THE future of vital services at Croydon University Hospital has once again been called into question after a faltering review of healthcare in south west London suggested closing two A&E and maternity units in the region.
Under the previous proposals only St Helier, in Sutton, would have lost these services as part of the controversial Better Services, Better Value (BSBV) review.
They would then have been centralised and expanded at three other hospitals in the region, including Croydon.
However, the review ground to a halt in November after the collapse of a hospital merger in Surrey raised questions of the clinical and financial evidence it was based on.
This week, clinicians admitted the report's recommendations have had to be entirely scrapped as a result of the decision to halt the merger between Epsom Hospital and Ashford & St Peter's NHS Foundation Trust.
As a result, Croydon's A&E and maternity units are back in the firing line. New proposals suggest that two from Croydon, Epsom, Kingston, St George's and St Helier hospitals should lose both departments.
However, a spokesman added that due to its "major role" in providing acute services such as stroke and major trauma, St George's, in Tooting, would retain its A&E and maternity units, making the choice two from four.
The Advertiser understands new recommendations about which hospitals will be affected will be decided upon as early as January 22.
Michael Bailey, consultant urologist and medical director of BSBV, said: "I would strongly emphasise that no decisions have been made yet.
"These are clinical recommendations from local doctors and nurses only. Further work needs to be done to determine whether they would work in practice."
Dominic Conlin, director of strategy at Croydon Health Services,remains hopeful that the trust will not lose its services.
He said: "In 2012 the first phase of BSBV undertook a forensic examination of a number of factors, included demographics, travel and quality of service and I would hope they would take those findings into account during the new process.
"Our clinicians will be part of that process and we are confident that the right answers in terms of clinical and financial sustainability will come out of it."
Carshalton and Wallington MP Tom Brake, a vocal critic of the plan to shut services at St Helier, remains committed to opposing any similar recommendation.
He said: "Unfortunately this just means more uncertainty about what direction our health services are heading in.
"It is difficult to see how BSBV can prove to people it offers something better in five, six or seven years time when what St Helier offers is viable already, whether thats in customer satisfaction or the patients who vote with their feet to have their children there.
"My sympathies are with the staff. I can only admire their dedication and commitment during a very difficult time. The uncertainty must have been disturbing for them.
"All I can do is promise that I remain committed to St Helier retaining its services."
The future of children's services remains under discussion but whichever model is chosen will not impact on the number of A&E or maternity services.
The review remains committed to a planned care centre covering the region but further work will be carried out on the viability of a separate, stand-alone midwife-led maternity unit.
BSBV's restart is further bad news for Croydon University Hospital which was counting on the extra investment it would bring to revamp vital services and provide a solid financial basis for its latest bid for Foundation Trust status.
The review aims to start a public consultation process in the spring or summer by which time the hospital has to have submitted its foundation bid if it is to meet the final deadline of March 2014.
Under the previous proposals only St Helier, in Sutton, would have lost these services as part of the controversial Better Services, Better Value (BSBV) review.
They would then have been centralised and expanded at three other hospitals in the region, including Croydon.
However, the review ground to a halt in November after the collapse of a hospital merger in Surrey raised questions of the clinical and financial evidence it was based on.
This week, clinicians admitted the report's recommendations have had to be entirely scrapped as a result of the decision to halt the merger between Epsom Hospital and Ashford & St Peter's NHS Foundation Trust.
As a result, Croydon's A&E and maternity units are back in the firing line. New proposals suggest that two from Croydon, Epsom, Kingston, St George's and St Helier hospitals should lose both departments.
However, a spokesman added that due to its "major role" in providing acute services such as stroke and major trauma, St George's, in Tooting, would retain its A&E and maternity units, making the choice two from four.
The Advertiser understands new recommendations about which hospitals will be affected will be decided upon as early as January 22.
Michael Bailey, consultant urologist and medical director of BSBV, said: "I would strongly emphasise that no decisions have been made yet.
"These are clinical recommendations from local doctors and nurses only. Further work needs to be done to determine whether they would work in practice."
Dominic Conlin, director of strategy at Croydon Health Services,remains hopeful that the trust will not lose its services.
He said: "In 2012 the first phase of BSBV undertook a forensic examination of a number of factors, included demographics, travel and quality of service and I would hope they would take those findings into account during the new process.
"Our clinicians will be part of that process and we are confident that the right answers in terms of clinical and financial sustainability will come out of it."
Carshalton and Wallington MP Tom Brake, a vocal critic of the plan to shut services at St Helier, remains committed to opposing any similar recommendation.
He said: "Unfortunately this just means more uncertainty about what direction our health services are heading in.
"It is difficult to see how BSBV can prove to people it offers something better in five, six or seven years time when what St Helier offers is viable already, whether thats in customer satisfaction or the patients who vote with their feet to have their children there.
"My sympathies are with the staff. I can only admire their dedication and commitment during a very difficult time. The uncertainty must have been disturbing for them.
"All I can do is promise that I remain committed to St Helier retaining its services."
The future of children's services remains under discussion but whichever model is chosen will not impact on the number of A&E or maternity services.
The review remains committed to a planned care centre covering the region but further work will be carried out on the viability of a separate, stand-alone midwife-led maternity unit.
BSBV's restart is further bad news for Croydon University Hospital which was counting on the extra investment it would bring to revamp vital services and provide a solid financial basis for its latest bid for Foundation Trust status.
The review aims to start a public consultation process in the spring or summer by which time the hospital has to have submitted its foundation bid if it is to meet the final deadline of March 2014.
