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Agenda item

Improving Healthcare Together

Consultation on proposed changes to St Helier Hospital

Minutes:

Ruth Charlton, Consultant Paediatrician at Epsom and St Helier NHS Trust, and James Blythe, Managing Director Merton and Wandsworth Clinical Commissioning Groups, gave a presentation on the proposals for the future of critical care services at the Trust. The presentation is an appendix to this report. 

 

The Government has allocated £500m to improve buildings and build new Specialist Emergency Care hospital (SECH). Under the proposals 85% services stay at Epsom and St Helier sites and a minimum of £80m will be spent on improving the existing buildings. Emergency services do not currently meet national standards and CQC rate them as needs improvement. There is also problem with recruiting sufficient staff. The current buildings are not fit for purpose and expensive to maintain which creates an ongoing problem with finances

 

The new clinical model would mean at least two District Hospitals (Urgent Treatment Centre; Outpatient services; Diagnostic services; Planned Care procedures; Hospital Rehab/recovery) and one Specialist Emergency Care Hospital (Emergency Department; Acute Medicine; Emergency Surgery; Critical Care; Births; Inpatient Paediatrics). There are three options for the new SECH site:

Epsom, St Helier, or Sutton (next to the Royal Marsden). Sutton is the preferred site for the CCGs as it has the smallest increase in average travel times, would be easiest and quickest to build; and based on the Government assessment formulae provides the best value for money.

 

Modelling shows a slight increase in beds is needed, most would be at Epsom, St Helier and Sutton but some would need to be provided at other hospitals including St Georges, Croydon, Kingston or the Surrey hospitals to mitigate increase pressure on those hospitals. There would be little time difference in Ambulance and Car travel to the single SECH site, but there will be increases in Public Transport journey times for some people. The NHS would need to work with transport providers to mitigate this before the facility opens.

 

All three options are possible and no decision has been made so responses to the consultation are encouraged before it closes on 1 April 2020.

 

Residents raised a number of points and questions, which are set out below along with any response from James and Ruth.

 

Issue

Response

Will improvements still be made to St Helier if the new centre is built elsewhere?

Yes, the blocks in worst condition, at the back of the hospital will no longer be used and increasing the number of single rooms will be a priority.

There will be a 62% reduction in beds at St Helier

Overall, there will be a slight increase in beds, although some of these will be at other hospitals.

Services will be taken from a deprived area to affluent Belmont

85% of services will be stay on site, for example anti-natal and pre-natal care will stay but services that needs 24 hour consultant cover will move to the new site.

Will it be more expensive to maintain more buildings on more sites?

Updating buildings should reduce ongoing maintenance costs

There will be no access to critical care if something goes wrong with in a surgery at St Helier

For planned surgery, risk would be assessed so those with high risk would take place at SECH. If something goes wrong with a low risk patient there would be sufficient resources to stabilise the patient and then move them to the SECH if needed.

A four-year completion for a new hospital seems ambitious.

This is the advice we have received, but it is clear the build will be relatively quicker at the Sutton site. There will need to be a lot of work on designs whatever option is selected.

Do the government’s recruitment plans not mean the need for consolidation will be negated?

We have worked with NHS Health Education England (HEE) to model staffing needs and supply. They show that there will continue to be a shortfall of specialist emergency staff even with new investment. A lot of the new recruitment is targeted on the North of England.

The buildings will be in place for the next 60 years so why is there so much emphasis on parking when cars will be phased out?

Residents and staff frequently raise car parking so will need to plan for car usage, as it currently exists.

How does the condition of Epsom Hospital compare to St Helier

Both sites have similar issues – not enough single rooms and some buildings in poor condition.

What will happen if patients need to move sites?

Acute surgical wards for recovery will be at the SECH, the rehabilitation wards will be at the District Hospitals so patients will be moved between the sites.

What will be the impact on other hospitals?

Some patients who are currently closest to Epsom or St Helier would be closer to St Georges, Kingston or Croydon if the SECH was at Sutton. Those sites would need additional investment and beds to meet the extra demand.

What are the advantages of having the SECH next to the Royal Marsden

It should be possible to link the buildings and share infrastructure like laboratories and diagnostic equipment, as well as share staff across the sites.

The increased journeys between the sites will increase pollution.

 

The proposals should take into account the future population growth in the area and as a result, it would be better to keep the existing Emergency services at the two hospitals and use the money to invest in those facilities.

 

What will happen to the training facilities currently on the existing sites?

Training options should be expanded under the proposals, and the new SECH should be more attractive to prospective students.

 

 

Supporting documents: