Options outlined for future of A&E in Shropshire

The eight different options drawn up as part of the Future Fit programme were presented to members of the Shrewsbury and Telford Hospital NHS Trust board at a meeting yesterday.

It had been widely reported that the creation of a new site somewhere in between the Royal Shrewsbury Hospital and Telford's Princess Royal treating people with life-threatening injuries was the preferred option of doctors and clinicians.

But the publication of the list shows health chiefs are not ruling out maintaining the status quo, which would also see community hospitals and minor injury units in Bridgnorth, Ludlow, Whitchurch and Oswestry retained.

• See also: Extra A&E patients cost Shropshire hospitals £2.3 million

All of the other options will see a major revamp of the hospital system in the county with the introduction of emergency centres, diagnostic and treatment centres, urgent care centres and local planned care facilities. Emergency centres treat patients with life-threatening conditions or injuries.

Diagnosis and treatment centres are fast-track surgery centres specialising in common operations with existing long waiting lists. Urgent care centres will offer treatment to anyone with a minor injury. They will be walk-in, without the need to make an appointment.

Local planned care facilities will be health "one-stop shops" providing out-of-hours GP services, outpatient appointments, x-rays and blood tests among other things.

Other than maintaining the status quo, other options being considered would see the creation of a single emergency centre, which would be at Royal Shrewsbury, Princess Royal or on a brand new site somewhere in between the two.

If it stays at either of the two hospitals, it will be supplemented with an urgent care centre and a local planned care facility, while the site which loses the emergency centre will instead have a diagnosis and treatment centre, urgent care centre and local planned care facility.

If the emergency centre moves to a new site, it could be supplemented by an urgent care centre and a diagnosis and treatment centre. In this case urgent care centres and local planned care facilities would be set up at both Princess Royal and Royal Shrewsbury.

If the final decision is to go with just an emergency centre and an urgent care centre on the new site, then there will be a diagnosis and treatment centre with urgent care centre and local planned care at Princess Royal, and an urgent care centre with local planned care facility at Royal Shrewsbury.

There would be two to five further urgent care centres dotted around the county.

Choices for emergency treatment

Emergency centres treat patients with life-threatening conditions or injuries. Diagnostic and treatment centres are fast-track surgery centres. They will specialise in common operations for which there are currently long waiting lists. The idea is the extra capacity in the centres will mean that patients with, for example, cataracts, can have them removed with far less delay.

Urgent care centres will offer treatment to anyone with a minor injury. They will be walk-in, no need for appointments.

Local Planned Care Facilities will provide out-of-hours GP services, outpatient appointments, therapy services, services for older people, minor surgery and procedures, x-ray, ultrasound, blood tests and community mental health services.

The options:

• Maintain status quo – A&E units on both the Royal Shrewsbury Hospital and Telford’s Princess Royal, with community hospitals and minor injury units at Bridgnorth, Ludlow, Whitchurch and Oswestry. Efficiency savings to be identified.

• Emergency centre with Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury Hospital. Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Princess Royal. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre with Urgent Care Centre and Local Planned Care Facility at Princess Royal Hospital. Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre with Urgent Care Centre at new site. Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Princess Royal. Urgent Care Centre with Local Planned Care Facility at Royal Shrewsbury. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre with Urgent Care Centre at new site. Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury. Urgent Care Centre with Local Planned Care Facility at Princess Royal. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre and Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury. Urgent Care Centre and Local Planned Care Facility at Princess Royal. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre and Diagnosis and Treatment Centre with Urgent Care Centre and Local Planned Care Facility at Princess Royal. Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.

• Emergency centre and Urgent Care Centre with Diagnosis and Treatment Centre on new site. Urgent Care Centre and Local Planned Care Facility at Royal Shrewsbury and Princess Royal. Two to five further Urgent Care Centres, ideally co-located with Local Planned Care Facilities and Community Units.