Half billion pound NHS cuts in southwest London branded 'unachievable'

St Helier Hospital

St Helier Hospital

First published in News
Last updated
Richmond and Twickenham Times: Photograph of the Author by , Chief reporter

Plans to save nearly half a billion pounds in healthcare cost across south west London has been dubbed unachievable by health service regulators.

A draft strategy from newly formed South West London Collaborative Commissioning (SWLCC) was published last week stating there is a predicted budget shortfall of £210m over the next five years shared between clinical commissioning groups working in Merton, Sutton, Wandsworth, Croydon, Kingston and Richmond.

In addition to this Epsom and St Helier, Croydon, Kingston and St George's NHS trusts have to identify £360m worth of savings over the same time period.

An ageing population, costs of new technology, the cost of drugs and hospital improvements were identified as the cause of the huge potential deficit.

Remarkably the document states these are ‘savings considered to be far in excess of what is considered achievable.’

The view comes from two bodies - The sector regulator for health services in England, Monitor, and the Foundation Trust Network.

A SWLCC spokesperson said: "The assertion about the likely achievability of the trusts’ savings plans is based on the view of Monitor and the Foundation Trust Network that cost improvement plans higher than 2.5 per cent of a trust’s budget are likely to be difficult to achieve.

"The plans of our local acute trusts all exceed 2.5 per cent. Again, it is a question for the trusts how the savings will be achieved if they do not succeed with their cost improvement plans."

The formation of SWLCC comes only months after the break down of Better Services Better Value, a healthcare review designed to cut costs across the area.

The unpopular review had recommended the cutting of major services to St Helier Hospital before it was abandoned.

Keep Our St Helier Hospital campaigner Georgia Lewis said: "The strategy document cites a £210m funding gap and £126m worth of savings coming from acute services - that means A&E departments.

"How can this be done without making significant cuts? ‘Consolidating services’ is the rhetoric.

"It just means fewer A&E departments. It has happened at Hammersmith Hospital and it can happen here too."

The document has emphasised community care opposed to hospital care could provide major cost savings.

A healthcare centre featuring two GP practices, physiotherapy, minor surgery wards and x-ray facilities is under construction on the former Nelson Hospital site in Kingston Road and NHS Merton Clinical Commissioning Group (CCG) has stated there are plans for a similar facility in Mitcham.

A spokesperson for Merton CCG, said: "The NHS has for several years been trying to move more care out of hospital and treat people closer to home, in response to an ageing population in which more people are living with long term conditions.

"This means that people only have to go to hospital when they really need to be there."

A meeting was held on Thursday to discuss Merton’s plans for implementing the five year strategy.

Among those who attended was Lower Morden Residents’ Association member Sally Kenny.

She said: "We are going round in circles.

"St Helier needs money spent on the building."

She said very little detail has been revealed so far on how the strategy will be implemented.

The publication of the draft strategy is the first in a two stage process.

Firstly it will be discussed for approval by each of the six CCG governing bodies over the next few weeks.

The second step is to agree on the detail including how trusts will deliver it.

Comments (16)

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10:13am Thu 5 Jun 14

Harryspur says...

in a few weeks the microbiology lab at kingston will be shut down and moved to st georges in tooting. followed by the entire pathology service for the whole of sw london merging and moving there too. this will definitely cause a downturn in the quality of service provided due to staff being made redundant and, and turnaround times for tests increasing due to transport issues...
in a few weeks the microbiology lab at kingston will be shut down and moved to st georges in tooting. followed by the entire pathology service for the whole of sw london merging and moving there too. this will definitely cause a downturn in the quality of service provided due to staff being made redundant and, and turnaround times for tests increasing due to transport issues... Harryspur
  • Score: 6

10:46am Thu 5 Jun 14

Forty_two says...

It should be pointed out that the BSBV review, and indeed this latest "draft plan" are largely based on the so called "London Quality Standards", which BSBV previously admitted on twitter were not achievable across five sites, even with unlimited funding. There simply are not enough consultants to meet them.

This set of "standards" (which incidentally are not mandatory), have I believe been drawn up with the specific intention to be used as a mechanism to close all but a handful of London's hospitals.

The suggestion that providing services "closer to home" will somehow be cheaper is nonsensical. How can it be cheaper to provide a service in six locations instead of one?
It should be pointed out that the BSBV review, and indeed this latest "draft plan" are largely based on the so called "London Quality Standards", which BSBV previously admitted on twitter were not achievable across five sites, even with unlimited funding. There simply are not enough consultants to meet them. This set of "standards" (which incidentally are not mandatory), have I believe been drawn up with the specific intention to be used as a mechanism to close all but a handful of London's hospitals. The suggestion that providing services "closer to home" will somehow be cheaper is nonsensical. How can it be cheaper to provide a service in six locations instead of one? Forty_two
  • Score: 5

11:08am Thu 5 Jun 14

Georgia Lewis says...

To put the figures into more perspective, the funding gap of £210m is over five years and the draft strategy document reports that the four acute hospitals - Croydon, St Helier, St Georges and Kingston - will be required to identify savings of £360m over five years. (For "savings" read "cuts"...). St Helier's share of this is put at £83m, with the report stating that 67% of this would have to be met from acute services which, as I stated, is a direct threat to A&E.
To put the figures into more perspective, the funding gap of £210m is over five years and the draft strategy document reports that the four acute hospitals - Croydon, St Helier, St Georges and Kingston - will be required to identify savings of £360m over five years. (For "savings" read "cuts"...). St Helier's share of this is put at £83m, with the report stating that 67% of this would have to be met from acute services which, as I stated, is a direct threat to A&E. Georgia Lewis
  • Score: 5

11:15am Thu 5 Jun 14

Forty_two says...

This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it.

Could it be that she was being "less than honest" about that by any chance?
This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it. Could it be that she was being "less than honest" about that by any chance? Forty_two
  • Score: 1

11:49am Thu 5 Jun 14

Georgia Lewis says...

A spokesperson for Merton CCG, said: "The NHS has for several years been trying to move more care out of hospital and treat people closer to home, in response to an ageing population in which more people are living with long term conditions.

"This means that people only have to go to hospital when they really need to be there."

__________

This all sounds nice in principle but there are still an overwhelming number of patients who do need to be in hospital with A&E and maternity close by. Most women prefer to give birth in hospital, c-sections cannot be done at home, broken bones need hospital attention, bumps to heads require sophisticated scanning, asthma attacks are best monitored in hospital etc etc etc.

Educate people about the time and resources wasted by going to A&E or calling 999 unnecessarily by all means but short of every house having hospital-grade facilities, the fact remains that we still need well-equipped hospitals.
A spokesperson for Merton CCG, said: "The NHS has for several years been trying to move more care out of hospital and treat people closer to home, in response to an ageing population in which more people are living with long term conditions. "This means that people only have to go to hospital when they really need to be there." __________ This all sounds nice in principle but there are still an overwhelming number of patients who do need to be in hospital with A&E and maternity close by. Most women prefer to give birth in hospital, c-sections cannot be done at home, broken bones need hospital attention, bumps to heads require sophisticated scanning, asthma attacks are best monitored in hospital etc etc etc. Educate people about the time and resources wasted by going to A&E or calling 999 unnecessarily by all means but short of every house having hospital-grade facilities, the fact remains that we still need well-equipped hospitals. Georgia Lewis
  • Score: 5

11:54am Thu 5 Jun 14

Simon Attwood says...

Oh, but we need the money to pay for the hugely expensive (£50 billion) and unnecessary HS2 line and we would prefer to sacrifice essential services like NHS and Education, etc.
Oh, but we need the money to pay for the hugely expensive (£50 billion) and unnecessary HS2 line and we would prefer to sacrifice essential services like NHS and Education, etc. Simon Attwood
  • Score: 11

11:55am Thu 5 Jun 14

Michael Barltrop says...

Message for Forty Two. Respect. Just to say that I agree with all your points. It isn't just Oonagh who said that St Helier is safe. They are at it again this week in the Wimbledon Guardian. Also, I heard about your sterling campaign work during the election. Much appreciated as always. I am out of ideas regarding St Helier. Give my regards to Bonnie. Mick
Message for Forty Two. Respect. Just to say that I agree with all your points. It isn't just Oonagh who said that St Helier is safe. They are at it again this week in the Wimbledon Guardian. Also, I heard about your sterling campaign work during the election. Much appreciated as always. I am out of ideas regarding St Helier. Give my regards to Bonnie. Mick Michael Barltrop
  • Score: 5

12:02pm Thu 5 Jun 14

Georgia Lewis says...

Michael, if you fancy showing support for the campaign to save St Helier Hospital, the campaigners are organsing a pub quiz at the Morden Brook (formerly The Beverley) on July 17. We will also have a presence at the St Helier Fair on the green opposite the hospital on June 14. Come on down, say hello, get some good information.
Michael, if you fancy showing support for the campaign to save St Helier Hospital, the campaigners are organsing a pub quiz at the Morden Brook (formerly The Beverley) on July 17. We will also have a presence at the St Helier Fair on the green opposite the hospital on June 14. Come on down, say hello, get some good information. Georgia Lewis
  • Score: 2

12:09pm Thu 5 Jun 14

Sameer the First says...

I am a bit confused by Georgia's comments above. The £360m is the total of all the 'savings' being projected by the hospitals (not the CCGs). Do St Helier's financial plans include closing their A&E?
I am a bit confused by Georgia's comments above. The £360m is the total of all the 'savings' being projected by the hospitals (not the CCGs). Do St Helier's financial plans include closing their A&E? Sameer the First
  • Score: 1

12:18pm Thu 5 Jun 14

Red_Rock says...

Forty_two wrote:
This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it.

Could it be that she was being "less than honest" about that by any chance?
Well either she knew about it and was lying or didn't know about it and was lying. Just another worthless politician.
[quote][p][bold]Forty_two[/bold] wrote: This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it. Could it be that she was being "less than honest" about that by any chance?[/p][/quote]Well either she knew about it and was lying or didn't know about it and was lying. Just another worthless politician. Red_Rock
  • Score: 3

12:37pm Thu 5 Jun 14

Forty_two says...

Red_Rock wrote:
Forty_two wrote:
This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it.

Could it be that she was being "less than honest" about that by any chance?
Well either she knew about it and was lying or didn't know about it and was lying. Just another worthless politician.
Well, in my humble opinion:
1. If she didn't know about it, she should not have commented without first finding out.
2. She has got no business "not knowing" about such a threat as a local councillor - rather failing in her duty to represent her electorate there.
[quote][p][bold]Red_Rock[/bold] wrote: [quote][p][bold]Forty_two[/bold] wrote: This all put's the leader of Merton Conservatives, Oonagh Mouton's claim that "St. Helier was safe" prior to the local elections into a different light, doesn't it. Could it be that she was being "less than honest" about that by any chance?[/p][/quote]Well either she knew about it and was lying or didn't know about it and was lying. Just another worthless politician.[/p][/quote]Well, in my humble opinion: 1. If she didn't know about it, she should not have commented without first finding out. 2. She has got no business "not knowing" about such a threat as a local councillor - rather failing in her duty to represent her electorate there. Forty_two
  • Score: 3

3:03pm Thu 5 Jun 14

Georgia Lewis says...

Sameer, the £360m is the savings that "providers" have claimed need to be made. The report that includes this figure was made by the CCGs, not the hospitals. It is the CCGs that are putting out this draft strategy which will in turn affect multiple hospitals including St Helier. It is the CCGs that hold the power here, not St Helier Hospital or the Epsom-St Helier Trust.
Sameer, the £360m is the savings that "providers" have claimed need to be made. The report that includes this figure was made by the CCGs, not the hospitals. It is the CCGs that are putting out this draft strategy which will in turn affect multiple hospitals including St Helier. It is the CCGs that hold the power here, not St Helier Hospital or the Epsom-St Helier Trust. Georgia Lewis
  • Score: 2

4:53pm Thu 5 Jun 14

SWL Collaborative Commissioning says...

There are a number of inaccuracies in this article to which the CCG Chairs are planning to respond.

In particular, we should clarify where the £360 million figure comes from. it is not our figure, but is the aggregate of all the savings identified by our four local hospital trusts. It is included in our strategy to provide context.

We did not ask the trusts to deliver this amount - they are responsible for their own finances and have identified the savings that they think they need to make to balance their books, which is part of their standard planning process. It is the CCGs, not Monitor or the Foundation Trust Network, who are questioning whether this level of saving can be achieved by the trusts, though we recognise that these are initial plans and may change.

The CCG Chairs will respond in more detail in a letter to the editor.
There are a number of inaccuracies in this article to which the CCG Chairs are planning to respond. In particular, we should clarify where the £360 million figure comes from. it is not our figure, but is the aggregate of all the savings identified by our four local hospital trusts. It is included in our strategy to provide context. We did not ask the trusts to deliver this amount - they are responsible for their own finances and have identified the savings that they think they need to make to balance their books, which is part of their standard planning process. It is the CCGs, not Monitor or the Foundation Trust Network, who are questioning whether this level of saving can be achieved by the trusts, though we recognise that these are initial plans and may change. The CCG Chairs will respond in more detail in a letter to the editor. SWL Collaborative Commissioning
  • Score: 1

12:16pm Fri 6 Jun 14

SWL Collaborative Commissioning says...

Our letter to the Local Guardian in response to this article is now on our website - http://www.swlccgs.n
hs.uk/documents/lett
er-to-the-wimbledon-
guardian/ The text of the letter is below.

Dear Sir

Your article (‘Half billion pound NHS cuts in south west London branded unachievable, 5 June) appears to have misunderstood a number of points in our draft five-year strategy for south west London.

Firstly, we should clarify that the combined savings targets of the six clinical commissioning groups come to around £210 million over the next five years. These savings do not amount to ‘cuts’. We will spend our money differently – for example, by delivering more services outside hospital and getting more for the same amount of money – but we won’t be spending less. The article contains some good examples of this type of change in Merton.

Secondly, the £360 million figure that you quote is the aggregate of the initial savings plans put forward by our four local hospital trusts, not the CCGs. Each hospital trust is responsible for its own finances and has its own cost improvement programme to make sure that it can balance its books. This is not something that the hospitals have been asked to do by the CCGs and the figure is included in our strategy for context only.

Thirdly, it is the CCGs, not Monitor or the Foundation Trust Network, who have questioned whether these savings are achievable. We know that they are initial projections and that they may change, but we would not be responsible commissioners if we didn’t question whether such ambitious efficiencies could be achieved.

Finally, we want to be clear that in the context of this financial challenge, our ambition as CCGs has always been to improve the quality of services in south west London. A whole system approach, with hospitals, community services, mental health services and GPs working much more closely together and with local authority social care teams, can in our view deliver improved care and ensure we meet our statutory obligations to live within our means.

Yours sincerely

Dr Tony Brzezicki – Chair, Croydon CCG
Dr Howard Freeman – Chair, Merton CCG
Dr Brendan Hudson – Chair, Sutton CCG
Dr Naz Jivani – Chair, Kingston CCG
Dr Nicola Jones – Chair, Wandsworth CCG
Dr Graham Lewis – Chair, Richmond CCG
Our letter to the Local Guardian in response to this article is now on our website - http://www.swlccgs.n hs.uk/documents/lett er-to-the-wimbledon- guardian/ The text of the letter is below. Dear Sir Your article (‘Half billion pound NHS cuts in south west London branded unachievable, 5 June) appears to have misunderstood a number of points in our draft five-year strategy for south west London. Firstly, we should clarify that the combined savings targets of the six clinical commissioning groups come to around £210 million over the next five years. These savings do not amount to ‘cuts’. We will spend our money differently – for example, by delivering more services outside hospital and getting more for the same amount of money – but we won’t be spending less. The article contains some good examples of this type of change in Merton. Secondly, the £360 million figure that you quote is the aggregate of the initial savings plans put forward by our four local hospital trusts, not the CCGs. Each hospital trust is responsible for its own finances and has its own cost improvement programme to make sure that it can balance its books. This is not something that the hospitals have been asked to do by the CCGs and the figure is included in our strategy for context only. Thirdly, it is the CCGs, not Monitor or the Foundation Trust Network, who have questioned whether these savings are achievable. We know that they are initial projections and that they may change, but we would not be responsible commissioners if we didn’t question whether such ambitious efficiencies could be achieved. Finally, we want to be clear that in the context of this financial challenge, our ambition as CCGs has always been to improve the quality of services in south west London. A whole system approach, with hospitals, community services, mental health services and GPs working much more closely together and with local authority social care teams, can in our view deliver improved care and ensure we meet our statutory obligations to live within our means. Yours sincerely Dr Tony Brzezicki – Chair, Croydon CCG Dr Howard Freeman – Chair, Merton CCG Dr Brendan Hudson – Chair, Sutton CCG Dr Naz Jivani – Chair, Kingston CCG Dr Nicola Jones – Chair, Wandsworth CCG Dr Graham Lewis – Chair, Richmond CCG SWL Collaborative Commissioning
  • Score: 1

5:34pm Mon 9 Jun 14

Georgia Lewis says...

How about Swl Ccgs quit perpetuating the myth that we cannot afford to keep all our services open? The NHS is underfunded and it appears that NHS England is going to great pains to run certain hospitals into the ground. How else to explain the prevalence of zero hours contracts, agency staff and the use of a staff bank? All this will happen at the expense of high quality service and help justify closures and downgrades to the public.

Instead of just accepting the narrative that £360m must be saved, why not lobby for better funding?

And while we're at it, we really do need to see the full accounts of all relevant hospitals because I'd hate to think any of them were spending excessive sums of our money unnecessarily.
How about Swl Ccgs quit perpetuating the myth that we cannot afford to keep all our services open? The NHS is underfunded and it appears that NHS England is going to great pains to run certain hospitals into the ground. How else to explain the prevalence of zero hours contracts, agency staff and the use of a staff bank? All this will happen at the expense of high quality service and help justify closures and downgrades to the public. Instead of just accepting the narrative that £360m must be saved, why not lobby for better funding? And while we're at it, we really do need to see the full accounts of all relevant hospitals because I'd hate to think any of them were spending excessive sums of our money unnecessarily. Georgia Lewis
  • Score: 2

8:35am Fri 27 Jun 14

sfocata says...

Worth also pointing out that we have one of the most cost-efficient public health services in the WORLD. More efficient than in some countries where the majority of healthcare is funded privately.

These are cuts from a government who insist upon a £50bn+ rail experiment and who are failing to collect £21TRILLION in offshore tax. One of or most precious public properties is being destroyed.
Worth also pointing out that we have one of the most cost-efficient public health services in the WORLD. More efficient than in some countries where the majority of healthcare is funded privately. These are cuts from a government who insist upon a £50bn+ rail experiment and who are failing to collect £21TRILLION in offshore tax. One of or most precious public properties is being destroyed. sfocata
  • Score: 0

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