South West London STP includes plans to close acute hospital

One of the five acute hospitals in the South West London sustainability and transformation plan (STP) footprint is due to close in order to meet standards of care, according to the area’s newly published plan.

South West London (SWL) follows North London and Birmingham and Solihull in publishing the plans, which have been subject to criticism for being too secretive and potentially leading to service closures.

Cllr Ruth Dombey, leader of Sutton Council and South London Partnership health lead, said: “As boroughs, we are concerned that the NHS centrally has not allowed the publication of our STP and that this is raising worries about its content and the process around its development.

“I am therefore publishing the South West London STP to increase transparency and support the development of robust plans that will deliver better services and outcomes across our area.”

The STP said stakeholders have reviewed plans to cut the number of acute hospitals currently in operation in the area. At the moment there are five: Croydon, Epsom, St Helier, Kingston and St George’s.

The document revealed health leaders had considered whether cutting this down to four or three would “an appropriate configuration to deliver clinically and financially sustainable care in south west London”, and had come to the conclusion that four would be possible.

The STP noted: “Initial evidence from our costs of capital analysis shows that, under comparable scenarios for three and four sites, four sites are expected to require approximately £150m less capital than three, if care is re-provided using existing acute sites.

“The main driver for reconfiguration of the acute sector is the view of clinicians, as expressed through the Clinical Board, that south west London will not be able to meet key clinical quality standards across five acute sites.”

SWL currently has 19 consultant vacancies, meaning it cannot deliver standards to a service required. It said that by delivering care on four acute sites, it would be able to reduce the number of consultant vacancies to 15.

By closing down two sites it would be able to meet its consultant numbers, but it said three sites was “unlikely to be deliverable” and would have higher capital costs.

The STP document added that it would be particularly difficult to recruit enough staff to deliver the seven-day NHS.

It added that plans to cut the number of hospitals down to four would be accompanied by service reforms.

“The four sites would be the ‘front doors’ to a system that was heavily clinically networked,” the papers said. “This might mean, for example, that some services were provided on fewer than four sites; or that staff worked across two or more sites, to ensure access to a wide range of training opportunities.”

The STP also includes plans to review specialised services at hospitals including St George’s, Epsom, St Helier and the Royal Marsden, to tackle the rising cost of care and identify the “optimal configuration” of services.

(Image c. John Stillwell)

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