THE committee of councillors scrutinising the decision on reorganising health services for outer south-east London may refer the matter to the Health Secretary.

The joint overview and scrutiny committee met last Thursday, following the decision by the joint committee of primary care trusts' (JCPCT).

The committee was split six-six on whether to make an immediate referral or wait until members had received the remainder of the information from the JCPCT.

Lewisham councillor Sylvia Scott, the committee chairman, used her casting vote to delay a decision until September.

Lewisham Hospital has denied claims, made at the scrutiny meeting, that it is already moving towards the 12-hour A&E for surgical emergencies.

A hospital spokesman said it had started work on planning how the new 8am to 8pm surgical A&E service would work, but there was no timetable for its implementation.

Under the JCPCT decision, the Queen Elizabeth Hospital in Woolwich will remain a full acute hospital and keep its day surgery service.

Its planned inpatient surgery will go either to Lewisham Hospital or Queen Mary's, Sidcup.

Lewisham Hospital will keep all of its emergency services except for the restriction on night-time surgical emergencies, estimated to affect between three and five patients a night.

The hospital will also keep its maternity and inpatient paediatric services, thanks to the intervention of the Academic Health Sciences Centre, an alliance of Guy's and St Thomas's, King's College and South London and Maudsley trusts.

They will bridge the lack of consultant support for both units, take the more complex children's surgery and send their less complex cases to Lewisham in return.

Michael Chuter, the chairman of the JCPCT, says none of the four hospitals, in Bexley, Bromley, Greenwich and Lewisham is currently meeting all of its minimum clinical guideline standards and would never be able to do so if services remained the same.

  • Three of the four hospitals' paediatric units do not have separate rotas for neo-natal and children's staff.
  • The shortage of staff stretched across the four maternity units means each is struggling to provide 40 hours of consultant coverage a week, when the recommended level is 98 hours.
  • The Royal College of Surgeons recommends A&E departments have a catchment population of at least 300,000, and preferably 450,000, to enable staff to keep up their skills levels.
  • The four A&E departments involved share a catchment of a million people between them.
  • None of the four hospitals has sufficient consultants or experienced doctors and nurses to provide 24-hour cover across all specialities in their A&E departments.

Jon Schick from A Picture of Health (APOH) said option three (reducing emergency services to just two hospitals) would have meant finding 400 extra acute beds at hospitals outside the four boroughs, plus 270 more beds at the Princess Royal in Farnborough and the Queen Elizabeth in Woolwich, and reducing beds at Sidcup and Lewisham.

Under the chosen amended option two, APOH says the bed shortage will be just 13 at Woolwich and some maternity beds at King's College Hospital in Denmark Hill.

It says Darent Valley Hospital, Dartford, will need 57 more beds, Guy's and St Thomas's, 43, and King's College, 31.

Once a patient no longer needs acute nursing, they will transfer to intermediate care at Queen Mary's or the proposed new Eltham Community Hospital or beds at the Beckenham Beacon, to ease pressure at the acute hospitals.

APOH is expecting between 40 and 60 per cent of A&E patients to be treated in future in the new urgent care centres at each of the hospitals.

Talks are to start with Transport for London and other providers, about improving public transport links to the reorganised hospital services.