Surrey Downs Clinical Commissioning Group (SDCCG) has announced its withdrawal from Better Services Better Value after its GPs overwhelming voted against proposals that would axe acute services at Epsom Hospital.

The results of secret ballot today showed that 74 per cent of GPs in the area who took part voted against proposed shake-up of acute hospitals which would have seen the hospital lose its accident and emergency and maternity units.

BSBV immediately issued a statement, agreed with the six other CCGs across south west London - Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth - saying they respected the SDCCG decision and would be drawing up new proposals for reshaping acute services in South West London as soon as possible.

Dr Claire Fuller, chairman of SDCCG, said: "As a GP-led commissioning group, we are charged with securing the best health outcomes for our population and we must do so within the resources we are allocated.

"Today’s important ballot result has shown that GPs within our CCG are not confident that the BSBV proposals are able to meet the needs of our local population at this time."

Dr Fuller added: "This decision is not taken lightly or without due care and consideration of patients and colleagues in south west London but our responsibility has to be to our local patients.

"We are not ruling out service changes in the future but we will now withdraw from the BSBV programme and together with our partners, focus our work on achieving the improvements we want to see locally."

Miles Freeman, chief officer at SDCCG, said: "Our conclusion as a governing body has been drawn from much deliberation and careful review of the BSBV proposals and from rigorous testing of Epsom and St Helier’s current quality and financial position.

"Our next steps are to make our vision for out of hospital care a reality so patients benefit from having integrated care delivered more effectively and efficiently.

"This important ambition can only be achieved with the support of patients and families, our partners in both health and local authorities and I now look forward to discussing our plans more widely."

The BSBV statement said: "We are taking stock of the fact that Surrey Downs CCG has chosen not to remain part of the BSBV programme, but we understand and respect their position. Clinicians want to achieve the best possible quality in our health services and we are all committed to the London Quality Standards.

"What is clear is that the problems we face have not gone away – indeed, more and more evidence is emerging at national and London level of the need for us to change the way the NHS operates if we are to deliver high quality, financially sustainable services for patients. While changes in hospital services are always difficult, we cannot allow our local services to be left behind as others commit to delivering 24-hour services to the highest quality standards.

"There have been two significant developments since the BSBV proposals were put forward and we need to respond to these.

" First, NHS England’s ‘Call to Action’ describes how the NHS is facing a number of significant challenges; an ageing population, increasing prevalence of long term conditions, lifestyle choices that lead to increases in conditions such as obesity or cancer, and rising healthcare costs.

"Combined with the assumption that the NHS budget will remain flat in real terms, this presents us with an unprecedented challenge to improve clinical quality whilst delivering a financially sustainable health system.

"Only bold and transformative change to how services are delivered will enable us to continue providing a high quality yet free at the point of use health service.

"All CCGs are required to respond to NHS England’s ‘Call to Action’ by developing five-year strategic plans that respond to the clinical and financial challenges faced by the NHS.

"Second, we have learned that the overall budget available for all CCGs to spend on hospital care is going to be reduced in the next two years, with £3.8 billion being allocated to the Integration Transformation Fund, a single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities.

"While this funding for better integration is welcome, it will leave less money available for us to commission hospital services.

"We know we will have to work together to ensure we can deliver safe, high quality and sustainable services.

"We also need to look again at the changing financial position.

"The six south west London CCGs will continue to work together to prepare a collective response to the Call to Action. We will continue to work very closely with Surrey Downs and with our members as we discuss the next steps.

"We recognise that the status quo is even less of an option now than it was when the BSBV programme started. We want to avoid continued uncertainty for patients and staff and will look to bring forward revised proposals as soon as we can, as part of our response to the Call to Action."

Epsom and St Helier Hospital Chief Executive Matthew Hopkins said: “As we have done throughout this process, we are committed to working with the Better Services Better Value team and our other healthcare partners, in particular our local commissioning groups, to ensure that we provide high quality, safe, accessible and compassionate care to the people we serve – now and in the future.

"My immediate priority is to continue to provide great care for patients every day and to build on the improvements that we have made as one Trust over the last couple of years, to improve our financial position. As we head towards winter, my immediate focus is making sure we have robust plans in place for winter for local people.”