Acute Healthcare Services in East of England

Technical Analysis

Simon Wood

December 2006

• Clinical outcomes

• Clinical sustainability

• Financial sustainability

Drivers for Reconfiguration

General surgery 300,000

Cancer surgery 1 million

Haemato-oncology 500,000

Burns 5 million

Oral & maxillofacial surgery 1 million

Neonatal intensive care 1.5 million

Vascular surgery 500,000

Urology 500,000

Clinical Guidelines (1) – Catchment

Populations

(1) Clinical outcomes and/or clinical sustainability

Other Clinical Guidelines (1)

Paediatric surgery

Cardiology

Stroke Services

Emergency Paediatrics

Ophthalmology

ENT

Renal Medicine

(1) Clinical outcomes and/or clinical sustainability

Population per General Hospital across Strategic Health Authorities

Source : IPPR Briefing – Hospital reconfiguration, Sep 2006

EoE Data Analysis

• Catchment populations – Southend 310,000 (EoE range 530,000 to 165,000)

• Births – Southend 3,600 (EoE range 5,500 to 2,100)

• Standardised activity rates per 1,000 weighted population (draft) – South-East Essex PCT 112

• Significant progress required to comply with 2009 European Working Time Directive standards (surgery & medicine; Southend at EoE average)

Key Pressure Points

• Emergency Surgery

• Local Emergency Services

• Maternity Services

Financial Position

• Large historic and underlying deficit

• Payment by Results will put additional cost pressures on PCTs and improve position of Acute Trusts

• Growth in income after 2007/08 will be modest

1. Surgical Subspecialisation

2. Maternity

3. European Working Time Directive

4. Acute Commissioning

5. Technical (Weighted Capitation, Population Growth)

Proposed General Workstreams