SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

We confirmed this decision with the Clinical Board and Programme Board during the post
consultation phase. This outcome is unchanged from pre-consultation.
3
● There should be enough major hospitals to support the population of NW
London
9.7.11 Purpose of third hurdle criterion to identify the number of major hospitals
required for NW London
The third hurdle criterion examines the number of major hospitals required for the population
of NW London.
9.7.12 Analysis to identify the number of major hospitals required for NW London
NW London population is forecast to increase by approximately 141,000 people (7%)
growing from circa 2 million to circa 2.15 million over the period to 2018. Clinicians
considered available evidence about the factors which contribute to high quality clinical care
to define the correct number of major hospitals to serve this population:
Evidence of the links between senior staff presence and quality of care, as
referenced in the acute clinical standards in Chapter 7, Section 7.3.1.
Patient volumes required to ensure staff build and maintain skills
Technology required to support high quality care
Interdependencies between different acute services and their required clinical
support.
Using these four criteria clinicians identified that there should be between three to five major
hospitals in NW London to support the projected population of over 2.15 million.
Rationale for proposing a maximum of five hospitals
The Case for Change noted that “National shortages of some clinical staff groups, such as
paediatricians, midwives, radiologists and pathologists, due to the numbers of individuals
currently entering training, are expected to continue in the future. Even if there were more
suitably trained staff in place, they would quickly begin to lose their skills as they would not
be seeing sufficient volumes of patients”.
Clinicians identified that having more than five major hospitals would be likely to lead to suboptimal
care because:
Recent reports from professional bodies, such as the Royal Colleges and NCEPOD
(National Confidential Enquiry into Patient Outcomes and Death) have highlighted
deficiencies of care in adult and paediatric acute emergency services. Significant
evidence demonstrates a variation in outcomes for patients depending on the time
and day of the week that they attend an emergency department, or are admitted to
hospital as an emergency. Additionally, London‟s maternity services do not perform
uniformly well with unacceptable inequalities in maternity outcomes in areas of
mortality, morbidity and experience. This has been explicitly highlighted in several
recent reports and reviews including the 2011 London maternal death review, Care
Quality Commission (CQC) reports from individual Trusts and the London Local
Supervisory Authority (LSA) annual report. Emergency admissions account for
9b. Decision making analysis stage 5 293