As chair of the Royal Surrey's Merger Working Group of Governors I have completed a survey of governors to capture all their questions and concerns about the merger. As a result a full day has been organised for 13 May when members of the Board and the hospital's executive will address all the issues raised as part of the governor's duty to scrutinise what the Board is doing.

Also as the hospital's governor representative on the so-called advisory Stakeholders Group comprising individuals for a wide range of bodies (e.g. local government, health commissioners GP Patient Participation Groups) I attended a recent meeting to encourage the two hospitals to put more energy into preparing literature to inform and engage the public assuming that the Competition and Mergers Authority gives the go ahead in a few months time. I will be joining a few others to review any such literature to ensure it is straight forward without jargon. Watch this space!

Refurbished Maternity Unit

I have just attended the official opening of the newly refurbished maternity Unit. It is a very splendid place and cost about £0.5 million. It features a new high dependency Unit and a high dependency area with birthing pool. Additionally a new education facility was opened for the unit at the same time. This will allow top class training within the unit itself. When the NHS as a whole and the Royal Surrey itself are under great financial pressure it is heartening to see they are still managing to invest.

 

Merger special web site

A special web site has been set up to inform the public about the proposed merger between the Royal Surrey and Ashford and St. Peters. It include Frequently Asked Questions. Go to http://www.working-together.org/index.html

Merger delay

The first step in achieving a merger is to gain clearance by the Mergers and Competition Authority (CMA). The case for merger was put to the CMA a while ago. The process is that the CMA has a short time either to approve  or to submit the case to more detailed appraisal. Today the CMA decided  that there was 'a realistic prospect of a substantial lessening of competition in a number of inpatient and outpatient specialties' and therefore withheld a decision until more work is undertaken. This will take a minimum of 6 months and thus the merger proposal programme has been moved back 6 months including planned wide ranging engagement with the public which would otherwise have started in a few weeks.

Merger proposals for 7-day working

A high profile national goal for the NHS is so-called '7-day working' and all hospitals are thinking how to achieve it. Clearly it will be very expensive in an environment where all NHS Trusts are strapped for cash and many are in, or heading for, a deficit. Many studies have shown that quality of care in the NHS is much reduced at weekends and death rates are higher and so ensuring that care is as good at weekends as in the week is extremely important: that is what 7-day working seeks to achieve.

The Royal Surrey has studied its position and would find it extremely difficult to achieve 7-day working albeit there might be little choice in the medium term. Ashford and St Peters are in the same position. The assertion is that, by merging, 7-day working becomes a viable proposition. For example if RSCH has 2 consultants in a specialty getting than to accept that one of them must always be present in the hospital and doing ward rounds etc. on Saturdays and Sundays would be difficult if not impossible. To recruit further consultant resource would be expensive even if recruitment was practical. However if ASPH also had two consultants in that specialty and there was a merger, then a rota between 4 consultants becomes possible. Thus goes the argument.

It is important to understand what 7-day working means. Much of the merger documentation uses this term without explanation leading some with the impression that the whole hospital would work exactly the same every day of the week. That is no so. Outpatient Departments would not change. 7-day working refers to inpatients and essentially to consultants being available on one or other of the sites and doing ward rounds etc. (plus necessary support functions e.g. diagnostics). It also does not refer to all specialties. Merger documentation currently refers to stroke, GI (gastrointestinal) and interventional radiology although others might come on board.

Thus the merger benefits of 7-day working as currently described are  limited but nonetheless very worthwhile. They might have to be realised anyway without a merger but with more difficulty and greater expense.

Merger progress

The process for seeking authority for the Royal Surrey and Ashford & St Peters to merge proceeds steadily. The Final Business Case is scheduled to be complete in February and will then be put to the Board for their approval and put to the governors for comment and support. A small delay of about a month has occurred due to the Competition and Mergers Authority whose approval is a necessary first step. There is no reason at present to believe that approval will not be given on the first pass but if the CMA requires a second pass a significant delay would occur. I will report as and when there is news.

I represent the RSCH on the joint 'Stakeholders Committee'  which deals with communications with the public, staff etc. They have decided to hold back on a big communications thrust until CMA approval has been given. Plans are being firmed up and I expect to help staff a stand in the Friary Centre before too long. I would like also to see a stand staffed in Tescos near the hospital and Burpham Sainsburys and await to see if that proves possible. Similar plans are being prepared for other places in the joint catchment area.

A & E

The BBC in a recent programme stated that the Royal Surrey had declared a Major Incident re its A&E. That is incorrect and the BBC has been informed. The Royal Surrey like all hospitals in the country, is under extreme pressure but nevertheless is coping well and meeting the 95% target for maximum 4 hours from arrival to discharge or admission. Whereas the hospital has missed this target on a few occasions it has done so only marginally. Recently its A&E was judged amongst the best in the country - let us hope the winter pressures do not change that position.