Agenda and minutes

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

Members of the Kent & Medway Joint Health Overview and Scrutiny noted the membership listed on the Agenda.

(1)       Cllr Wildey proposed and Mr Bartlett seconded that Mrs Chandler be elected as Chair of the Committee.

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

(1)       The Chair proposed and Cllr Purdy seconded that Cllr Wildey be elected as Vice-Chair of the Committee.

(2)       RESOLVED that Cllr Wildey be elected as Vice-Chair.

Apologies were received from Cllr Royle and Mr Pugh who was substituted by Mrs Hamilton

(1)       There were no declarations of interest.

(1)       RESOVLED that the Minutes of the meeting held on 22 January 2018 are correctly recorded and that they be signed by the Chair.

(2)       In relation to Item 4, paragraph 16, Cllr Wildey expressed a view that the feedback from the public consultation relating to the Kent & Medway Stroke Review had not been taken into account by the NHS at the Evaluation Workshop.

Dr James Thallon (Medical Director NHS England South East), Oena Windibank (Programme Director, Kent & Medway Vascular Review), Michael Ridgwell (Programme Director, Kent & Medway STP), Liz Shutler (Deputy Chief Executive and Director of Strategic Development and Capital Planning, 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) , Dr David Sulch (Interim Medical Director, Medway 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.

(1)       The Chair welcomed the guests to the Committee. Dr Thallon began by giving a summary of the review and providing an update. He explained that the review commenced in December 2014 in response to a commissioner led derogation for both East Kent Hospitals University NHS Foundation Trust (EKHUFT) and Medway NHS Foundation Trust (MFT) which identified the inability for both Trusts to deliver against either the national specification for specialist vascular services or the guidelines from the Vascular Society which included the delivery of services in a network model.

(2)       Dr Thallon noted that patients from North and West Kent travelled to Guys and St Thomas Hospital Trusts for vascular surgery. It was not proposed that those patients would be directed however, it was acknowledged that this may change in the future if a centre of excellence was established in Kent & Medway. The catchment area for the review was therefore East Kent & Medway which had a population of approximately 800,000.

(3)       Dr Thallon stated that the case for change was agreed in 2016 by the Programme Advisory Board (PAB) and the review process had identified a clinical model of a single inpatient centre in Kent & Medway supported by a number of spokes including an enhanced spoke unit. A Get It Right First Time (GIRFT) review in 2018, supported the case for change, and highlighted a number of key issues to be addressed including the introduction of a hub and spoke model, increased patient volumes and better outcomes.

(4)       Dr Thallon explained that a clinical network had been established between EKHUFT and MFT and there was broad clinical agreement for the long-term arterial centre to located be in East Kent subject to public consultation. However, the site of the arterial centre in East Kent would be determined by the outcome of the East Kent Transformation Programme, as it was recommended that vascular services should be co-located on the site of a major emergency centre, which was being modelled on a seven year plus timetable.  A need for an interim solution for vascular services had therefore been identified due to the length of time for the long-term option to be implemented.

(5)       Dr Thallon noted that the Vascular Network had four primary objectives which included shared multidisciplinary teams/meetings and a single on call rota. He reported that there had been some progress towards collaborative working  ...  view the full minutes text for item 7.

Stuart Jeffery (Deputy Managing Director and Chief Operating Officer, NHS Medway CCG) and Michael Griffiths (Partnership Commissioning Programme Lead – Children and Families, Medway Council and NHS Medway CCG) were in attendance for this item.

(1)       The Chair welcomed the guests to the Committee and noted that an additional report has been added to the agenda, via a supplement, as she had agreed that it should be considered at this meeting as a matter of urgency, as permitted under section 100B of the Local Government Act 1972; this was to enable the Committee to consider the East Kent CCGs’ position statement which was not available for despatch as part of the main agenda on 4 October 2018.

(2)       Mr Jeffrey began by providing an update about the progress of the review since presenting to the Kent HOSC and Medway HASC in January 2018; he noted that the initial timetable was running significantly behind schedule. He stated that there was currently a single schedule of policies in Kent & Medway relating to Assistive Reproductive Technologies (ART) services which included two cycles of IVF for eligible patients. He reported that NHS Dartford, Gravesham & Swanley CCG and NHS Swale CCG had started pre-consultation engagement on IVF cycles, NHS West Kent CCG was about to begin, and NHS Medway CCG had concluded this stage of work. He highlighted that the East Kent CCGs had decided not to participate in the review relating to the reduction in IVF cycles as they had other priorities in relation to hospital reconfiguration in East Kent. He noted that whilst NHS Medway CCG was the lead commissioner for ART services, each CCG was independent and there was a risk that different policies could be created across Kent & Medway. In relation to donated genetic material (DGM), all Kent & Medway CCGs were supportive of the review to establish the inclusion of DGM in the ART schedule of policies. He explained that a meeting had been held earlier in the week and there were still a few issues to resolve before CCG agreement which was expected within the next couple of months.

(3)       Members enquired about the use of a new technology to reduce the costs of ART and pre-conception advice. Mr Jeffery stated that he was not aware of the new technology being referred too but would look into it. He reported that comments about pre-conception advice had been highlighted in the pre-consultation engagement phase and would be taken forward with the Commissioning Support Unit. Mr Griffiths added that the STP Prevention Group was considering a study of 1000 women in relation to pre-conception.

(4)       Members expressed concerns about the potential for different levels of provision for couples seeking IVF in Kent & Medway and welcomed the inclusion of the use of DGM. In response to a question relating to achieving a unified CCG position, Mr Jeffery noted that there was currently different level of provision across England. As lead commissioner, he stated that his preference would be for a unified decision. He  ...  view the full minutes text for item 8.