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Epsom and St Helier 2020-2030: Our next steps in securing a sustainable future for our hospitals
The results of the Epsom and St Helier 2020-2030 engagement campaign (see Epsom and St Helier 2020-2030 - booklet [pdf] 1MB) were published on Friday 10 November, after more than 25,000 people joined the conversation about the long term future of the Trust’s healthcare services.
In this section of the website, you will find more information about what our patients and visitors think, as well as the views of our local councillors, MPs and community groups.
As a brief overview, the findings show that the potential scenario of consolidating acute care in a new, purpose-built facility on any one of the Trust’s hospital sites (representing 15% of the current care provided by the Trust) is widely supported. 79.8% of those who responded to the engagement questionnaire supported this scenario.
At the same time, the Trust also published the Strategic outline case for investment in our hospitals 2020-2030[pdf] 2MB, which details how creating a brand new acute facility would allow the Trust to further improve patient care and achieve all the additional clinical quality standards we are required to meet, including round-the-clock seven days a week consultant cover for our sickest patients.
The SOC, building on the scenarios put forward in the engagement material, also includes an indicative financial analysis of three potential future scenarios (a new acute specialist facility at Epsom Hospital, at St Helier Hospital, or co-located with The Royal Marsden at Sutton Hospital).
The SOC shows that a move to a consolidated acute facility on one site would result in a minimum £35 million reduction in the Trust’s annual deficit. A preliminary estimate of capital investment required to deliver the facility ranges between £377 million and £444 million, depending on site.
The Trust will now submit the Strategic Outline Case to its regulator, NHS Improvement. They will consider all of the information, and following this, will decide if the process can move to the next stage and develop a full business case. The strategic outline case will also be sent to the Sutton Local Transformation Board as the Trust’s input into their component of the South West London sustainability and transformation programme (STP) refresh, which is due to be concluded at the end of November, and to the Surrey Heartlands STP.
The Trust will support the work of its commissioners as they evaluate the relative merits of the different scenarios. This will include a timeline for further work required that enables the local system to reach a shared view of the preferred scenario(s) that the public can be formally consulted on.
You can read the full Strategic outline case for investment in our hospitals 2020-2030[pdf] 2MB, as well as our Strategic Outline Case Summary: An introduction to our next steps in securing a sustainable future for our hospitals[pdf] 2MB. You can also read the latest news story about it here.
The findings of our engagement
In addition to our Epsom and St Helier 2020-2030 Your views[pdf] 3MB, we wanted to provide local people and interested parties a thorough breakdown of the feedback we received during our period of initial engagement. Due to the volume of responses we received, we have created a number of appendices so you can find information more easily. If you have any questions about this section of the website, please email esth.communications@nhs.net and we will be happy to help.
What did people tell us?
We received 1,059 individual responses to our questionnaire, which was developed with the Consultation Institute. The five questions, and what people told us, are below.
Question 1: Do you agree with our aim to provide as much care as possible from our existing hospital sites at St Helier and Epsom and do this by working more closely with the other local health and care providers?
Question 2: Do you think we have made the case that we will improve patient care by bringing together our services for our sickest or most at-risk patients on a new specialist acute facility on one site?
Question 3: We have set out several scenarios on how we can do this. In all of these 85% of patients will continue to be seen and treated as they are now with the sickest and most at-risk patients being cared for in a new specialist acute facility located on one of our three sites (Epsom or St Helier or at Sutton co-located with the Royal Marsden). Do you think we should consider any other scenarios?
Question 4: How would you like to be involved in these discussions in the future?
914 people answered this question. 52 people confirmed that they wanted to be involved by simply answering yes. Others confirmed how they would like to be involved.
- 170 people – the majority of those who responded to the question – confirmed that they would like to be contacted by email, with some also wanting to attend meetings.
- 143 people mentioned meetings, and a further 108 people mentioned post, media, website and newsletters.
- 83 people said they did not want to be involved, with 128 people responding N/A.
A small, but important, number of elderly people (fewer than 20) mentioned that they would not be able to be involved because of their age or illness.
Question 5: Is there anything else you would like to tell us?
Although most people did not answer question 5, many of those who did chose to repeat their choice for where a single acute specialist site should be located.
84 respondents took the opportunity to leave comments about the services they had personally experienced or improvements which could be made. The majority of these comments were positive.
There were also 64 responses highlighting issues relating to transport, including congested roads, the need for better parking at the site and poor bus services between sites.
22 people asked further questions ranging from wanting clarification on the scenarios to how and if the funding will be available:
“Your leaflet mentions £300m - £400m costs - in the current economic environment (and uncertainty post Brexit) is this amount ever likely to be allocated?” [Local resident].
Please see pages 13-21 of [INSERT YOUR VIEWS DOCUMENT LINK] for more information about what people told us.
What we heard from meetings
We were invited to attend a number of meetings held at different times and locations across our catchment area, and were delighted to be able to attend and support these meetings. See meetings we attended [pdf] 34KB.
Many questions were asked by people at the meetings, which provided an opportunity to discuss issues and concerns.
Issues raised at most of the meetings were as follows.
- Transport and accessibility, including the travel times between sites if services move
- Levels of deprivation and social issues
- The number of reviews which have already taken place
- What ‘85% of services remaining local’ actually means
- What ‘15% of services’ actually means for local people
- What the scenarios will mean for maternity and children’s services
- Funding – how it will be funded, if it is feasible to attract the level of investment needed and the cost of funding
- Whether this would lead to deprivation.
Members of KOSHH (Keep Our St Helier Hospital) contributed to a large number of the public meetings, sharing their view that both sites – Epsom and St Helier – should keep all acute services. The campaign group was clear to make the point that they did not support any investment if it meant services moving off either site to a single facility, even if that facility was located at St Helier Hospital.
Our local Healthwatch organisations – what they said
Healthwatch Surrey
Healthwatch Surrey designed a communications and engagement programme which enabled it to speak to over 2,000 people on high streets, outside supermarkets and at community events about the Trust’s ‘involvement opportunity’.
Through a direct email and postal campaign, PR and social media it generated over 5,000 views of a dedicated web page explaining the proposals, press coverage through BBC Surrey radio and over 25,000 Twitter impressions. This report summarises the activity undertaken by Healthwatch Surrey on behalf of the Trust. You can read their report into their findings here: Healthwatch Surrey: Enhancing the conversation about ‘Epsom & St Helier 2020-2030’ [pdf] 372KB.
Healthwatch Sutton
Healthwatch Sutton carried out a short survery prior to its meeting on 5 September 2017. Read the Healthwatch Sutton: short survey overview [pdf] 347KB
Healthwatch Merton
Healthwatch Merton held a public event on 26 September 2017 to discuss Merton residents’ views on the ‘Epsom and St Helier 2020-2030’ engagement. Read the report from its meeting on 26 September 2017: Healthwatch Merton: Merton residents’ views on the ‘Epsom and St Helier 2020-2030’ engagement [pdf] 698KB
What the media said
As you might expect, during this period of engagement the Trust was never far from the media spotlight. We have created a media coverage report [pdf] 84KB (an overview of the coverage we received, as well as a measurement of potential reach, as provided by the media monitoring platform we use) for your information.
Petitions
Here is a full breakdown of the petitions we have received.
| Name of group | Number of letters/signatures received | Example of letter |
| St Barnabas Church St Helier Hospital Engagement | 38 | |
| Local Resident & Parishioner St Theresa’s RC Church | 431 | |
| Local Resident & Parishioner Our Lady of Assumption | 30 | Our lady of assumption church [pdf] 197KB |
| Local Residents & Parishioners of St Peters & St Pauls | 226 | St Peter's and St Paul's church [pdf] 202KB |
| South London Nepalese (Gurkha) Association | 154 | South London Nepalese Assoc. [pdf] 187KB |
| Response from Pollards Hill Residents | 84 | Pollard's Hill residents [pdf] 176KB |
| Residents of Yenston Close | 24 | Yenston Close residents [pdf] 128KB |
| North East Mitcham Community Centre | 15 | NE Mitcham Community Centre [pdf] 216KB |
| Keep St Helier Hospital’s Acute Service Open | 40 | Keep St Helier Acute Service open[pdf] 104KB |
| Keep St Helier Hospital’s Acute Service Open – We the undersigned want all services at St Helier Hospital to stay open on its current site past 2020, including all A&A and consultant led maternity services. Any funds should be used to improve St Helier on its current site. | 30 | Keep St Helier Acute Service open[pdf] 104KB |
| Save St Helier Hospital Campaign | 156 | Save St Helier Hospital[pdf] 99KB |
|
Sutton Save St Helier Hospital Campaign |
115 | Save St Helier Hospital Sutton[pdf] 119KB |
| Hatfeild Primary School Morden | 81 | Hatfield Primary School[pdf] 188KB |
| Aragon Primary School, Morden | 131 | Aragon Primary School[pdf] 191KB |
| Malmesbury Primary School Meeting | 61 | Malmesbury Primary School[pdf] 187KB |
| Cranmer School | 66 | Cranmer Primary School[pdf] 201KB |
| Morden Primary School | 88 | Morden Primary School[pdf] 190KB |
| Abbotsbury Primary School, Morden | 89 | Abbotsbury Primary School[pdf] 191KB |
| St Teresa’s Primary School | 50 | St Theresa's primary school[pdf] 191KB |
| Dharshika Devanamby - Central Medical Centre – Keep St Helier Hospital’s Acute Services Open | 72 | Central Medical Centre[pdf] 104KB |
| Baitul Futuh Mosque, Morden | 1,195 | Baitul Futuh Mosque[pdf] 192KB |
| Carshalton & Wallington Labour Party | 245 | Carshalton and Wallington Labour Party[pdf] 111KB |
Conclusions
We cannot continue running acute services on two sites because we will not be able to meet all of the clinical standards expected of us. The Trust will continue to become clinically and financially unviable and will not have the appropriate buildings to deliver 21st century healthcare. This is not an option we believe is acceptable for our patients and our staff.
The Trust analysis shows that all three single acute site scenarios, where six acute services are consolidated on a single site and 85% of care remains at both St Helier and Epsom Hospitals enables us to deliver the required quality standards and we become clinically sustainable.
The financial benefit of all the consolidation in all of the three scenarios is significant when compared to where the Trust is now. The difference in total financial benefit between the three scenarios is relatively small.
Significant capital investment is required in each of the scenarios of between £377 and £444 million.
This initial work has shown that there is not a preferred scenario which can be identified at this stage. At this stage, only the initial viability of scenarios has been considered; none of the scenarios have been assessed against any formal agreed criteria.
Further work is needed with commissioners and the public to define broader criteria for assessment of different scenarios and further analysis is required to understand the performance of different scenarios against these.
A number of themes for criteria that are important to local people, for example travel distances have been identified from the feedback we have received throughout public involvement. The local commissioners will need to work with stakeholders and the public to determine the non-financial criteria that should be used to evaluate the scenarios in future using the information already provided from questionnaires, meetings, formal responses, letters and petitions. Thank you to everyone who took time to get involved and shared their views.
This strategic outline case will be shared with:
- NHS Improvement, the Trust’s regulator
- Sutton Local Transformation Board (as the Trust’s input into their component of the South West London Sustainability and Transformation Partnership refresh, which is due to be concluded at the end of November)
- Surrey Heartlands Sustainability and Transformation Partnership
- NHS England.
Further work will include the Trust supporting commissioners to evaluate the relative merits of the different scenarios. As part of this we have recommended to commissioners that the following is considered in detail:
- travel times and modelling travel time impacts for different groups of patients, relatives and visitors
- deprivation, healthcare needs and the location of acute hospitals
- an assessment of any equalities impact
- the impact of scenarios on other providers.
A programme plan would need to be developed by the relevant parties during the next stage but the process and timing could look something like:
| Activity | Indicative timeline |
|---|---|
| Agreement to proceed | December 2017 |
| Pre-consultation / outline business case | June 2018 completed (if required) |
| Public consultation (if required) | Summer/autumn 2018 |
| Decision on outcome of public consultation | Spring 2019 |
If the Trust was to proceed with developing new facilities, it is initially envisaged that these could be open in 2024-26.
This would be subject to an intense period of work including developing planning permission and producing a full business case.
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