Telford A&E Local will only open for 'core hours'

David Evans, the accountable officer for Shropshire and Telford & Wrekin clinical commissioning group, has also commented on details of what an A&E Local plan would mean for Telford’s Princess Royal Hospital (PRH) as NHS England gave its first indication of what the service would look like.

The question over what an A&E Local service would feature has become a focus of discussion since the Secretary of State for Health Matt Hancock’s decision to back the Future Fit plans for the reorganisation of the county’s major hospitals – Royal Shrewsbury Hospital (RSH) and PRH.

While approving the overall plan, which will see RSH become home to the county’s only full A&E – and its consultant-led women and children’s services – Mr Hancock did ask NHS England to investigate making PRH an A&E Local instead of an urgent care centre.

NHS England has now confirmed the model would look at delivering A&E services “during core hours”.

Reports have also indicated it would have to include a consultant – with the Royal College of Emergency Medicine stating services could only be classified as an A&E if they are led by an emergency care consultant.

A spokesman for NHS England said: “The A&E Local model is in development and will be part of the package of NHS emergency care services delivered through our long-term plan, set up to deliver A&E services during core hours in a small number of health systems.”

Clarity

Mr Evans, part of the Future Fit programme board which oversaw the creation of the plans, said the understanding of what it would involve is becoming clearer.

He said: “My reading of it is that it is an enhancement of what we were proposing and will include a consultant-led service for some period during the day.”

It is understood overnight arrangements for areas covered by A&E Local would be decided in the area it covers, and not by government.

He added: "There is quite a wide range between what a full-blown A&E offers and most people's idea of what an Urgent Care Centre offer. It is where it is pitched in the middle there.

"Clearly if you have a consultant working there is takes it to a different threshold in terms of what patients could be seen and treated.

"There's where you need to flesh out what would it look like if you had a consultant there but you still do not have a high dependency unit or an intensive care unit."

Mr Evans also said a model following those guidelines would not pose any problems for Future Fit.

He said: “I think if you look at what is in Stafford at the moment where there is an A&E open during the day, then I think that would be possible to implement without compromising the fundamentals of the Future Fit model.”

Asked if he expected the A&E Local to be a full A&E department Mr Evans said: "I do not think that is what the Secretary of State was envisaging."