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Report from Karen Constantine, KCC Health Overview and Scrutiny Committee member

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"It seems advanced plans for a massive shake up of General Practice's surgeries (GPs) and Queen Elizabeth The Queen Mother Hospital (QEQM) services are well underway.

Here is my take on the plans and impact, but nothing is yet entirely in the open so I am surmising a likely direction of travel and outcomes based on knowledge of both the NHS and private sector, nationally and locally, I shall be seeking formal confirmation and clarification on your behalf from our NHS leaders. I shall be holding those making these decisions accountable.

As you may know stroke services for Thanet are being moved to Ashford. This flies in the face of what most of us have been taught to believe. That in the event of a stroke to get to hospital for emergency treatment within an hour. Ashford is about an hour away, recent information from the ambulance service shows 50% of patents suffering a stroke wait 18 mins for an ambulance, (50% will wait even longer).

The current Stoke service at QEQM is poor. Surely the best thing to do is to improve it? Not to move it so far away!

Also with not one jot of prior consultation with the public, 'super surgeries' will replace small local GP practices across Thanet. Some of the more straightforward clinical procedures currently carried out in QEQM will also be delivered in these super surgeries.

Bear in mind the original plan put forward was for the development of 4 'hubs’. It now appears we will be losing our spokes. We were also informed that these hubs would facilitate the introduction of technology designed to make patient lives easier. That's not been mentioned since.

A close look at what is happening shows different ambitions from those previously stated by our Clinical Commissioning Group (CCG).

The Margate 'super surgery’, the Bethesda practice, will 'mop up' both some of Margate's GP practices, particularly as GPs retire. It will also provide some facilities that are currently provided at QEQM. The expectation is that surgeries will close and patients will be required to travel to the Bethesda.

The proposed Ramsgate ‘super surgery’ is to be built and located next to Sainsbury's at Westwood Cross at a cost of £10 million. Presumably this is intended to serve both Broadstairs and Ramsgate. A number of local GP practices are already earmarked to move in.  Although Dashwood and Eastcliff will remain as they are ( for the time being). That means Newington (yes, you read that correctly), The Grange, St Peters and Mocketts Wood will all fully combine.

A further ‘super hub’ seems to be earmarked for Minster.

Elsewhere in the U.K. GPs are looking at how to move themselves (and healthcare) closer to the people they serve and closer to those with the greatest needs. Based on that model, surely Newington Surgery would remain for the benefit of local residents? Factor in that in established practices the GPs and patients have good strong relationships built over many years. It may be a simple ambition to deliver services elsewhere, but transferring the doctor-patient culture is as difficult as it is necessary. Combining the culture of up to 6 surgeries is a tough challenge. This is especially apparent where one of the current drivers is the reliance on locum doctors.

These 'super hubs' are being formed to take the pressure off QEQM. What I'm afraid they will do is contribute to the continuing 'hollowing out' of clinical services available at our local hospital. This will also act as impetus to funnel yet more services across to William Harvey Hospital in Ashford.

A further worry is the plan to divide some of the clinical practices between these 3 hubs. So, in one hub you might be able to get your cataracts seen to, another may provide ENT ear, nose and throat services and so on.

This in itself presents risk. If one of the surgeries 'falls down' for any reason all the services will be halted. Unlike in a hospital where they could be carried on. The biggest risk is that patients are put off, are confused, or don't access these vital services, or access late when their conditions are more difficult to treat.

For Thanet, where life expectancy is low, where disability is high. This really isn't good enough. Contact me with your thoughts and concerns. I'm creating a file on the experiences of local residents."

Karen@karen4labour.uk

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