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Report to: |
East Sussex Health Overview and Scrutiny Committee (HOSC)
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Date of meeting:
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30 June 2022 |
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By: |
Assistant Chief Executive
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Title: |
Reconfiguration of Cardiology Services in East Sussex
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Purpose: |
To consider the HOSC Review Board’s report on NHS proposals to reconfigure cardiology services in East Sussex. |
RECOMMENDATIONS
The Committee is recommended to:
1) agree the report and recommendations of the HOSC Review Board attached as Appendix 1; and
2) agree to refer the report to NHS Sussex for consideration as part of its decision making process.
1. Background
1.1. On 2nd December 2021 the HOSC considered a report by the East Sussex Clinical Commissioning Group (CCG) in partnership with East Sussex Healthcare NHS Trust (ESHT) on the proposals to reconfigure ESHT’s cardiology services in East Sussex.
1.2. ESHT provides acute cardiology services for the residents of East Sussex at its two main hospital sites at Eastbourne District General Hospital (EDGH) and Conquest Hospital, Hastings, as well as cardiology rehabilitation in the community. The Trust’s acute cardiology services encompass interventional cardiac services, which include surgical procedures or investigations that might require an overnight or longer stay in hospital, as well as outpatients, non-invasive diagnostics, cardiac monitored beds and heart failure services.
1.3. The CCG and ESHT undertook a review of the Trust’s acute cardiology services that concluded, amongst other things, the service has workforce challenges; is not providing the recommended safe volume of various interventional procedures; and is not consistently meeting all of the performance indicators and national guidance for cardiology care.
1.4. As a result, the CCG and ESHT are proposing the following changes to the acute cardiology services provided by ESHT:
· locate the most specialist cardiac services, including surgical procedures or investigations that might require an overnight or longer stay in hospital, at one of the two acute hospitals (either EDGH or Conquest);
· introduce a “front door model” involving forming a Cardiac Response Team to support patients on their arrival at A&E, alongside ‘hot clinics’ that will provide consultant-led rapid assessment at both acute hospital sites; and
· retain outpatients, non-invasive diagnostics, cardiac monitored beds, cardiac rehabilitation and heart failure services at both hospitals, and in the community.
1.5. A pre-consultation business case (PCBC) setting out specific proposals, was developed by the CCG in partnership with ESHT, to reconfigure the Trust’s cardiology services. The CCG undertook a public consultation between 6th December 2021 and 11th March 2022 seeking views on the case for change, the proposed new clinical model for services and whether people preferred EDGH or the Conquest as a site for the location of the specialist cardiac services.
2. Supporting information
2.1. Under health scrutiny legislation, NHS organisations are required to consult affected HOSCs about a proposed service change that would constitute a ‘substantial development or variation’ to services for the residents of the HOSC area. At the meeting held on 2nd December 2021 the Committee resolved that the proposals constituted a ‘substantial development or variation to services’ requiring formal consultation by the CCG with HOSC in accordance with health scrutiny legislation.
2.2. The HOSC established a Review Board to consider the evidence in relation to the proposed reconfiguration of cardiology services and prepare a report and any recommendations as the Committee’s response to the consultation. The Board comprised Councillors Belsey, di Cara, Marlow-Eastwood, Robinson, and Turner. The Review Board elected Councillor Robinson as the Chair of the Review Board.
2.3. The Review Board considered a wide range of written and oral evidence from NHS and other witnesses and agreed a report and recommendations by a majority decision (with one Board member not supporting recommendation 1), which is included as Appendix 1 to this report.
2.4. The HOSC is recommended to agree the Review Board report and submit it to NHS Sussex (the NHS organisation due to replace the CCG from 1st July 2022) for consideration as part of its decision making process, alongside its own Decision Making Business Case (DMBC). NHS Sussex will then report its decision to the HOSC on 22nd September 2022 and the Committee will consider whether the decision is in the best interest of health services locally.
3. Conclusion and reasons for recommendations
3.1 The HOSC is recommended to agree the Review Board’s report and agree to refer it to NHS Sussex for consideration as part of its decision making process.
PHILIP BAKER
Assistant Chief Executive
Contact Officer:
Harvey Winder, Scrutiny and Policy Officer
Tel. No. 01273 481796
Email: Harvey.winder@eastsussex.gov.uk