Emergency and maternity care could be cut from at least one south-west London hospital as NHS bosses struggle to meet financial demands and quality standards.

A draft sustainability and transformation plan (STP) drawn up by South West London Collaborative Commissioning (SWLCC) concludes “none of the [region’s] acute hospitals meet all of the London Quality Standards for urgent and emergency care” and all “over-rely on agency staff to support acute services”.

Acute care, which includes A&E, critical care, emergency surgery, maternity, paediatrics and stroke services, is currently provided at hospitals in St Helier, Epsom, Croydon, Kingston hospitals and St George’s in Tooting.

The five-year plan was published this week by the SWLCC, which comprises of NHS England and the clinical commission groups (CCG) for Sutton, Kingston, Merton, Richmond, Wandsworth and Croydon. 

It adds the borough’s NHS trusts are failing to meet “minimum standards for acute urgent and emergency care”. 

The full STP is due to be published next month, but a copy leaked to Health Service Journal this week stated “evidence for south-west London suggests that continuing to provide acute services on five sites is unsustainable”.

The report also revealed the potential for cancer services at St George’s, Epsom and St Helier and the Royal Marsden hospitals in Sutton and Chelsea to be moved on to one shared site, but added: “We would only look to move routine cancer surgery with Kingston and Croydon to a new centre if this would deliver demonstrably better outcomes.”

In 2011, the Better Services Better Value programme began a review of acute services across Kingston, Epsom, St Helier, St George’s and Croydon hospitals.

It recommended services at St Helier be downgraded and just three hospitals retain maternity and A&E departments. The idea was abandoned in 2014 after numerous protests.

A 2015 version of the report, available on the south west London Collaborative Commissioning Group, website states: “Doing nothing is not an option – we need to act now to improve standards.

"We propose to shift more care from hospitals into the community, so we can provide care that is closer to home, tailored to people’s individual needs and supports them to stay as well as possible for as long as possible.”

The STP for south-west London is one of 44 being drawn up across England to meet significant cuts, an investigation by 38 Degrees revealed in August.
Director Laura Townshend said the findings showed the NHS was “dangerously under-funded”.

She added: “These proposed cuts aren’t the fault of local NHS leaders. The health service is struggling to cope with growing black holes in NHS funding. The NHS belongs to all of us – so local people should get a say in any changes to their local services.”

A spokesman for SWLCC said: “As the needs and expectations of our population change, we need to develop services that keep people well and treat them as close to home as possible. 

“To do this we need to transform services outside hospital, as well as considering how we provide even better, high quality and sustainable care for those who need hospital care.

"A good deal of further work and public engagement will be needed before we are in a position to understand what this may mean for hospital care in south-west London.”