NHS in Shropshire special report: How the changes will affect south Shropshire

This week the Shropshire Star is visiting all corners of Shropshire, as well as Mid Wales, to discover just how any change in emergency NHS care could impact their lives.

Today we visit south Shropshire, which already faces long journey times to existing A&E departments in Telford and Shrewsbury.

The likelihood is only one of the county's two main hospitals - Royal Shrewsbury or Telford's Princess Royal - will have an A&E department in the future.

That means at least some of south Shropshire will be facing even longer drives by ambulance than they do already.

But with A&E so far away, many of the county's more rural residents have slightly different view on the importance a delayed decision by health bosses on the fate of Shrewsbury and Telford's units - agreeing that better facilities locally are the more pressing issue.

There was much upset and disappointment when the NHS Future Fit review of health services in the county failed to decide where A&E would be this autumn.

However, Peter Corfield, chair of the League of Friends of Ludlow Hospital, has said all along that the focus should be on deciding where upgraded urgent health care should be first, to make it easier to decide where central A&E should be.

South Shropshire will almost certainly gain a new urgent care centre, or UCC, under plans for the future of healthcare in Shropshire. Possibly based at Ludlow Hospital, it would deal with non life-threatening illnesses and injuries. Those needing treatment for serious conditions will be taken to the county's single A&E department, at either the RSH or PRH.

Mr Corfield said: "The Future Fit board had a meeting on October 1 and said Ludlow met all the parameters for providing a UCC, to have additional clinics, diagnostic facilities and stuff like that on the site

"The Friends have just agreed to a £65,000 ultra sound scanning unit at Ludlow, so we're doing what we can to enhance facilities, but there has to be a decision on the UCC's soon. We want a clear commitment on rural care."

He said once established UCCs should ease the pressure on over-stretched A&E services in the central hospitals, so were vital.

"In my opinion the concentration on whether to have two A&E's or one, or whether it's going to be in Shrewsbury or Telford, is deflecting from the really important problem of people using A&E as an out-of-hours medical service, not specifically just for accidents and emergencies," he said.

Gren Jackson of the Bishop's Castle Patient's Group steering committee went further, saying A&E in the big hospitals was less important to people in deep rural areas as it was already so far away.

He said: "What is known is that people from this area do not use A&E to the same extent as people that live closer to Shrewsbury or Telford."

"We are a much deeper rural area - even Ludlow minor injuries unit is 20 minutes away, and A&E is 40 minutes.

"People's views on health services and how they use them are conditioned quite differently because of that."

He said the same was true of how health professionals worked.

"First responders bring a GP in, they don't wait for paramedics. There's almost an alternative A&E system operating behind the scenes, if you will."

For that reason, he said, he wanted to see local services, whether ambulance, hospital or GP, more integrated - as barriers often seemed to be created in the NHS with different trusts responsible for different things.

Still, the patient's group had been "disappointed" a firm decision on the future of A&E had been delayed.

"But the upside of it is that it allows for more detailed consideration of local provision," he said.

Given the choice, he said, south west Shropshire residents would obviously prefer to see A&E retained in Shrewsbury.

He said many towns, particularly those east of the A49 such as Bridgnorth or Cleobury Mortimer, had more than one hospital A&E department they could be taken to, and even Ludlow was as close to Hereford County Hospital as Shrewsbury.

"We don't have a choice - we only go to Shrewsbury," he said "and quarter of patients registered in Bishop's Castle live in Wales."

Retired vicar Canon John Holden, from Church Stretton, agreed with that sentiment.

"When it come to the NHS things are not regional - these decisions affect people across the border too," he said.

"The feeling is if Shrewsbury A&E went it would be a real loss for people here and anywhere west."

The 81-year-old was cut from the wreckage of his car after a horrific accident on the A49 this spring, though escaped without life-threatening injuries.

He said his concern was where ambulances would be based - and if increased lengths of time on the road might tie them up for longer.

"If they were all centred on Telford the time to get to an accident might be significantly prolonged," he said.

"Clearly the extra time could make a difference, not just to Church Stretton, but to places like Oswestry. Presumably there would be a percentage of people for whom it would be critical if it was to take longer."

But, he added, it was not always that simple. After his accident he was originally going to be taken to Shrewsbury, but in the end he was conveyed to Stoke, a decision he said he "couldn't fault" as there was a specialist unit there.

He said the decision over where A&E should be should not be based on fear and emotion, but statistics on what would make the most efficient service possible.

"Ultimately it has to be based on facts," he said.