FRESH fears have surfaced over the future of the Royal Surrey County Hospital accident and emergency department after a sensitive document was leaked to The Haslemere Herald this week. Headed "Pulling it all together - possible future models of care", it shows the number of current acute A and E hospitals in Surrey, of which there are five, including The Royal Surrey and Frimley Park hospitals. But it also shows that under two separate models of care, two hospitals in the county will lose their A and E departments, to be replaced by integrated walk-in centres, (iWICs), and other services including outpatients' clinics, chronic disease and community care centres. Its implications are that by losing two A and E centres, it would immediately resolve the deficit which will be up to £120million by 2008/2009. The document is believed to be part of a set of papers showing a number of emerging options which have been debated by working groups involved in the discussions. The latest shock waves on A and E closures follow a crucial meeting of the newly named South East Coast Strategic Health Authority due to meet yesterday (Thursday) to discuss the future of Surrey's health services. The top-level talks were to include representatives from Surrey, East and West Sussex and Brighton and Hove. To be attended by all Surrey acute-hospital chief executives, the meeting was called to discuss all the latest options on the table to save money, while continuing to provide the services needed. "The health economy across Surrey is facing a significant financial challenge and steps need to be taken to address this," said a statement from the East Surrey Primary Care Trust this week. The spokesman said: "We realise that people feel very strongly, but because of the nature of the scale of the financial challenge, some of the thinking has been radical and some of the solutions might need to be tough." But the spokesman assured the public that "nothing has been decided and there have been no decisions made". There are also fears that the A and E department at St Richard's Hospital in Chichester could also face the axe as part of the measures to wipe out another huge deficit in West Sussex. Closer to home, the Haslemere Hospital League of Friends believes that, despite winning a reprieve for its community beds only four months ago, the community hospital still faces an uncertain future. Robert Knowles of the League of Friends said: "We know that at one meeting they wanted to cut 490 community beds across Surrey to 286, and we suspect that Haslemere could be under threat again." And he said that with all the acute hospitals in Surrey north of the downs, the situation for A and E departments could be made even worse if St Richard's A and E were to close. At Guildford and Waverley PCT, where the Department of Health was brought in as part of a "turnaround plan" to help it make £12 m of savings this year, and a further £9m for 2007 and 2008, the PCT has focused on patients receiving care close to where they live. It is now in the throes of employing two specialist heart-failure nurses, sponsored by the British Heart Foundation, who will help identify patients at risk, monitor them in their homes and in the community and run clinics at the Royal Surrey, to reduce the need for consultant outpatient appointments. It has also increased its community matrons from six to 10. Discussions on the latest cost-saving moves will be ongoing throughout September and October and a set of final options will be presented in a public document and subject to public consultation which expected to place late October, 2006. • UNISON has condemned compulsory redundancies by Surrey and Sussex NHS Trust. Eleven NHS finance workers have been made redundant because their jobs have been transferred to the private sector. "It is disgraceful that local NHS workers are losing their jobs because of outsourcing, which is effectively privatisation. "How can the financial cost of making these workers redundant be justified, when the NHS is being subjected to budget cuts and cuts in services?" said a spokesman for UNISON.
