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Wednesday 24 June 2020

Changes to the North Kent Dermatology Service

Introduction

NHS Kent and Medway Clinical Commissioning Group has suspended DMC Healthcare’s contract to provide dermatology services in Medway, Swale, Dartford, Gravesham and Swanley.

This briefing note outlines the current situation.

Background

On 1 April 2019, the North Kent Dermatology Service, run by provider DMC Healthcare, went live offering patients across Medway, Swale, Dartford, Gravesham and Swanley.

The procurement process for the new service, which was led by Medway CCG, followed a period of engagement which included patient, staff and clinician involvement.

DMC Healthcare was chosen as the provider following a full procurement and due diligence process, allowing the CCG the opportunity to scrutinise providers to ensure the service on offer was safe, efficient and could be delivered for the duration of the contract. The selection process, which involved dermatology patients, was made on an anonymised basis which offers assurance that decisions are based on merit.

Why has DMC’s contract been suspended?

The CCG has recently had concerns about whether the way the service is managed is in the best interest of patients, the clinical assurances around the service as well as DMC’s ability to meet NHS standard contract requirements.

Recently DMC provided new data that indicated a significant number of patients could be at risk. The data is now being clinically analysed but we believe around 1,000 patients need to be seen urgently.

What action has the CCG taken?

Upon receipt of the new data, the CCG verbally suspended DMC’s contract to provide dermatology services on Friday 19 June. We also requested all clinics be cancelled due to patient safety concerns. This was followed up with written confirmation on Monday 22 June.

Prior to this, we had been working with DMC for some time holding weekly contract meetings to support safe delivery of the service. Unfortunately insufficient improvements were made and we suspended the contract to ensure patient safety. 

What happens to patients now?

In the short term, patients who need urgent investigation following review by their GPs will be referred to Sussex Community Dermatology Service. They are already an alternative provider delivering dermatology care in the area through patient choice and have the has capacity to provide additional support until longer term solutions are established.

We have also made arrangements for the most at risk patients to be seen as soon as possible. The CCG has rapidly sourced another provider known as the 18 Week Support team, which has worked in partnership with the NHS since 2014, specialising in reducing waiting lists and getting patients referred for treatment.

The team has an agreement in principle to see patients who are most at risk within six weeks at Rainham Healthy Living Centre in clinical rooms that have not treated patients with Covid symptoms. The recovery will be clinically led by the founder of the 18 Week Support team Dr Conal Perrett; he is a Consultant Dermatologist and Dermatological Surgeon at University College London Hospitals NHS Foundation Trust where he leads the skin cancer service.

How will this affect other services?

DMC is also a primary care provider. The decision to suspend DMC’s contract will not currently affect primary care, but as with all providers we are closely monitoring the services provided.

DMC also runs a much smaller dermatology service in East Kent but cancer patients and more serious cases are seen by East Kent University Hospitals University NHS Foundation Trust.

What happens next? 

The CCG is now working with DMC Healthcare, NHS England and the Care Quality Commission to review the dermatology service, as well as the primary care services that DMC provides in Medway, Swale and Maidstone.

This is a developing situation and we will endeavour to keep you up-to-date as and when it is appropriate.

NHS Kent and Medway Clinical Commissioning Group
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