Fittock - Member of Benenden Hospital

·        Mr Horne – Member of the League of Friends, Tonbridge Cottage Hospital

·        Mr London – Member of the League of Friends, Sevenoaks Hospital

(2)       A copy of the presentation given on the West Kent Community Hospitals Review is set out as Appendix 2 to these Minutes.  The Committee was informed that the recommendations in the West Kent Primary Care Trust Board report for July 2007 had been approved.  Mrs Ross spoke about the further work that needed to be done relating to the Minor Injuries Unit (MIU) at Edenbridge, the Tonbridge Cottage Hospital and the Livingstone Hospital in Dartford.  Ms Harrison said she felt that, where beds were being done away with, it was important that the Primary Care Trust explain what they were replacing these beds with; communication with the public was key to service-change.  This was acknowledged by Mrs Ross who very much hoped that local authorities would act as community leaders in concert with health colleagues.

(3)       Health colleagues said they aimed to reduce the number of unnecessary journeys and provide more services in community hospitals, including bed-based “step up” and “step down” services, end-of-life care and neuro-rehabilitation.  Mrs Ross informed the Committee that the Pembury Private Finance Initiative (PFI) hospital plans were predicated on the idea of a whole lot of services being provided in the community.  Turning to specific local issues, Mr Horne said that the original review of community hospitals undertaken by the consultancy firm Tribal had not been favourably perceived in the community.  The failure to come up with split tariff arrangements with local acute-service providers was detrimental to service-provision in the community hospitals.  The need for 24-hour and seven-days-a-week care in some cases had not been properly acknowledged.  Local GPs in the Tonbridge area had not been consulted, which ran counter to the idea of Practice-based Commissioning.  Mrs Ross said in response that the plans for Tonbridge Cottage Hospital still had not been finalised, that consultation would take place and that Mr Horne would be fully involved in this process.

(4)       Mrs Ross also confirmed that consultation would take place on the proposals for the Livingstone Hospital at Dartford when these had been finalised.  With regard to the split tariff Mrs Ross said that this was still being discussed and that there were no outcomes to report yet.  Ms Jones added that she had met with GPs on at least two occasions to discuss issues that had been raised in a letter to the Primary Care Trust.  She argued that achieving an optimal length of stay in community hospitals would allow more people to be treated using fewer beds.  She said that it would not be possible to keep surplus beds open in case they might be required.  She acknowledged that there was always the need for some 24-hour seven-days-a-week care; and this would be provided in other parts of the system.  She added that some care could take place at home, in a hospice or in a residential care home.  She said that there would never be a situation where no beds at all would be required in community hospitals.  Mrs Ross said that one option for the currently unused space at Tonbridge Cottage Hospital would be for some form of bed-based care.  Mr Horne noted that Maidstone and Tunbridge Wells NHS Trust had been buying beds in the private nursing home sector, when there were perfectly good beds going unused at Tonbridge Cottage Hospital.  He noted that the Hospice in the Weald was experiencing bed-blocking problems while beds remained closed at the Cottage Hospital and were under threat of being permanently closed.  Dr Thallon said that the Primary Care Trust was desperate to get agreement on tariff splitting, as achieving this would be essential for the success of the new PFI hospital. The issue would have to be resolved, either locally or nationally.  Mr Lake spoke as the local Member for Edenbridge and Sevenoaks.  He said that the community he represented had no GP care at weekends and, as such, needed the MIU at the Edenbridge War Memorial Hospital.  He referred to a letter from Julian Webb, Emergency Care Consultant with Maidstone & Tunbridge Wells NHS Trust, about the quality of the service being provided at Edenbridge.  Mr Lake said that the Edenbridge Hospital was being closed by the back door and local people did not understand what this was all about, they believed that it was effectively becoming a residential care home.

(5)       Dr Andrew Russell, Chairman of the League of Friends of Edenbridge War Memorial Hospital, then addressed the Committee.  He said that he was a retired GP. He did not share Mr Lake’s perception that the hospital was becoming a rest home for the elderly.  He said that it was a very vibrant hospital and he explained to the Committee the various consultant clinics that were available.  What the League of Friends was petitioning against was the decision to change the name of the Minor Injuries Unit at Edenbridge before any consultation had taken place.  He said that the Unit saw 4,000 patients per annum, with 28% of these receiving follow-up care. This was comparable to the services provided at Crowborough and Uckfield.  Dr Russell said it was disingenuous of the Primary Care Trust to argue that the Edenbridge MIU was in reality just a “treatment clinic” because it was dealing with so many follow-up cases.  There was only one nurse at Edenbridge Hospital who was kept very busy, often working beyond the hours for which she was paid.  He said that changing the name now, in advance of the formal consultation on the future of the MIU, undermined the service.  Dr Thallon made it clear to the Committee that he did not agree with the contents of Julian Webb’s letter.  Turning to the Livingstone Hospital, Mrs Angell said that the service provided by the Hospital was an exemplar of good practice.  If the service was to be relocated to another site in Dartford she very much hoped that it would continue to be provided by the Primary Care Trust. 

(6)       Mrs Hall of the Tonbridge Cottage Hospital League of Friends expressed concern about Maidstone and Tunbridge Wells NHS Trust buying services from residential care homes in the independent sector, rather than using Tonbridge Cottage Hospital. Unlike care homes, the hospital provided rehabilitation and had a resident doctor.  In some cases elderly patients from Tonbridge who had never left the town before were being sent to Rochester when they could be cared for in their local cottage hospital.

(7)       She said that it was important that the closed beds at Tonbridge Cottage Hospital were reopened immediately.  Finally, in response to a question as to whether or not there was provision for a community hospital in the Maidstone area, to provide “step up” and “step down” care, Dr Thallon answered that there were no such plans.

(8)       RESOLVED that the report be noted.