• Long-attempted reconfiguration project proceeds to next stage
  • Epsom and St Helier University Hospitals Trust has been attempting to rationalise its site for roughly 16 years
  • Redevelopment options submitted to NHS England and Improvement

A hospital reconfiguration project stalled for roughly 16 years is a step closer to being realised after commissioners and clinicians across regional boundaries signed off a joint business case.

Three London and Surrey clinical commissioning groups and their two clinical senates have agreed the submission of a pre-consultation business case for the redevelopment of the crumbling Epsom and St Helier hospitals.

The move is the first time Surrey Downs Clinical Commissioning Group, Sutton CCG and Merton CCG have been able to agree a set of options to be submitted to the central NHS bodies for approval.

The document sets out the rankings for three options, with the highest rated being the concentration of major acute services on the trust’s Sutton site.

It comes as HSJ this morning revealed many schemes which have in theory gained approval from government since 2017 have not then received the funding for them.

If NHS England and Improvement approve the pre-consultation business case, an option can be publicly consulted on. When that process is complete, the trust can submit an outline business case for the money to the Department of Health and Social Care and the Treasury.

The Sutton option is expected to cost around £500m.

A team from the trust has investigated a range of funding options, covering different balances of public and private funding.

Following the installation of a new chancellor at the Treasury last week, it is not clear what government policy on private finance will be, including on the use of the Local Improvement Finance Trust programme, charitable funds or the local authority borrowing method

Trust chief executive Daniel Elkeles told HSJ: “This is a significant breakthrough in the building of a new hospital here, after the best part of 20 years.”

The news comes shortly after the new prime minister Boris Johnson named “20 hospital upgrades” as an early priority for his government, although no subsequent details were given.

Epsom and St Helier’s senior management believes the trust has a structural deficit because it is forced to run services over two sites for populations that could be better served from one.

The business case released on Monday estimated there were financial benefits of between £33m and £49m a year from colocating the services.

Merton CCG also wanted work done assessing any impact on more deprived communities if services were to move. An analysis for the trust found the disadvantage of slightly longer journeys was significantly outweighed by the improvement in services.

The trust’s ambition to redevelop, possibly at the Sutton site, has received support from the Royal Marsden Foundation Trust.

The London cancer specialist runs a satellite service from Sutton, which has faced criticism for not being colocated with intensive care services that can stabilise deteriorating paediatric patients.