Agenda item

Specialist Vascular Services Review


In attendance for this item: Rachel Jones, Executive Director of Strategy and Population Health, K&M CCG, Su Woollard, Transformation Delivery Manager (Kent & Medway), NHS England, and Nicky Bentley, Director of Strategy and Business Development, EKHUFT.


In virtual attendance for this item: Janette Harper, Deputy Director of Transformation and Recovery, NHS England, Kierstan Lowe, Senior Communications and Engagement Manager, NHS England South, Central and West and Carol Wood, Head of Communications and Engagement, NHS England


1.    Rachel Jones (Kent & Medway CCG lead on vascular reconfiguration) introduced the item and provided a brief overview of the agenda report. A virtual public consultation had run between 1 February and 15 March, which included 4 online events, additional events for staff, presentations to community groups, surveys and direct patient contact. They had also spoken on BBC South East and outreached to seldom heard group (including the gypsy, roma and traveller community who are known to suffer from vascular disease).


2.    Responses were broadly in favour of the proposal, but key areas of concern were around travel and transport to the Kent & Canterbury Hospital, particularly for visitors of patients. The only treatments affected by this change were urgent treatment and planned overnight surgery. Day surgery would continue to be delivered in the same way.


3.    Ms Jones recognised the importance of visits from family and friends and described some of the mitigations being put in place to make access easier.


a.    There would be an initial clinical consultation over the phone to assess need. Vascular opinions would be possible at the patient’s incumbent hospital.

b.    The team were mapping what transport links were currently in existence and how long those journeys were. Once complete, a further piece of work would be undertaken to see how these journeys could be improved.

c.    Journey routes and times would be available on the CCG’s website to assist patients and visitors.

d.    Patients would be offered treatment times that took into account their journey time.

e.    An implementation group would be established – this had been well received during the consultation and a number of people had already shown interest.


4.    A Decision Making Business Case (DMBC) was being written for submission to the Integrated Care Board (ICB) and Specialist Commissioning at NHS England, hopefully in June 2022.


5.    The changing landscape of public transport was discussed, with one Member voicing concern at the deteriorating quality. Local changes included the introduction of on-demand buses and a KCC consultation on reducing certain public transport routes. Ms Jones confirmed these changes were being considered.


6.    Ms Jones recognised the pressure the ambulance service was under and conceded there may be a need for additional private transport. She accepted a different approach may be required, to ensure visitors can access the site. If the pressure on ambulance services continued, the CCG would need to consider increased investment (though an investment in one area would likely require a dis-investment in another). A KCC Member was keen for the ambulance service to receive thorough scrutiny soon (it was a regular attendee to Medway’s HASC) and the Chair offered to look into the best way of achieving this outside of the meeting (recognising that SECAmb covered a number of regions).


7.    Speaking about fuel poverty, Ms Jones recognised the rising cost of fuel and the impact additional travel may have on lower income families. This would be a matter for discussion within the implementation group.


8.    A Member asked whether there was digital infrastructure in place to enable joint working. Ms Jones offered to look into this outside of the meeting.


9.    Asked about the impact of the changes on staff, Ms Jones explained that the surgical teams had rotated for surgery only in the past year but that had worked well. Further radiologists had been recruited. In terms of additional travel, staff were entitled to claim expenses for travel beyond their designated base.


10.Members asked what lessons could be learnt from the virtual public consultation. Ms Jones said the virtual aspect and been well-received and recognised that some people were more comfortable in a digital setting. However, that wasn’t right for everyone and in future she envisaged using a hybrid model for consultations, utilising both physical and virtual events. Ms Lowe agreed, and explained the pandemic had changed views on the use of digital methods to reach people.


11.In response to a question, Ms Jones acknowledged there was a backlog for vascular treatment, as there were for many specialties. The aim was to clear the vascular waiting list backlog within six months.


12.Asked about the extent of integrated working across health and social care, Ms Jones reflected that the pandemic had necessitated improvements in this area, and all involved were intent not to lose the benefits as business returned to normal. Both sectors were represented on the Integrated Care Board, and more joint sector roles were on offer. There was also increased input from research, academia, and the voluntary sector. All were driven to write an Integrated Care Strategy by December 2022.


13.Looking to page 13 of the agenda pack, a Member asked about the new Interventional Radiology (IR) suite that was to be completed in June 2022 at the Kent and Canterbury Hospital. Ms Jones explained that an upgrade to the IR suites was required regardless of the Vascular Services reconfiguration as it was used for a number of treatments. Ms Bentley explained there were three elements to the IR theatre work, representing an investment of £5m: a new IR suite, replaced and additional IR equipment, and refurbishing the existing theatre.


14.RESOLVED that the report be noted.


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