STRUCTURE: Surrey Downs Clinical Commissioning Group is undertaking a review into the future of its four community hospitals.

The review comes as the CCG reported a forecast deficit of £10.7m by the end of the year, having expected to deliver a £3.3m surplus at the start of 2014-15.

The community hospitals have been a contributing factor to the CCG’s large deficit, according to figures in its February finance report.

The review is due to be completed by the end of July.

In the minutes for the CCG’s January meeting, chief officer Miles Freeman said the “only option” to address the deficit was to “transform local services”. He said this was in line with the CCG’s original mission statement.

Another board member, Peter Collis, said the group had focused on transformation from its inception but that the financial issues were “simply pushing the issues harder and faster”.

The four community hospitals – Leatherhead, Molesey, New Epsom and Ewell, and Dorking – provide inpatient and outpatient services. They are all run by social enterprise CSH Surrey.

A report to the CCG’s February board meeting said there were a “range of challenges” in providing these services “under the current operating model”.

Each hospital has a “relatively small bed base” of 12-15 beds, which “impacts on efficiency” and is “vulnerable” to short term staffing challenges.

Leatherhead Hospital had already been forced to move its 15 inpatient beds to neighbouring hospitals in December because of staff shortages.

In the group’s finance report for February it said there had been a £1.1m overspend on community hospital services.

There was also a £13.4m overspend on acute services. The CCG said the “unbudgeted” transfer of £4.7m to NHS England for specialised commissioning had contributed to its poor financial position.

HSJ previously reported that NHS England had asked CCGs across the south to transfer part of their budgets to the arm’s length body to pay for specialised services.

Surrey Downs CCG was previously part of a review of acute hospital services across seven CCGs in south west London, but pulled out after GPs voted against the plan. Under the proposals, Epsom Hospital and St Helier Hospital could have seen some services downgraded.

Jo Pritchard, chief executive of CSH Surrey, said: “Any overspend within community hospital services incurred by Surrey Downs CCG in the last financial year is not attributable to CSH Surrey.

“CSH Surrey fully supports the review of services provided at the community hospital sites and we are working closely with the CCG to ensure the review meets its aims of transforming local services in a way that introduces more innovative and integrated ways of improving patient care, while also improving financial efficiency.

“CSH Surrey fully supports the CCG’s vision to create a new model of care that will better meet the changing needs of Surrey’s ageing population in the long term – and will thus create stable and sustainable services that will be beneficial to both patients and providers.”