A NEW review of healthcare in south west London could recommend closing key services at some hospitals, the Advertiser has been told.
It follows confirmation that its predecessor, the ill-fated Better Services, Better Value (BSBV), has finally been scrapped.
That process, which was beset by delays and controversy, recommended shutting A&E and maternity units at two of five hospitals, with one option including Croydon.
In a joint statement the region's six clinical commissioning groups (CCG) said this week that they will now work on a new five-year plan to meet rising pressure on local health services.
When asked whether that could include the loss of A&E, maternity or children's units, a senior figure said "reconfiguration" was "highly likely".
Paula Swann, chief officer of Croydon CCG, told the Advertiser: "You can only improve health services without reconfiguration up to a certain point.
"I think we will get to the stage where we will need to think about reconfiguration of services.
"It's not clear at this point what that would be, but it's highly likely that reconfiguration will have to happen."
This week's statement was released by the GP head of six CCGs in south west London: Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth.
While they have dropped the recommendations made by BSBV, which caused particular concern in Sutton as it threatened both St Helier and Epsom hospitals, they remain committed to the 'case for change'.
That includes meeting the needs of an ageing population, tackling the variation in quality of care at hospitals at different times of the day, week and year, and addressing a shortage of consultants across the region.
BSBV had stalled a number of times since its inception in 2011 ant then ground to a halt last summer amid concern about the financial calculations it was based on. Then, in November, Surrey GPs pulled out completely leaving the process floundering.
That was a blow for Croydon University Hospital which, although threatened by one of the options under consideration, could have received significant investment in its A&E and maternity units.
"From a Croydon perspective we were disappointed that we weren't able to continue with BSBV but the work it produced is still valid," said Mrs Swann.
"I don't think it was a waste of time or money because there's still valuable work we can use as the platform for the new plan. It means we're not starting from a blank piece of paper."
The CCGs say the new process will be broader in scope and bring about swifter, more incremental changes.
A strategic plan has to be submitted to the Department of Health by June with details of the revised proposals likely to released in July.Why do GPs think healthcare in south west London has to change?
Though Better Services, Better Value (BSBV) has finally flatlined and been confined to the morgue, medical professionals still believe they can salvage some of its body parts.
But what is the 'case for change' - on which BSBV based its plans to close a number of A&Es and maternity units - that clinicians are still convinced by?
The list below is why those driving the new review of healthcare in south west London believe doing nothing is not an option:
- The population is ageing and up to a third of people are living with long term conditions, meaning there is a need to provide more and better care out of hospital and closer to where people live
- None of the hospitals in south west London meet the minimum safety and quality standards set out by clinicians based on Royal College guidance – the London Quality Standards
- There is a variation in the quality of care between different hospitals and different times of the day, week and year
- There is a shortage of key clinicians and not enough to meet the London Quality Standards and deliver seven-day services across the four major acute hospitals in south west London. Even if staff were available to hire hospitals cannot afford them
- The NHS is unlikely to be given extra money in the foreseeable future, yet the costs of providing healthcare are rising much faster than the rate of inflation
- There is less money than in previous years to spend on hospital care, as £3.8 billion has been taken from Clinical Commissioning Group (CCG) budgets for the Better Care Fund.
- Mental health services need to be redesigned so that they achieve the highest possible standards and are focused primarily in the community.
- Primary care and other community-based services must meet the highest possible standards.
