Critical Care Hospital bites the dust. Prepare for a "Major Acute Hospital" Foundation instead!!
On July 19th I posted an article "The Tesco Foundation Hospital at St Helier??" where I speculated that:
"1. By October, Epsom may be downgraded for A&E and Maternity, with St Helier providing these functions. More Sutton residents will have to go to Epsom for elective procedures.
"2. Over the next 5-10 years more complex cases will migrate to St Georges. I suspect the Sutton Hospital CCH would have still suffered the same problem, even if put next to the Marsden.
"3. Rebuilding on St Helier will probably be phased operation. It may be partly financed if a major retailer (eg Tesco, Sainsbury's) is asked to develop retail/restaurant facilities on the site and replacing current contractors and services provided by the League of Friends. This sort of partnership may be tied in with the Epsom and St Helier Trust securing Foundation status in due course. A mixed Housing development may also be part of this proposal, with affordable key worker housing "downstairs" and some lovely flats with superb views "upstairs"."
As you can see above I was not expecting a significant movement forward from the Secretary of State, so her decision this week not to proceed at present comes as no great surprise. The decision is clearly a great disappointment, but it has to be said that this whole process has been ruined anyway by the local NHS establishments obsession with the Sutton site which dates back to at least 1992.
It should also be remembered that the proposed development we are all talking about was unlikely to be ready prior to the London Olympics anyway!!:-)
In other words the Secretary of State has in effect simply endorsed the new local status quo over the distribution of acute services, which has emerged since the recent Safety and Sustainability Review of Epsom and St Helier and which has been remarkably endorsed by all three Health Scrutiny Committees (some without a meeting on the subject)!!
We should:
1. Remenber that St Helier was always intended as the main acute hospital for this area from 2006-2012 even under the discredited BHCH proposals. The local NHS establishment only wrongly proposed replacing it with Sutton after that date.
2. Now look at the methodology used to identify acute hospital requirements in the neighbouring Surrey and Sussex Hospital Review. Go to
http://www.surreysussexfitforthefuture.nhs.uk/
for details. This identifies 4 types of Hospital for the future:
a) Critical Care Hospital
b) Major Acute Hospital
c) Local General Hospital
d) Local Care Centre
Judging by current trends I would now see our 5 local "Critical Care Hospitals" as being St Georges at Tooting, Mayday at Croydon, Kingston, St Peter's at Chertsey and East Surrey at Redhill.
I suspect St Helier now looks much more likely to evolve into a "Major Acute Hospital" linked to St Georges, whilst Epsom is likely to develop into a Local General Hospital with its campus also hosting other health providers. The interesting question for Health Scrutiny Committees, is if St Helier doesn't become a Critical Care Hospital and evolves into a Major Acute Hospital with some critical care provided at St Georges, will many people notice?
Hopefully local PCT's will develop or commission local care centres (see my article below on "Local Care Networks") in the coming years in a much more bottom up approach than the top down approach (wait until we have sorted out the CCH etc) proposed in BHCH. This is a key area for local Council's to work with the local NHS on. For example a combined health and leisure development on the Malden Road baths site.
Having attended the Epsom and St Helier Trust meeting in early August, it seems to me the following action is likely to be the priority of the Acute Trust in the coming years:
1. The development of the Epsom Health Campus site, with a range of health providers on it.
2. The establishment of Epsom and St Helier as Foundation Trust. It is vital that the Sutton and Merton Health Scrutiny Committees ensure they strongly imput into the Foundation Trust document. I will set out a checklist of key issues in due course. The most crucial issue will be do we want a "Critical Care Hospital" or a "Major Acute Hospital" in the borough? This will be an issue for a future article.
There is a danger that once it becomes a Foundation the Trust will try to resurect the Sutton Hospital CCH option again in conjunction with the Royal Marsden (probably as a much samller proposal on part of the Sutton site with some sold off to fund it), though this may not be allowed as the Critical Care part of the NHS is unlikely to become a quasi-market as it more likely to be driven by unexpected illness rather than personal choice of healthcare.
That is why residents in Sutton will need to continue to campaign now for Acute services to continue to be provided on the St Helier site in the period after 2012.
"1. By October, Epsom may be downgraded for A&E and Maternity, with St Helier providing these functions. More Sutton residents will have to go to Epsom for elective procedures.
"2. Over the next 5-10 years more complex cases will migrate to St Georges. I suspect the Sutton Hospital CCH would have still suffered the same problem, even if put next to the Marsden.
"3. Rebuilding on St Helier will probably be phased operation. It may be partly financed if a major retailer (eg Tesco, Sainsbury's) is asked to develop retail/restaurant facilities on the site and replacing current contractors and services provided by the League of Friends. This sort of partnership may be tied in with the Epsom and St Helier Trust securing Foundation status in due course. A mixed Housing development may also be part of this proposal, with affordable key worker housing "downstairs" and some lovely flats with superb views "upstairs"."
As you can see above I was not expecting a significant movement forward from the Secretary of State, so her decision this week not to proceed at present comes as no great surprise. The decision is clearly a great disappointment, but it has to be said that this whole process has been ruined anyway by the local NHS establishments obsession with the Sutton site which dates back to at least 1992.
It should also be remembered that the proposed development we are all talking about was unlikely to be ready prior to the London Olympics anyway!!:-)
In other words the Secretary of State has in effect simply endorsed the new local status quo over the distribution of acute services, which has emerged since the recent Safety and Sustainability Review of Epsom and St Helier and which has been remarkably endorsed by all three Health Scrutiny Committees (some without a meeting on the subject)!!
We should:
1. Remenber that St Helier was always intended as the main acute hospital for this area from 2006-2012 even under the discredited BHCH proposals. The local NHS establishment only wrongly proposed replacing it with Sutton after that date.
2. Now look at the methodology used to identify acute hospital requirements in the neighbouring Surrey and Sussex Hospital Review. Go to
http://www.surreysussexfitforthefuture.nhs.uk/
for details. This identifies 4 types of Hospital for the future:
a) Critical Care Hospital
b) Major Acute Hospital
c) Local General Hospital
d) Local Care Centre
Judging by current trends I would now see our 5 local "Critical Care Hospitals" as being St Georges at Tooting, Mayday at Croydon, Kingston, St Peter's at Chertsey and East Surrey at Redhill.
I suspect St Helier now looks much more likely to evolve into a "Major Acute Hospital" linked to St Georges, whilst Epsom is likely to develop into a Local General Hospital with its campus also hosting other health providers. The interesting question for Health Scrutiny Committees, is if St Helier doesn't become a Critical Care Hospital and evolves into a Major Acute Hospital with some critical care provided at St Georges, will many people notice?
Hopefully local PCT's will develop or commission local care centres (see my article below on "Local Care Networks") in the coming years in a much more bottom up approach than the top down approach (wait until we have sorted out the CCH etc) proposed in BHCH. This is a key area for local Council's to work with the local NHS on. For example a combined health and leisure development on the Malden Road baths site.
Having attended the Epsom and St Helier Trust meeting in early August, it seems to me the following action is likely to be the priority of the Acute Trust in the coming years:
1. The development of the Epsom Health Campus site, with a range of health providers on it.
2. The establishment of Epsom and St Helier as Foundation Trust. It is vital that the Sutton and Merton Health Scrutiny Committees ensure they strongly imput into the Foundation Trust document. I will set out a checklist of key issues in due course. The most crucial issue will be do we want a "Critical Care Hospital" or a "Major Acute Hospital" in the borough? This will be an issue for a future article.
There is a danger that once it becomes a Foundation the Trust will try to resurect the Sutton Hospital CCH option again in conjunction with the Royal Marsden (probably as a much samller proposal on part of the Sutton site with some sold off to fund it), though this may not be allowed as the Critical Care part of the NHS is unlikely to become a quasi-market as it more likely to be driven by unexpected illness rather than personal choice of healthcare.
That is why residents in Sutton will need to continue to campaign now for Acute services to continue to be provided on the St Helier site in the period after 2012.
posted by Charlie Mansell at 6:00 pm
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