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

the service models. Options for the configuration of major hospitals were assessed using
hurdle criteria to determine that five were needed and to produce a list of eight configuration
options. These eight options were evaluated using criteria (covering quality of care, access
to care, value for money, deliverability and research & education) developed before and after
consultation. This evaluation enabled us to determine a preferred option. We confirmed that
this remained the best option if our modelling assumptions changed through the sensitivity
analysis.
10. The proposed future configuration of hospitals in NW London
This chapter summarises the results of the decision making analysis and sets out the
programme’s proposed future configuration of hospitals in NW London. This is based on
Option A in the consultation and has been refined following feedback from the consultation
and the analysis in response to this feedback. The recommendation is for a local hospital
(including an Urgent Care Centre operating 24 hours a day, 7 days a week) and major
hospital (24/7 A&E with co-located obstetrics and maternity unit and inpatient paediatrics) on
the Chelsea and Westminster, Hillingdon, Northwick Park, St Mary’s and West Middlesex
sites, a local and elective hospital at Central Middlesex, a local hospital at Charing Cross
and Ealing and a local and specialist hospital with an obstetric-led maternity unit at
Hammersmith.
11. Assuring the proposals
This chapter shows that there has been ongoing assurance and scrutiny to verify that
proposals are sound and well communicated to and considered by all stakeholders
throughout the programme. During the pre-consultation phase the programme was assured
by an Office of Government Commerce Gateway review. The clinical proposals were
assured by the National Clinical Advisory Team (NCAT), external clinical reviews and
through our own review of the relevant clinical evidence. NHS London confirmed that the
programme met the Four Tests for reconfiguration set out by the Secretary of State. During
and following the consultation, the programme has continued to work to meet the Four Tests
and sought further assurance from NCAT and external clinical reviews. This includes a
detailed literature review of recent clinical evidence and a review of clinically relevant
feedback from the consultation.
12. Travel and access implications
This chapter describes the expected travel and access impacts of the recommendation, by
borough and site, for all modes of transport, including emergency travel times and maximum
journey times to the proposed major hospital sites. This chapter also considers the impact of
public transport options. The programme established a Travel Advisory Group bringing
together representatives from local authorities, Transport for London, London Ambulance
Service and public and patient representatives. 91% of activity will be unaffected by the
proposals. Changes to travel times will be greatest in Ealing, Brent and Hammersmith and
Fulham. Evidence shows that travelling to the right location for the right care has a greater
impact on outcomes than distance travelled.