A review of specialised vascular services in Hampshire has recommended centralising surgery in Southampton, meaning that neighbouring Portsmouth would lose some services.

The recommendation has come from the Wessex Clinical Senate. A decision over whether to implement the proposals will be made by NHS England’s Wessex local area team.

The clinical senate has recommended a single vascular service, including all surgeons and radiologists, with a single clinical director and management team.

As a matter of urgency, the senate recommended all emergency and elective major inpatient interventions should be delivered by University Hospitals Southampton Foundation Trust.

The single service should enable clinicians to deal with high enough volumes of work to allow them to maintain competence, establish a single rota for emergency assessment and interventions seven days a week.

This rota should support the regional major trauma centre, also run by University Hospital Southampton Foundation Trust.

The senate rejected an alternative proposal put forward by Portsmouth Hospitals, which would have shared research, training and complex cases between the two sites.

A previous attempt to merge vascular services in the area failed in 2012 after the Southampton and Portsmouth trusts failed to agree how some services should be split between them, and amid objections from patients.

The clinical senate doubted Portsmouth’s plan for more networking between the two cities. “Given the historical difficulties in collaboration between the trusts, the senate was not confident that the described arrangements were sustainable,” the report said.

The clinical senate council did not support maintaining two separate vascular centres – “because the model is unsustainable in a five to 10 year time frame”.

This was due to a forecast reduction in the number surgical procedures due to screening, and technological advances which will reduce the need for surgery. There is also a shortage of clinical staff, meaning 24/7 working would not be possible, while keeping two sites up to date would require “an unsustainable level of investment at both sites”.

Peter Mellor, director of corporate affairs and business development at Portsmouth Hospitals, told HSJ that the quality of service offered at his trust was good, and already offered 24/7 consultant cover. Travelling between the two sites was “tortuous”, he added.

Mr Mellor said that Portsmouth Hospitals was not represented on the senate.

NHS England’s Wessex Area Team is yet to explain whether it will act on the report. University Hospitals Southampton made no comment on the review.

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