Future Fit: All you need to know about changes to services at Shropshire's hospitals
Are you confused about the future of what is happening to Shropshire's health services under Future Fit?
This week the recommendation has been made that an emergency centre should be based at Royal Shrewsbury Hospital, while the majority of day case surgery should be carried out at Telford’s Princess Royal Hospital under the health shake-up in the county.
The recommended plans will go to public consultation once Future Fit is given the go-ahead from NHS England.
We take a look at what exactly this will mean for health services in Shropshire if approved.
The Royal Shrewsbury Hospital, Shrewsbury
Royal Shrewsbury Hospital should house the county’s sole emergency centre, the Future Fit Programme Board agreed ahead of an independent review that finished this week.
The hospital is already home to the county’s trauma centre and as such sees most blue light cases being transported there.
As a date is to be set for consultation, the services that would be provided at the hospital – should it be passed – have been outlined.
Emergency department – the new 24-hour single emergency centre would be provided to treat the most serious emergencies. The department would be 50 per cent larger than the current smaller A&Es, helping to attract more consultants to the hospital and ensure a sustainable workforce for the future.
Critical care unit – a state-of-the-art 30-bedded intensive therapy unit and high dependency unit would be provided alongside the emergency centre.
24-hour accident and urgent care centres – six out of 10 people, including children, who arrive at the current A&E departments would continue to be seen at an A&U.
Specialist wards – these would cover cardiology, including a coronary care unit, endoscopy, gastroenterology, nephrology, neurology, stroke, respiratory and acute medicine for patients needing acute inpatient care.
Trauma – trauma, including orthopaedics and unplanned and complex surgery.
Acute maternity services – inpatient facilities for women, including obstetrics, neonatal services, early pregnancy assessment services, antenatal care, outpatient and scanning, as well as a consultant-led maternity service.
Children’s services – inpatient and outpatient facilities for children, including a children’s assessment unit oncology and haematology.
Outpatients – outpatients appointments, including a fracture clinic, would still take place meaning patients would have their appointments at their local hospital.
Diagnostics – facilities, such as X-ray, ultrasound, CT and MRI scanning would still take place.
Inpatients – the hospital would have approximately 510 inpatient beds and a dedicated ambulatory care unit to accommodate 49 patients.
Day Case Renal Unit – kidney dialysis available for patients at their local hospital.
Cancer centre – patients needing day case treatment such as chemotherapy would get this from their local hospital as a service would be provided at both the RSH and the PRH in Telford.
The Princess Royal, Telford
Under the preferred option proposed by Future Fit, Princess Royal Hospital would become the home of planned care.
It has now spelled out the services that would be provided at the Telford hospital should the proposals be given final approval after the consultation.
24-hour Accident and Urgent Care Centre (A&U) – six out of 10 people, including children, who arrive at the current A&E department would still be seen at the new A&U.
A number of mothers and children would still access Women and Children’s Services at the planned care site – it would also continue to provide the majority of local services like maternity services at a midwife led delivery unit, early pregnancy assessment services, antenatal care and outpatients and scanning; children’s outpatients services and women’s services like gynaecology outpatients appointments. More than 500 women a year would still be able to have a baby at the planned care site.
Elective and day case surgery – the majority of adult planned inpatient surgery would take place at the site as well as most adult day surgery.
Orthopaedics – the vast majority of planned orthopaedic appointments.
Endoscopy – a purpose-built endoscopy facility for day case patients.
Centres of Excellence – the trust aspires to create centres of excellence in bariatric services and breast services, which would be housed at PRH. The number of weight loss surgeries performed in Shropshire could double, with 300 patients seen per year if the move goes ahead.
Medical beds – they would be available for ongoing acute care and rehabilitation.
Outpatients – appointments, including a fracture clinic, would still take place at PRH.
Diagnostics – facilities, such as X-Ray, ultrasound, CT and MRI scanning would still take place.
Inpatients – approximately 350 inpatient and day case beds would be at the hospital, including beds for elective orthopaedics, breast service, frailty, and elderly care, rehabilitation and ongoing medical care.
Day case renal unit – kidney dialysis treatment would be available for patients at their local hospital.
Cancer centre – Patients needing day case treatment such as chemotherapy would get this from their local hospital as a service would be provided at both the Royal Shrewsbury Hospital and the PRH in Telford. PRH will also benefit from a new cancer unit for patients needing day case treatment such as chemotherapy. The new cancer unit, which will save patients in Telford having to travel to Shrewsbury, will be delivered whatever the outcome of the Future Fit process.
MPs in favour of preferred A&E choice
MPs representing both Shrewsbury and Mid Wales have supported the preferred option for the county’s hospitals.
They have said that action needs to be taken quickly, and delays to the Future Fit process need to stop.
Shrewsbury and Atcham MP Daniel Kawczynski spoke in Parliament to ask whether more could be done to remove the stumbling blocks that have caused the decision to be pushed back.
The Conservative MP has always maintained that Royal Shrewsbury Hospital must retain its A&E, and since the announcement of the Future Fit board’s preferred option he has called on officials to follow the advice of experts.
He has now called for “mature decisions” over the proposal.
Mr Kawczynski said: “We have to start recognising these changes for what they are, the opportunity for a £300 million investment into our region’s health services. Failure to put our house in order would put that at risk. Therefore, mature decisions are needed so that we can find the best route to better health provision for all.”
Mr Kawczynski has also called for clinicians working in the hospitals to be given the final say over what happens to hospital services.
He said: “These professionals have come up with very bold innovative and medically-driven proposals designed to safeguard and protect patient safety and to improve the care of patients not just today but for future generations.”
He has called for public consultation to begin as soon as possible, to allow the project to move forward as soon as possible.
And his sentiments have been echoed by the leader of Shropshire Council Peter Nutting, who said he didn’t believe many people have altered their thinking over the months of the independent review.
Glyn Davies, MP for Montgomeryshire, whose constituents rely on Shropshire for hospital treatment, said he had hoped health chiefs would take a decision to go out to public consultation over future hospital care when they met on Monday.
But that will only happen, potentially between the end of September and middle of October, once the move has been given the go ahead by NHS England.
Mr Davies said the position was becoming desperate because local politics had taken precedence over providing care.
Outcry over threat to PRH services
People in Telford have been vocal against what they see as possible “cuts” to hospital services in their borough.
Telford & Wrekin Council has also threatened a judicial review against the Future Fit proposals.
Future Fit, run by its own board under the county’s two clinical commissioning groups, is looking at the reorganisation of hospital services in Shropshire.
It has previously recommended one A&E unit set up at Royal Shrewsbury Hospital and that Princess Royal Hospital Telford’s department be downgraded.
After the recommendation was made, Telford & Wrekin Council threatened to lodge a legal challenge to halt the proceedings.
Following an independent review of the decision, pushed for by the council, which claimed there were issues with the way the preferred option was decided, the Future Fit board has decided that it is still the best way forward.
Since the release of the independent review Councillor Shaun Davies, the leader of Telford & Wrekin Council, has said that he believes the outcome is a foregone conclusion and said the planned consultation is nothing more than paying “lip service” to the process of talking to the public.
He said that issues raised in the review have not properly been looked at ahead of the consultation.
But Telford’s MP, Lucy Allan, has said the delays mean that hospitals risk losing funding for the changes.
Health bosses agree that the situation is not sustainable in its current form.
And if funding is lost, the transformation of hospital services will not go ahead, leaving the matter in a perilous position.
Ms Allan said delays in the Future Fit process mean the county is losing out on “significant funding” for its health services.
In an email to members of the Shrewsbury and Telford Hospital’s NHS Trust Board, she said that residents should have been given more certainty over the ongoing progress.
She, along with Wrekin MP Mark Pritchard, has accused people of using the hospitals debate as a “political football” and said that residents need clear guidance as to what changes will mean for them.
