Consultation on east Kent A&E and health service changes pushed back to unknown date

QEQM Photo Chris Constantine

Plans for public consultation on changes to hospital services, including accident and emergency care, in east Kent have been pushed back to an unspecified date due to the need for more detailed work to take place.

The Kent and Medway Sustainability and Transformation Partnership Programme Board has been discussing two potential options for accident and emergency care and six potential options for planned inpatient orthopaedic care in east Kent.

The plan was for the proposals to go out to public consultation at some point this year but health commissioners say due to the extensive preparation work that is needed, it is now not possible to give a date for when consultation will start.

Preparations

Caroline Selkirk, managing director East Kent, said: “The Kent and Medway Sustainability and Transformation Partnership Programme Board has agreed that plans for health and care services in east Kent will go out to public consultation as soon as they are fully ready.

“As part of the preparations for that, we are pulling together the relevant data on patient pathways, travel times, and workforce in current state, to develop a robust pre-consultation business case.  At the same time, we are continuing our pre-consultation engagement with stakeholders and local communities in east Kent.

“This is helping us develop the detail behind potential options and, importantly, look at how we can best develop local out of hospital care.  It will culminate in a whole system simulation event where we will stress test proposals before we move to formal consultation. All of this will build on work already undertaken and help us move forward.

“Once we have a shortlist of established proposals to go to public consultation, there will be a rigorous assurance process before the consultation launches.  We have established a Joint Committee of CCGs in east Kent who will take the final decision about which options should go out to public consultation.

“It is a process that requires a great deal of hard work and, while it is being progressed as quickly as possible, it is not possible currently to give a date for when consultation will start.”

Services now

Currently the three main hospitals – at Ashford, Canterbury and Margate – each provide different services, with A&E departments at Margate and Ashford and an Urgent Care Centre at Canterbury. A range of specialist services are located at different hospitals. For example, the trauma unit is located at William Harvey Hospital, and inpatient kidney services are at the Kent and Canterbury Hospital.

Last November the east Kent CCGs agreed two options for A&E and other health services needed further investigation but were expecting proposals to be ready for consultation this year.

Cllr Karen Constantine with Labour’s Harry Scobie  Photo Chris Constantine

County councillor Karen Constantine, who sits on the health overview scrutiny panel at the authority, said: “I have been raising concerns over the past 18 months about the speed and pace of changes. If changes need to be made then the CCGs must be able to clearly demonstrate the need and the value to Thanet residents”

Cllr Constantine said she is now calling on South Thanet MP Craig Mackinlay to enter into discussions about the funding difficulties and staff issues that she says are holding the NHS back in Thanet.

Save Our HNS in Kent (SONIK)

A spokesperson for SONiK said: “The people of East Kent must keep signing our petition demanding that the Kent & Medway NHS mangers hold off on the A&E consultation until 2019 at the earliest. So far the STP have not agreed to do that, and it could still begin in the last months of 2018, very shortly after the last phase of the stroke consultation.”

SONiK have been trying to get clarification from Kent and Medway STP what the ‘delay’ communicated to the HSJ actually means. They say “The public need to have breaks in between consultations, otherwise it’s just an information overload. Look at the quantity of documentation on the Stroke Review – expecting people to deal with three of these in one year is too much.

“SONiK will continue with our petition until we get confirmation that the public consultation will start no earlier than 2019. We are also asking that any pre-consultation meetings for the A&E Review be clearly publicised with ‘A&E’ in the title, that they are publicised widely in East Kent, that a good amount of notice for the meetings is provided and they should be held on evenings or weekends in accessible places.”

Find the petition here https://www.change.org/p/c-selkirk-nhs-net-kent-and-medway-nhs-consultation-meetings-are-undemocratic-and-failing-to-inform

The options

Option 1, an estimated £160million NHS investment:

QEQM hospital
  • a much bigger, modern, A&E at William Harvey Hospital, Ashford, which would also provide services for people that need highly specialist care (such as trauma, vascular and specialist heart services) in east Kent
  • an expanded, modern A&E at Queen Elizabeth the Queen Mother Hospital (QEQM), Margate, with inpatient care for people who are acutely unwell, emergency and day surgery, maternity and geriatric care
  • investment in beds and services at Kent and Canterbury Hospital which would have a 24/7 GP-led Urgent Treatment Centre, and services including diagnostics (such as X-ray and CT scans), day surgery, outpatient services and rehabilitation.

Option 2, an estimated £250million NHS investment:

  • the fitting out of a new build and refurbishment of some of the current buildings connected to the Kent and Canterbury Hospital, which would provide a single 24/7 A&E and all specialist services (such as trauma, vascular and specialist heart services) for the whole of east Kent
  • QEQM Hospital and William Harvey Hospital would have 24/7 GP-led Urgent Treatment Centres, as well as diagnostics (such as X-ray and CT scans), day surgery, outpatient services and rehabilitation.

Developer Quinn Estates has offered to donate to the NHS land and the shell of a new hospital, as part of a development of 2,000 new homes, which includes an access road from the A2. It would be subject to planning permission.

Commissioners say this would be less than half the cost of building a new single site hospital on green belt land, which would cost some £700million and take 10 years to construct.

Six potential options for planned inpatient orthopaedic care.

  1. only the Kent and Canterbury Hospital
  2. only QEQM Hospital
  3. only William Harvey Hospital
  4. both the Kent and Canterbury Hospital and William Harvey Hospital
  5. both the Kent and Canterbury Hospital and QEQM Hospital
  6. both William Harvey Hospital and QEQM Hospital

NHS commissioners and the NHS centrally (NHS England) will need to approve the shortlist before it goes out to public consultation, including a business case for funding the changes, because all the options require significant capital funding.

7 Comments

  1. The public want and need option 3 , all 3 hospitals to have their own a and e, pressure from save our nhs in Kent (sonik) have put the unelected ccg in Kent on the back foot. Thanet people will not be treated like second class citizens, this a partial victory, keep fighting

  2. Save Our NHS in Kent have asked for clarity on this issue from NHS Kent’s managers, as the article in the HSJ is very ambiguous, and it’s not clear if Kent & Medway STP have altered their position on the date at all. Last week, the STP said the A&E consultation for East Kent would take place sometime this year, probably at the end of the year. From the HSJ article, it seems that ‘the last months of this year’ could still be an option. SONIK’s petition is asking for the A&E consultation to be pushed back to 2019 at the earliest. Any sooner would be asking too much of the public, as the next phase of the stroke consultation will be happening in September/October, and the engagement exercise regarding the GP supercentres is happening this year too. That’s too many major NHS service reconfigurations in a matter of months. The public need to be able to digest the information and make decisions, and do a bit of research if they wish to.
    Our petition is here, please sign to make sure the A&E consultation is delayed until 2019 at the earliest: https://www.change.org/p/delay-the-a-e-acute-consultation-on-cuts-and-closures

  3. Rather than waste so much time, effort and money on a seemingly endless permutation of options (which none of the committees, panels, partnerships, consultation groups, commissioners and other quangos can agree upon in any event) somebody needs to make a decision and get on with it !

    Little is to be gained from a further public consultation (wasting more time and costing more money) because the residents of each locality will want all the facilities to be closest to them.

    Even the experienced, professional doctors and consultants cannot agree which would be the best options.

    At the end of the day, nobody will be satisfied with the outcome (if we live long enough to ever see an outcome) so the decision may as well be made now by the simple drawing of straws . . .

    • Hi John, I think your view might be quite unpopular amongst most people, who don’t agree that it’s necessary or best practice to cut the number of A&Es in Kent, or anywhere for that matter. Save Our NHS in Kent are campaigning for ‘three excellent hospitals, with three A&Es’.

      • Yes – I agree – three excellent hospitals with A&Es would be the common sense situation but it seems that more money is wasted by trying to save money rather than just spending the money on providing NHS services in the first instance.

        That may be an over-simplification but surely a public consultation will only show that the public want the best and most comprehensive services to be available at their nearest hospital. Why would I vote to spend an hour or more being transported in the back of an ambulance with my dislocated hip when I only need to spend ten minutes ?

        Whilst SONiK is doing an excellent job, its existence should not even be necessary if we did not have so many committees arguing the toss and unable to agree or decide as to what is best for us mere minions. in my view, public consultation is buck-passing by those who are paid to make such decisions. It wastes time, delays decisions, costs money – and as a result there is then not enough money left in the pot because the cost of the eventual scheme has increased in the meantime !

        • Without a public consultation, plans get approved without public scrutiny, so I do not agree. But I agree with you in the sense that it would be better to not waste public money on plans that are clearly not fit for purpose in the first place.

  4. The people of East Kent demand 3 excellent hospitals. The proposals are ultimatum dressed up as options. People are rightly concerned that these plans are cuts disguised as clinical improvement.

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