On Wednesday 27 September the Croydon Assembly will hold a special briefing meeting on the potential adverse impact on Croydon of plans across South West London to close one or two of the area’s five acute hospitals.
Croydon University is one of them within the South West London NHS area which includes the boroughs of Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth. If any services in other hospitals in the area are closed then more people will need to use Croydon’s.
The area’s Sustainability and Transformation Plan being drawn up by South West London Collaborative Commissioning group they want to reduce that to four or even three.
The Epsom & St Helier Hospitals NHS Trust have now announced its plans within the STP for the future of hospital services in its area.
It is now proposing the closure of the acute services at either or both Epsom and St. Helier Hospitals.
Please note the deceptive way in which the Trust is seeking public support through an on-line message option. It has yet to announced a proper consultation process and timetable.
What is an acute hospital?
By an acute hospital they mean a hospital that provides:
A&E, Intensive Care, Acute Medicine, Emergency Surgery, Consultant led Maternity and Paediatrics (Children’s).
The Epsom St Helier cuts
This latest plan announced by the Trust sees them cutting all of the above from Epsom, St Helier or most likely BOTH.
They also say they intend cutting all cancer treatment services from Epsom and St Helier hospitals too and “merging them with the Marsden”.
Their plan is to downgrade one or both of these hospitals from a major acute hospital to little more than a cottage hospital or poly clinic, and to have just ONE new centre in their place.
The new centre could be co-located with Epsom or St Helier but the campaign group KOSHH we believe the Trust’s preferred most likely with the Royal Marsden on what was the Sutton Hospital site.
So both these local hospitals would lose their emergency facilities and the Marsden would gain them.
Implications for patients
Most people would have to travel further, in an emergency, at the very time that speed is most important.
- Woman in labour and their babies would be a serious risk of harm or even death if they had extended journeys to reach to have an emergency Cesarean.
- Longer travel times mean poorer outcomes in emergency situations
Half of the beds in this proposed ‘facility’ would be ‘single’ rooms. This fits with:
- the new laws which enable Trusts to gain 49% their funds from private patients.
- the Marsden’s ambitions as they are the hospital that so far has the highest percentage of private income in the whole of England.
The Sutton hospital/Marsden site has very bad transport links- as described by local MP Paul Scully. He also said the Sutton hospital site was too small for a school. Scully and his colleague Crispin Blunt (Tory MP, Reigate) think it’s a fine location for our only acute emergency services
The Trust has now sold Sutton Council the land for the school. It therefore seems that there will be even less land available.
- Chris Greyling, Tory MP for Epsom wants to separate Epsom from the E&STH Trust.
- Siobhain McDonagh MP for Sutton wants St Helier left as it is.
The Trust say they plan to keep the same current low bed numbers with no increase into 2030, despite their own predicted huge population increases.
The CEO of the Trust says that they will only take their new plan IF the public support it.
The KOSHH campaign wants Epsom and St Helier improved, refurbished and enlarged or added to, and to carry on providing all the services to the communities they currently serve.
It argues that the Trust is just pushing the idea of the shiny new facility and asking for public support for the borrowing of £400m from the private sector in what the CEO described as “a sort of PFI 2 ”
PFI has been described as “one of the costliest experiments in public policy making ever attempted. PFI debts lead directly to even deeper public service cuts and hospital deficits.
Downgraded hospitals, once the ‘front door’ of A&E and Maternity are removed often wither away and soon become “financially unsustainable” and are then closed completely.
- does not support the closure of the major acute centres at Epsom and St. Helier, which are both sited in the middle of the communities they were built to serve,
- does not want a very expensive PFI plan for a smaller replacement, further away than the two existing ones.
- argues that if the Marsden needs acute facilities, lets have that in addition not instead.
- points out that there is no clinical justification it is simply to comply with NHS directives to save £22.5 billion over the next few years.
Local Councils have to express their views on the plans. Last December, the Leader of Sutton Council to say that she had written to the NHS ‘on behalf of all the boroughs to confirm that we will not be endorsing the STP for our area.’
On 8 December last year the Health and Social Care Scrutiny Sub-Committee of Croydon Council discussed the South West London STP from the Croydon perspective.
It was presented with the following report
The minutes state:
‘The Committee having previously received a presentation regarding the South West London STP plans, they welcomed the opportunity to receive the detail with a Croydon focus. As the STP is a shared risk between the commissioner and provider, officers from both organisations were in attendance to make a presentation and receive questions from the Committee. The Committee were in agreement that developments of the STP were an important area that they needed to keep a watching brief. The lack of consultation and information from NHS England was a disappointment which the Committee dad previously communicated to NHS England. The lack of transparency and instruction given to health professionals, not to share information with politicians and the public was not in keeping with the spirit of scrutiny. Members were questioning if NHS England recognised local scrutiny’s statutory role and the role of NHS England to consult. The positive working relationships with CCG and CHS could have been at risk due to this instruction as it was an example of poor engagement and that the access to and flow of knowledge was being ignored and the lack of transparency to enable the statutory role of scrutiny.
Social Care and the importance of its successful delivery to various initiatives that are due to come online is an area that the Committee recognised needs support and focus. There was agreement that this area of work should be reflected in the current and future work programmes. Despite this poor start local scrutiny has gone some way to build the confidence by its continued review of the local health economy’s financial recovery.
Key messages and outcomes of the STP are to deliver a 5 year saving and transformation plan. On 14 November 2017 this sector plan was published and outlined how the significant challenges that health are facing would be addressed, the estates review and the appropriate venues for future service delivery.
Taking into account the local health and social care landscape, the Committee asked officers if specific Croydon challenges had been aligned with those across the sector. It was reported that there had been a general focus on prevention, supporting self-management and improved quality of delivered. Hospital provision was viewed on a sector wide basis with a view of specialist care being delivered elsewhere across the sector.
The Committee agreed that the presentation had been a useful update.’
Note the absence of mention of the fact that the Council is supposed to be refusing to support the STP at that stage according to the letter of the Leader of Sutton Council.