Agenda item

The Joint Programme Director for Acute Sustainability gave an overview of the report and highlighted that Epsom and St Helier Trust developed a Strategic Outline Case which set out three key challenges; clinical sustainability, modernising the estate and financial sustainability. The Trust conducted an engagement exercise and made recommendations to address these challenges and identified potential solutions.

Sutton, Merton and Surrey are the three principle customers of services from Epsom and St Helier therefore the respective Clinical Commissioning Groups have formed the Improving Healthcare Together 2020-2030 programme to look at the challenges identified by Epsom and St Helier. It was recommended that the Joint Health Overview and Scrutiny Committee should mirror the NHS arrangements.

A recent meeting of the Committees in Common agreed the initial proposals within the Improving Healthcare Together Programme and given approval for the work to move to the engagement stage. The CCGs are keen to engage with all sections of the public and local authorities.

Members noted that the report is still at a high level and asked if the figures are predicated on current provision and if so what assumptions will be made. The Managing Director for Merton and Wandsworth said the current assumptions are broadly based on current services, this information is still being compiled. Further information will model the demographic and non-demographic growth as well as planned commissioning changes. As the population is ageing, south west London will need the range of services that are provided at the moment retaining the current acute services and any potential solution must retain acute services within the combined geography.

Members were concerned that a reconfiguration of acute services could result in a change in patient flows as residents may use acute services elsewhere rather than local community services. The Managing Director for Merton and Wandsworth said they recognise there may be a change in the local authorities who are affected by the change in acute configuration. They have commissioned some work to assess travel times as many acute services are accessed by ambulance, there is a need to understand how patient flows will change. They will also look at the impact of deprivation and how deprived communities access care differently and if they use more acute care.

There are no results at this stage, the outcomes from the reviews will feed into

engagement when the information becomes available. The Improving Healthcare Together Programme is also working closely with other acute providers to ensure they are not de-stabilised by this process.

Members asked how the CCG’s can lead on the provision of healthcare from modern buildings when the power to raise this funding rests with the acute trusts. The Joint Programme Director for Acute Sustainability said Commissioners will play an important role in developing the pre- consultation business case which will demonstrate if the proposals are affordable, they are also working with regulators and the Trust. Members noted it will not be possible to go to public consultation until support in principle is secured for capital investment.