The must-read stories and debate in health policy and leadership.

Reconfiguring Kent

Reconfiguring acute services is a long job, but it is likely no one in East Kent could have predicted how long it might take to even reach the starting line.

Two leading options had emerged. The first involves an expected consolidation of many services at the William Harvey Hospital in Ashford but with an accident and emergency department retained in Thanet. The second entails a surprise “new build” in Canterbury, dependent on housebuilding elsewhere in the city.

A public consultation had been mooted for spring 2018, but was pushed back and now seems unlikely to start before next year.

In the meantime, costs have grown, as have concerns a “two site” option, retaining an A&E at two hospitals, may not be sustainable in the longer term.  A third option – with a single A&E and consultant-led maternity at Ashford – seems to have garnered some support but was deemed unaffordable. It was never discussed in public but would have been phenomenally unpopular in Thanet, where it would have meant an hour-long journey to A&E for many.

So we have a head-to-head between the “two site” Ashford option and a new hospital in Canterbury. Canterbury is more expensive and dependent on an offer from a developer to fund the “shell” of a hospital in return for planning permission elsewhere. But some feel this solution is more sustainable and would not need revisiting later.

The site is also close to the planned medical school, and a school of nursing, plus it is in one of the most attractive parts of Kent, which could make recruitment easier. The final choice may depend on what the centre is willing to put its hand in its pocket to fund.

Delays in Essex

HSJ revealed on Monday that the planned merger of three Essex hospital trusts has been pushed back a year.

Setbacks to mergers are not uncommon, so the delay to the ambitious amalgamation of three mid-sized hospitals – Basildon and Thurrock University Hospitals Foundation Trust, Southend University Hospital FT and Mid Essex Hospital Services Trust –  was perhaps inevitable.

But it represents a potentially costly blow. The trusts told HSJ it leaves question marks over a large chunk of capital – £118m – the Treasury provisionally allocated to them for a major clinical reorganisation, which they are not yet able to access.

All eyes are now on Matt Hancock, who needs to sign off the controversial clinical reorganisation after it was referred to the health and social care secretary by Southend on Sea Borough and Thurrock councils.