Agenda item

19.1.    The Committee considered a report providing an overview of the proposals to redesign cardiology services at Maidstone and Tunbridge Wells NHS Trust (MTW), which are used by some patients in East Sussex.

19.2.    The Committee asked what South East Coast Ambulance NHS Foundation Trust’s (SECAmb) views were of the requirement under the proposals to transfer some patients from the Emergency Department (ED) on the ‘cold’ site to the Coronary Care Unit or cath lab on the ‘hot’ site.

19.3.    Dr Laurence Nunn, Consultant Cardiologist and Clinical lead for Cardiology at MTW confirmed the Trust has designed the service to minimise the burden on SECAmb. The ambulance trust is fully involved with the plans and MTW has been meeting with them to discuss, amongst other things, the impact of the single siting; agreement of protocols for admitting patients directly to the specialist site; and how to enable SECAmb to contact the consultant cardiologists via telemedicine, which has been used successfully for stroke services and for tertiary cardiology centres like Ashford and Guys and St Thomas. He added the patients will receive emergency treatment at both sites and the ED on both sites will be able to use telemedicine to enable consultant cardiologists at the specialist site to determine whether the patient would need to be transferred to the Coronary Care Unit.

19.4.    The Committee asked how the proposed changes will impact travel times of patients.

19.5.    Jo Cutting, Programme Director for Cardiology at MTW, said the Trust had conducted robust analysis of the travel times both by car and public transport, and the time of day of the journey. This analysis showed that whichever option is chosen will result in extended travel for a small number of people, however, the clinical improvements, particularly the reduction in length of stay made possible by having expertise on site 24/7, will reduce the number of journeys families and friends have to make. The Trust will also look to mitigate the impact, for example, through hospital transport and dedicated car parking for whichever option is chosen.

19.6.    The Committee asked how the single site might achieve ‘centre of excellence’ status.

19.7.    Dr Laurence Nunn said the primary reason for the reconfiguration is to provide a robust cardiology service 24/7 for all cardiology emergencies, however, there is no reason why the services could not be enhanced further. Whilst no decision has been made on the site yet, one of the advantages of locating it at Maidstone Hospital would be to allow co-adjacency with stroke services that may allow for thrombectomies (mechanical removal of blood clots during a stroke) to be performed at the cardiology cath labs. Dr Peter Maskell, Medical Director at MTW, added that single siting expertise should allow for more complex procedures to be performed locally rather than having to transfer patients to London.

19.8.    The Committee asked how MTW was conducting its public engagement in East Sussex. 

19.9.    Jo Cutting explained that the engagement has been advertised very widely already across a number of different media platforms, including newspapers, press releases and online. The newspaper adverts include a telephone number and address for those people who want a physical copy of the proposals document and survey. The Trust has also set up pop up stalls in shopping centres and other places (with staff wearing masks), telephone surveys and online listening events. There are online listening events planned for the next two weeks and potentially more will take place if necessary. The Programme Director said she had also met with the Tunbridge Wells Older People’s Forum virtually and would be happy to meet with any other organisations to explain the proposals.

19.10.  The Committee RESOLVED to:

1)         agree that the proposals are not a substantial variation to services; and

2)         agree to submit a formal written response to the public engagement being undertaken by MTW.