Agenda item

In attendance for this item: Dr Andrew Taylor (Consultant Anaesthetist, Maidstone & Tunbridge Wells Trust), Mr James Nicholl (Clinical Director for Trauma and Orthopaedics and Orthopaedic Surgeon), Sarah Davis (Deputy Chief Operating Officer, MTW Trust), Mark Atkinson (Director of Integrated Care Commissioning, Kent & Medway CCG), and Rachel Jones (Director of Strategy, Planning & Partnerships, Kent & Medway CCG)

1.  Dr Taylor introduced the report and spoke to the slide deck (included in the agenda pack). The presenters spoke about the operational and procedural benefits of the proposed changes, as well as the communications and engagement strategy in place. The changes were necessary under Get It Right First Time (GIRFT) requirements.

2.  A Member asked if letters had been sent as part of the engagement process, as opposed to just digital information, to which Ms Davis confirmed it had.

3.  Asked about patient transport, Ms Davis confirmed that was an area under investigation, including the use of public transport. She also confirmed that patients would have the choice to stay with their current surgeon, if that is what they wanted. The barn theatre was providing an additional option. In Mr Nicholl’s experience, patients did not mind travelling to a different site if it was in their best interests. The Trust were aware that certain bus contracts in Kent were currently under review.

4.  The Trust had been in communication with Healthwatch Kent. Mr Goatham spoke about that engagement and asked whether the Trust would look to the Cardiology review for lessons learnt on what worked well. Ms Davis confirmed the Trust would continue to engage with Healthwatch regarding the changes.

5.  A Member asked if the private sector was being utilised to meet demand. Ms Davis confirmed all four acute trusts were using independent providers. The new theatre would provide additional capacity. Dr Taylor spoke of the benefits to junior doctors of more work being carried out in house, in particular they were able to carry out more operations and therefore improve their skills and confidence.

6.  Ms Davis confirmed that the new theatre would only be used for elective surgery, not emergency care. Since the pandemic, patient pathways had been streamlined and this meant elective and emergency care would not be mixed.

7.  A Member asked what the pathway was for reducing the waiting list. Ms Jones explained that the demand for the new theatre was dependant on the quantity of patients within Kent and Medway making a choice to use the new provision. Part of the engagement work would consider that, along with data collected once the theatre went live. An additional centre in East Kent was also under consideration and that would also impact projections. She offered to return to the Committee after six months with a firmer projection.

8.  Responding to a question about staff retention, Mr Nicholl’s felt staff would be happier in the new setting, due to the improved environment and the ability to concentrate on the work they enjoyed (orthopaedics) without getting pulled into other areas of work. From experience, Dr Taylor said there was a feeling of safety, knowing there were colleagues nearby should there be a medical emergency. 

9.  The Chair thanked the guests for attending and all the hard work that had gone into the project. He did not believe the proposals constituted a substantial variation of service.

10. RESOLVED that:

(a) the Committee does not deem the proposed reconfiguration of elective orthopaedic services across Maidstone and Tunbridge Wells NHS Trust to be a substantial variation of service.

(b) the report be noted.