Agenda and minutes

Councillor Wells proposed, Councillor Matterface seconded and Members agreed that Councillor Game be the Chairman of the QEQM Hospital Cabinet Advisory Group.

Councillor Game in the Chair.

Apologies were received from Councillor Glenn Coleman-Cooke who was substituted by Councillor Jeremy Fairbrass.

Councillor Wells, Leader of the Council advised the meeting that after his appointment to the Cabinet Advisory Group, Councillor Coleman-Cooke became an employee of the East Kent Hospital University Foundation Trust (EKHUFT). He therefore would have had to declare a pecuniary interest at all meetings of the advisory group and leave the meeting room. Councillor Jeremy Fairbrass was now his replacement moving forward.

To receive any declarations of interest. Members are advised to consider the advice contained within the Declaration of Interest form attached at the back of this agenda. If a Member declares an interest, they should complete that form and hand it to the officer clerking the meeting and then take the prescribed course of action.

There were no declarations made at the meeting.

Hazel Carpenter, Accountable Officer, South Kent Coast CCG and Thanet CCG to present.

PLEASE NOTE that this item will be taken ahead of Agenda Item 4 (Agree terms of reference of the QEQM Hospital Cabinet Advisory Group) in the main agenda.

Hazel Carpenter, Accountable Officer for Thanet CCG and South Kent Coast CCG led discussion with a PowerPoint presentation, which is hereby attached as Annex 1 to this minute item. She explained that the Clinical Commissioning Group (CCG) was a grouping of General Practitioners from whom one GP is elected chairman to lead the group. They hold a National Health Services (NHS) budget for Thanet which was currently at £200 million per year. This budget excludes services like primary care or specialist services where cases are usually referred to London.

The Thanet CCG was currently working with three other CCGs in the South East Kent to develop approaches for future integrated working. EKHUFT has been discussing proposals for a health service strategy for the future. However the Trust cannot go it alone. There is a need for a more holistic approach moving forward that would involve engaging the various CCGs who hold the legal obligation to consult in cases where new health delivery strategies are being proposed.

Case for Change

Hazel Carpenter said that there was a rising demand for care in a situation where service provision was fragmented and there was a need reconsider how health services can be provided in a seamless way to enhance the patient experience. Care Quality Commission (CQC) performance results show poor performance. Whilst the constitutional performance targets for A&E are a four hour wait for 95% of the people, QEQM Hospital’s A&E results are more likely to be under 70% in some weeks. There was shortage of specialist skills in the NHS and locum staff are being used to fill in the gaps, and this was not sustainable in the long run.

There were inequalities in health standards. For example, in Thanet life expectancy goes down 17 years as one moves from one area to another. There was therefore a case for addressing these issues through a holistic re-organisation of health service delivery. Chief Executives and Medical Directors of all major health organisations (Ambulance Services, NHS, Social Care Services etc), Kent County Council, four clinical Commissioning Groups Chairs meet as a Strategic Board chaired by Sarah Philips to come up with a model for integrated working which is sustainable and closes the current gap of quality, affordability and inequalities.

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The Board is building a case for change through understanding the various needs and gaps at local level (Thanet level), sub-district level and county level. They are looking at some work streams which are:

a)  Maternity and Paediatrics;

b)  Mental health care;

c)  Urgency and Emergency care;

d)  Prevention and self care;

e)  Learning disabilities;

f)  Long term conditions and frailty;

g)  Planned care and Specialist care;

h)  End of life care

The Board is looking at what the best should be like for each of these services and developing a model for integrated care. In the process the board is developing a Kent Integrated Data set that allows for the analysis flow across health and social care. This facility is new  ...  view the full minutes text for item 4.

Madeline Homer introduced the item for discussion and referred members to the draft terms of reference in Annex 1 to the sub group report. The Leader said that it was important to get timing for the intervention by Council right to influence the decision. This would call for getting the information from the Thanet CCG at the appropriate time.

Councillor Wells proposed, Councillor Matterface seconded and Members agreed that the following be the amended terms of reference of the QEQM Hospital Cabinet Advisory Group:

1.  Consider or shadow the proposed re-organisation of East Kent health services through the work of the East Kent Strategy Board;

2.  In the event of a public consultation relating to the provision of health services at QEQM Hospital in Margate, prepare a draft Thanet District Council response to the consultation;

3.  Prepare a final report for consideration by Cabinet.

The amended terms of reference will need to be approved by Cabinet.

Madeline Homer said that there was need to clarify how the public consultation process will be conducted and the role of the Thanet Health & Wellbeing Board in this process. In response to a suggestion to increase the membership size of the advisory group, Councillor Wells indicated that the size was appropriate for the time being and any Members who wanted to take part in the discussions of the sub group could attend meetings and speak under Council Procedure Rule 20.1.