The Health Overview and Scrutiny Committee of Kent County Council met on Wednesday, 3 June 2026, to discuss significant structural changes within the NHS Kent and Medway Integrated Care Board (ICB), a controversial revision to fertility treatment commissioning, and the proposed redesign of Bedgebury Ward. The committee also reviewed the response to a meningitis B outbreak in Canterbury.

Structural Changes to NHS Kent and Medway Integrated Care Board

Dominic Cox, Deputy Chief Commissioning Officer for NHS Kent and Medway ICB, presented the structural changes being implemented as part of a new operating model from 1 July 2026. He explained that the ICB is becoming more strategic in its commissioning, focusing on being proactive, outcome-focused, and addressing inequalities. This involves earlier planning of commissioning intentions and priorities, with a move towards joint commissioning opportunities across the NHS and local authorities. Mr Cox acknowledged that organisational restructuring can impact staff and confirmed that a dedicated group is focusing on staff wellbeing during this transition. He also highlighted that some services, such as procurement and digital data and technology, are being developed as shared models with other ICBs.

Councillor Stuart Jeffery raised concerns about the lack of explicit integration with local authorities in the presented plans and questioned how wider inequalities would be addressed. He also queried the direction of travel regarding all-age continuing care, expressing concern that moving away from joint teams and pooled budgets with local authorities could exacerbate existing problems. Mr Cox responded by explaining the development of neighbourhood health teams across Kent and Medway, which aim to shift services into primary care and neighbourhoods, with a focus on prevention and working in partnership with councils. He stated that joint commissioning is a key element of the ICB's new policy and that opportunities for collaboration will be explored.

Councillor Shane Mochrie-Cox questioned the scrutiny process, particularly in light of Healthwatch's abolition, and asked how decisions would be scrutinised to ensure a balance between clinical and community needs. He also expressed concern that neighbourhood plans had already been submitted to the government, suggesting a lack of genuine local engagement. Mr Cox acknowledged the challenges and stated that the ICB is committed to a new approach that allows for more time for engagement with partners and the public. He also clarified that the ICB has a formal line of accountability to the Department of Health.

Harry Rayner, a substitute member, raised concerns about the lack of financial detail in the report and asked about the ICB's outstanding debt to Kent County Council. He noted that previous Finance and General Purposes Committee meetings had indicated significant deficits owed by the ICB. Mr Cox stated that there were ongoing discussions about historical contractual disputes but could not provide specific figures. Mr Rayner expressed dissatisfaction, highlighting that Kent County Council often picks up more health-related expenses than other areas.

Mr Anthony Hook asked about patient experience changes resulting from the structural changes. Mr Cox explained that the aim is to become more effective and integrated, leading to better use of capacity and capability. Becky, Deputy Director of Nursing, added that the move to strategic commissioning provides opportunities to improve patient experience by using evidence around population needs and demographic data to make better commissioning decisions underpinned by equity and equality analysis. She suggested that patients might experience improved accessibility, with services brought closer to them within neighbourhoods.

Changes Made to Commissioning of Fertility Treatment in Kent and Medway

The committee discussed significant changes made to the commissioning of NHS-funded fertility treatment in Kent and Medway, which came into effect on 1 April 2026. The previous offer of up to two IVF/ICSI cycles and up to four embryo transfers for individuals under 40 years old has been revised to one cycle and up to two embryo transfers for those starting treatment before their 38th birthday.

Dominic Cox, Deputy Chief Commissioning Officer for NHS Kent and Medway ICB, apologised for the lack of formal consultation with the committee before the decision was made, stating that this was a planned communication that did not occur. He explained that the changes were based on clinical evidence, aiming to focus resources on patients most likely to benefit and ensure the sustainability of services. He noted that 69% of ICBs nationally now offer a single cycle of IVF.

Becky, Deputy Director of Nursing, elaborated on the rationale, explaining that IVF success rates in terms of live births per embryo transfer show a steep decline after the age of 37. She also highlighted that improved embryo selection and freezing techniques meant that reducing the number of embryo transfers would not significantly impact success rates.

Councillor Shane Mochrie-Cox expressed strong disapproval, arguing that the changes appeared to be a cost-saving measure rather than being solely evidence-based, particularly as cycles and transfers were reduced alongside the age limit. He proposed that the committee write to the Secretary of State to review the decision.

Councillor Stuart Jeffery echoed these concerns, stating that the changes would have devastating consequences for families and that the public consultation had not been adequately conducted. He went further than Councillor Mochrie-Cox, requesting a formal call-in from the Secretary of State to review the decision. He argued that the changes discriminated against people on lower incomes and increased stress for women trying to conceive.

Mr Anthony Hook seconded the proposal to write to the Secretary of State, describing the decision as appalling and highlighting the three substantive reductions in service. He questioned the lack of identified financial savings and the impact on individuals.

A significant debate ensued regarding the evidence base for the age reduction and the perceived financial motivations behind the changes. Concerns were also raised about the disparity in treatment for same-sex couples, who were required to pay privately for six rounds of IVF before NHS treatment, a cost estimated at £30,000. The ICB representatives clarified that the requirement for same-sex couples was to demonstrate 12 months of trying to conceive and the use of intrauterine insemination, not six rounds of IVF, and that this eligibility criterion remained unchanged.

Ultimately, the committee voted to write to the Secretary of State requesting a call-in of the decision, with 12 votes in favour and three against.

Bedgebury Ward and Proposed Service Redesign

The committee discussed the proposed redesign of services at Bedgebury Ward, a 10-bedded rehabilitation unit located within the medium-secure estate at the Trevor Gibbens Unit in Maidstone. Sharon Roots, Service Director, explained that the current model is not in line with national rehabilitation expectations and that the proposal is to redirect resources into more proactive, community-based services, including assertive outreach and multidisciplinary intensive support. Admissions to Bedgebury Ward have been paused, and current patients are progressing through individual discharge plans.

Councillor Perry Cole expressed disappointment that a facility established just 10 years prior was already being decommissioned, questioning the impact on service resilience and capacity across Kent. He asked for assurances that the loss of these beds would not put undue pressure on other services. Rose, a service director, explained that the ward's location within a medium-secure estate made it suboptimal for rehabilitation and that the funding would be reinvested into community-based provision, including an assertive outreach team, to bridge the gap between secure care and community mental health teams.

Harry Rayner moved that the proposed redesign be considered a substantial variation of service, requesting further details on the finances and the reinvestment of resources. He argued that the report was lightweight and lacked financial specifics. He also supported the recommendation that NHS Kent and Medway representatives be invited to present an update with more detailed financial information. Mr. Jeffery seconded this motion.

Councillor Shane Mochrie-Cox raised concerns about cost shunting and whether savings would be passed on to other authorities or charities. He also questioned the halfway house nature of the ward and whether it was truly about patient needs or budget lines. He supported Mr. Rayner's call for more financial detail.

Mr. Oliver Bradshaw asked about the risk of disenfranchising people in specific areas of Kent due to the removal of these beds, but was informed that rehabilitation units are spread across the county. Robbie Gotham from Healthwatch questioned the extent of patient engagement and whether their experiences had been listened to, noting that the paper did not clearly demonstrate this.

Mr. John Baker asked for evidence of better patient outcomes, to which Rose responded that the current unit is not the preferable option for rehabilitation and that patients already discharged have benefited from community placements.

Following further debate, the committee voted to deem the Bedgebury Ward pathway redesign a substantial variation of service and requested that NHS Kent and Medway representatives provide an update with more detailed information, including financial data and the impact of the changes.

Meningitis B Outbreak Response

The committee received a report summarising the response to a Meningitis B outbreak in Canterbury in March 2026. The report highlighted an excellent collaborative response across multiple agencies, including Kent County Council, NHS, UKHCA, schools, the university, and a nightclub. A major incident was declared, leading to mass antibiotic prophylaxis and vaccinations.

The response involved stepping up emergency planning, with strategic and tactical commissioning groups working intensively for several weeks. The report detailed the administration of 13,500 antibiotics and 12,000 vaccinations across various sites, noting the proactive communication and excellent scale of mobilisation.

Learning points identified included coordination between local and national responses and workforce resilience, as the intensive nature of the incident placed a significant burden on a small number of individuals.

Mr Alex Ricketts noted that while the vaccination and antibiotic rollout was fantastic, there were concerns about the time taken to flag the initial incident. He also pointed out that Club Chemistry was mentioned twice in the report, but Eck Huft was not mentioned at all, despite being a major player. He requested further information on how the incident was initially flagged and any potential failures.

Mr Oliver Bradshaw, a student at the University of Kent at the time of the outbreak, shared his concern that students were first made aware of the outbreak through a video of a student being removed by ambulance in biohazard gear. He questioned the University of Kent's urgency in reporting the incident and whether this impacted the NHS's response time.

Mr Harry Rayner acknowledged the concerns about the slow start but stated he would not take the matter further as he was not medically trained. He did, however, commend the KCC administration for their handling of the situation, particularly in briefing opposition leaders daily.

Mr Stuart Jeffery suggested that in addition to noting the report, the committee should thank the teams involved in the response and express sympathy to the families of those who died and suffered. This was agreed.

Mr. Cole asked if the system had been lucky that the outbreak occurred mid-term, questioning how different the situation might have been if it had happened at the end of term when students were dispersing across the country. He asked what lessons had been learned for future responses. The presenter indicated that reviews were underway and that the scenario of students going home had been considered, driving the speed of the vaccination programme.

The committee agreed to add Mr. Jeffery's suggestion to thank the teams and express sympathy to the report's recommendations.