South West London Collaborative Commissioning

Why do you think you need fewer acute hospitals when demand is rising?

The changes we want to make will reduce the need for ‘acute’ hospital care – by which we mean A&E, intensive care, acute medicine, emergency surgery, specialist maternity care and specialist children’s care. By treating people earlier, strengthening GP and community-based services, working with people to help them live healthier lives and providing dedicated community-based support to people with long term conditions, the frail elderly, children and people with mental health problems, we will be able to help people before their needs become more urgent.

Because of the pressures on these services and a shortage of doctors in some specialties, we think it will be difficult to meet the clinical standards required across five acute hospitals – though we need to do further work on this, including talking to the public, before any decision is made. At the moment, our best working hypothesis is that we will need four hospitals providing these services rather than the current five. We also need to ensure that our acute hospitals meet the minimum standards required. This is not currently the case, but by improved clinical networking between hospitals and concentrating acute services like emergency care, obstetrics and specialist children’s services in fewer hospitals – probably four rather than five – we can improve the quality of care.