Below is Steve Bax's interview in full with James Blythe, Director of Commissioning and Strategy at the CCG.
SB - Why did the CCG decide to undertake a review of the community hospitals?
JB - We only came into being as a clinical commissioning group in 2013. We had always planned to look at community hospital services, and given our ageing population, and new community services that were starting to come on board, it was a good time to bring it all together as part of a thorough review. We also had hospital League of Friends asking about possible investment opportunities so we wanted to do the review to understand what we need longer term before they committed their money.
SB - Tom Elrick of the CCG has publicly stated that the review is "not about money" in his testimony to Elmbridge councillors but cost savings must factor into this to some degree - to what extent is the CCG under pressure to reduce its spending levels?
JB - As an organisation, it’s true to say we are in a challenging financial position but we have always been very clear that the aim of the review was to look at the services we need in future and where they are best located, taking into account changes in our population, the current buildings and a range of other issues. We have a Financial Recovery Plan in place, which includes over 20 projects, many focusing on ways to improve care, reduce duplication and inefficiency to deliver savings – but there is no ‘savings target’ as such against this project. Three of the four options we consulted on would involve changes to where services are provided. If the Governing Body chose to proceed with one of these options, and we had the opportunity to make savings on rental costs, then that is something we would explore – but this has never been the main focus of the review.
SB - How much is currently spent on keeping the 5 community hospitals open?
JB - The total costs for the buildings are just over £3.2m each year to run all five community hospitals. This figure includes rental costs, electricity, cleaning and catering. It doesn’t include the money we pay CSH Surrey to provide the services as this forms part of a wider contract.
SB - Who is analysing the public feedback for the CCG and submitting a report to yourselves?
JB - When running a public consultation it is best practice to have all feedback and responses independently analysed so we are working with a research organisation called Participate. They will be analysing all the feedback for us and providing a summary report, which the Governing Body will need to take into account when deciding on next steps. We will also publish the feedback report on our website.
SB - For the benefit of residents who attend the public meeting on July 29th, what is the process by which a decision will be made? Will there be a debate, a show of hands, what? And will the public be allowed to speak?
JB - On 29 July the Governing Body will meet in public and will make a decision on next steps. We are currently awaiting the summary feedback report from the public consultation. We will need to consider the feedback we have received and use this to inform a Governing Body paper. The paper will be published a week in advance of the 29 July meeting and is likely to include a recommendation on next steps. It will then be for the Governing Body to discuss, and debate the feedback and next steps at the meeting. If there is not consensus within the group, a decision could go to a vote but where possible we would always try to reach agreement.
In terms of opportunities to speak, our Governing Body meetings are held in public so local people can come and hear the meeting and hear what we discuss – but they are not public meetings as such. There is an opportunity ask questions at our Governing Body meetings but given the extensive engagement already undertaken, and that the main purpose of the item is for the Governing Body to agree next steps based on the feedback report, there will be limited time for questions.
SB - The Molesey Hospital building has been allowed to deteriorate and the Friends group tell me their offers to fund repairs were refused. In the event that the hospital remains in use, what investment will be forthcoming?
JB - We can’t pre-empt the Governing Body’s decision, but if the decision is for services to remain at Molesey Hospital then it’s clear that there will need to be a plan for investment. If this is the outcome, then we will need to work closely with NHS Property Services, who manage the estate, to develop this plan.
SB - We understand that Propco has levied an annual charge of £763k against the CCG for use of the Molesey site, which is more than half of the hospital's £1.5m yearly budget. Will this rent be coming out of the hospital's budget if it stays open?
JB - The CCG is responsible for paying rent on the Molesey site, which costs us just over £450,000 per year. This cost includes rental costs, as well as costs relating to electricity and cleaning and catering). If services remain at the site, the CCG will continue to be responsible for the rent. If services were to relocate then we would need to work with NHS Property Services to look at whether other services would go in instead or whether the site was no longer required. If an alternative use for the building could not be found, the CCG would no longer pay rent and NHS Property Services would look at what happened to the site in the longer term.
SB - If the decision is to relocate the inpatient beds, what will become of Molesey Hospital, will it close or continue to provide outpatient services?
JB - If the Governing Body chooses ‘option 3’ then inpatient and outpatient services would both relocate. If this happened, we would need to work with NHS Property Services and local providers to understand if there are other services that could go into the site.
SB - Can you assure that the Molesey Hospital will not be "sold off" for housing or any other purposes?
JB - The Molesey Hospital estate is managed by NHS Property Services so as a CCG we just pay rent for the site. If the site was no longer needed, and was considered to be surplus to requirements then NHS Property Services may consider selling off the land. If this ever happened our hope would be that they would work with us and the local community to find a suitable solution - but we need to wait until we have a decision - under two of the four options Molesey Hospital would remain open.
SB - One idea that is gaining some traction locally is for the hospital to be demolished and replaced with new facilities including a GP surgery, as West Molesey has no GP of its own. Is this a possibility?
JB - As part of the public consultation we heard from a number of people who were keen to see more GP services in the Molesey area – and this is one idea that has been mentioned. Regardless of the Governing Body decision, we need to ensure we have the right primary care services in place for our local population so this may be something we need to explore further.