The Trust showed a video info graphic about the current challenges facing Epsom and St Helier hospitals. The Chief Executive reported that in the last year there were 900,000 patient contacts which is the highest number to date. Also, it was the only Trust in South East England to deliver the Accident and Emergency standard. The Panel congratulated the Trust on their  achievements.

The Chief Executive reported that this  engagement process is to consider the next steps after 2020. The current challenges are caused by the following issues:

·         The current buildings are not designed for 21^st healthcare

·         Clinical staff currently work between Epsom and St Helier sites. This is not sustainable as there are not enough staff to provide high quality healthcare on both sites.

·         The Trust needs to be financially sustainable.

A panel member said the consultation has been on-going  since 2002 at an approximate cost of £40 million.  Concern was expressed  that this is yet another process and a decision should be made. St Helier was put forward as  the most appropriate site given the high levels of deprivation in the surrounding area. 

The Chief Executive said it is a concern that a decision has not been reached about this for the last 20 years. The good performance at the Trust is a good platform to highlight that the current situation is unsustainable and this issue needs to be resolved.  It is a long process and there will not be a new hospital until at least 2024.

The Medical Director added that they need suitable buildings and sustainable levels of staffing to provide world class services. Staff need to be on a single site to provide this level of care. If the acute trust operated one site, there would be no need for agency staff. 

A panel member asked what consultation response rate would be deemed as successful or in favour of one option. The Chief Executive reported that a consultation will take place when the NHS has made a decision on big service change, and we are nowhere near that stage yet.  The Trust are being open and transparent from the beginning, outlining the problem, and potential solutions and want to engage. This will mean the consultation would have tackled the issues that are currently being raised. The Chief Executive reassured the Panel that all the options are deliverable.

Panel members were informed that this engagement process should lead to a  consultation if there is enough support for the investment. A strategic outline case will be published in November and feed into the refresh of the Sustainability and Transformation Plan for Merton.  The NHS need to agree a business case which will take six months.  The options, a public consultation and a full decision could be reached  by 2019.

A panel member asked which of the three sites is best served by transport links. The Chief Executive said transport is poor when travelling  between two sites. Ten percent of capital is for infrastructure which can address transport needs.

The Chair reiterated the councils support to maintain St Helier Hospital on the existing site and  expressed concern that health inequalities has not been identified as a major issue of concern. The Chief Executive reported that the public health team at the council are the experts who lead on this and they will address this in responding to the three options for the future of the hospitals.