Families of over 300 children avoid driving 30,000 miles for appointments thanks to new hospital alliance

The families of over 300 children with epilepsy and other neurological diagnoses have avoided having to travel nearly 30,000 miles of hospital trips after two hospitals joined forces to provide care closer to home.

The new partnership between two hospital trusts has reduced the need for children to miss school for medical appointments, minimised days off work for parents caring for their children and led to better, more convenient care for families.

Previously, families from Kent were taking their children out of school for appointments and travelling around 20 miles to Evelina London, based at St Thomas’ Hospital and part of Guy’s and St Thomas’ NHS Foundation Trust.

But since Guy’s and St Thomas’ and Dartford and Gravesham NHS Trust formed a collaboration in 2016 to improve patient care, a new clinic – run jointly by Evelina London clinicians and a new local consultant – can see double the number of patients.

The children can now go to Darent Valley Hospital in Dartford instead of Evelina London Children’s Hospital for a specialist clinic

Support at home was also limited and patients regularly ended up at the Emergency Department (A&E), so with the support of a children’s charity, a specialist epilepsy nurse was appointed to provide additional support using the first videoed job advert by the former Dartford and Gravesham, Chief Executive, Susan Acott.

Gerard Sammon, Acting Chief Executive of Dartford and Gravesham NHS Trust, said: “We didn’t want children to need days off school and families to travel long distances for a service we could provide closer to home by thinking creatively.  We quickly realised that by working together we could do that while also increasing the sustainability of both organisations.”

Maria Higson, Head of the Healthcare Alliance at Guy’s and St Thomas’, said: “While we wanted the children to get the best care we also wanted to help sustain the smaller hospital of Darent Valley and a major factor was recruiting the right clinicians.

“By linking the Darent Valley and Evelina London hospitals, sharing clinical leadership skills and workloads, consultants in Dartford have access to patients and resources at Evelina London making it a more attractive offer.”

The partnership formed part of the NHS England Vanguard Programme, which asked NHS trusts to develop ways to work together to deliver improved, more efficient care and find solutions to shared challenges.

Across the NHS, 14 Integrated Care Systems (ICS) and 30 Sustainability and Transformation Partnerships are seeing NHS and local government join forces to pool resources and budgets and simplify systems for the patient across primary and secondary care. Spreading this approach will be a key part of the long term plan for the NHS that is being drawn up over the coming months.

Neil Churchill, Director for Patient Experience at NHS England, said: “As the NHS shifts towards working in more integrated local health and care systems, it is crucial that hospitals work together to share best practice.

“Local health leaders can build on these models, test them further and determine how they can support other new models of care. We want to see more of this kind of innovation as we develop the long term plan.”

Building on the success of the collaboration, Guy’s and St Thomas’ recently formed the Healthcare Alliance, with Dartford and Gravesham as its founding member, to improve patient care, help sustain smaller hospitals and share clinical skills and leadership.

Clinicians identified children with epilepsy in Kent as frequent users of A&E, because of the likelihood of seizure episodes, and saw a gap in their service as well as the rising need for time off school.

The Roald Dahl Marvellous Charity sponsored the first nurse and parents were on the recruiting panel. The nurse now follows the patient and ensures they have enough support.

A good example is the Joint Neurology Clinics by Dr Kaminska, Consultant Neurologist from Guy’s and St Thomas’, and Dr Ude, Neurology/Epilepsy Special Interest Consultant at Dartford and Gravesham. This clinic is held around 10 times a year and provides specialist input locally for over 150 patients a year.

The Healthcare Alliance shows cross boundary working is possible because the hospital referral pathways move between both South East London and Kent and Medway STPs.

Dartford and Gravesham have an annual budget of £215 million employing around 3,000 staff and Guy’s and St Thomas’ have an annual turnover of almost £1.5 billion and employ more than 16,000 staff.

Guy’s and St Thomas’ also now delivers Dartford and Gravesham’s procurement function, saving them over £800,000 in the first year of operation – money which can be reinvested instead on direct patient care, staff training and development or research.

The have worked together to improve cardiology, vascular and children’s services and have also introduced shared access to clinical records.