Margate’s QEQM hospital could lose its A&E designation under radical plans to tackle a looming £486 million funding black hole for health and social care across Kent.
But voters won’t know until public consultation on the plans – the details of which are being fleshed out behind closed doors – starts after June 8’s General Election.
The plan would leave just one main A&E centre for a catchment area of 1.5 million people.
The QEQM has already had resources taken away from it in 2013, in a move that designated it a “local emergency hospital” and the William Harvey a better resourced “trauma unit”.
Break your spine on a motorbike in Thanet now, or go into cardiac arrest? You’re already in for a long bumpy drive in the back of an ambulance to Ashford.
The plans were revealed in the NHS’s “Strategic Transformation Plan (STP)” for Kent, published late last year. They are being pursued by the East Kent Delivery Board (EKDB), a little-known organisation set up to enact sweeping healthcare reforms.
The local NHS trust (EKHUFT) is considering “the closure of one site and the creation of a single site option” the report clearly states.
It adds on page 21:
Initial thinking sees the creation of one emergency hospital centre with specialist services and a trauma unit for a natural catchment of over 1.5m. [My italics]
This would be supported by a “further emergency hospital centre” the STP says.
The document is jargon-rich and ripe with exuberant management-speak about “transformation”, “sustainability” and “efficiencies”, but this latter term is not defined.
Given that the QEQM was already designated a “local emergency hospital” back in 2013, it’s unclear what EKHUFT means. I fear that it means a hospital that’s unable to provide any emergency surgery or accept ambulances 24/7.
A&E may stay over the door, but the hospital have had even more services cut.
Local NHS followers will recognise that this is not new news. But it deserves revisiting, as plans for a radical shakeup of healthcare provision in Kent gain pace.
Public consultation is slated to begin later this year for the “truly transformational ambition” which will make greater use of volunteers and private healthcare. That’s according to the EKDB which is driving through the changes.
The EKDB is made up of eight clinical commissioning groups (CCGs), seven NHS providers including North Thanet’s EKHUFT, and two local authorities – Kent County Council and Medway Council, working closely with Virgin Health.
Among its key aspirations: “People in Kent and Medway will take good care of themselves and of each other – taking charge of their health and wellbeing and being experts on their own health…”. (Bite down on that belt, take a glug of whisky and cauterise those wounds with a poker).
Top of its agenda is keeping people out of hospital. “Your own bed is the best bed” it warns, adding that the future will see it “provide a range of out of hospital services through Local Care hubs… facilitating increased local accessibility.”
Yet the EKDB is also planning to “optimise our estate footprint as the landscape of care provision becomes more local”. (Jargon for selling off even more buildings).
The aim is to reduce gross spending on the “acute sector” by £210 million by 2020/21, by shifting to a more preventative “local care model”.
(Remember how the helpful and well-staffed Post Office shut down, to be replaced by a long queue for one tired member of staff in a dark corner of WH Smith? The pessimist in me pictures something like this, but for cancer and broken legs).
Clearly, not all the suggested reforms are bad. CCGs working more closely together for economies of scale in commissioning, and breaking down IT system “silos” makes sense, as does a real focus on reforming care for the elderly.
(As the report highlights, in Kent and Medway, over 75s with multiple chronic conditions and people with dementia make up 13% of the population and 40% of the health and social care spend.)
The risk though, looking at the report in its entirety, is that services disappear “into the community” where poor performance is harder to track and A&E is centralised in Ashford as cuts are made widely to rein in a snowballing deficit.
Beware bureaucrats with a snowballing deficit wielding the word “rationalisation”. It means that something, somewhere, is going to bleed.
As your MP, I’d fight tooth and nail to make sure that it is not people in North Thanet.
Reforms must work for the public good, not just mask shrinking budgets.
I apologise for the tabloidese of the headline, but it’s important that people know what’s going on and if it takes some shrieking, so be it. I urge everyone to read the STP and keep an eye on updates here and here.