The business case for major changes to services at Ashford and St. Peter’s hospitals, has been published by Ashford and St. Peter’s Hospitals NHS Trust. The business case sets out the figures and costs behind:

  • Making St. Peter’s the focus for emergency admissions with the construction of a new two storey modular 56 bed ward linked to the Duchess of Kent Wing;
  • Refurbishing the Emergency Department at Ashford Hospital to provide a 24 hour NHS Walk-in service;
  • Making Ashford the main centre for adult day surgery – the majority of surgery at the Trust is done as day surgery - but moving the small amount of children’s day surgery from Ashford to St. Peter’s Hospital in line with recommendations from the review carried out by the Royal College of Paediatricians.
  • Making use of the first floor wards at Ashford Hospital for an orthopaedic treatment centre including joint replacements such as hips and knees;
  • Construction of a day surgery unit with its own operating theatre and a first floor extension to the existing operating theatres to enable the recommissioning of an additional operating theatre at St. Peter’s;
  • Refurbishing the three ground floor wards at Ashford Hospital to become rehabilitation wards;
  • Creation of additional critical care beds (intensive care, high dependency and coronary care) at St. Peter’s;
  • Formation of a surgical assessment unit for the management of surgical emergencies at St. Peter’s; and
  • Demolition of the upper end of The Ramp to create replacement car parking in lieu of that lost at the Duchess of Kent wing end of the hospital.

Presenting the plan to the Trust Board Glenn Douglas, Chief Executive at Ashford and St. Peter’s Hospitals NHS Trust said: “This Business Case takes us one step closer to the changes we consulted on with our Primary Care Trust colleagues in 2003 and 2004. In the light of a significant increase in activity this winter and to allow sufficient time for schemes to support patients in the community to become established, a phased implementation of changes to the beds across the two hospitals and the community will be taken.

“The Business Case sets out the new model of care that improves the way the two hospitals, community and primary care services work together by providing planned orthopaedic surgery (such as joint replacements) and the majority of day surgery at Ashford, with A&E, intensive care, emergency medical care and all other planned surgery requiring an overnight stay in St. Peter’s Hospital. We estimate that less than 10 per cent of patients who use Ashford Hospital will be affected by the changes. Working closely with the Primary Care Trusts this new model of care will deliver service improvements, including improved access to specialist services. It will make the best use of assets, both staff, equipment and buildings, whilst maintaining the majority of services locally.”

Underpinning the changes at Ashford and St. Peter’s Hospital is the development of the provision of a wider range of community services for vulnerable adults and older people. The strategy developed by North Surrey PCT, following the ‘Shaping the Future of Local Health Services’ consultation, advocates bringing care closer to home and developing services in primary and community care. The key aspects of this are:

  • Emphasis on integration of whole system of health and social care, working across traditional organisational boundaries.
  • Beds organised and managed for rehabilitation within local areas for ease of step down and to be part of a network of local services. The community hospitals will be developed to their greatest potential, with some specialisation within them.
  • Older people, those with chronic conditions or a disability and their carers will be assisted to manage their own condition with the emphasis on appropriate intervention and support. For example, within North Surrey PCT six new ‘advanced primary nurses’ are being recruited, specifically tasked with looking after the whole ‘care package’ of a number of frail and elderly patients. These nurses will be based in local GP practices.
  • Emphasis on prevention as well as intervention with the development of the ‘Expert Patient’, facilitating patient understanding of their condition and involvement in their care plan.
  • In addition, community based services such as the Falls Service and Respiratory Care Teams are helping to keep vulnerable people from unnecessary hospital admission by treating and caring for patients in their own homes.

At St. Peter’s Hospital preparatory work has begun with work on essential infrastructure such as the recent delivery of new oxygen storage tanks and upgrading the electrical supply. At Ashford Hospital it is expected that work turning the ground floor wards into a dedicated rehabilitation service will start in the next couple of months.

Following approval by the Board of Ashford and St. Peter’s Hospitals, the Business Case has to be approved by the Boards of Hounslow, Surrey Health and Woking, and North Surrey, Primary Care Trusts (PCTs). Surrey and Sussex Strategic Health Authority are due to consider the business case for approval and allocation of the balance of the capital funding required for the changes on 15th March 2005. The Planning Committee at Runnymede Borough Council are scheduled to hear the planning application on 16th March 2005.


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