This set of working papers is being issued in advance of a period of formal consultation, which will take place probably over a 14-week period, probably mid-July to end October 2004.
The formal consultation will be on a
proposed reconfiguration of healthcare services associated with the creation of
a network of Local Care Hospitals, supported by a
Ahead of this formal consultation, this set of working papers has been written to set out how the NHS intends to approach four issues: -
· The processes of engaging public and patients (before, during and after consultation).
· Financial considerations
·
The criteria against which
sites will be chosen for both the
· The weightings – if any – to be attached to each of the criteria
This set of working papers is not a formal
consultation paper, but it is being published in the interests of
openness. Any comments made will be considered
if they are received by end April 2004.
The Epsom/St Helier
Trust has been talking to many people, patients and staff about the problems
and opportunities it faces. This process
was crystallised into a discussion document "A
better future for your local health care".
This document proposed that the Trust
should aim for a significant decentralisation of services from its current two
main sites (Epsom and
These Local Hospitals would be supported in
their work by one
Maternity services would also be provided
at the
Hospital Doctors would be expected to work
from one or more
There was a reasonable measure of support for this concept, qualified by anxieties about the impact of having a single site dealing with serious casualties as opposed to the two sites which now exist.
To make a reality
of these ideas the NHS concluded there would need to be work on two fronts.
Firstly, on the
'clinical pathways' for patients - that is to say specifying for groups of
illnesses just how the system would guide patients along the stages of diagnosis
and treatment.
Secondly, work
would need to take place on the reconfiguration of buildings which would be
necessary.
The NHS therefore
took the following steps:
Working Paper 3 to
this paper, therefore, is a working paper which sets out the criteria it is
intended we should use; the rationale behind each one; and the way we expect to
apply them.
Working Paper 4
discusses whether each criterion should be equally weighted.
This paper needs
to be seen in the context of the overall process, which is:
1.
Preparing
for the process of appraisal
2.
The
appraisal process, producing a preferred option
3.
Formal
Consultation on the preferred option
4.
Consideration
of the responses to the formal consultation
5.
Outline
Business Case
6.
Full
Business Case
7.
Procurement
Working Paper 1 to
this paper describes our current ideas and timetable for how to handle each of
these 7 steps. Although not a formal
consultation document in and of itself, we would nevertheless also welcome
comments on this seven step process.
In the weeks since
the publication of the Strategic Outline Case some commentators have raised the
question of whether the concept is affordable – and as a consequence, whether
we should go out to consultation at all on proposals.
That is not a view
we currently share.
Primary Care
Trusts – who use tax funding to commission services – may indeed face problems
of affordability. But this is because the number of cases they have to pay for
is forecast to rise. From 2005 onwards they will have to pay for each case at a
national fixed price – regardless of whether the Epsom/St Helier
Trust costs are going up or down.
The Epsom/St Helier Trust will see a rise in its spending on capital
charges because of the new developments. But if, as we
expect, its caseload rises it will see a rise in income too.
Working Paper 2
sets out these arguments in greater depth.
It also commits us
to re-examining the financial figures, and to putting them forward as part of
the evidence to the June appraisal panel.
To summarise, we
are particularly interested to hear views on the following:
1. Are the
criteria sensible and fair?
2. Are there any
criteria which ought to be there and are not?
3. Should all
criteria carry equal weight? If not, which are the most important?
4. Are we making
heavy weather of all this? We are striving hard to be transparent in the period
prior to formal consultation. But is there a danger that the key issues
actually get lost in the detail?
We would be
interested to hear what the key issues are in people’s minds so that when we do
engage in formal consultation during July – October, we can keep a focus on the
important things.
East Elmbridge and Mid
Sutton & Merton PCT
Epsom/St Helier NHS Trust