1. Acute Healthcare Services in East of England Technical Analysis Simon Wood December 2006

2. Clinical outcomes Clinical sustainability Financial sustainability Drivers for Reconfiguration

3. General surgery300,000 Cancer surgery1 million Haemato-oncology500,000 Burns5 million Oral & maxillofacial surgery1 million Neonatal intensive care1.5 million Vascular surgery500,000 Urology500,000 Clinical Guidelines (1) – Catchment Populations (1) Clinical outcomes and/or clinical sustainability

4. Other Clinical Guidelines (1) Paediatric surgery Cardiology Stroke Services Emergency Paediatrics Ophthalmology ENT Renal Medicine (1) Clinical outcomes and/or clinical sustainability

5. Population per General Hospital across Strategic Health Authorities Source : IPPR Briefing – Hospital reconfiguration, Sep 2006

6. EoE Data Analysis Catchment populations – Southend 310,000 (EoE range 530,000 to 165,000) Births – Southend 3,600 (EoE range 5,500 to 2,100) Standardised activity rates per 1,000 weighted population (draft) – South-East Essex PCT 112 Significant progress required to comply with 2009 European Working Time Directive standards (surgery & medicine; Southend at EoE average)

7. Key Pressure Points Emergency Surgery Local Emergency Services Maternity Services

8. Financial Position Large historic and underlying deficit Payment by Results will put additional cost pressures on PCTs and improve position of Acute Trusts Growth in income after 2007/08 will be modest

9. 1.Surgical Subspecialisation 2.Maternity 3.European Working Time Directive 4.Acute Commissioning 5.Technical (Weighted Capitation, Population Growth) Proposed General Workstreams