A summer-long engagement programme by Epsom and St Helier Hospital Trust has found support for creating a new acute care unit to replace the services at both hospitals.

“Epsom and St Helier 2020-2030” set out the trust’s case for moving acute care to one of Epsom Hospital, St Helier Hospital or the Royal Marsden in Sutton.

Trust chief executive Daniel Elkeles said: “It feels like a really important moment in securing our future. The thing that I think is really exciting is we are wanting to secure one of the biggest investments in the NHS – between £377million and £444million.”

The services in question comprise 15 per cent of all patient contacts, and include the major part of accident and emergency (patients who are unwell and need complex clinical assessment and procedures like resuscitation), inpatient paediatrics (children who stay in hospital overnight), birth services and complex emergency medicine (such as high-dependency care and coronary care).

Mr Elkeles said: “We just can’t carry on as we are. Over the years, Epsom and St Helier will offer fewer and fewer services because we won’t be able to fund them.”

The new plans would be expected to save the trust between £36million and £45million.

Of the 1,059 questionnaires completed during the 13-week process, 79.8 per cent of respondents agreed with the trust that a single 500-bed specialist site would best serve patients.

Issues people raised included transport – concerns about distance, parking, accessibility, traffic and public transport, deprivation – the impact on elderly, frail and vulnerable people, people with less income and families, and the impact changes would have on other hospitals, including St George’s in Tooting and Croydon University Hospital.

But Dave Ash from the Keep Our St Helier Hospital campaign group claims this will mean services will be made worse, and will even lead to people dying.

He said: “The problem is that a lot of people came away from meetings thinking they were either getting a new hospital or an additional facility. But acute care services are, in reality, being removed from one of or both Epsom and St Helier hospitals.

“One problem is that it would mean most people would have further to travel. A second is that it would constitute a reduction of one in three acute beds. In our area, it’s already way below what we need. It’s going to lead to people losing their lives.”

Mr Ash’s claim about acute bed reductions comes from a 2015 Freedom of Information request that the trust responded to, which states it had 759 acute beds in 2014.

Mr Elkeles said the 2014 figure used a general definition of “acute”, and did not properly reflect the services to be offered in the new facility.

There are currently 1,048 beds across the trust, and proposals include between 992 and 1,026 beds.

Following the engagement programme, the trust has published its Strategic Outline Case (SOC), claiming “it is unlikely the trust will be able to deliver clinical standards by providing care to its sickest patients across two acute sites”.

The board has submitted the SOC to NHS Improvement, with the prospect of the proposals going to a formal consultation in the future.