Future Fit: As public consultation ends it’s decision time over Shropshire A&E
More than 16,000 people have had their say in the Future Fit consultation – and now the talking has finally drawn to a close.
During the past 15 weeks, clinicians have spoken to hundreds of people at public exhibition events across the county.
More people have been reached through pop-up displays, medics have hosted question and answer sessions on Twitter and thousands of surveys have been filled in to leave feedback.
It is now time for an independent company to look at the views which have been expressed, that will ultimately shape the difficult decisions health commissioners will have to make.
The Future Fit programme launched more than four years ago in response to the Government’s ‘Call to Action’, which asked NHS staff, patients, the public and politicians to come together and agree what changes were needed to make local NHS services fit for the future.
It has since been the topic of much controversy – with many having different ideas on what should be done, with some campaigners making repeated calls that it should be scrapped altogether.
Shropshire Star comment:
Dozens of options where whittled down to just two, with Shropshire & Telford & Wrekin Clinical Commissioning Groups signing them off for public consultation.
They both involve creating an emergency care site for the county at either Royal Shrewsbury Hospital or Princess Royal Hospital in Telford, which would deal with the most serious cases.
The alternative site would take on responsibility for planned care and urgent care centres would be set up at both RSH and PRH.
The plans will also affect where consultant-led women and children’s services are based.
It could cost as much as £312 million to deliver, however health bosses argue the changes are necessary and doing nothing is not an option.
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They say it has become difficult to make sure that there are enough doctors, nurses and other healthcare staff to provide services 24-hours a day, seven days a week at both hospitals.
A local and national shortage of healthcare professionals is also said to have led to difficulties in recruiting.
But since the Government announced Future Fit would get the funding it needed, health chiefs say it has already led to a boost in the recruitment of consultants at Shropshire’s hospitals.
It has come at a time when a shortage of staff has now led to serious discussions around whether it will be safe for Shrewsbury and Telford Hospital NHS Trust (SaTH) to keep both of its A&E departments open 24-hours-a-day.
The trust says it has only been down to the considerable efforts of A&E staff that both units at RSH and PRH have been able to remain fully open.
Dr Edwin Borman, medical director at SaTH, told the last trust board meeting that three options are now being considered about how to manage the situation. If a way cannot be found to maintain both A&E departments, it would mean having to close either A&E in Shrewsbury or Telford overnight between the hours of 8pm and 8am.
Patients would be forced outside of the county, with uncertainty surrounding how neighbouring trusts could cope with the change.
Although health bosses say no decisions have yet been taken, chairman of the trust board, Ben Reid, admitted that difficult decisions may have to be taken at the end of the month. As analysis of the public feedback to the Future Fit plans gets under way, it also comes at a time when the health watchdog, the Care Quality Commission (CQC), has taken ‘urgent enforcement action’ against SaTH.
The regulator has put conditions on the trust in how it handles patients with sepsis and other deteriorating conditions, and environmental safety in Telford’s A&E.
It followed an inspection at SaTH, but its chief executive Simon Wright says the concerns raised by the regulator have been highlighted by the trust itself.
He said repeated requests have been made for additional staff, with little result.
Concerns
He believes the Future Fit programme will lead to better conditions, top facilities and will make it easier to recruit the staff needed, reducing the need for agency workers.
Clinicians have also commented that separating emergency and planned care will bring other benefits, such as fewer planned operations having to be cancelled.
But throughout the Future Fit consultation there have been recurring concerns which also must be addressed. One of the main concerns has been around travel and transport, with people saying public transport links to the hospitals need to be improved, especially in the more rural areas of the county.
It is being looked at by a Future Fit travel and transport group, which is also considering the impact the proposals will have on ambulance services. Bosses at West Midlands Ambulance Service say the trust already expects it will need additional resources to cope with any changes.
Shropshire and Telford & Wrekin CCGs have said they will take the group’s feedback into consideration before making a final decision. The plans have also faced a backlash from campaigners who say there are unanswered questions over subjects such as who will run the urgent care centres and how exactly the scheme will be financed.
Claims have been made that the CCGs should go back to the drawing board.
No final decision will be made until all feedback from the public consultation is collated and analysed by an independent company.
This will be done in the upcoming weeks and it will then be down to a joint committee to have the final say.
Future Fit facts
Future Fit was the name given to the project to review the future of health services in the county and the hospital services provided at Royal Shrewsbury Hospital and Telford’s Princess Royal Hospital.
The project, which launched more than four years ago, has been led by Shropshire and Telford & Wrekin Clinical Commissioning Groups – the organisations that commission health services.
Initially, health bosses say they considered dozens of options on how to transform services for the future.
Doctors, nurses and other healthcare staff developed a proposed new model of care – for one hospital to become an emergency care site and the other hospital to be responsible for planned care.
Under these proposals, 24-hour urgent care centres would be set up at both RSH and PRH.
Consultant-led women and children’s services would be on the same site as the emergency department, but there would be a range of women and children’s services available on the other site.
Commissioners are required by law to involve the public when considering making significant changes to NHS healthcare.
For more than three months people have been giving their feedback on the plans during a public consultation.
The project is expected to cost up to £312 million to deliver.
What now?
All feedback will be collated and analysed by an independent company.
They will then produce a report which will be considered by Shropshire and Telford & Wrekin CCGs.
The CCGs will also look at how travel and transport will affect the options, including ambulance travel times.
The boards of the two CCGs will consider all of the evidence and a joint committee of Shropshire and Telford & Wrekin CCGs will be convened to make the final decision.
It will take about five years before any changes are fully implemented.
