Daniel Elkeles, Chief Executive of Epsom and St Helier University Hospitals NHS Trust gave an overview of the report highlighting that St Helier was the only hospital in the country to achieve their targets on accident and emergency. However improvements need to be made in infection control as seven people were affected.  The Trust had a financial surplus through  selling land, in reality this masks a small deficit.   The Trust is addressing a number of challenges:

Staffing – there are currently five hundred vacancies. This is largely due to the uncertainty surrounding the future of the hospitals. In response the Trust has developed a five year strategy, guaranteeing that the hospitals will remain open for the next five years. This has provided the required reassurance and the Trust has been able to recruit people through open days.

Variability of care – standards of care can fluctuate based on the time of day and between the different hospitals.  Evenings and  weekends can be particularly problematic.

Quality of the Estate – the low quality of the estate is a significant problem affecting the quality of care. Many of the departments are not situated in the correct place causing clinicians to have to travel across the sites. An extra £1million is spent on some services due to the poor quality of the estate these include; cleaning, maintenance and energy costs.

Daniel Elkeles paid tribute to the staff at the Trust who provide an excellent service often in difficult circumstances. This was demonstrated when St Helier remained  fully functional during an IT failure.

The Trust will begin engagement with the local community over the summer to determine what people would like to see in a new hospital. A panel member asked how the Trust will raise the money for a new hospital. Daniel Elkeles reported that it is still early in the process however the only way is by a loan from the government and the Trust will need to develop a business case.

A panel member asked how the Trust will reduce infection rates. Daniel Elkeles reported it can be tackled through improved practice such as improving catheter use and ensuring everyone has clean hands. Other causes relate to the old crumbling buildings which makes the environment more susceptible to infections.

A panel member said that people want a new hospital but will be concerned about where it is located. It was added that every local campaign had been to keep the hospital on the current site and there would be strong resistance to moving it.  Lisa Thomson Director of Communications said the purpose of the community engagement exercise would be to find out people’s priorities for a 21^st century hospital. The comments from the community will help to shape the options for the future of the hospital.

A panel member asked if one part of the estate has specific problems with infections. Daniel Elkeles reported that infections are not located within any specific area, but are caused by a number of reasons including; not having enough single rooms, the beds are too close together, and the fabric of the hospitals are difficult to maintain.

A Panel member congratulated the Trust on their commitment to St Helier and the estate. However there is great concern over the recent incident where the national press reported that consultants were overheard talking about future plans to create a super hospital in Sutton to replace Epsom and St Helier. Were the consultants paid for their work after the incident? Daniel Elkeles said they were embarrassed by the incident and understand that it could damage trust with the local community. The conversation that was reported did not reflect the discussions that took place in the hospital. The Trust took legal advice and the contract was re-negotiated to a substantially reduced amount. The level of the reduction cannot be disclosed due to commercial sensitivity but the consultants were paid around £93-97,000.

A panel member asked if there is a secret plan to close St Helier hospital Daniel Elkeles responded that this is not the case.

A panel member said they had a strong impression that the Better Services Better Value Review had  a pre-determined outcome and as a result the local community had little faith in the  proposals  for hospital services. There is also anecdotal evidence that some people feel their voice doesn’t count and the decisions about St Helier will be based on the influence of the rich and powerful.

Daniel Elkeles said everyone in the catchment area is equally important. The Trust moto is ‘Great care to every patient every day’. The Better Services Better Value review  was a commissioners report and it was not supported by the providers.

A panel member asked if it was possible to take forward previous proposals to build a new hospital opposite the current St Helier site. Daniel Elkeles said the proposed site is metropolitan open land, therefore it is possibility and could be a cheaper option but the various options need to be modelled.

A panel member highlighted that millions of pounds have already been spent investigating possible  land for a new hospital. The Trust is urged to make use of this information rather than spend more money on consultants. Daniel Elkeles said the all the historical information is available and will inform the review.

Lisa Thomson informed the Panel that the feedback from the community is scheduled for  the October Board meeting but the Trust will need to work in conjunction with other reviews happening across the NHS in Southwest London.

RESOLVED

The Trust were  thanked for their work and will be invited to a future panel meeting to provide an update on their discussions with the community