Health commissioners agreed today that two potential options for urgent, emergency and acute medical care and six potential options for planned inpatient orthopaedic care in east Kent, should be assessed further, to see which should go forward to public consultation next year.

The two potential options for urgent, emergency and acute medical care are:

Potential option 1, an estimated £160million NHS investment, to enable:

  • 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.

Potential option 2, an estimated £250million NHS investment to enable:

  • 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.

Potential option 2 has been included because a private developer 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.

This would be less than half the cost of building a new single site hospital on green belt land, which was ruled out because there isn’t enough national funding to pay for it and it would take too long to build[1].

The commissioners agreed to look further at 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

The decision was taken today at the first meeting of the Joint Committee of East Kent Clinical Commissioning Groups (CCG)s, representing NHS Ashford CCG, NHS Canterbury and Coastal CCG, NHS South Kent Coast CCG and NHS Thanet CCG.

These potential options for urgent, emergency and acute medical care and planned inpatient orthopaedic care will now be assessed further by NHS staff, patient and public representatives against evaluation criteria to reach a shortlist for public consultation.

The assessment to reach a shortlist will look at the options to see if they deliver improvements in patient care, are accessible for patients, can be staffed, are affordable within the funds available, deliverable within the timeframe needed and support research and education.

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.

No final decisions will be taken until after commissioners have had the opportunity to consider feedback from the formal public consultation alongside all other evidence later next year.

Why is change needed?

The NHS in east Kent has been working with health professionals and the public on how to improve standards for patients and ensure future services, both in and out of hospital, can better meet the needs of a growing and ageing population and be safe, high quality and sustainable into the long-term.

Dr Tony Martin, Clinical Chair of NHS Thanet Clinical Commissioning Group, said: “We want the NHS to provide excellent healthcare for everyone in east Kent. To achieve that, it has to change.

“The meeting today is part of a very rigorous process we are going through to agree how hospital services should be organised in the future, to meet the needs of local people.

“Demand for health services is constantly growing and changing too. This means that our health and care system in east Kent is under real strain and is not meeting national quality standards. There are limited specialist staff and there is limited money to spend, so we need to use what we have wisely and effectively.

“The next stage is detailed testing and analysis by health professionals and patient representatives of all the potential options, to reach a shortlist that we can consult the public on next year.

“There may well be changes to the options discussed today by the time of the public consultation.”

To meet the growing demand for health and care services and provide better quality care and better outcomes for patients, the NHS is also planning to treat more people closer to home. Local teams of health and social care professionals, working in GP surgeries, health centres and local communities, are already offering improved services to frail older people, or people with complex needs, to help keep them well, and treat them at home if they have a downturn in their health.

This will mean for day-to-day care and treatment, some people won’t have to go to hospital as they sometimes do now.

When people do need hospital treatment, the NHS wants to make sure it is safe, people are seen quickly and care is high quality and that people only stay in hospital for as long as they need to.

East Kent Hospitals’ Medical Director, Dr Paul Stevens said: “There have been huge medical advances over the last 30 years. We treat patients very differently now, with specialist teams looking after people with specific conditions such as kidney disease and heart conditions. This has led to much more effective treatment and people are living longer, with a better quality of life.

“Currently too many people are spending time in hospital when they could be better treated by health professionals closer to home and staff and services are being stretched too thinly across too many hospitals. We know we can care for patients better by doing things differently.

“Our aim is to provide hospital services where specialist teams have the equipment and staffing they need to provide excellent patient care; where people can get specialist intensive rehabilitation and outstanding planned inpatient orthopaedic care, and where you can get fast access to hospital treatment because people who no longer need hospital care are receiving appropriate treatment closer to home instead, freeing up beds for other patients.”

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[1] A single site on green belt land is estimated to cost approximately £700 million and take in the region of 10 years to build.