7.1. The Committee considered a report providing an update on the progress of the implementation of the reconfiguration of Ear, Nose and Throat Services (ENT) provided by ESHT. The Committee then asked the witnesses present a number of questions.
7.2. The Committee asked for an update on any success with the recruitment of clinicians and whether consultants have sufficient time allocated to training junior doctors.
7.3. Dr Bull explained that the trust currently has an overall 10% vacancy rate compared to a national average of 16%. The turnover was 9.5% compared to an average of 15-16%. He added that there were variations around those numbers and difficulties remain recruiting to specialities, which included ENT. To help improve recruitment in ENT the two joint consultant posts are being advertised in conjunction with Brighton & Sussex University Hospital NHS Trust (BSUH). This will enable consultants to have access to both the tertiary work that goes on in Brighton and the district general work at Eastbourne District General Hospital (EDGH).
7.4. Adrian Bull said there is no doubt that the reputation of the trust is much better. As a result, he was mostly shortlisting two or three applicants for most advertised consultant specialities, except in those few areas where there were shortages, and a new generation of young consultants was beginning to develop at the trust. He added that many consultants were attracted to district general work generally, and East Sussex specifically, and not all wanted to go work in a tertiary centre and its associated academic pressures. Some, though, enjoyed exposure to both, and the relationship with BSUH and Kings College NHS Trust helps to attract those seeking this balance. ESHT also continues to support the medical schools at the University of Brighton and the emerging one in Kent.
7.5. The Committee asked for clarification whether the addition of an adult surgery list at Conquest Hospital didn’t run against the proposal to centralise the service at EDGH
7.6. Dr Adrian Bull clarified that the original purpose of the reconfiguration was to centralise adult ENT surgery at EDGH, not the entire ENT service. The final configuration has adult inpatient surgery centralised at EDGH but with a monthly day list retained at Conquest Hospital. This was at the request of ENT surgeons who wanted to ensure that the theatre teams had the opportunity to practice the skill set required for ENT surgery so that in the event of an emergency procedure there was sufficient knowledge and resources in place. Dr Bull said it was possible to accommodate this additional day list and still address the issues of ENT medical staffing being over stretched over two sites because the previous planned surgery lists at Conquest included patients who needed an overnight stay at the Conquest, meaning that ENT doctors then had to travel from the EDGH inpatient ward to see them the next day.
7.7. Adrian Bull added that the paediatric list at the Conquest, on the other hand, was for children who needed to stay overnight following more complex surgery, such as for sleep apnoea, at the paediatric ward at that hospital site.
7.8. The Committee asked for confirmation whether the ENT staff were on board with the proposals
7.9. Adrian Bull confirmed that ENT staff supported the proposals. He said that early on some nursing staff had thought there were going to be no services available, but this was resolved quickly once they understood what the proposals were going to mean for them. The consultants are also all now supportive following their concerns about emergency care. he added that they are of the view that all ENT paediatric patients should, in the long term, be seen in a tertiary centre. This is not currently a national requirement, however, and they are satisfied that the current configuration is sufficiently safe.
7.10. The Committee RESOLVED to request that the Trust’s performance reviews of ENT are circulated by email for information.