Epsom General Hospital has recently been included in a review of hospital facilities for the South West London region. The current proposals would likely lead to the closure of (amongst other wards) the current Paediatric and Maternity facilities at both Epsom General Hospital and St Helier. This would mean that patients would have to travel to either St George’s in London, Kingston or Croydon for in-patient paediatric or maternity facilities. This could potentially affect us all.
There is a public meeting of the Commissioning Group’s Governing Board taking place on 17th May at 1.30pm at the Epsom Downs Racecourse, where these proposals will be discussed. We are in danger of being railroaded into these changes, so if you would be concerned about having to travel to St George’s for in-patient paediatric care, or for maternity facilities, please come to this meeting and make your views heard. Even if you have nothing to say, your presence will show your support for our local services. Please put this date in your diary now.
Epsom Hospital currently has a consultant led paediatric facility with 8 Consultant Paediatricians, complemented by 3 Associate Specialists, 3 Staff Paediatricians and full tiers of Middle and Junior Grade doctors. The Consultants work an ‘attending week’ system taking responsibility for the acute admissions for one week in six, returning to their outpatient working during the other weeks. During the attending week, Consultants are free from all other duties, providing two ward rounds per day as well as Consultant-delivered care to all children attending acutely according to clinical need.
‘Out of hours’ provision for acute Paediatric care is well developed with twice daily Consultant supervised handovers (8.30 – 9:30am and 4pm – 5pm) on Monday to Friday , which encourages good standards through in-site training and ensures patients are managed safely via effective communication. On weekends Consultants again supervise handover from 08:30- 09:30 and then conduct both Neonatal and General Paediatric Ward rounds, reviewing all children present on both units. In addition a Consultant ‘virtual’ ward round is undertaken between the Consultant on call and the duty ST4+ every evening at 10 pm discussing all patients & admissions during the intervening period. Consultants regularly and frequently return to site to aid management of children with complex or difficult presentations.
Inpatient Services are provided in Epsom General Hospital within a dedicated Children’s Ward serving over 1500 patients each year (16 beds & cots) with the ability to provide short term intensive care / high dependency provision, including for acute severe asthma, bronchiolitis, seizure disorders, management of children with complex disability (e.g. patients from the Children’s Trust, Tadworth), Paediatric Oncology patients with neutropenic sepsis as well as management of all common paediatric acute medical problems. Facilities also include 6 isolation cubicles catering to the requirements of children with infectious illnesses, very young infants and children requiring oncology inpatient treatment.
All Consultants provide designated Consultant-led cover to Labour Ward as well as providing a range of specialist services including:
- Medical and High-risk Obstetrics
- Antenatal screening (including antenatal ultrasound and prenatal diagnostic procedures)
- Counselling services (working in concert with Paediatric services)
- Diabetes in pregnancy
- General gynaecology
- Fertility support services
- Gynaecological oncology
- Colposcopy / vulvoscopy
- Out-patient hysteroscopy
- Recurrent Miscarriages
- Early Pregnancy Assessment Unit (EPAU)
The Labour ward currently delivers 2,100 babies per annum with a growth of 6% per annum since 2004. Most importantly the safety figures for Epsom are some of the best in the country, which calls into question why the facilities should be closed, when safety is cited as one of the key drivers:
· The maternal mortality in the trust including Epson has been zero for the past 10 years;
· New figures from a national report show that premature and newborn babies born at Epsom and St Helier hospitals are receiving some of the best care in the country.
· The report, published by the Centre for Maternal and Child Enquiries (CMACE), shows that the death rate of newborns delivered at our hospitals was significantly less than the national average. It also showed that the number of stillbirths that occurred at the Trust is below average.
· The report showed that sadly, for every 1,000 births in the UK, an average of 5.4 perinatal babies (the period from 24 completed weeks gestation to seven days after birth) died. At the Trust, the figure is lower at 3.2 deaths/1000 births.
· The average number of neonatal deaths (the period from seven to 28 days after birth) across the UK was 2.1/1000 births. At the Trust, this figure was 0.8.
Co-located Midwifery-Led Unit (MLU)
Epsom General Hospital has recently secured funding from the DoH to refurbish part of the in-patient facilities to be an MLU co-located with the current labour ward. The building work has already started and due to open in May 2013.