A FALTERING review of healthcare across south-west London is key to Croydon University Hospital's latest attempt to become a foundation trust, the Advertiser can reveal.
All hospitals must achieve the status, which grants more independence and accountability, by March 2014 - or face being merged with other trusts.
To do this, Croydon Health Services (CHS), the trust which runs the hospital, must meet strict criteria related to the quality of its services and its finances. At the moment, it falls short in both of these areas.
Dominic Conlin, director of strategy, told the Advertiser that Better Services, Better Value (BSBV), a review of healthcare in south-west London, is "critical" if the trust is to meet the increasingly stringent requirements.
BSBV promises significant investment in Croydon University Hospital, including additional consultants and redeveloped A&E and maternity units.
But last month the review ground to a halt, following the collapse of a hospital merger in Surrey which raised questions about the clinical and financial evidence it is based on.
After crisis talks, the GP-led review is to look again at the proposals, in the light of the decision to halt the merger of Epsom Hospital and Ashford & St Peter's NHS Foundation Trust.
This has delayed the 12-week public consultation over the changes, which envisaged A&E and maternity services closing at St Helier in Sutton, until after Easter next year.
However, in order to meet the Government's foundation trust deadline, CHS has to apply by August.
An added complication is that CHS is reluctant to begin its own public consultation until after the results of the BSBV survey.
Mr Conlin said: "The last consultation was in 2006 so we don't think it's relevant, particularly if we are going to satisfy the legal requirements.
"We don't know (when the new consultation will be). We have a date in our timetable but I would prefer to follow the BSBV consultation. Given the implications the review will have, it doesn't make any sense to go before.
"The critical issue for the trust is to be able to demonstrate that we can provide high quality clinically and financially-viable services.
"We need to demonstrate this to our patients and to health service commissioners.
"That is the challenge, irrespective of an application for foundation trust status, and the Better Services Better Value review is key as its decisions will help shape the type of services that we are able to provide."
Two other attempts to be awarded foundation status, in 2006 and 2008, both failed due to concerns about the trust's finances and standards of care respectively.
Mr Conlin said the trust is determined to do things differently this time around. Last week it held a meeting with members to explain the changes, particularly around accountability.
He added: "The very worst thing that could happen is for someone else to tell us we are missing something important. That is what happened in the past."
The extra money promised by BSBV would not reach CHS until at least 2016-17, but Mr Conlin said the foundation trust application can be based on future investment as long as it is "concrete".
If CHS does not meet the March 2014 deadline, Croydon University Hospital could be merged with another trust, though the report being written by Robert Francis QC into the scandal at Stafford Hospital, where hundreds of patients died due to inadequate care, may change the timetable when it published early next year.
