Agenda and minutes

The Chairman announced that he had called this special meeting of the Committee following the NHS announcement on 17 September of a preferred option for Hyper Acute and Acute Stroke Services which did not include Medway Maritime Hospital. 

The preferred option had been selected at an Options Evaluation Workshop of the Joint Committee of Clinical Commissioning Groups (JCCCG) held on 13 September 2018. The Chairman stated that his invitation to that meeting had been as an observer as Chairman of Medway’s Health and Adult Social Care Overview and Scrutiny Committee, rather than as Vice-Chairman of the Joint Health Overview and Scrutiny Committee (Joint HOSC). The next stage in the review involved the development of a business case which would be formally presented to the Joint HOSC for comments before a final decision was taken by the Joint Committee of the Clinical Commissioning Groups (JCCCG).

The Chairman advised that the purpose of tonight’s was meeting was therefore to provide members of the Health and Adult Social Care Overview and Scrutiny Committee with an opportunity to understand the reasons for the preferred option, and to express views and raise questions which could be taken forward to the Joint HOSC by the four Medway Members of that Committee.

Apologies for absence were received from Councillors Clarke, Freshwater and Howard.

To approve the record of the meeting held on 21 August 2018.

The record of the meeting held on 21 August 2018 was agreed and signed by the Chairman as a correct record.  

There were none. 

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

This report notifies the Committee of publication by the NHS in Kent and Medway of a preferred option for three new specialist “hyper acute stroke units” (HASUs)  to be located alongside acute stroke units at Darent Valley Hospital in Dartford, Maidstone Hospital and William Harvey Hospital in Ashford.

A Joint Health Scrutiny Committee (comprising representatives from the four affected local authority areas – Kent, Medway, East Sussex and Bexley) has been set up, as required by legislation, to exercise the power available to local authorities to comment to the NHS ( and or make recommendations) on this substantial change to the health service in the four areas.

The Committee is invited to provide any comments and suggest questions for the four Medway Members on the Joint Committee to feed into the process.

Discussion:

Following on from his comments under ‘Chairman’s Announcements’, the Chairman referred Members to a letter from Councillor Filmer and an email from Councillor Freshwater, Members for Peninsula Ward, copies of which were distributed. These expressed concern and disappointment at the selection of the preferred option for three specialist hyper acute stroke units (HASCs), option B (Darent Valley, Tunbridge Wells, and William Harvey Hospitals), and highlighted the impact of Medway Maritime Hospital not being included on the accessibility and quality of health care for residents on the Peninsula.

Patricia Davies and Rachel Jones, Senior Responsible Officers for the stroke services review, gave a presentation on the background to the review; consultation feedback; post consultation evaluation criteria; the evaluation workshop and the selection of the preferred option.

Patricia Davies said the review had found that specialist stroke services were being spread too thinly and that most hospitals did not meet national standards and best practice ways of working. The vision was to give anybody who had a stroke, day or night, anywhere across Kent and Medway and border areas, the best chances of survival and recovery. It had therefore been concluded that urgent stroke care should be consolidated on three hospital sites with each site to run 24/7 and include a HASU; an acute stroke unit (ASU); and transient ischaemic attack (TIA or ‘mini stroke’) clinic. Following the development of a clinical model and identification of five reconfiguration options for stroke services, consultation had been conducted through a variety of channels. Engagement with a wide range of stakeholders and with the Joint Health Overview and Scrutiny Committee (JHOSC) was continuing. A set of evaluation criteria had been used to evaluate the five remaining options and a workshop had been held on 13 September to reach consensus on the preferred option for the location of the HASU/ASUs.

Rachel Jones said that, at the workshop, the evaluation matrix was explained and then applied to the five options, with the hospital names being anonymised. After the first evaluation round, two options was excluded and a further option was excluded after the second round. After the third round the preferred option, option B, had been identified.

The following comments and questions were raised by members of the Committee and were responded to by the health representatives present:

Financial evaluation criteria – The Chairman questioned the use of the financial evaluation criteria as, at the evaluation workshop, he had understood that finance would not be a consideration.

Response - Where there was a financial impact, it had been considered; if there was no impact there would be a neutral score. The review process was not about seeking a reduction in cost. Investment of £38m had been secured for the reorganisation of stroke services and none of the options would exceed that amount.

The Chairman asked what the cheapest option would be over a 10 year period as he believed it to be option B. Rachel Jones undertook to provide this information.

Evaluation of Options – The  ...  view the full minutes text for item 390.