Kent & Medway NHS call for unity over changes to hospital services in east Kent

Rachel Jones, executive director for strategy at Kent and Medway Clinical Commissioning Group (CCG)

By Local Democracy Reporter Ciaran Duggan

Additional reporting Kathy Bailes

An NHS leader says the county needs £460million to transform health care in east Kent.

Rachel Jones, executive director for strategy at Kent and Medway Clinical Commissioning Group (CCG), said they are seeking to bid for cash from the UK government to radically improve emergency services in east Kent.

She added there was “no plan B” for funding the potential transformation.

Ms Jones said: “We all need to be united in the need to invest in health services in Kent and Medway.”

The two options on the table include enhancing hospital services in Ashford and Margate or creating a big emergency unit in Canterbury.

Both options will result in a removal of some services from Margate’s QEQM with the Canterbury option meaning a loss of A&E to be replaced by an urgent treatment centre.

The Canterbury proposal includes a “super” hospital, which would see a facility built on farmland next to the ageing Kent and Canterbury Hospital, in Ethelbert Road.

Developers Quinn Estates would build the shell of the hospital for free as part of a wider housing development of 2,000 homes on surrounding land, with the NHS having to find the money to equip it.

The five-storey building would host a major emergency unit for east Kent, with specialist services such as heart and stroke care centralised in the city.

Meanwhile, an alternative option has been proposed to improve and expand existing A&E services at Ashford’s William Harvey Hospital. Under this option QEQM would retain an A&E.

Kent & Medway health chiefs say the aim is to provide better care for patients, improve working conditions for staff and help meet the 2050 net zero carbon targets.

Ms Jones added: “If we do not get this money, there is no other pot. This is it. We will lose this opportunity for the foreseeable future.”

A document outlining the update on health service changes says: “The Pre-Consultation Business Case (PCBC), setting out the ‘case for change’ and detailed investment case for both options, was approved by Kent and Medway Clinical Commissioning Group’s Governing Body and East Kent Hospitals University NHS Foundation Trust’s Board in July 2021.

“In August, the document was reviewed as part of NHS England’s Stage 2 Assurance process where it was successfully assessed against rigorous criteria for planning and delivering service change and reconfiguration. However, the programme cannot currently move forward to formal public consultation on the options until confirmation of approval of Treasury funding for the capital element of the programme is secured.”

The document says investment would support improvement in a wide range of service areas including:

  • New wards, operating theatres and inpatient areas
  • Clinical support services such as outpatients, radiology, pathology, audiology and pharmacy services
  • Specialist service investment in areas such as renal, urology, vascular, endoscopy and NICU (neonatal intensive care unit)
  • Funding for diagnostics, tests, and scans and to support wider hospital infrastructure.

However Rachel Jones also warns in the report of the fall-out if funding is not gained, saying: “Not having this investment in east Kent and not delivering either option in east Kent will mean:

  • our backlog maintenance requirements in East Kent Hospitals will rise to unprecedented levels over the next five years and we will continue to work out of buildings that have come to the end of their useful life;
  • 78% of our buildings will continue to need significant investment to meet modern standards and it will cost at least £121m just to catch up with basic maintenance required on the buildings, now;
  • a loss of up to £600m of economic impact to east Kent’s businesses; and,
  • the opportunity to create up to 400 jobs (up to 7,800 ‘job years’2 ) across east Kent will be lost.
  • more than half of beds will still be provided in old fashioned ‘nightingale’ wards with less than 8% of beds (80 beds) being single rooms;
  • East Kent Hospitals University NHS Trust will lose the opportunity of developing over 570 ensuite rooms and bays, directly impacting on its ability to manage infection effectively;
  • more than 1,200 inpatients will continue to be transferred between hospitals each year, to get access from more than one specialist team, currently working from different sites;
  • just 15% of the communal areas in east Kent hospitals will meet the requirements of frail and disabled people; and
  • only 9 of the 36 ‘expected’ national clinical standards would be met in east Kent.

Last year, Prime Minister Boris Johnson pledged to deliver 40 hospitals across England by 2030, backed by £3.7billion of investment.

Expressions of interest are being made by NHS trusts wishing to have their hospital plans considered, including Kent and Medway.

At County Hall in Maidstone on Thursday (Dec 2), Kent councillors agreed to send a letter to Health Secretary Sajid Javid, calling for greater investment to transform health care in east Kent.

Ashford county councillor Paul Bartlett (Con) said: “We have to lobby, talk, cajole our MPs to ask questions in the house. It all falls us to be united, not just as Kent, but Medway too.”

However, some elected members remain divided over the way forward between the two tabled options.

Cllr Karen Constantine, who represents Ramsgate at the authority, said she couldn’t possibly agree to either of the two options as there were too many variables that can’t yet be answered.

She said: “Post Covid life is very much changed and we need to check where we are now with regard to the figures for Thanet. Have strokes increased or decreased and what are the outcomes? I gather the latest data will be shared with us soon.

“The NHS is on its knees and is now faced with an impossible challenge of a workforce crisis, waiting lists are rising and there is a  lack of access to GPs.”

Cllr Constantine said forthcoming consultation was questionable as public confidence in Thanet was already dented by the lack of a robust procedure with regard to the Hyper-acute stroke units decision to centralise east Kent emergency stroke services to Ashford.

She added: “ 141,000 people live more than 60 minutes from the proposed HASU, and we are currently being warned of a six hour wait for ambulances throughout the winter, therefore up-to-date clinical evidence is vital.”

Medway councillor Teresa Murray (Lab) was unconvinced about the “apocalyptic” fallout from the lack of money.

She said: “If this is going to be a deliverable project it has to be capable of addressing the problems we have got now, such as health inequality, staffing shortages and training to recruit and retain staff.”

Health campaigners, including Save Our NHS in Kent, have called for all three east Kent major hospitals to have A&E facilities.

A public consultation on the two options will take place after a key decision is made by the UK government on the new hospitals, which is expected next spring.

Hospital service options

  • Option 1 – Major emergency centre with specialist services at William Harvey Hospital in Ashford, emergency centre at Queen Elizabeth The Queen Mother Hospital in Margate and an elective surgical centre with a 24/7 Urgent Treatment Centre at Kent & Canterbury Hospital in Canterbury
  • Option 2 – Major emergency centre with specialist services at Kent & Canterbury Hospital, elective surgical centres with 24/7 Urgent Treatment Centres at William Harvey Hospital and Queen Elizabeth The Queen Mother Hospital


    • Bet if you said you wanted a bible class/sermon from Dr Scott he would have you booked in the same day or next.

  1. Apart from the little local difficulty over sewage patients per GP in Thanet is somewhat above the national average despite the relatively older (and generally sicker) population : impossible workloads may explain recruitment problems ?
    Surely an unanswerable pair of arguments for declaring a moratorium on all substantial estate development – especially on green fields ?
    Can’t wait to see a ‘rebalanced’ revised Local Plan addressing such issues !

  2. I would assume that works on the A&E department is currently underway at the moment it looks like medway CCG is creating lies or wants all the money for their why was the Thanet CCG allowed to amalgamate with the others the people should have been consulted about this.? It’s time for the abolition of this body in Kent by referenda or petition doctors should be looking after all patients instead of controlling the budget.

  3. Whole thing is a joke. Keep seeing all these doctors being interviewed on television saying the backlog is mostly due to people not going to them during the pandemic, no-it is mostly due to you hiding away during the pandemic.

    They say people need to come forward now & not be afraid, but the problem is they are still hiding away behind Skype calls-which are useless for most. People cannot even get on the waiting lists, because the doctors refuse to see them,

    As the poster here says-no appointment for another month & that will be by phone! The promise was once the jabs were in enough people things would get back to normal, we had four GP’s & a swathe of others jabbing non-vaccinated people for months on end-surely they all being Asian & mostly obese would have been at huge risk doing that & then at minimum risk after? But no, the doctors are still hiding from face to face appointments. Now they are demanding as per the government line more boosters are needed & no doubt in a few months it will be the new jabs for Omicron-meaning even more delays, backlogs & services cut. Those who do see people have now been told to ignore the elderly & new patients health to get those jabs into arms.

  4. Something has gone wrong in Kent. Previously from Essex I couldn’t believe the state of Canterbury Hospital when I took a friend there. Basically a collection of brick huts connected by corridors appalling. Check out Queen’s Hosp Romford, or Harlow Hosp huge 5 stories high, with atrium, Starbucks, WH Smith, piano playing in Foyer amazing wards …..Canterbury and QEQM astonishing in their paucity….

  5. How many more times are we going to hear “ it will improve patient care” it never does any such thing. I worked at Kent & Canterbury hospital in the 80s 90s then QEQM in the 90s 2000s All we ever heard was downgrades unit closures and services being moved. Now it looks like having run the NHS services in east Kent into the ground the Kent and Medway commissioning group are going to the government cap-in-hand begging for money to prop up a service that has been allowed to deteriorate year after year. Why are they are named Kent and Medway when they are both in Kent seems odd. Kent does even have one major trauma unit that’s why serious injuries are taken to kings College hospital London.

  6. The solution is always to throw more money into a bottomless pit.
    There are difficulties with building maintenance which should be dealt with separately, but the main problem relates to the management model which is inefficient and ineffective. Just talk with the staff at all levels and you will find that they are fed up with not being listened to, and the management structure and ethos are 100 years out of date. The top-down control of people just does not give them any control over their working environment. In modern management, the direct staff are those who have the input to improve their processes as they are the ones at the coal face who know what is going on and what needs to be improved.
    I hope that the introduction of Excellence principles now being introduced in some parts of the hospitals will in the short term alter the dynamics of how the hospitals are run. But I fear that there will be an uphill battle.
    Let the patients and the staff have a say in which way the Health Service is organized.

  7. If you impose decisions in a top down fashion, fail constantly on patient care, and get involved with the likes of Quinn Estates, you can hardly expect the community to fall in behind your failing enterprise.
    GP services in many parts of the CCG are failing and as a result A+E is being over taxed.
    The vaccination roll out was abysmal and other trusts had to take over.
    What the CCG is about is saving money and rationing care. As a result the out comes are poor and the patients know it. The CCG needs to be broken up, the EK Hospital trust needs to be broken down into manageable sections and some reality needs to enter into the heads of management in this outfit.
    East Kent is down by the head with over 60’s who paid tax elsewhere, but the resources have not moved with them. So East Kent has insufficient income to deal with adult social care and elective treatments for the aging population.
    Cutting the cloth with sharper scissors is not going to alter the fact that there is not enough cloth all round.
    The infrastructure is dreadful, so having services located in Ashford is a non starter,
    I would put the 5 eastern districts with one trust based in Canterbury, but with decent roads to connect it with the rest of East Kent. Ashford could then concentrate on its area, parts of Swale and possibly the Marsh.
    I would recommend that a new CCG, Hospital trust and Unitary Council all exist in the same area and are made to work together. That might work. This begging bowl plea will not.

  8. QEQM’s MP is Sir Roger Gale who supported the closure of the stroke unit in Margate! He has not fought for his constituents & condemned them to a frightening journey to Ashford.
    Anyone interested in the Tory plan for our NHS should watch these films on You Tube 1: The Great NHS Heist. 2: Groundswell 3: The Dirty War on the NHS. 4: Under The Knife 5:SickoUK 6:Sell Off.
    Your NHS is being privatised so the Tory Cronies can increase their shares in healthcare providers, essentially taking money from patients to fill their greedy pockets.
    Just look at how many people go bankrupt in the USA as a result of medical bills.
    You could roll over & accept what they’re doing or fight!!

  9. I work at QEQM, I can tell you now privatisation is not someething that will happen in the future, it is here now.
    There are many contracts in the NHS that are fulfilled by private companies, usually badly.
    This is happening, in my humble opinion it’s already too late.

    • Yes, so much already privatised. One example: the MRI scanners at QEQM, Cantebury and Ashford, sold to private comapnies who now lease them back to the NHS for a profit!

    • If you have time, contact me or Save Our NHS in Kent with a list of all the privatisation examples you know of. Most of our FOIs get ignored or rejected these days…

  10. “Last year, Prime Minister Boris Johnson pledged to deliver 40 hospitals across England by 2030, backed by £3.7billion of investment.”
    This has been shown to be complete rubbish.
    Most of these “deliveries” are refurbishments or upgrades to existing facilities, not new hospitals at all.
    We (collectively) voted overwhelmingly for a tory government. Their ideology is to move public money as effectively as possible into investors’ (off-shore) bank accounts (see Virgin Healthcare, for example)

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