Future Fit: No guarantee money is there for Shropshire hospital changes, says report

A report by KPMG, which has now been made public, was ordered after concerns were raised the Future Fit process hadn't been done fairly.

It raises three areas of concern, which as well as funding, include the need for a proper plan for the future of community care, and the disagreements between groups in Telford and those in Shrewsbury about where services should be based.

The review has taken eight months and cost £50,000.

The report states: "It is currently not clear whether the health economy is in a position to source the required capital funding for any of the shortlisted options.

"We recommend the programme seeks the rapid provision of assurances around the proposed funding solution for the programme, including the mix of sources if public dividend capital is considered unlikely to be sufficient.

"Since inception Future Fit has been described as an acute and specialist services reconfiguration programme, reflecting the fact that the stated primary driver for change was recruitment of acute staff, particularly in emergency care, and the impact that was having on maintaining safety. However, early in the programme significant consideration was also given to models of community care that would complement the services being reconfigured in acute settings.

"It is currently not yet clear how the local health economy will execute its community reconfiguration, nor how this will be funded, particularly in the context of uncertain funding for Future Fit itself and an overall substantial deficit for the health economy.

"It is clear that a barrier to further progress is a fundamental disagreement between stakeholders within the two main localities, and an inability for the local governance mechanisms to deliver a shared preferred option.

"It is essential that progress is made against each of these issues before the programme moves forward to public consultation and a decision-making business case."

Health leaders say they will meet next week to discuss the next steps towards providing "safe and sustainable" hospital services for patients in the region.

On Monday the Future Fit programme board agreed that there has been no material evidence presented in the independent review, or in the women and children’s reports, that should change the original recommendations to the joint committee as set out in December 2016 and therefore they should be reaffirmed.

This included a recommendation with regard to a preferred option to go to public consultation on the proposed changes to hospital services.

The recommendation will be considered on Thursday by the joint committee, at 6pm at Clayton Hall, Shrewsbury College.

When a formal public consultation is launched, the CCGs will ask local people their views on which hospital would become an emergency care site and which hospital would become the planned care site.

David Evans, chief officer for Telford and Wrekin CCG and Simon Freeman, accountable officer for Shropshire CCG, said: “The programme board reviewed an independent report on the process undertaken so far and an impact assessment on the women and children’s services, before reviewing their recommendation made in November 2016.

“The programme board determined that there was nothing in the reports that materially changed their decision and therefore is making a recommendation to the joint committee to progress to public consultation on all clinically and financially viable options. This includes a preferred option of the emergency care site at the Royal Shrewsbury Hospital and planned care site at the Princess Royal Hospital.”

Telford & Wrekin Council leader Shaun Davies said he was disappointed next week's meeting was not being held in Telford.

"We asked that this meeting be held in Telford given that the communities that will be most affected by this decision are in Telford and Wrekin and eastern Shropshire," he said.