Improving Healthcare Together FAQs
How does this programme differ from previous reviews of the Trust’s services?
• Commissioners started previous reviews because they wanted to develop the best future plan for services for the area; this review is being carried out in response to the Trust telling us that things cannot go on as they are. The Trust is saying that it cannot continue to deliver its current services without changes being made. That is a very different starting point.
• This review is focused specifically on acute services at Epsom and St Helier, as this is the only hospital trust in south west London or Surrey to declare that its current services are not sustainable. The review is being carried out by the commissioners of services at the two hospitals: Sutton, Merton and Surrey Downs CCGs.
Will one of Epsom or St Helier hospitals close?
• We will not be closing any of our hospitals. We will continue to need both Epsom and St Helier hospitals.
• Merton, Sutton and Surrey Downs CCGs will look in detail at the issues raised by Epsom and St Helier, considering how we can best ensure that the Trust continues to deliver high quality, sustainable services for local people. As the Trust is raising significant concerns, it makes sense for commissioners to consider their response.
Are the Trust’s acute services sustainable?
The Trust will continue to provide acute services; the challenge is to make sure they are organised in the best way.
The South West London Clinical Senate has agreed a set of clinical standards for six clinical services in hospitals: emergency department; acute medicine; paediatrics; emergency general surgery; obstetrics; and intensive care. Hospitals in South West London including Epsom and St Helier University Hospitals NHS Trust (ESTH) were asked to self-assess their services against the agreed clinical standards and to feed this work into local health and care plans for their area.
Epsom and St Helier’s self-assessment suggested their acute services were not sustainable without some changes in the way they are delivered. The three CCGs will now need to test those self-assessments and consider what actions will be required to deliver the necessary clinical standards for all our patients.
What impact would changing acute services at Epsom or St Helier have on neighbouring hospitals?
A key part of our work is to carry out an analysis of any proposed changes on neighbouring acute hospitals. This work is now underway and we will take the findings fully into account.
What are acute services?
By acute services, we mean the emergency department, acute medicine, paediatrics, emergency general surgery, obstetrics and intensive care.
What is your view of the Trust’s Strategic Outline Case, which suggests that its acute services should be consolidated on one of the Epsom, St Helier or Sutton Hospital sites?
Epsom and St Helier University Hospitals Trust is making the case for a new acute hospital This could involve building a new hospital on the Sutton Hospital site or redeveloping either Epsom or St Helier site.
As commissioners, we don’t yet have enough detail about the proposed model of care, the funding, the likely patient flows and the impact on patients, to take a view on whether this is the right – or only – solution.
We will look at all the available evidence and develop any proposals for change by working with local people and organisations. Should we develop proposals for significant changes to services – such as consolidation of acute services on one site – these would be subject to full public consultation before any decisions were made.
When are you going to consult us? What are the timescales?
Merton, Sutton and Surrey Downs CCGs are putting in place a robust and inclusive process to look at the challenges faced by the Trust and to consider the best ways forward. This will include looking at proposed models of care, quality of care, affordability, whether proposals have support and whether they can be delivered. We think this will take a few months.
If any significant changes are proposed – such as a new hospital or any consolidation of acute services – commissioners would assess these and would fully consult the public before making any decisions. We do not expect any consultation to take place before the autumn of 2018 at the earliest.
We will of course work with local people and communities throughout the life of the programme. There will be a number of opportunities for people to get involved in shaping the discussion at every stage.