THE threat to hospital services in Winchester became clearer today after health bosses unveiled options for the future.

Six clinical options are being considered and most involve moving services such as A&E and maternity from the Royal Hampshire County Hospital in Winchester, to a new as yet unbuilt hospital.

Winchester MP Steve Brine this afternoon expressed criticism, saying it was the "wrong time to seek major changes to the local NHS if your aim is to do so with a modicum of engagement and consent from the general public."

Local NHS organisations are looking to revamp services across north and mid-Hampshire to deal with changing demands, financial pressures and best practice guidelines.

They had been looking at eight options and have ruled out two: keeping services as they are, and moving all services from the RHCH and North Hampshire Hospital in Basingstoke to the new hospital.

Managers have been exploring the possibility of centralising some of the most specialist services for the sickest people on one site, rather than spread across two main sites, in Winchester and Basingstoke.

They say that consolidating those specialist services in one place would mean a better use of senior clinicians, who are currently spread too thinly. It would also mean clinical teams treat more patients with particular conditions and illnesses, helping to better maintain their expertise.

Initially eight options were considered by doctors, nurses, and other clinicians and evaluated against pre-agreed criteria to decide whether they should be discounted or investigated.

Further work will be undertaken to evaluate each option. Options will be assessed over clinical quality, patient experience and outcomes as well as the impact on staffing levels, cost and affordability, accessibility and deliverability, to inform the development of a shortlist.

The six options are:

Option B – Investment to sustain hospital services at Basingstoke and Winchester for the long-term. Services including emergency care, consultant-led maternity care and intensive care would be centralised at one of the hospitals. Centralisation will help to ensure delivery of the clinical quality standards required for these services, so they can continue to be provided in north and mid Hampshire.

Option C – Emergency care, consultant-led maternity care and intensive care would be centralised in a new hospital, as would a new outpatient centre which would enable patients to undergo scans, have tests and an appointment with their consultant in the same visit. A centre for surgery planned in advance would be provided from a main satellite hospital, which would also benefit from additional investment. Outpatient consultations and a other hospital services would be provided at additional satellite locations across north and mid Hampshire.

Option D - Emergency care, consultant-led maternity care and intensive care would be centralised in a new hospital, as would a centre for surgery planned in advance and a new outpatient centre which would enable patients to undergo scans, have tests carried out and have an appointment with their consultant in the same visit. Outpatient consultations and a range of other hospital services would be provided at satellite locations across north and mid Hampshire, with some additional investment.

Option E – Emergency care, consultant-led maternity care and intensive care would be centralised in a new hospital, as would a centre for surgery planned in advance and a new outpatient centre which would enable patients to undergo scans, have tests carried out and have an appointment with their consultant in the same visit. An outpatient centre, offering the same services described above, would also be provided from a main satellite hospital, which would also benefit from additional investment. In addition, outpatient consultations and a range of other hospital services would be provided at additional satellite locations across north and mid Hampshire.

Option F – Emergency care, consultant-led maternity care and intensive care would be centralised in a new hospital, as would a new outpatient centre, which would enable patients to undergo scans, have tests carried out and have an appointment with their consultant in the same visit. A centre for surgery planned in advance and an outpatient centre offering the same services described above would be provided from a main satellite hospital, which would also benefit from additional investment. In addition, outpatient consultations and a range of other hospital services would be provided at additional satellite locations across north and mid Hampshire.

Option G – Emergency care, consultant-led maternity care and intensive care would be centralised in a new hospital, as would a centre for surgery planned in advance. An outpatient centre which would enable patients to undergo scans, have tests carried out and have an appointment with their consultant in the same visit would be provided from a main satellite hospital, which would also benefit from additional investment. In addition, outpatient consultations and a range of other hospital services would be provided at additional satellite locations across north and mid Hampshire.

Five of the six options currently being explored involve the construction of a new hospital. Four of the six options involve the development of a main satellite hospital and all options have some health care services provided elsewhere, working together as a network to serve the people of north and mid Hampshire. Work is ongoing to identify proposed locations for these services.

Dr Matt Nisbet, a local GP and a clinical lead at the Hampshire and Isle of Wight Partnership of CCGs, said today: “We would like to thank everybody who has taken part in our listening exercise during the summer as well as those who have taken part in our recent options development sessions.

“The six options for the way we organise clinical services in north and mid Hampshire in the future will now be investigated further. Our evaluation criteria for shortlisting will be further developed, building on what respondents said was important to them during our listening exercise. The criteria will be refined with further input from clinicians, staff, patients, and other stakeholders.

“This work will allow doctors, nurses and other clinicians, with the help of a specially formed options development group including staff and patient representatives, to use the evaluation criteria to draw up a shortlist recommended for public consultation. The CCG governing body will review a detailed business case and make a decision on the options for consultation. We expect to launch this consultation early in the new year.”

This afternoon Steve Brine MP said: “I have worked incredibly hard all summer, including writing to thousands of households myself at one point, to get constituents to speak up during the Hampshire Together process which has otherwise passed by unnoticed. That is hardly surprising which is why I have said publicly, privately and in the House of Commons this is the wrong time to seek major changes to the local NHS if your aim is to do so with a modicum of engagement and consent from the general public.

“As I have maintained all along, this is about building a new hospital for Basingstoke and I repeat my call for the Trust to be honest how that will impact on the acute service in Winchester. Over the past ten years I have made it my business to understand the local NHS and support what is in our best interests in line with clinical advice. Politicians do not design health services and nor should they.

“I’ve never met a constituent who doesn’t want to be taken to the right place, to get the right treatment, when they’re acutely unwell and we deserve services here that give us the best chance of recovery should illness strike. Equally, we should be clear what services are actually at the RHCH now - and which ones haven’t been there for decades - including full service A&E.

“A District General Hospital is a delicate eco-system and the services it has are highly dependent on each other. We should be extremely careful before changing that and, if we plan to do so, be crystal clear with residents what change looks like. It is up to the clinicians to make that case. We’re listening.”