Published Advice & Recommendations

The KSS review reports and recommendations will become available in this section as completed and published. Reviews and recommendations 2013-2020 are available here.

Joint Clinical Senate Review of the Improving Healthcare Together 2020-2030 Pre-Consultation Business Case for Surrey Downs, Sutton and Merton CCGs: March 2019
Future Acute Stroke Services in Kent and Medway: A Clinical Senate review of the STP’s preferred option for Stroke Service Configuration: November 2018
Joint Clinical Senate Review of the Case for Change and Clinical Models for Surrey Downs, Sutton and Merton CCGs: August 2018
Helping Patients and Staff to Stop Smoking: The Essential Role of Acute Hospitals: January 2018
25% of hospital inpatients are smokers, and over one million smokers are admitted. Many more attend outpatient departments. Acute hospitals therefore have a major role in helping patients and staff to quit smoking, but few have taken steps to fulfil this potential. To help acute  trusts and their staff, and other key health economy stakeholders, the South East Clinical Senate has reviewed the role of acute hospitals in smoking cessation, and developed a set of recommendations for trusts and their health system partners. These are contained in our publication, ‘Helping patients and staff to stop smoking: the essential role of acute hospitals’, which is endorsed by Public Health England. A renewed and re-invigorated focus on smoking cessation with this perspective, allied with an integrated approach to community based services, is going to be key to fulfilling the key ambition to reduce smoking rates in England, improve the quality and length of people’s lives, and help give the NHS a sustainable future.

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Future acute stroke services in Kent and Medway: A clinical senate review of the STP’s draft proposals prior to public consultation: January 2018
South East Clinical Senate Emphasising Quality, Delivering Value: July 2017
Reducing avoidable hospital based care: re-thinking out of hospital clinical pathways: November 2016

Improving health outcomes, preventing serious illness, providing convenient, timely and cost effective care, and avoiding the unnecessary use of acute hospitals, is a shared goal across the NHS, and requires a radical re-think about how and where care is delivered, for both acute and long term conditions. The design and implementation of high quality community-focused clinical pathways now requires the full range of health and social care professionals and their organisations to work together, alongside patient and public partners. New ways of working are required that maximise the impact of available staff, facilities and resources, and creative and innovative but realistic models of care need to be implemented. This report is intended as a guide for all stakeholders to improve clinical pathways and develop models of care that are less dependent on acute hospitals. Its recommendations are relevant to both acute and long term condition pathways. The report provides a detailed guide to managing acute symptoms and acute conditions out of hospital where safe and appropriate to do so. It also provides detailed guidance on effective common city based pathways for three common long term conditions: heart failure, respiratory conditions and patients living with and beyond cancer. The key requirements for and potential of community based clinical hubs are also described. This report complements the Urgent and Emergency Care Review and its ‘Safer, Faster, Better’ report, and anticipates some of the learning expected from the national Five Year Forward View vanguard sites that relate to joined up working between primary, community and hospital care.

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Hospitals without acute stroke units - implications and recommendations: January 2016

The South East Clinical Senate review for Surrey CCGs which addresses the generic question of how high quality, safe and appropriate care can be ensured for patients developing a stroke in populations where their local hospital does not have both a hyper-acute and acute stroke unit.

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The South East Clinical Senate review of future stroke services in Sussex: December 2015
Sussex Collaborative sought advice from the South East Clinical Senate (SECS) about their plans for future stroke services in Sussex. Sussex Collaborative sought advice from the South East Clinical Senate (SECS) about their plans for future stroke services in Sussex. The review ensures that current proposals reflect best practice, are sustainable and fit for the future, and have appropriately considered the clinical relationships with adjacent stroke and other clinical services. The SECS report includes a review of the methodology used by the Sussex Stroke Clinical Reference Group (SSCRG) to date. The review provides a number of key recommendations that have a wider application in relation to similar change programmes.

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Kent and Medway Vascular Surgery Services Review Report: June 2015
Kent and Medway Stroke Services Review Report: June 2015
The Clinical Co-dependencies of Acute Hospital Services: A Clinical Senate Review: December 2014

This clinical senate report provides a comprehensive clinical overview of the inter-dependencies of a wide range of acute hospital-based clinical services, and some of the key factors that should be taken in to account. Given the current intense national focus on the future shape and function of hospitals, stakeholders in health care systems have to consider the most appropriate configuration of their hospitals so that their clinical services are adequately supported by other specialties, are fit for purpose, sustainable, accessible and deliver the highest possible quality of care. The clinical relationships and dependencies of hospital-based services on each other is key, but the evidence base to guide an understanding of these dependencies is uncertain. On this basis, the seven Sussex CCGs (through their Collaborative) sought from the South East Clinical Senate (SECS) generic, evidence-supported clinical advice on the necessary relationships between acute hospital services, to inform their future local discussions and planning. The remit of the review was to provide generic advice, not region or locality-specific, and to identify evidence where it exists, or clinical consensus where it did not, to describe what services needed to be provided in the same hospital (either based there, or inreaching), and what could be provided on a networked basis. A clinical reference group was established, a literature review undertaken, and a clinical senate summit convened, and SECS worked closely with the four strategic clinical networks in the region. The dependencies of eleven major acute hospital services were reviewed: A&E (emergency medicine), the acute medical take, the acute surgical take, critical care (ITU), trauma, vascular surgery, cardiac, stroke, renal, consultant-led obstetric services and acute general paediatrics. The clinical dependencies of these services on a wide range of acute hospital based services was reviewed, and a four-level system for describing the strength of the dependencies was developed, and a co-dependency grid constructed. From the completed grid, it was possible to identify core groupings of services required to be based on the same hospital site, and delineate what an emergency hospital should provide on-site as a minimum, and the needs of the more specialist acute services reviewed. The report contains important reviews of addition broad themes that must be taken account of in considering service change. These include the public and patient perspective, ambulance service issues and opportunities, workforce issues, the teaching, training and research issue, the provision of liaison psychiatry support to acute hospitals, and the potential for telemedicine to enable better networking or services. This report is intended to be a useful clinical reference point to commissioners, providers and clinicians in the future planning of their acute hospital services.

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Advance Care Planning: April 2014

Advance Care Planning in Kent, Surrey and Sussex: A Report and Recommendations from the South East Clinical Senate. South East Clinical Senate (SECS) has launched an important publication entitled ‘Improving Advance Care Planning in Kent, Surrey and Sussex’. This publication has been written for a wide audience, including, health and social care professionals, organisations responsible for education and training of health and care staff, commissioners, the community and voluntary sector, and public and patient engagement organisations. Advance Care Planning (ACP) is a vital component of end of life care planning, and is appropriate to consider for a wide range of patients (particularly those with progressive chronic conditions or at risk of acute deteriorations in health) as well as the public. It is the process of discussion to help a person decide on their future care whilst they have the mental capacity to do so. Our publication summarises the benefits of ACP, explores the current barriers to its greater uptake, and provides a wide range of recommendations to enable its greater use, and has been informed by a literature review, a clinical senate working group and a regional summit held in May 2014, which was attended by a wide range of stakeholders including patients and the public. Our publication endeavours to provide a clear and pragmatic guide as to how this can be achieved. There is a real opportunity to increase the use of ACP to ensure that it is fully integrated into high quality, patient-centered care across Kent, Surrey and Sussex. Simon Chapman, Director of Policy, Intelligence and Public Affairs at the National Council for Palliative Care said: “Too many people still aren’t talking about or getting their end of life wishes met, which is why we welcome this important new publication. Planning ahead makes it more likely you will be able to get the care and support that is right for you, and we fully support the emphasis that the South East Clinical Senate are putting on raising awareness about the importance of Advance Care Planning. There needs to be radical change so that everyone approaching the end of life is offered Advance Care Planning as an integral part of their care.” If you would like to discuss the document or require any further information, please contact Ali Parsons, Clinical Senate Manager at aliparsons@nhs.net.

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