(Presentation given at 2011 League of Friends Annual General Meeting) A Vision for the Future of Leatherhead Hospital

Jo Pritchard (Joint Managing Director of Central Surrey Health), and Peter Adams (Director of Adams Consulting Partners)

The Hon Chairman welcomed the hospital staff, and explained how the problems that the League of Friends had experienced in not being allowed to proceed with a refurbishment of the X-ray department had led to our desire to clarify the future prospects for Leatherhead Hospital. Following a meeting between the officers of the LOF committee and the joint managing directors of Central Surrey Health, it was decided to use £10k of our funds to employ an independent firm of consultants to carry out phase 1 which is merely the starting point. An important input for the consultation was the survey of LOF members, and Audrey thanked everyone who responded.

The Hon Chairman handed over to Jo Pritchard (Joint Managing Director of Central Surrey Health) to explain the background to the consultation. Jo gave the current details of the reforms (which are subject to possible change) in the Health and Social Care Bill 2011, and the cost pressures on the NHS due to funding not rising in line with the costs caused by an ageing population with a high proportion of long term conditions, and the ever evolving technology. The local position is that:- there are severe financial pressures in Surrey; commissioning is moving from NHS Surrey to GP commissioning groups; the future of Epsom Hospital is unclear; and the future ownership of the Leatherhead Hospital site is unknown (currently owned by NHS Surrey which will cease to exist).

At this point Jo Pritchard handed over to Peter Adams (Director of Adams Consulting Partners) who said that due to the illness of Jacqui Adams, he would be presenting the details of the progress so far.

This consultation is an opportunity to review how Leatherhead Hospital can develop by offering affordable services that do not duplicate others, with services that are less highly technical than acute hospitals. The key criteria are :- what is most needed locally at the hospital; what is most affordable and cost effectively delivered at the hospital; which services most optimally complement those delivered from local acute hospitals such as Epsom. Stage 1 of the project was to ‘Think the Possible’, stage 2 would be to ‘Test the Possible’ (feasibility study), stage 3 would be to ‘Develop the Financially Achievable’. Thus stage 1 was to enable the LOF to lead development of a locally agreed model/vision for its future configuration, and produce potential service options for the site, and enable the LOF to justify its expenditure to the ‘Charities Commission’. Adams Consulting Partners Ltd were retained, and work commenced in February.

The planning group consisted of representatives from:- LOF, Central Surrey Health, Surrey Links (patient group), MEDLiNC GP Consortium, Mid Surrey GP consortium, NHS Surrey, Surrey County Council, Epsom & St Helier Hospital, South East Coast Ambulance, Surrey & Borders Partnership Trust. Stage1 was to agree the POTENTIAL services to be included at the hospital in the future, and 5 fortnightly meeting were held from February to April. These meetings considered modern examples of Community Hospitals and best practice examples; an important input was the LOF member survey.

The LOF survey had a high response of over 55%, and the top preferences for current services to be retained were in-patient beds, physiotherapy gym, and X-ray. The main reason for voting to retain clinical services was that they are ‘closer to home’, and there was low support for retaining non-clinical services. The single largest preference for enhancements was to have more in-patient beds, and the next most popular was to have a minor injuries unit and GP out of hours presence.

Many possible uses of the site were thought possible including: ‘Traditional’ Community Hospital; Daycare Treatments; Day Surgery; Outpatient Clinic & Diagnostic Facility; Intermediate Care Centre; Community Prevention & Rehabilitation Centre; Supported Independent Living Campus; Long Term Conditions Management Hub; Urgent Care Centre; GP Health Centre. New care models involving both bed based care and non-bed based care, with people being treated at home perhaps using telecare were considered, from the simple alarm system currently used in Mole Valley, to the telemedicine link to an acute hospital used at Caterham Dene – thus introducing the concept of ‘virtual hospital beds’ with the patient remaining at home for much of their treatment. New working practices involving the Ambulance Service Paramedic Practitioner have already been trialed, and show that Community Hospitals help avoid patients getting ‘stuck in the acute system’ because paramedics can choose the most appropriate hospital for conveyance. Integration of care teams is also an important part of new working practice.

A very brief summary of the vision from phase 1 is that Leatherhead Community Hospital should serve a wide range of patients, from children to the elderly, who have non-acute, non-emergency problems. The hospital should treat both unscheduled/urgent care and scheduled care patients, and ideally should be open 7 days per week, 08.00-20.00

The services at Leatherhead would fall into several groups (or zones) of inter-related services which would have an integrated access point. These zones could be :- Support Zone (supporting most other groups of service, e.g. X-ray); Urgent Care Zone; Healthy Living Zone; Planned Care Zone; Intermediate Zone; Domestic Living Zone; Children’s Zone.

Now that stage 1 is complete, the next step is for the LOF Trustees to consider whether they should proceed to stage 2, which would be the Feasibility Study. This would be to confirm that the proposed vision is sound and sustainable, and assessing which of the services in the zones could be delivered affordably and effectively at Leatherhead Community Hospital.

The Hon Chairman invited questions, which all indicated strong support for the hospital and the consultation process, she then thanked Jo and Peter for the presentation, and closed the meeting.