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Uncertainty surrounds the provision of specialist skin cancer care after a new provider was picked for dermatology services.
For patients in in Medway, Swale, Swanley, Dartford and Gravesham dermatology services, covering things like eczema, skin cancer and acne, will be moved to community clinics when Medway Maritime Hospital closes its department in April.
Medway Clinical Commissioning Group has assured users all five levels of care will continue to be provided by DMC Healthcare, which was awarded the contract on Monday.
However, only levels one to four are set to be provided directly by DMC, which already runs several GPs in Medway and Swale, as part of the £17.5 million contract.
It's set to outsource the most complex care. Medway Maritime currently sends patients who require that treatment to East Grinstead's Queen Victoria Hospital.
It's not known if the new provider will continue with that arrangement.
"It is clear that patients in the area are largely unaware their service is to be decommissioned." — British Association of Dermatologists
The new-look consultant-led service will be "more consistent" and waiting times will be cut, says the CCG.
Patients can expect routine appointments within six weeks, or two if there is any suspicion of cancer and they can go to clinics in any of the participating areas, convenient if they're, for example, from Rainham but work in Swanley.
Deputy managing director at the CCG Stuart Jeffery said: “DMC will be providing services from community bases, rather than from the main hospital sites, which avoids patients having to travel to hospital unnecessarily."
In September it was announced by Medway Community Healthcare that dermatology services would be closed in Rochester, Lordswood and Parkwood, with patients having to travel to Strood.
Critics say consultation has been minimal and many patients were unaware the changes were even happening.
Nina Goad, from the British Association of Dermatologists, said: "Our primary concern is over the lack of public consultation as it is clear that patients in the area are largely unaware their service is to be decommissioned. The CCGs and the trust have a clear duty to involve the public before making any decision as to the services the population of North Kent can expect to receive."
While there was no formal consultation process, since 2014 more than 400 patients from Dartford, Gravesham, Swanley, Swale and West Kent had responded to a survey about the service.
But due to the short time scale to find a new provider Medway CCG only launched an online survey about the proposed changes in October.
In total 207 patients and two staff from across north Kent responded. Last year there were 40,000 dermatology appointments in the area.
The CCG said the survey was promoted via all the CCG’s Facebook and Twitter accounts and emails were sent to stakeholders including Patient Participation Group chairs and patient reference group members.
The survey was also sent to clinics in Swale, Dartford, Gravesham and Swanley as well as Medway Maritime Hospital.