35. Surrey Heartlands
What concerns have been raised about your STP?
Health planners are trying to reduce NHS deficits and think about ways to re-organise care. However getting the large deficit under control could prevent facilities being developed that can cope with the health and care social needs of local people.
There are few details of the changes that will take place within the STP document, although there will be changes to acute services.
Epsom Hospital could see its A&E department closed.
The sexual health clinic at St Peters Hospital is set to close at the end of September 2017.
Changes in who organises our care
In June 2017 Simon Stevens announced that Surrey Heartlands will have a health and social care devolution style deal, rather like Manchester.
There will be new models of care in the community that will focus on reducing visits to A&E and hospital admissions, including the development of an accountable care organisation in Guildford and Waverley CCG. The general aim is to provide a fully-integrated service in the community with easy access to many disciplines for the frail and elderly in the area.
What are the proposed aims of the STP?
- Elimination of projected 2020/21 deficit of £102 million;
- Integration of health and social care;
- Increased efficiency of back-office services;
- Development of community hubs to act as multi-disciplinary centres for the frail and elderly;
- Reduction in A&E visits and hospital admissions (1-4% reduction by 2020/21);
- Reconfiguration of specialist services.
Like other areas the STP aims to transfer services out of hospital and into the community. The concern is that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.
The major part of Surrey Heartlands STP documents deals with the implementation of new models of care in the community as a method of reducing visits to A&E and hospital admissions. These are discussed in terms of 'locality hubs' or 'community hubs' and in Guildford and Waverley CCG as an accountable care organisation. The general aim is to provide a fully-integrated service in the community with easy access to many disciplines for the frail and elderly in the area.
The Bedser hub is GP-led and referred to as a 'locality-hub', whereas the Epsom Health and Care 'community hub' is led by Surrey Downs CCG, Epsom and St Helier University Hospitals NHS Trust, Central Surrey Health, the local GP federation and Surrey County Council. Guildford and Waverley CCG has set up a community hub incorporating acute, community, primary care, mental health and social care. The hub involves an integrated teams of professionals , from both health and social services, delivering coordinated care for patients who are vulnerable.
The STP plans to increase spend on primary care and put in place a strategy for recruiting more GPs.
There are three hospitals with A&Es in the Surrey Heartlands area, St Peter's Hospital in Chertsey (part of the Ashford and St Peter's Hospitals NHS Foundation Trust), the Royal Surrey County Hospital in Guildford, and Epsom Hospital. As Epsom Hospital is partnered with St Helier Hospital in the south West London STP area, Epsom Hospital is also discussed within the SW London STP.
There will be some as yet unspecified changes in the provision of acute services, with it being likely that services will be concentrated in fewer hospitals than they are now, includes services such as children's cancer, child and adolescent mental health services, HIV, blood disorders and renal services.
In September 2017 the Epsom and St Helier Hospital Trust produced a leaflet outlining three main proposals for the future of acute care, including A&E, at Epsom Hospital and St Helier Hospital. The options include a new state-of-the-art facility being built at Epsom, both hospitals maintaining services or them being moved to Sutton. Currently acute services are provided at both Epsom and St Helier Hospitals separately but the proposals make the case for bringing these services together at one site.
One option is for a new state-of-the-art facility to be built at Epsom and acute services removed from St Helier or for acute services to be maintained at both of the hospitals. The third option would see both Epsom and St Helier hospitals losing their acute facilities with a new facility being built at the Royal Marsden Hospital, in Sutton just over the Banstead border.
HealthWatch Surrey has criticised Surrey Heartlands STP for opting to run small, in-depth events to get feedback on proposals, rather than consult with the wider public. The organisation has called for “quality engagement” by the NHS with residents.
“We acknowledge Surrey Heartlands has taken steps to engage with the public in an innovative way, and are calling for as much ongoing and meaningful involvement as possible as their more detailed plans are developed."