Agenda and minutes

Members of the Kent and Medway NHS Joint Overview and Scrutiny Committee are asked to note the membership listed above.

(1)       Members of the Kent & Medway NHS Joint Overview and Scrutiny Committee noted the membership listed on the Agenda.

(1)       Mrs Chandler proposed and Cllr Royle seconded that Cllr Purdy be elected as Chair of the Committee.

(2)       RESOLVED that Cllr Purdy be elected as Chair.

(1)       The Chair proposed and Mr Angell seconded that Mrs Chandler be elected Vice-Chair of the Committee.

(2)       RESOLVED that Mrs Chandler be elected as Vice-Chair.

(1)       Mr Whiting declared an interest that his wife was an employee of the Kent Community Health NHS Foundation Trust.

(1)       RESOLVED that the Minutes of the meeting held on 28 November 2016 are correctly recorded and that they be signed by the Chair.

Michael Ridgwell (Programme Director, Kent and Medway STP) and Patricia Davies (Accountable Officer, NHS Dartford, Gravesham and Swanley CCG and NHS Swale CCG and Senior Responsible Officer, Kent & Medway Stroke Review) were in attendance for this item.

(1)       The Chair welcomed the guests to the Committee. The Chair informed the Committee of a written submission received from Cllr Belsey, Chair of East Sussex County Council’s Health Overview & Scrutiny Committee, and gave Members and guests the opportunity to  read and comment on it.  The Vice-Chair requested that the guests take note of the comments in the written submission particularly those that were not raised as part of the discussion; Mr Ridgwell confirmed that he would. 

(2)       Mr Ridgwell began by acknowledging the significant time taken to reach the pre-consultation stage. He noted that the current model in Kent & Medway was not fit for purpose and required reconfiguration, which was already happening in other areas, to improve the quality of stroke service provision. He stated his intention to bring the options and consultation documents to the Committee in January, once the proposals had been presented to NHS England as part of its assurance process.  He reported that the new service model would reduce the number of sites providing stroke services from seven to three sites to enable seven day specialist consultant-led stroke services; he noted that centralisation of stroke services in other areas had led to significant improvements to workforce. He explained that a Joint CCG Committee had been formed to make decisions about stroke services. The membership of the Joint CCG Committee included the eight Kent & Medway CCGs; Bexley CCG and High Weald Lewes Havens CCG had also joined as a proportion of their population used stroke services in Kent & Medway. He stated that he had attended both Bexley Council’s People Overview & Scrutiny Committee and East Sussex County Council’s Health Overview Scrutiny Committee who had determined that the proposals were likely to be a substantial variation for their areas.

(3)       Members enquired about the creation of the new JHOSC and the Joint CCG Committee. Mr Ridgwell explained that he had written to the Chairs of Bexley Council’s People Overview & Scrutiny Committee and East Sussex County Council’s Health Overview Scrutiny Committee at the beginning of October as activity modelling had highlighted the extent of external flows of stroke patients to Kent & Medway from those areas. He was subsequently invited to present at both Committees who had determined that the proposals were likely to be a substantial variations for their areas. Ms Davies highlighted that the NHS had a statutory duty to consult with Bexley Council’s People Overview & Scrutiny Committee and East Sussex County Council’s Health Overview Scrutiny Committee.

(4)       In terms of the Joint CCG Committee, Ms Davies explained that the Joint CCG Committee had recently been constituted. The Terms of Reference had been agreed by each CCG; some CCGs were required to change their Constitution in order to delegate decision making to the Joint CCG Committee. Prior to the creation  ...  view the full minutes text for item 29.

Michael Ridgwell (Programme Director, Kent and Medway STP), Nicky Bentley (Director of Strategy and Business Development, East Kent Hospitals University NHS Foundation Trust), Simon Brooks-Sykes (Senior Strategic Development Manager and Programme Manager for the Kent and Medway Vascular Clinical Network, East Kent Hospitals University NHS Foundation Trust) and Dr Anil Madhavan (Consultant Interventional Radiologist at Medway NHS Foundation Trust and Deputy Chair for the Kent and Medway Vascular Network) were in attendance for this item.

(1)       Mr Ridgwell began by introducing the guests and outlining the current service provision in Kent & Medway. Vascular services were currently delivered at the Kent & Canterbury Hospital and Medway Maritime Hospital; both sites were non-compliant with the national specification for vascular surgery particularly in relation to the number of procedures being undertaken. As part of the review process, the Kent & Medway Vascular Network was established by the two providers, Medway NHS Foundation Trust (MFT) and East Kent Hospitals University Foundation Trust (EKHUFT), to enable the future delivery of sustainable vascular services through a single arterial centre. The Network had undertaken an options appraisal which had indicated that the arterial centre would be best placed in East Kent with an enhanced non-arterial centre in Medway.

(2)       Members commented about recruitment, local care and consultation. Dr Madhavan explained that there was a national shortage of vascular surgeons and interventional radiologists. The two centres in Kent & Medway currently had seven vascular surgeons and seven interventional radiologists; the network model would require eight vascular surgeons and eight interventional radiologists. He stated that once the centralised model, which would be compliant with the national specification and be used to deliver the service for the next 15 – 20 years, had been finalised, it would attract staff to Kent & Medway. Mr Ridgwell noted that the provision of optimally configured health services improved recruitment; he gave the example of the Estuary View Medical Centre in Whitstable. Dr Madhavan stated that only a small proportion of patients were required to travel to an acute specialist centre for treatment. He confirmed that the majority of the service would continue to be delivered locally including pre-operative and post-operative assessments. Mr Ridgwell explained that a range of engagement activities had been undertaken including a survey, targeted listening events and workshops. He reported that when the review was presented to Stage 1 of the NHS England assurance process in June 2016, the assurance team advised that the change did not require formal consultation if adequate engagement was carried out. 

(3)       Members enquired about the financial gap which had been identified in the development of the business case. Ms Bentley confirmed that the business case was near completion and that financial investment would be required to consolidate the two services. In terms of the deficit, Mr Brooks-Sykes reported that there was a combined deficit of £4 million which took into account £2.2 million deficit at MFT, £.1.1 million deficit at EKHUFT and additional investment required to house the new facilities. He stated that the network board was in  ...  view the full minutes text for item 30.