FAQs

The Academic Health Science Centre (AHSC)
Decision making and governance
Biomedical Research Centre (BRC)
Finance
What about service provision?

1. The Academic Health Science Centre (AHSC)

a) What is an AHSC?
The Academic Health Science Centre is a healthcare organisation that integrates governance and management for service delivery, teaching and research, and is based on tried and tested models around the world such as Johns Hopkins in Baltimore; Harvard / Massachusetts General in Boston; Karolinska in Stockholm.

b) What will the new organisation be called?
The name of the AHSC is still under discussion.

c) Is this a merger or a takeover?
Neither. It is an entirely new concept for the UK, with two hospitals becoming one organisation that works in partnership with Imperial College.

2. Decision making and governance

a) Do the partners require approval from the new London SHA in order to proceed?
The Secretary of State makes the decision but it is unlikely she will agree to the proposal without the support of the London SHA.

b) Will Imperial College staff have the power to influence trust management decisions and where AHSC funds are spent?
Yes, in so far as senior Imperial nominees will sit on the board as non-executive members. However the board of a trust is obliged to have a range of non-executive members and these people add valuable wider perspective to discussions and decisions.

c) Will the AHSC have the power to influence Imperial College funds?
Yes, decisions taken at the AHSC will require Imperial to ensure its own programmes of work align with those of the AHSC. In addition, the shared leadership of core areas of focus will require the trust and Imperial to work in partnership.

d) Who will be making the final decision about whether the boards of the organisations can create an AHSC?
The Secretary of State (SoS) for Health.

e) Who has ultimate responsibility for delivering the creation of the AHSC?
The Joint Steering Committee (JSC), independently chaired by Lord Tugendhat, is responsible for overseeing the creation of an AHSC. It consists of the Chief Executives and Chairs of both trusts, the Rector of Imperial College and the Principal of the medical faculty, and representation from the Primary Care Trusts and the Strategic Health Authority.

The JSC is given delegated authority from all three organisations to act in key strategic areas related to progressing the AHSC.

A small programme management team, headed by a programme Director and reporting directly to the JSC leads the project.

The Trust Boards in partnership with Imperial have responsibility for agreeing the creation of an AHSC and putting a proposal to the SoS.

3. Biomedical Research Centre (BRC)

a) What will happen to the successful joint Biomedical Research Centre (BRC) application if the creation of the AHSC does not go ahead?
The BRC process does not allow for joint applications and in the event the AHSC is not created the Department of Health could disqualify the bid.

4. Finance

a) How much will be spent creating an AHSC?
Most work so far has been done by trust and Imperial college staff. However we will need specialist external assistance to help us, for instance, manage the project, give legal advice, assess financial projections, independently assess the consultation etc. We have a budget of £600,000 which will be reviewed in April 2007. Savings are estimated to more than recover these costs in the first full year of operation.

b) How much will the public consultation cost?
It depends on the work we are doing now with stakeholders asking them how and when they would like to be consulted, and what information they need to make an informed choice.

c) If the AHSC is created, what will happen to the financial deficit of Hammersmith Hospitals Trust?
Any new organisation will inherit the joint balance of the two trusts. 1-year and 5-year business plans will be assessed as part of the case made to the SoS for the creation of the AHSC. A detailed first-year operating plan for the AHSC, which has to be submitted to the Secretary of State for approval, must show that the new organisation is financially viable by the end of the first year. Each hospital has its own Cost Improvement Programme (CIP) which assesses the opportunities to re-organise its clinical services making further improvements to outcomes and efficiency. These programmes will need to be refined and improved once a new trust is established.

d) Will the £15m plans to improve critical care and interventional medicine at St Mary's, which was recently approved by the SHA still go ahead?
Yes if the business case for it is approved by the Department of Health. The critical care facilities require an upgrade due to immediate volume issues.

5. What about service provision?

a) Will this affect service provision?
The consultation will describe options for how services could be provided in the future, but it is not a consultation on services. The AHSC will enable us to improve services. More care will be provided closer to people's homes by GPs, community nurses and in clinics.

Services for patients with common conditions that don't require an array of complex technology will remain local.

Rather than the two hospitals competing for patients to try and keep a specialist service open, there needs to be a concentration of expertise with enough patients being treated by each specialty to ensure the service provides the best quality care.

b) Will there be a reduction in beds as a result of the AHSC?
There is an excess of inpatient beds in North West London and combined with the shift to increased day surgery and delivering more services in primary care settings and at home there is likely to be a further decrease in beds. This does not mean worse services - quite the contrary. Patients cared for on well-constructed plans benefit from timely care and shorter hospital stays.

c) Are you going to close Charing Cross Hospital?
There are no plans to close the hospital or any of the current sites. Hammersmith Hospitals has various estates issues to address, particularly on the Charing Cross site. The Trust is looking at options to address this issue. However, significant investment continues to be made in Charing Cross Hospital, with four new linear accelerators (additional, £6.5m, Dec 06), a new 72-hour day-and-stay surgery unit (Spring 06, £3.5m), new research facilities, Maggie's Cancer support Centre (Spring 07, £2.5m) and new mental health services.