Deficits, Transformation, Car Parking and a big thank you

All four East Kent Clinical Commissioning Groups (CCGs) in East Kent, Ashford Canterbury & Coastal, South Kent Coast (Folkestone & Dover) and Thanet are in special measures following NHS England’s annual assessment of the area’s finances.

• Ashford CCG deficit 2018/19 moved from a planned deficit of £8.6m to £15.1m

• Canterbury & Coastal deficit 2018/19 moved from a planned deficit of £9.2m to £18.5m

• South Kent Coast CCG deficit 2018/19 moved from a planned deficit of £5.7m to £15.8m

• Thanet CCG deficit 2018/19 moved from a planned deficit of £4.34m to £6.6m.

The CCGs have a combined deficit of £57 million.

The CCGs of East Kent are responsible for commissioning the majority of services you as a patient experience, including hospital care, community health services, rehabilitation services, mental health services and others. They commission services for more than 695,000 patients across 72 GP surgeries in East Kent.

The vast majority of the commissioned work is undertaken at the Buckland Hospital (Dover), Kent & Canterbury Hospital, The Queen Elizabeth The Queen Mother Hospital (Margate), The Royal Victoria Hospital (Folkestone) and the William Harvey Hospital (Ashford). All these hospitals come under East Kent Hospital University Foundation Trust (EKHUFT) which according to the Care Quality Commission remains at requiring improvement. The Trust is doing all it can to change and improve.

Below is a table of all 72 GP practices and the number of patients each practices has across all four CCG areas of East Kent. Most of the patients end up going to one or more of the hospitals above to receive their commissioned health care. Data for the number of patients listed at 65 out of the 72 GP practices was available via NHS Digital for July 2019.

The CCGs are responsible along with East Kent Hospital University Foundation Trust (EKHUFT) for the restructuring of healthcare provision in East Kent.

On the 6th Nov 2018 at Hythe Pavillion in South Rd representatives of the Four East Kent CCG’s Ashford, Canterbury, South Kent Coast & Thanet plus senior staff of the East Kent Hospital University Foundation Trust (EKHUFT) met to listen and inform the public of the two options regarding the restructuring of the East Kent NHS Health services under the Sustainability & Transformation Plan. The two options are:

Whichever of the options are chosen, both the CCGs and EKHUFT hope that the changes will bring about an improved services to all patients who use the services commissioned by the CCGs.

The journey facilitating the change continued on July 18th. 40 members of the public and 40 clinicians, GP’s, Anaesthetists, Surgeons etc, met at Canterbury Cricket ground in Canterbury to move the discussion along about the two options. We add it is NOT a finished process, so nothing discussed at that meeting is set in stone. The lead for the day was Caroline Selkirk, (pictured) Managing Director of Ashford, Canterbury and Coastal, South Kent Coast, and Thanet clinical commissioning groups.

Clinicians and members of the public were only allowed to discuss and comment on two out of the five evaluation criteria. These were clinical sustainability, and accessibility.  Finances, deliverability and strategic fit were NOT open for discussion or input.

At this meeting it was made clear there are significant issues with the recruitment of consultants, GPs, nurses and therapists in East Kent. But it is not just recruitment issues.

According to latest data available, (Dec 2018) Patients having planned operations & care within 18 weeks of referral ranked our Trust, East Kent Hospital University Foundation Trust as the worse trust in the Country meaning it was 131st out 131 trusts. What with the target set at 92%, England as a whole hit 86.6%, but our trust hit just 72.4%. The Trust last hit its target in Oct 2015.

Patients starting cancer treatment within 62 days of urgent GP referral according to figures released in Dec 2018 show that our Trust, East Kent Hospital University Foundation Trust has not met the target of 85% since Sept 2014.  In Dec 2018 the Trusts average was 82.1% and ranked 74th out of 131 trusts.

So the evidence demonstrates change is needed. However, the public need more information, especially about the three evaluation criteria not open for discussion on the 18th July at Canterbury Cricket ground. Fiscal change is needed to reduce the £57 million pound deficit the CCGs have and the £76.4 million deficit  EKHUFT have (combined deficit £133.4m). This is why NHS England have placed all four East Kent CCG’s into special measures.  Without a reduction in the deficits change may be difficult, if not impossible.

However, it is necessary to put some perspective on the deficits. The three primary hospitals and two secondary hospitals in East Kent receive 1.5 million visits for advice and treatment each year, of which 1.3 million are at the QEQM, William Harvey Hospital and the Kent & Canterbury Hospital. 1.1 million (86.6%) of the visits to the hospitals are for routine care that does not require patients to stay in hospital, such as outpatient appointments, visits for minor injuries and illnesses and tests and scans.

14% or 204,000 visits are for more complex care for patients needing to stay in hospital,eg if you are acutely unwell, seriously injured or in need of highly specialised care that most of the East Kent population won’t ever need.

All this provided by 8,045 staff which is quite remarkable. We’d like to say thank you to each and every one of them. Without you there would be no NHS.

However, EKHUFT spent £36.4 million on agency staff in 2018/19, which was £17 million more than anticipated. This reliance on agency staff demonstrates the ongoing difficulties EKHUFT have in recruiting staff and retaining them.

Finally, the 40 members of the public who attended the next steps forward event at Canterbury cricket ground on July 18th,  were asked to speak about accessibility to EKHUFT hospitals. One of the aspects of accessibility is car parking at hospitals. We note that EKHUFT made £4,379,000 million from car parking in 2018/19, an increase of £452,000 on the previous financial year. In our opinion this needs to change if they are to make hospitals more accessible for patients and visitors alike.

The Shepwayvox Team

Journalism for the People NOT the Powerful