Proposals for east Kent hospitals could mean A&E and other services moved from Margate to new Canterbury site

QEQM hospital

Health commissioners holding  public events to discuss potential options for future hospital services in east Kent have revealed more details of their proposals which could include moving many services, including accident & emergency, to a new build hospital in Canterbury.

At the events, between October 30 and November 20, doctors and other leaders from east Kent’s clinical commissioning groups (CCGs), which plan and pay for local health services, will talk about ideas for changes to urgent, emergency and acute medical care (including A&E departments), specialist care, and planned inpatient orthopaedic care (such as hip and knee operations).

New details reveal that as part of looking at two options for urgent, emergency and acute medical services in east Kent, commissioners are also discussing whether to move maternity and children’s inpatient services to a new hospital in Canterbury and options for moving specialist services to either Canterbury or Ashford. There are also plans for new urgent care centres.

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 at different hospitals, such as the trauma unit  at William Harvey Hospital and inpatient kidney services  at the Kent and Canterbury Hospital.

NHS professions and the East Kent Hospitals University Foundation Trust (EKHUFT) say there is a body of evidence that shows specialist services, such as stroke, trauma, vascular and specialist heart services need to be centralised and located together.

Hospital proposals

There are two options for urgent, emergency and acute medical care

Option 1 – A&E at Ashford and Margate

Reorganising some specialist services across each of the three hospital sites and using the William Harvey Hospital (Ashford), Kent & Canterbury Hospital (Canterbury) and Queen Elizabeth the Queen Mother Hospital (Margate) in different ways. This would mean consolidating specialist services on one site at the William Harvey Hospital in Ashford, with more day-to-day hospital services provided at Canterbury and Margate.

Under option 1 there would be an A&E at William Harvey Hospital as part of the major emergency centre and an A&E Department at QEQM.

This would be supported by 24/7 GP-led care, including an Urgent Treatment Centre treating illnesses and injuries which are not 999 emergencies, in Canterbury.

Option 2 – A&E at a new Canterbury hospital

Added to the medium options list in October 2017 following an offer by Quinn Estates to build the shell of a new hospital in Canterbury as part of a development of 2,000 new homes. It would involve changes at all three sites, including moving some services currently provided at the William Harvey and QEQM hospitals.

Under option 2 there would be an A&E department for east Kent  at the major emergency centre at Canterbury. This would mean that A&E, acute medical care and complex inpatient surgery, which currently take place at William Harvey and QEQM, would relocate to Canterbury.

This would be supported by 24/7 GP led care, including Urgent Treatment Centres treating illnesses and injuries which are not 999 emergencies, in Ashford and Margate.

Urgent treatment centres

Under both options, the NHS aims to open further urgent treatment centres in east Kent by December 2019, as part of a national drive to simplify urgent care. Urgent treatment centres bring together a whole range of services for illnesses and injuries that need urgent care but are not a 999 emergency.

The NHS is asking for views on the potential locations and opening hours of the urgent treatment centres.

Specialist inpatient services

Both of the potential options propose bringing together all specialist inpatient services, including trauma, specialist heart services, inpatient treatment for veins and arteries (vascular services) and specialist renal, urology, head and neck services and children’s inpatient services in a major emergency hospital with specialist services.

This would be at William Harvey Hospital in option 1 and Kent & Canterbury Hospital in option 2. These services would not then be provided elsewhere in east Kent. They are not provided at all hospital sites now; but they are provided at different sites rather than one specialist site.

Maternity services and children’s inpatient services

Consultant-led maternity units and children’s inpatient services are both currently available at William Harvey and QEQM hospitals. The Kent and Medway NHS say best practice is for these services to be on the same site as an emergency department in case there is a need for additional specialist support.

In option 1, this would mean consultant-led maternity units and children’s inpatient services would continue at William Harvey and QEQM. There would be a range of maternity and children’s outpatient services provided, including clinics and antenatal day care, at Kent & Canterbury Hospital.

In option 2, all consultant-led maternity units and inpatient children’s services would relocate to Canterbury. There would still be a range of maternity and children’s outpatient services provided at William Harvey and QEQM, including clinics and antenatal day care.  The NHS is also keen to understand and assess whether women would choose to use standalone midwifery led birthing units and views on this will be sought at the events and through other engagement work with local people.

Frail elderly services

In option 1, consultant-led services for frail older people would be provided at William Harvey Hospital in Ashford and the QEQM in Margate and in option 2 at the Kent & Canterbury Hospital.

Day surgery and outpatients

Under option 2, it is currently proposed that day surgery and outpatient appointments would  move away from Kent & Canterbury Hospital to other sites.

As part of exploring the developer’s offer to build the shell of a new hospital the NHS has looked at how big the hospital could be; and how many services could be located there. Given the size of the site the current proposal is to create a major emergency centre with specialist services providing emergency care, complex inpatient care and specialist services. This would mean that day surgery and outpatient appointments would need to be provided elsewhere.

This could be by providing more of these services from GP surgeries and other community settings in the Canterbury area such as Estuary View (Whitstable); or from other east Kent locations such as Buckland Hospital (Dover); the William Harvey (Ashford) and QEQM (Margate). The NHS is keen to understand views on this proposal.

‘Modern health services’

Caroline Selkirk, Managing Director of East Kent Clinical Commissioning Groups, said: “We want to test with the public our emerging proposals which are still being developed, led by doctors, nurses and others from the hospital and clinical commissioning groups.

“This will help us understand people’s views, and take onboard their ideas and concerns. It is a vital part of the process we need to go through as we identify options to take to formal public consultation next year.

“Our aim is to design modern health services that are high quality, meet people’s changing needs and are sustainable for years to come.”

The proposals are not yet part of a formal public consultation.  It is expected that formal consultation on any proposed changes will take place later next year.

Concerns

A spokesman from campaign group Save Our NHS in Kent spokesperson said: “People were shouted down at listening events earlier this year when they said that the loss of a stroke unit might lead to further losses such as A&E and maternity. Now we have proposals popping up that could mean QEQM is left with a midwifery-led maternity unit and a GP-led ‘A&E’.

“This appears to be an ongoing drive to remove QEQM’s specialist consultants, leading to a downgraded hospital. As a result of these plans, there’s a possibility that all acute care will ultimately go to another hospital. Acute care means treatment of severe injury or illness that requires rapid intervention to avoid death or disability – so this could mean an awful lot of ambulances, or even all ambulances going to another hospital in future.

“Canterbury has been left without consultant-led maternity care for some time now and it means that pregnant women in Canterbury are in fear that if something goes wrong during childbirth, they face a delay in treatment and a journey in an ambulance. Midwife-led childbirth is not suitable for everyone.

“This reduction in service now threatens Thanet and Ashford populations as it has in Canterbury. Again, Kent’s NHS executives are engineering a situation in which locations are expected to fight each other for the best health care. SONIK say that all three hospitals deserve consultant-led maternity care, and all three hospitals deserve acute care on site.”

“Save Our NHS in Kent recommends to everyone in east Kent that they keep a close eye on these developments and attend the listening events coming up in October and November. Details of events and news updates can be followed on our facebook page and website.”

SONIK can be found at: www.facebook.com/saveournhskent and  www.saveournhskent.org.uk

Labour’s parliamentary candidate for South Thanet, Rebecca Gordon Nesbitt, said the options present a lose-lose situation for Thanet.

She said: “The two options for hospital reconfiguration in East Kent represent a lose–lose situation for Thanet. 

Under option 1, we lose a whole raft of services; under option 2, we lose our A&E. It seems our worst fears are being realised, with services being stripped out of QEQM and moved to Ashford or Canterbury. The stroke unit is just the start. The people of Thanet can ill afford this.

 “As I’ve said several times before, Thanet has high levels of deprivation, meaning that our people are more likely than people in other parts of the county to suffer from strokes, heart and cardiovascular disease. Moving the relevant services further away from the people who need them is a failure of the statutory duty of health commissioners.

I’d like to echo the view of SONiK, of which I’m a member, that East Kent hospitals shouldn’t have to compete with each other for excellent services. If the Government funded the NHS properly and the Department of Health took responsibility for commissioning services, we wouldn’t be in this mess.”

Craig Mackinlay MP

Conservative MP Craig Mackinlay said: “I always listen carefully to the recommendations of the doctors, nurses and others from our various NHS Trusts and organisations, but these proposals are at a very early stage of development.

“You can be assured that, given Thanet’s geographical position and population, I support QEQM maintaining as broad a spectrum as possible of full range services – including a full A&E – into the future.”

MP Sir Roger Gale has been asked for comment.

Public NHS listening events in Thanet

Tuesday 13 November: Ravenscliffe Suite, Pegwell Bay Hotel, 81 Pegwell Road, Ramsgate CT11 0NJ
6.30pm to 9.30pm (registration from 6.15pm)

Tuesday 20 November: The Lido, Ethelbert Terrace, Margate CT9 1RX
10am to 1pm (registration from 9.45am

To come to one of the listening events register online at http://kentandmedwaynhs.eventbrite.com/. Alternatively, you can email [email protected] or call 01622 211940 to reserve a place.

For more information visit  https://kentandmedway.nhs.uk/eastkent.

9 Comments

  1. Here we go again! They just want to waste even more precious money on more pointless consultations. They don’t care what we think or need they will just do what they want in any case. This practise of moving all services under one roof needs to be halted now before it goes any further. It is best to have services in several locations which serve the population well rather than a cattle station hours away from where you live. Congestion on the highways is already a problem, when these changes come into force it will be much worse. Many more patients will no longer be able to get to appointments on time like they would be able locally. I see problems here that are being overlooked. Lives will become miserable for people having to travel many miles in poor health.
    Leave the services alone and spend the consultation money on improving all services for everyone at the three hospitals we have.

  2. So QEQM A&E and the William Harvey A&E have both come under focus and srutiny, with the promise of the already thrown out super hospital at Canterbury, I suspect this is another ruse to turn away the attention the already unpopular proposed changes to Stroke services in East Kent.
    Mr Quinn of Quinn Estates/Developments etc has had along term eye on the potential of building homes at both QEQM + William Harvey hospital sites, so who knows if its a joint misinformation for both the Stroke and Quinn Estates to get both balls rolling in the hope to get both projects of the ground and hoping the public will be confused as to what information to beleive and trust. I can guarentee you can trust neither of them.

  3. This is what the Tory government are doing gradually to our NHS…..Privatising it! It’s a shame so many people in Thanet vote for them because this is what they do. They have taken away our Electricity, Gas, Railways and next it will be our NHS.

    • They will probably have Burger King sponsoring the Cardiac ward soon. This is an are of deprivation which sees us have a lot of health issues-yet they seem intent on closing QEQM down.

  4. As a long-term supporter of the NHS (I was born at home in a small village with the aid of one of the (then) new District nurses arriving in her Morris shooting brake car), I am always keen to see new developments and improvements in the Health Service that has always served me well. But, these days,like so many people, I suspect, I am instantly on the alert whenever I hear of exciting changes and innovations being announced by the medical authorities. Because we know that all the grand plans and intentions are made against a background of cutting back the money spent on the Health Service as well as privatising as much as possible in order to syphon off loads of cash to private companies and individuals.(Who then make generous donations to the political Party that made this happen.)
    So, here we go again. Impressive announcements about how great the Service will be in Canterbury but less said about how this means that we in Thanet will then lose services from QEQM. When will Thanet people stop voting for Parties that stab them in the back?

  5. The only reason that a brand new hospital at Canterbury is even being considered is because a developer is offering to knock up the external superstructure in exchange for permission to build 2,000 houses.

    Where is the cash strapped NHS going to find the millions upon millions of pounds required to complete all the internals (floors, walls, ceilings, doors, etc.) then the rest of the infrastructure (water, electric, and associated ducting and the rest of the fixtures and fittings, toilet, baths, sinks, showers) and all that is before we get to beds and all the necessary medical equipment, operating theatres, etc ? ? ?

    Far cheaper and more cost effective to improve and expand the facilities we already have. (I will undoubtedly be dead before this hare-brained scheme is ever open and operational and at least twice the currently non-existent budget).

  6. So whatever option is chosen, frail, elderly people and women in labour somewhere will have to travel ridiculous distances.

  7. Once again the Thanet Clinical Commissioning Group is NOT listening to the people of Thanet, instead they are licking the Tory governments boots, and breaking up the NHS to sell it off bit by bit! I was born before the NHS but paid into it all my working life, and like any other insurance plan, I expected to get what I paid for! Due to a genetic condition I require hand surgery ever few years, which has to be monitored over a period of time. Three years ago I was told this surgery could no longer be carried out at the QEQM, and to go to the Kent & Canterbury for my checkups. Its a day out of my life trying to get to the K & C by public transport, and back again, so I refused treatment! If I don’t have the surgery then it would mean one or more fingers would have to be amputated, so I stamped my foot, and eventually the monitoring was carried out at the QEQM, and at the forth attempt inside 11 months, so was the surgery! Rebecca Gordon-Nesbitt is right, and the people of Thanet are being short changed, especially when treatment means traveling miles, sometimes to London, for why? Because this Tory goverment won’t make the filthy rich pay their taxes, which would pay for ever increasing demand on the NHS!

  8. UPCOMING PLANS FOR A&E, MATERNITY, STROKE etc…Below is an attempt to clarify what are a very confusing set of proposals regarding East Kent hospitals.

    1. Stroke is being lost at QEQM, retained at Ashford, and not restored at Canterbury (unless the new super-hospital is built, in which case both QEQM and Ashford lose their stroke units).

    2. Full, consultant-led maternity will either be only at Canterbury, or only at QEQM and Ashford. ie – either Canterbury continues to lose out, or Canterbury get it back and QEQM and Ashford lose out. MLUs will replace what is lost, and do provide very good care but it is not suitable for many births and does not provide emergency care needed if complications arise. MLUs (midwife-led units) also cannot provide epidurals, caesareans, surgery or anaesthetics, and no consultant will be on site.

    3. A&E at QEQM will be downgraded under Option 1 – it will still be called A&E, but Ashford will become the MEC (Major Emergencies Centre), meaning specialist A&E services will be located there, and some patients will go there instead of to the ‘A&E’ at QEQM. The use of confusing labelling may lead some to believe (including the South Thanet MP) that A&E isn’t as risk in Margate or Ashford. Under the other option, Canterbury will get the MEC and both Ashford and QEQM will get GP-led urgent care centres…these are not A&Es: there will be no consultants, they will be run by GPs.

    SONIK still don’t have as much information as we’d like, and the upcoming listening events will have the plans for these three services PLUS changes to child inpatient care and other services being crammed into one event, so expect a thoroughly confusing ride. We at SONIK will do our best to clarify. But we know that the intricacies of the plan will lead to a lot of confusion, allowing the NHS Executives to muddy the waters and capitalise on that confusion and many people won’t understand what is being lost or where to.

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