This page includes questions and answers about the East Kent NHS proposals for improving hospital services and local care provided from GPs and other community-based services. We will keep adding to the page as the proposals develop towards a full public consultation.
Why are there only two options?
We have been developing these options led by clinicians and health leaders and involving patient and public representatives since 2016. We have looked at numerous potential options including one with all three hospitals offering all services. A medium list of two options was confirmed in November 2017.
The reasons some options could not be included in the medium list was published in November 2017 when the Joint Committee of Clinical Commissioning Groups announced the medium list. You can read about this in the Medium list options paper. The specific points about three A&E units not being possible are on pages 4-8.
Further information on the evaluation process, including how the medium list options have been assessed will be published as part of a pre-consultation business case at the start of a formal public consultation.
Is this all about A&E?
Some publicity of this work has referred to it as an ‘A&E consultation’. This is incorrect, the proposals include A&E but also affect a wider range of NHS services.
The proposals are looking at all specialist inpatient services and under one of the options other consultant-led services including maternity would see changes.
Beyond the proposed hospital service changes, which will be formally consulted on, our plans are also looking at how to offer as much NHS care as possible as close to people’s homes as possible.
We encourage everyone to read the summary of the two options at https://kentandmedway.nhs.uk/where-you-live/plans-east-kent/east-kent-options-summary/
Why can't there be full A&E, specialist and maternity services at all three hospitals?
Some people are calling for a third option to be added for consultation with full A&E and maternity services at all three hospitals, at Canterbury, Ashford and Thanet.
We have recorded this request as part of the feedback on the proposals. However, to avoid any doubt, we cannot put such an option into a public consultation. The possibility of running three full A&E departments has already been considered and ruled out. It would not be consistent with the latest clinical guidance on emergency care, it would not be possible to staff, and it would not be affordable.
Even if the money was available and there were enough specialist staff to run full services on all three sites; it would still not be the right thing to do clinically. National quality guidelines set out the minimum recommended population required to deliver certain specialist services. This is to ensure staff see enough patients with the range of conditions they treat to maintain and build their skills.
The evaluation which ruled out this option was part of the earlier stages of developing our proposals. You can read the evaluation paper. The specific points about three A&E units not being possible are on pages 4-8.
Would Option 1 mean a downgrade to A&E at Queen Elizabeth the Queen Mother
It has been claimed that because in option 1 the William Harvey Hospital is the Major Emergency Centre the A&E department at QEQM hospital will be a downgraded A&E. This is not right.
In option 1, there would be investment to expand and improve the accident and emergency department at Queen Elizabeth the Queen Mother Hospital. It would continue to have emergency surgery and an intensive care unit, and would treat the full range of emergencies that it does now (with the exception of stroke which is subject to change under a Kent and Medway wide review of stroke services).
The William Harvey Hospital would provide other specialist services in addition to Accident and Emergency. This combination of A&E with other specialist services is referred to as a “Major Emergency Centre”.
The only specialist services that is currently based at QEQM is gynae-oncology (treating women’s reproductive cancers). In option 1 this would move to William Harvey but it would not reduce the level of treatment provided by the A&E department at QEQM.
When will the full public consultation happen?
We have not set a date for the consultation. We are working with our national regulator, NHS England, and clinical experts in the South East Clinical Senate (a committee of doctors, nurses and health professionals working across the south east of England) who are reviewing our draft proposals to make sure it proposes the best clinical outcomes for patients.
We will consider their feedback as part of finalising a pre-consultation business case which will go to NHS England for approval. Once this has happened we will be able to begin a formal public consultation.
When our formal consultation does happen there will be more public events across east Kent alongside a wide range of other ways for people to give their views.
Will it be safe if people have to travel further for treatment?
We know travel times and distances are a concern for people.
Clinicians are leading the development of our options and providing safe high-quality care is the top priority. For serious illness and injuries, the most important thing is to get patients to the right specialist care first time – not necessarily the nearest hospital.
As part of finalising the options we will be looking closely at the potential impact on ambulance services and whether they would need additional resources in order to implement and deliver any proposed changes.
We are also looking at travel for patients and visitors using cars and public transport. To help consider these issues we have established a Travel Advisory Group with patient and public representatives and members of local patient transport services and public transport services.
How will GPs and community services develop to support the proposed changes to hospitals?
Our proposals for changes to hospital services are closely linked with work to improve the range of care people can get without needing to visit a hospital.
Services we have already put in place are helping frail older people and those with multiple long-term conditions. They are reducing the number of unplanned, emergency hospital admissions and helping people get home again faster after hospital treatment.
Other examples now happening in east Kent include; small surgical treatments that used to need a hospital visit are now being done in GP surgeries and other community locations – for example, cataract surgery. Regular appointments to review patients with haemophilia are now happening online with patients using an app to send results to their doctors; avoiding the need to travel to a hospital appointment.
You can read about some of the improvements already happening in the East Kent You Said We Did document
Are the plans about saving money?
The proposals would mean a significant investment in the NHS in east Kent. They would provide higher quality specialist hospital services and more care through GPs and other community services for everyone in east Kent.
Helping people to stay healthy, avoid hospital admissions and get home without delay after hospital treatment would help us to provide better care. After the initial investment to improve services, the new ways of providing care would offer better value for money in the long term.
How are the plans for Hyper Acute Stroke Units affected by these proposals?
The NHS ran a public consultation on Kent and Medway stroke services in 2018. The preferred option includes creating a hyper acute stroke unit at the William Harvey Hospital in Ashford.
Under option 2 a new hospital in Canterbury would become the major emergency centre for east Kent and we would anticipate any hyper acute stroke service would also move with the other specialist services. This was highlighted during the stroke consultation.