Improving Healthcare Together


Improving Healthcare Together 2020-2030 is led by NHS Surrey Downs, Sutton and Merton Clinical Commissioning Groups (CCGs) – the organisations responsible for making decisions about how healthcare services should be provided in the local area.

Epsom and St Helier Hospitals have faced significant challenges for many years. This is in terms of the suitability of its buildings and how major acute services are organised. NHS Merton, Sutton and Surrey Downs CCGs are looking in detail at the challenges faced by the Trust and how it can make sure the hospitals continue to deliver high quality, safe and sustainable services for local people in the years ahead. The main challenges faced are;

  • Improving clinical quality
  • Providing healthcare from modern buildings
  • Achieving financial stability

These challenges mean we need change and new ideas. If we do not tackle them, they risk affecting the quality of care, patient experience and potentially patient outcomes.

Engagement activity


Since June we have been talking and listening with local people about the challenges at Epsom and St Helier hospitals and some of the potential solutions to the issues around clinical standards, buildings and finances.

During our early engagement period, we received over 1000 responses from a range of people and there is a clear consensus that things must change if we are to continue to provide high quality care for our communities, not just now but in the future.

You can read the engagement publications on the Improving Healthcare Together website, including the independent engagement reports and Improving Healthcare Together 2020-2030 issues paper which is accesible in both normal and easy read formats. 

Options workshops


As well as all this early engagement work, three further workshops with members of the public, NHS professionals and other experts to consider these potential solutions.

These were part of our ongoing options consideration process and involved active participation from our communities to help develop the criteria, weightings and scoring of the options.

These workshops were independently facilitated and are part of our ongoing evaluation. You can read the report about the workshops here.

The information from these workshops will be looked at alongside the planned second phase of the Integrated Impact Assessment, financial assessments, the impact on other local NHS providers and feedback from NHS England, NHS Improvement, the joint London and South East Clinical Senates and the Joint Health Overview and Scrutiny Committee.

All of this evidence will be reviewed by the CCGs before we decide whether we wish to proceed to a public consultation on any proposals. No decisions have been made and no preferred solution has been decided.

Stakeholder Reference Group


A Stakeholder Reference Group (SRG) was set-up in May 2018 to advise on plans for public engagement, language, tone and style of engagement materials, how seldom-heard groups should be consulted and what forms of consultation would be most appropriate for these groups. 

The membership of the SRG comprises representatives from different communities of interest in the local area, including patient groups, community groups and voluntary groups who indicated that they wished to be involved in the programme. 

To date the SRG has provided invaluable feedback and input in the following ways:

  • As a sounding board for the programme;
  • As a forum for the programme to reach out to further service users and seldom heard groups;
  • Input into the production of the programme's website, subtitled animation video and mobile engagement work;
  • Input into travel and access issues;
  • Feedback on the initial equalities analysis; and
  • Review of our options consideration and appraisal process through making recommendations around the evaluation workshops. Members of the group were also involved in this process in an observer capacity.

Mobile pop up events


Two events (one in Mitcham Market and one at the Nelson Health Centre) were organised to encourage local people to engage with the issues. Feedback was captured through a survey.

Service user conversations on the clinical model


Six focus groups were also arranged across the three CCGs with service users of maternity, paediatric and emergency services to seek feedback on the clinical model.

Equalities focus groups


An early equalities analysis was undertaken to understand which protected characteristic groups may be affected by any changes to acute services. Healthwatch and the IHT programme undertook a series of focus groups with deprived communities and those from different backgrounds to understand the impacts of the potential solutions and to put in place any mitigations so that different groups are not disadvantaged or disproportionately impacted.

Merton Healthwatch ran five focus groups which reached over 40 residents representing people with physical and learning disabilities, mental health needs and children and young people. 

Other engagement undertaken with community groups in Merton involved imagine independence (mental health support group), Merton Vision (support group for people with visual impairments), Merton Mencap, Hearts and Minds (support group for young people with mental health needs) and service users at the All Saints Community Resource Centre for reach to the elderly, frail and people with physical impairments.

Common themes which emerged included: 

  • Impact of transport links, longer journey times, limited parking, parking costs and increased travel costs
  • Ensuring services were disability friendly and that family, friends and carers are able to visit
  • Meeting food and language requirements for people with different cultural backgrounds
  • Ensuring quality of care
  • Need to improve buildings and staffing levels

Next steps


Over the coming months we will be gathering further information on the positive and negative impacts of any potential changes to services on our local communities, to make sure we are not disadvantaging any groups with any proposed changes.

No decisions are made about services until after a consultation has finished and all the evidence and feedback has been assessed.