32. Kent and Medway

What concerns have been raised about your STP?

Health planners are trying to reduce NHS deficits and think about ways to re-organise care. However getting the large deficit under control could prevent facilities being developed that can cope with the health and care social needs of local people.

Proposed changes

Reorganisation of the Kent and Canterbury, the William Harvey in Ashford and the QEQM in Margate. One hospital will become a ‘super medical site’ whilst the other two will be downgraded.

A reduction of 300 acute hospital beds.

This reorganisation will mean:

  • Only one hospital site will provide all specialist treatments as well as an A&E and planned care and maternity;
  • A second site will offer an A&E and planned care and maternity;
  • The third site would focus on inpatient elective surgery, including orthopaedics, and rehabilitation with a GP-led urgent care centre. All the minor injuries units would also be retained.

Changes in who organises our care

The STP includes plans to develop a multispeciality community provider (MCP)  type model of care, which would eventually lead to the development of an accountable care organisation (ACO).

What are the proposed aims of the STP?

  • Eliminate a projected 2020/21 deficit of £486 million;
  • Delivery of an integrated health and social care model;
  • Develop primary care into multispecialty community provider (MCP) type arrangements;
  • A dramatic reduction in the level of activity in the acute care sector;
  • Improvements in the health of the area's population.

Further information

The STP does not contain details about  just how the STP will be funded. In the STP it is noted that a lack of new capital would be a “significant barrier to change”.

Hospitals

The reorganisation of hospitals means vascular; renal; head and neck; urology; hyper-acute stroke; haematoncology and gynaeoncology in patient services; as well as trauma care; would all move to the one main site.

No decision has been announced as to which hospital site will become the major medical site. However, in June 2017, the chief executive Matthew Kershaw of the Kent and Canterbury (K&C) Hospital was unable to offer any reassurances to campaigners about its future as an acute site. From June 2017, emergency heart and stroke patients would no longer be taken to the K&C because most of the hospital’s junior doctors have been moved to Ashford as there are insufficient consultants to supervise them at Canterbury.

Community care

The STP includes plans to bring general practices into clusters, and then aggregating clusters into multispecialty community provider (MCP) type arrangements. This would eventually lead to the development of a small number of larger accountable care organisations (ACO) that would hold capitated budgets.

The STP hopes that the use of this model will lead to the management of demand for acute services, and a significant reduction in acute activity and length of stay in hospital.

Back-office services

The Kent and Medway area, along with Greater Manchester, Mid and South Essex and North West London, has been chosen to test out models of regional back-office mergers. The areas will explore different approaches to making savings on back-office services that can become models for the other STPs during a national implementation phase.