John Lister comments – 

Health chiefs in Merton and Sutton CCGs have agreed without serious debate to press ahead with a controversial project which would halve the number of acute beds provided by Epsom & St Helier University Hospitals Trust.

Under the ridiculously misnamed ‘Improving Healthcare Together’ (IHT) plan, the existing Epsom and St Helier Hospitals would be downgraded, their A&E units reduced to urgent treatment centres, and downsized, with a severely reduced number of beds, no longer designated as acute but as step-down “district hospital” beds; instead a new £400m+ hospital would be built in Sutton.

All specialist emergency and elective services and all of the consultants would be centred at the new Sutton Hospital, which is planned to hold a nominal 520 beds, although just 387 of these would be front line acute beds – down from over 750 available in the trust during the 2019-20 winter.

The Decision Making Business Case, backed by the Epsom & St Helier trust board, has now been nodded through by CCGs, despite the opposition of both of the local authorities, the London boroughs of Merton and Sutton.

Nonsense

The plan also makes a nonsense of the recent launch of a South West London Integrated Care System. Not only is the ICS supposed to build “partnerships” with local government, but it appears that the ICS has taken no view or maybe even not been consulted on the IHT plan.

The only published plans for the ICS so far are based on the 2016 Sustainability of Transformation Plan, which stated clearly that:

“South West London STP will continue to need all of the hospitals it currently has, but does not believe that every hospital has to provide every service. … The immediate focus is on getting primary care and services in the community right.”

However ICS Independent Chair Millie Banerjee has not responded to a letter from Merton & Sutton TUC, and expressed no public view on the IHT plan – effectively nodding it through.

Unions have pointed out that reduction in acute bed capacity flies in the face of explicit NHS England guidance earlier this year even prior to the Covid crisis calling for an end to reductions of acute bed numbers.

The IHT plan would slash bed numbers AND dispose of land and buildings at Epsom & St Helier – as the NHS faces the problem of relaunching elective inpatient services with social distancing, and the reduced use of capacity putting space at a premium.

Post-Covid

Indeed more recent NHS England guidance, looking forward to a post-Covid situation, is even more categorical.

NHS England/Improvement’s estates chief Simon Corben has called for trusts to reduce the amount of non-clinical space by converting it to “surge capacity” to deal with winter pressures and a possible second peak in Covid cases: Epsom & St Helier trust bosses on the other hand are determined to sell off any spare space.

Speaking about the government’s plans for new hospitals, which include funding for Epsom & St Helier, Mr Corben said it was “paramount” that lessons learned from covid-19 were “captured” when designing the new facilities.

“We must use covid-19 as an opportunity to design facilities that give us resilience going forward,” he said.

The fight goes on to stop the juggernaut: but will NHS England take its own guidance seriously and knock back the most advanced of the plans for new hospitals?

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John Lister
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