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

Source https://www.ekhuft.nhs.uk/
  • 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