STRUCTURE: A long running and controversial process to reconfigure vascular services in south Hampshire has resumed this week with the dispatch of a specialist team to assess services in Southampton and Portsmouth.

  • Review of vascular services in the South first mooted in 2008
  • Previous proposals to transfer services from Portsmouth to Southampton dropped following local campaigns
  • Vascular Society review to feed into options to be put forward for consultation

The review by the Vascular Society could recommend the creation of a single, specialist “arterial centre” by moving some services currently delivered by Portsmouth Hospitals Trust to University Hospital Southampton Foundation Trust.

Proposals for vascular service reconfiguration in the NHS England South region have been on the agenda since 2008.

The latest national guidance from the Vascular Society recommends that to improve patient outcomes, inpatient care should be concentrated into “arterial centres” based around a population of at least 800,000. University Hospital Southampton serves a population of 900,000, while Portsmouth Hospitals covers 650,000.

These centres should act as “hubs”, with key aspects of the vascular service being maintained at “spoke” sites.

portsmouth

One option is to create a hub in Portsmouth

In 2011 regional commissioners proposed centralising emergency and elective complex inpatient vascular surgery at Southampton General Hospital.

A second review by the Wessex Clinical Senate in 2013 recommended that “all emergency and elective major inpatient interventions” should be delivered at Southampton “as a matter of urgency”.

On both occasions objections by Portsmouth Hospitals, which warned of the impact on other services, and patients concerned about having to travel to Southampton for treatment, resulted in the proposals being mothballed.

HSJ understands that NHS England is keen for a resumption of a clear direction of travel for the reconfiguration. The NHS England Wessex area team confirmed this week that the Vascular Society was conducting a clinical review of services.

The review will feed into two options which are due to be put forward for consultation.

The first option would involve the concentration of all services in one arterial centre at Southampton, which would become a “super centre” enabling complex cases to be treated in Hampshire without the need to travel to London.

The second option would involve the creation of two hubs - one at Portsmouth, with the potential of Chichester becoming a spoke, and Southampton, with Winchester and the Isle of Wight, continuing as spokes. As in option one, Southampton would be a super centre for complex cases.

An NHS England Wessex area team spokeswoman said: “It is vital that we ensure sufficient clinical input into the options appraisal for the future of vascular services in southern Hampshire.

“The options will be subject to wide consultation before any decisions are taken.”