1. EKHUFT Clinical Strategy Case for Change

2. Why do we need to change Although we achieve good outcomes for patients, we need to continue to improve Improved treatments require improved facilities We need to make the best use of the resources we have

3. Key principles Some of the foundations on which we build

4. Short Stay Care Reasons for change So what might it look like

5. Outpatients Why do we need to make changes What might it look like 1 Map Showing Proposed 6 Outpatient sites Key Trust Sites Proposed North Site ? ? ? ? ? ?

6. Emergency Paediatrics What do we want to improve What might it look like

7. Emergency Gynaecology What do we currently provide So how might it look in the future

8. Emergency Medicine What happens now What might it look like in the future

9. Major Trauma Why do we need to change How might it be delivered in the future

10. Surgery Reasons why we need to change How might it look in the future

11. Options Option 1- Hub WHH – 1 spoke at QEQM, K&C remains largely unchanged Option 2 - Hub at K&C – 2 spokes; WHH and QEQM Option 3 - Hub QEQM & WHH

12. Option 1 (WHH hub) AdvantagesDisadvantages Single consultant rota Aligns with Women’s and Children’s service provision All specialist knowledge in one place providing a centre of excellence Co-aligns with an emergency trauma service Travel times from North Kent will be longer for a number of patients Will need to provide 2 other middle grade surgical rotas to support the unselected medical take at QEQM & K&C Capital investment in ITU Doesn’t resolve vascular sub specialisation issues

13. Option 2 K&C hub AdvantagesDisadvantages Centre of the Trust – geographically Less travel time for patients from North Kent than if the hub is WHH Co-aligns with vascular and urology surgery which facilitates workforce and training solutions Overall more patients will have to travel Will need to provide 2 other middle grade surgical rotas to support the unselected medical take at QEQM & K&C Capital investment in ITU and theatres Does not co-align with an emergency trauma service or other surgical services doesn't co-align with paediatric services

14. Option 3 (2 hubs) AdvantagesDisadvantages Local service for patients Travel times remain as now Aligns with Women’s and Children’s service provision Co-aligns with an emergency trauma service No specialist hub or centre of excellence Doesn’t resolve vascular sub specialisation issues Requires 2 consultant on call rotas and the implications of workforce availability as described

15. Next Steps Three month engagement process Test our plans with the long term commissioning plans Take independent advice from the Royal College of Surgeons

16. Questions?