We looked at all the possible options and applied three initial tests:
- Does the potential solution maintain major acute services within the combined geographies? This is a key commitment for us and any potential solution must maintain all major acute services within our combined geographies.
- Is there likely to be a workforce solution to deliver the potential solution? This includes ensuring any potential solution meets our standards for the quality of major acute services with the available workforce.
- From which sites is it possible to deliver major acute services? This considers whether different sites are feasible for the delivery of a major acute hospital.
Applying these tests sequentially reduces the long list:
After the first test, any potential solution that does not offer all major acute services within the combined geographies is eliminated (e.g., no major acute hospitals or only providing major nine adult emergency department services within the combined geographies). This provisionally results in 50 potential solutions.
After the second test, workforce limitations and co-dependencies mean that any potential solution with more than one major acute site and any potential solution relying on external workforce is eliminated. This provisionally results in four potential solutions – a single major acute site from one of four sites (Epsom Hospital, St Helier Hospital, Sutton Hospital, or a new site within our combined geographies).
After the third test, only existing sites appear feasible. This provisionally results in three potential solutions.