35. Surrey Heartlands
What does the STP mean for your area?
Epsom Hospital could see its A&E department closed.
Patients at risk of a heart attack could be denied vital tests and potentially life-saving operations under plans to make £55m of budget cuts.
The sexual health clinic at St Peters Hospital is set to close at the end of September 2017.
Senior NHS sources in this area have disclosed that they are also being forced to "think the unthinkable" and consider proposals to:
- Ration knee arthroscopy operations, cataract removals and tonsillectomies
- Introduce “lifestyle rationing” so that patients who are obese and smoke will have to lose weight and stop smoking before they can have, for example, a knee replacement to treat their arthritis
- Shut beds or even whole wards in community hospitals
- Restrict patients’ access to hearing aids and IVF treatment
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;
- Overall, the STP aims to reduce the use of the acute sector and move care into the community sector.
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, which falls into the south West London STP area,
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.
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."