It serves a local population of around 759,000 people. It is a teaching trust involved in the education and training of doctors, nurses and other healthcare professionals, with King's College London and, since 2018, Kent and Medway Medical School.[1]
In April 2014 it was reported that the trust was looking for a partner to develop a private hospital at the William Harvey Hospital site and enhance the returns from the Spencer private hospital on the Queen Elizabeth The Queen Mother Hospital site with a contract over the next 15 to 15 years.[3]
The trust's proposal to centralise surgery on the Canterbury site in order to manage problems caused by "the increasing sub-specialisation of surgery, the lack of availability of surgeons with skills that are essential to managing high risk and emergency general surgery, and the difficulty recruiting both permanent and locum medical staff" in May 2014 aroused opposition among consultants.[4]
In May 2018 the trust announced plans to transfer 850 cleaning, catering, switchboard and portering staff who work for Serco and 250 NHS staff working on estates, procurement and facilities to a new limited company owned by the trust and described as a social enterprise.[5] This organisation is named 2gether Support Solutions.[6]
Buildings
In August 2022 it was reported that the trust needed £65 million worth of improvements for critical risk infrastructure including the high voltage transformers at the Kent and Canterbury Hospital, high voltage upgrade works at the Queen Elizabeth, the Queen Mother, Hospital, replacement of obsolete fire alarm cabling and replacement of defective heat exchangers at the neonatal intensive care unit at the William Harvey Hospital. 8% of its estate was classified as bad, life expired and/or at serious risk of imminent failure.[7]
Performance
Four-hour target in the emergency department quarterly figures from NHS England
In 2010, it was named "Trust of the Year 2010" by the healthcare information organisation Dr Foster.[9]
In 2015 the Trauma Audit & Research Network showed that the William Harvey Hospital in Ashford was the best performing hospital receiving trauma patients in England and Wales, out of 100 hospitals offering trauma facilities across the country, according to survival rates of patients.[11] The Care Quality Commission upgraded the trust from "inadequate" to "requires improvement" and cited significant improvements. Two of the trust's five hospitals were rated as "Good". It was one of 26 responsible for half of the national growth in patients waiting more than four hours in accident and emergency over the 2014/5 winter.[12] It hit controversy when an RAF sergeant was asked to leave the waiting room in case his uniform upset other patients.[citation needed] It admitted breaching a patient's human rights when it placed a "do not resuscitate" (DNR) order on the patients notes because the patient had learning difficulties. The trust had not consulted the family about the decision.[13]
In 2016 the trust saw improvements in its annual Patient-Led Assessment in Care Environments audits, which were introduced nationally in 2013. All hospitals, hospices and day treatment centres that give NHS-funded care are subject to a PLACE inspection. In April 2016 it admitted that it could not cope with the overwhelming demand on its ophthalmology department, which saw nearly 100,000 patients in 2015/6. 7000 were in need of follow-up and at risk of deteriorating eyesight.[14]
In October 2017 after months of very poor performance against the A&E four hour target it was clearly the worst performing trust in England on A&E in 2017–18, with around 30%t of patients waiting over four hours. The chair of the trust, Nikki Cole, resigned and was replaced by Peter Carter.[15] In 2017–18 East Kent Hospitals saw 74.3% of A&E patients within four hours.[16]
In August 2018 it announced that planned orthopaedic operations would be moved from the William Harvey Hospital to the Kent and Canterbury Hospital in an attempt to avoid cancellations.[17]
In 2018 it had 214 estates and facilities related incidents. It runs more than 100 buildings, some of which date back to the 1930s, and appealed for £34 million in emergency capital funding in January 2019.[18]
In September 2018, SERCO were sacked as the facilities provider for the Trust. They were replaced by 2gether Support Solutions, a brand new company, wholly owned by the Trust. 2Gether were given a 25 year contract and a loan of £100 million from the Trust. The deal was signed off by the then CEO Susan Acott and the then Chairman Steven Smith. [19][20]
The trust commissioned 28 beds from a residential home, Ami Lodge in Deal, Kent, to support patients medically fit to leave hospital but not able to return to their own home. It was forced to abandon the scheme when the Care Quality Commission rated the home "inadequate" in November 2018.[21]
Maternity deaths and Kirkup report
In January 2020, the inquest of baby Harry Richford revealed that he had died due to 7 gross failings which, the coroner said, amounted to neglect. [22] This led to a public inquiry led by Dr Bill Kirkup. Well over 200 families came forward to have their own maternity cases examined by the inquiry.[23]
In 2020 the BBC found 7 cases of babies either stillborn or who died shortly after birth since 2016, these cases should have been prevented with better care. The Royal College of Obstetricians and Gynaecologists found in 2015, consultants, failing to do labour ward rounds, failing to review women, make care plans or attend out of hours when asked, consultants, rarely did CTG training, and reportedly were, "doing their own thing rather than follow guidelines" Staff alleged at the review, the board did not consider maternity services a priority and no action would be taken over concerns raised. In 2014 the trust was put into special measures after Care Quality Commission rated its care, including maternity care inadequate. Since then the CQC rated it as requiring improvement.[24]
From 2016 to 2019 the trust had to close one of its two maternity units, which are nearly 40 miles apart, to new births 111 times. At least 120 women in labour were diverted. Although it is not unusual for maternity units close or divert for short periods these closures were unusually frequent.[25]
In October 2020 the trust was prosecuted by the Care Quality Commission for failing to provide safe care and treatment exposing Harry Richford and his mother Sarah to avoidable harm. Harry died a week after his birth at Queen Elizabeth The Queen Mother Hospital in 2017. This is the first such prosecution of an acute trust.[26] The trust were fined £1.1 million reduced to £733k following a guilty plea.[23]
The families investigation into Harry's death was masterminded by Derek Richford, Harry's grandfather. The BBC said of the family's efforts "However, it took a skilled, determined, grieving family's fight for justice to force meaningful change on a reluctant and failing organisation." [27] The story was covered nationally on all channels and later on the BBC website Michael Buchanan wrote Derek's story "No-one joined the dots" [28]
Following two years of investigation into maternity services at East Kent Hospitals, a report named Reading the signals led by Dr Bill Kirkup was published on 19th October 2022. The review found that up to 45 babies may have survived if they had received better care. The report focused on the Trust's two maternity units, at the William Harvey Hospital in Ashford, and the Queen Elizabeth the Queen Mother Hospital in Margate.
In particular, when speaking of the seminal case, Harry Richford, Kirkup said - 1.112 This pattern of behaviour by the Trust, clearly evident in this case, recurred in many others that we examined. It included denying that anything had gone amiss, minimising adverse features, finding reasons to treat deaths and other catastrophic outcomes as expected, and omitting key details in accounts given to families as well as to official bodies. Although we did not find evidence that there was a conscious conspiracy, the effect of these behaviours was to cover up the truth. 1.113 Even had none of the previous failings been known – and they were – baby Harry’s death should surely have been a catalyst for immediate change. In fact, it required public remonstration by a coroner over two years later, precipitated by the persistence, diligence and courage of baby Harry’s family, to reveal an organisation that did not accept its own failings, considered itself above scrutiny or accountability, and consistently rejected the opportunity to learn when things went wrong. [29]
In response to the report, Chief Executive Tracey Fletcher apologised for the "harm and suffering" caused.[30][31]
The William Harvey Hospital is a hospital in Willesborough, Ashford, Kent, England. It is one of the three main hospitals in the East Kent Hospitals University NHS Foundation Trust area and is named after William Harvey (1578–1657), the Folkestone-born doctor who discovered the blood circulatory system.
Monitor was an executive non-departmental public body of the Department of Health, responsible between 2004 and 2016 for ensuring healthcare provision in NHS England was financially effective. It was the sector regulator for health services in England. Its chief executive was Ian Dalton and it was chaired by Dido Harding. Monitor was merged with the NHS Trust Development Authority to form NHS Improvement on 1 April 2016.
The Countess of Chester Hospital is the main NHS hospital for the English city of Chester and the surrounding area. It currently has 625 beds, general medical departments and a 24-hour accident and emergency unit. It is managed by the Countess of Chester Hospital NHS Foundation Trust, one of the first Foundation Trusts in the UK, formed in 2004. Cardiac rehabilitation services at the hospital are provided by Cheshire and Wirral Partnership NHS Foundation Trust.
Queen Elizabeth Hospital in King's Lynn, Norfolk, England. It is located on the outskirts of King's Lynn, to the eastern edge of the town. The catchment area of the Queen Elizabeth Hospital covers the West Norfolk area, South Lincolnshire and Northern part of Fenland District, Cambridgeshire, an area of approximately 1500 km2 and 250,000 people. It is managed by the Queen Elizabeth Hospital King's Lynn NHS Foundation Trust. The Queen Elizabeth Hospital is named after Queen Elizabeth The Queen Mother, rather than Queen Elizabeth II.
Newham University Hospital is an acute general hospital situated in Plaistow in the London Borough of Newham. It is managed by Barts Health NHS Trust.
Liverpool Women's NHS Foundation Trust runs Liverpool Women's Hospital, a major obstetrics, gynaecology and neonatology research hospital in Liverpool, England. It is one of several specialist hospitals located within the Liverpool City Region; alongside Alder Hey Children's Hospital, Liverpool Heart and Chest Hospital, the Walton Centre, Mersey Regional Burns and Plastic Surgery Unit, and Clatterbridge Cancer Centre.
The Queen Victoria Hospital (QVH), located in East Grinstead, West Sussex, England is the specialist reconstructive surgery centre for the south east of England, and also provides services at clinics across the region. It has become world-famous for its pioneering burns and plastic surgery. The hospital was named after Queen Victoria. It is managed by the Queen Victoria Hospital NHS Foundation Trust.
Furness General Hospital (FGH) is a hospital located in the Hawcoat area of Barrow-in-Furness, Cumbria, England. It is managed by the University Hospitals of Morecambe Bay NHS Foundation Trust.
Barking, Havering and Redbridge University Hospitals NHS Trust is an NHS trust which runs King George Hospital in Goodmayes and Queen's Hospital in Romford. It also operates clinics at a number of sites in the nearby area including Barking Hospital and Brentwood Community Hospital.
University Hospital Lewisham is a teaching hospital run by Lewisham and Greenwich NHS Trust and serving the London Borough of Lewisham. It is now affiliated with King's College London and forms part of the King's Health Partners academic health science centre. It is situated on Lewisham High Street between Lewisham and Catford.
Medway NHS Trust is an NHS foundation trust based in Kent which runs Medway Maritime Hospital.
The Furness General Hospital scandal involves an investigation by Cumbria Constabulary and other government and public bodies into the deaths of several mothers and newborn babies, during the 2000s at Furness General Hospital (FGH) in Barrow-in-Furness, Cumbria, England. Cases date back to 2004, with a number of major incidents occurring in 2008. The death of Joshua Titcombe and a suppressed report by the Morecambe Bay NHS Trust brought the spotlight onto FGH in 2011 when investigations began. Claims of medical records being intentionally destroyed alongside the discovery of major wrongdoing on behalf of midwives led to threats of closure to the maternity ward.
Lewisham and Greenwich NHS Trust is an NHS trust which was formed on 1 October 2013 and is responsible for running two acute hospitals, Queen Elizabeth Hospital and University Hospital Lewisham, in addition to community health services in Lewisham.
Mid Cheshire Hospitals NHS Foundation Trust (MCHFT) is an acute hospital trust in Cheshire. It runs Leighton Hospital in Crewe, Victoria Infirmary in Northwich, and Elmhurst Intermediate Care Centre in Winsford. MCHFT was established as an NHS Trust in April 1991, and became an NHS Foundation Trust in April 2008. The trust is currently led by Chair of the Board of Directors Dennis Dunn and CEO Ian Moston.
North East London NHS Foundation Trust (NELFT) is an NHS foundation trust which provides mental and community health services. It runs Foxglove Ward, Goodmayes Hospital and Sunflowers Court in Ilford, Phoenix House in Basildon, Heronwood & Galleon Inpatient Facility in Wanstead, Grays Court Community Hospital in Dagenham, and Hawkwell Court in Chingford. Altogether it operates from more than 150 sites.
Shrewsbury and Telford Hospital NHS Trust is the main provider of hospital services for Shropshire, Telford and Wrekin and North Powys. It runs the Royal Shrewsbury Hospital, the Princess Royal Hospital in Telford, Oswestry Maternity Unit, and Wrekin Community Clinic, Euston House, Telford, in Shropshire, England. It is one of a small number of English NHS Trusts which takes patients from over the border in Wales.
Healthcare in Kent has, from 1 July 2022, been mainly the responsibility of the Kent & Medway Integrated Care Board. Certain specialised services are directly commissioned by NHS England, coordinated through the South East integrated regional team. Some NHS England structures are aligned on a Kent and Medway basis, others on a South East basis and there is liaison with London to provide many tertiary healthcare services.
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