The Improving Healthcare Together programme has now submitted the updated draft Pre-Consultation Business Case (PCBC) [pdf] 300KB to NHS England for the next stage of the national assurance process. This is a significant step in the process to confirm our long term future.
The proposals detailed in the draft PCBC are focused on keeping hospital services within the combined geography of the three clinical commissioning groups (CCGs). The proposed new model, developed by experienced GPs and clinicians from the hospitals, will mean that the vast majority of patients (85%) would see no change to the hospital location where they receive their care. This will mean that Epsom Hospital and St Helier Hospital will continue to run the majority of services as they do now including: urgent treatment centres, outpatients, day case surgery, antenatal and postnatal clinics, chemotherapy, dialysis, beds for people who are medically stable, endoscopy, imaging and diagnostics. For the sickest and most at-risk patients, representing 15% of the people who use the hospitals’ services, the proposal is to consolidate acute services onto a single site in a new purpose built facility. This new facility would deliver: the majors element of A&E, acute medicine, critical care, emergency surgery, hospital births and inpatient paediatrics, and could be located at one of the hospital sites: Epsom, St Helier or Sutton.
The draft PCBC is a technical and analytical document that sets out the information necessary for the three governing bodies (Merton, Sutton and Surrey Downs) to make a decision as to whether to proceed to consultation. It describes in detail the process to identify a compelling case for change, why ‘do nothing’ is not tenable, and the proposals for change and the implications. It brings together all of the evidence to-date including the report from South East and London Clinical Senates, the Phase 2 draft Interim Integrated Impact Assessment, the provider impact assessment, the financial modelling work and the feedback received to date from the engagement work with patients and public.
Based on the non-financial and financial evidence to date, the updated draft PCBC contains a provisional ranking of the three options of where to locate the new acute facility, to enable regulators to assess the proposals and make a decision in principle on capital. Based on the further work carried out, Sutton is the highest ranking option, followed by St Helier and Epsom, but this is not a preferred option and a preferred option will not be decided upon until after the draft PCBC has been through this assurance stage with NHS England and the CCG Governing Bodies have met in public to consider all of the evidence to date.
As it may be many months before the assurance and capital decision making process is complete, the IHT Programme has produced and published a stakeholder briefing document (which can be viewed here). It is really important to state that this is not a consultation document. It has been produced to bring everyone up to speed on where the programme is and with the current thinking.
Following feedback from the national assurance process, and an agreement in principle that capital funding will be available, the three CCGs will meet in public to consider all of the evidence and decide on a preferred option. This will trigger a formal public consultation on all options including the preferred option.