43.1. The Committee considered a report providing an update on the proposed development of Cardiology and Ophthalmology services at East Sussex Healthcare NHS Trust (ESHT).
43.2. The Committee requested confirmation at its next meeting on the number of patients who would be affected by the proposals, particularly for cardiology; the location of these patients; the current number of cross-site transfers of patients; and whether the proposals will affect patient flows of cardiology services in East Sussex.
43.3. Joe Chadwick-Bell confirmed that the impact on the population, changes in patient flows, including cross-site transfers, and impact on other NHS organisations is all considered during the options appraisal process and in the PCBC. These details will be made available to the HOSC at its 10th June meeting.
43.4. The Committee asked why ESHT’s cardiac cath labs do not carry out thrombectomies (mechanical removal of blood clots).
43.5. Joe Chadwick-Bell clarified that clot busting procedures are available at ESHT but more complex tertiary procedures like cardiac surgery would not be provided on every NHS hospital site due to the low volumes and necessary high expertise of the surgeons who perform them. They would, however, be carried out at regional centres of excellence such as the Royal Sussex County Hospital (RSCH) in Brighton. The aim of the cardiology reconfiguration is not to ensure all cardiac procedures are provided at ESHT but that the services provided at its hospitals are best practice for a district general hospital.
43.6. Joe Chadwick-Bell said the options appraisal and PCBC will make clear what services are provided on the sites currently and what will be in future. This will also include background information on what services are provided in specialist tertiary sites.
43.7. The Committee asked whether South East Coast Ambulance NHS Foundation Trust (SECAmb) has concerns about longer travel times for patients needing cardiology treatment, and what advantages there might be if they receive care at a centre of excellence.
43.8. Joe Chadwick-Bell explained that the operating model of the current cardiology services involves both hospital sites providing a weekday service for acute cardiac services, but evening and weekend services are provided from a single site that alternates between the two. SECAmb is involved in transporting patients under this configuration and has indicated it has no impact on their resources.
43.9. Michael Farrer, Strategy, Innovation & Planning Team at ESHT, said that the PCBC will include modelling work on the impact of the proposals on patients, including travel time, but a full answer is not currently available on the potential impact. SECAmb will also be involved in the options appraisal process that precedes the PCBC to provide their opinion on the potential impact on their service for each option.
43.10. The Committee asked how the CCG will have the capacity to run the inpatient mental health and cardiology/ophthalmology consultations at the same time.
43.11. Jessica Britton said that the CCG, which is the responsible organisation for both consultations, will resource them jointly with the two trusts that are affected – ESHT and SPFT. The CCG is confident there is sufficient resource to deliver both.
43.12. The Committee asked how the recent engagement with stakeholders was carried out during COVID-19.
43.13. Jessica Britton said the CCG has been undertaking the engagement using Microsoft Teams or the phone to speak with people; social media to advertise the engagement; and its website to host the surveys people are asked to fill out. The cardiology and ophthalmology engagement work has involved one to one interviews with patients who have experienced either service. Michael Farrer said the CCG has had very good response to its pre-engagement work with over 200 written responses and 39 in-depth interviews with patients, the public and key stakeholders about what does and does not work well with the two services. This data will feed into options development process. The Executive Director said the CCG has had a better response than for some engagement work done pre-COVID-19.
43.14. The Committee asked whether the CCG will use the Consultation Institute to help develop the public consultation plan.
43.15. Jessica Britton confirmed the CCG will always use an external organisation to evaluate its consultation plans and feedback to consultations. This will be the case for the public consultation on both Cardiology and Ophthalmology and Inpatient Mental Health.
43.16. The Committee asked whether the Cardiology and Ophthalmology consultations will be for all patients in East Sussex, or just those who are in the catchment area for ESHT.
43.17. Jessica Britton confirmed that should proposals be subject to public consultation, any communications and feedback methods, together with supporting events will be held as widely as possible for all residents of East Sussex and not just those using the service.
43.18. The Committee RESOLVED to:
1) consider and note the report; and
2) agree to consider a further report at its 10th June meeting.