St Mary's hospital

St Mary’s Hospital is set to undergo a £132million makeover in a major overhaul of the health system that will see it become a focal point of emergency and acute care, while patients with less serious and long-term ailments are cared for away from the hospital.

The accident and emergency department at St Mary's Hospital, Paddington. Picture: Polly Hancock

Healthcare bosses have decided to give the go-ahead to some of the biggest changes to the way healthcare is delivered in the history of the NHS.

It will mean St Mary’s will be extended and have its capacity increased to deal with an estimated 11 per cent more cases in a larger A&E department with new operating theatres, as well as host a new mortuary and absorb the Western Eye Hospital, to be relocated from its current Marylebone Road home.

The Hyper Acute Stroke Unit at Charing Cross Hospital will also be moved to St Mary’s, which would remain as north-west London’s major trauma unit.

The news comes as other hospitals lose their A&E departments entirely – Hammersmith, Charing Cross, Ealing and Central Middlesex.

The changes at St Mary’s, in Praed Street, Paddington, are part of a reorganisation of all hospitals in the area, creating an anticipated nine per cent increase in maternity admissions there by 2015/16, as well as an 85 per cent rise in elective surgery admissions and 26 per cent rise in non-elective admissions.

Bed numbers will increase from 418 to 479 to cope, and the urgent care centre at the hospital will remain.

As it increases its focus on critical and acute care, less serious cases and patients with long-term health problems, including dementia, will be dealt with in healthcare “hubs” based in the community, with integrated care at the heart of an ambition to make treatment from GP to specialist as seamless as possible.

More than £190million is planned to be poured into out-of-hospital care over the next five years to improve community facilities, create healthcare hubs and GP surgeries so they have the capacity to deal with non-urgent and preventative care.

Dr Mark Spencer, medical director for the overarching plans called Shaping A Healthier Future, put together by the Joint Committee of Primary Care Trusts (JCPCT), said: “This decision will save lives and improve care dramatically for the two million people living across north west London.

“I am pleased that the JCPCT agreed that this was the best decision for a clinically safe, high quality and financially secure future for all the hospitals and NHS trusts in north west London.

“There are urgent and pressing needs to make these changes. If we do nothing people will continue to die unnecessarily and services will fail.”

Jeff Zitron, JCPCT chairman, added: “I am delighted that, after thorough and careful examination, we are able to fully recommend what clinicians feel will deliver the best possible care for local people for years to come. We have not taken this decision lightly, and have been very careful to consider the many thousands of responses we received during our extensive consultation last summer.”

Imperial College Healthcare NHS Trust, which runs St Mary’s Hospital, welcomed the plans, which aim to reduce the number of unneccesary visits to A&E and address challenges including the demands of an increasing, ageing population.

Proposals for care in the community include hubs at St Mary’s Hospital itself, and another in Church Street area and a third in Pimlico.

GP surgeries’ opening hours will be extended, a “Wellwatch” telephone-based case management service to monitor high-risk patients, and providing appointments with consultants in the hubs, including cardiology and respiratory services.

A broader rapid response service is also planned to prevent avoidable hospital admissions “and maintain patients at home wherever possible”.

A central tenet for the reorganisation of healthcare is “appropriate time in hospital when admitted, with early supported discharge into well-organised community care”.