Telford hospital's urgent care services after shake-up yet to be finalised

The draft strategic outline business case for Shropshire’s hospitals shake-up scheme was submitted to the NHS for formal approval at the end of October. The plans for Future Fit, now known as the ‘hospitals transformation programme’, will need to be approved by NHS bosses before details are made public.

Under the scheme, Royal Shrewsbury Hospital will house the county’s main A&E with PRH losing its consultant-led women and children’s services and becoming the site for planned care.

Both hospitals were also originally due to get urgent care centres, but after the plans were reviewed in 2019 former Health Secretary Matt Hancock asked NHS England to provide advice on how the ‘urgent care model’ at PRH could be delivered through an ‘A&E Local’.

The Shrewsbury & Telford Hospital NHS Trust, which runs the hospitals, says the enhanced urgent care model at PRH will be staffed by ‘highly skilled senior health professionals’.

Hospital chiefs say the majority of people who currently attend the county’s A&E departments require ‘urgent’ and not emergency care, and about two thirds of those who currently access A&E services at PRH would still get the care they needed at that site.

A spokesman for the Shrewsbury & Telford Hospital NHS Trust said: “As set out in the public consultation, we are proposing that A&E services will be consolidated at RSH, with a 24/7 urgent care model at PRH that will offer an extensive range of services and care staffed by highly skilled senior health professionals.

“The creation of a new dedicated emergency care centre, where specialist doctors treat the most serious cases, will deliver benefits for the entire population and help us to address the issues we currently face in this area. The precise range of urgent care services to be offered at PRH will be determined as we develop our more detailed plans, but based on initial analysis, we would expect that around two thirds of patients who currently access A&E services at this hospital would continue to receive the urgent care they require at PRH under the proposed plans.”

Hospital bosses say that creating a new dedicated emergency care centre, where specialist doctors treat the most serious cases, means emergency patients will benefit from timely access to specialist consultants and there will also be fewer delays and cancellations to planned care.

Towards the end of 2019, NHS England wrote to Mr Hancock confirming what services would be provided in an ‘A&E Local’.

In their letter Professor Stephen Powis, national medical director for NHS England and NHS Improvement, and Pauline Philip, the organisation’s national director of emergency and elective care, said: “SaTH have put forward a model that would increase the volume of activity that would safely be delivered through the proposed urgent treatment centre on the planned care site at PRH.

“They propose an emergency medicine consultant presence during core hours, a consultant-led ambulatory emergency care service for specific pathways and additional diagnostic presence. This model means PRH will continue to provide A&E services.

“We are satisfied that this meets the proposed A&E Local model outlined above and will work with SaTH and their partners in the development of the model and a timeline for implementation.”

Under the definition offered by them, the trust’s A&E Local would be open for ‘core hours’ and would have an emergency medical consultant for ‘defined hours’.

Ambulances would take seriously ill patients elsewhere for treatment, and seriously ill ‘walk in’ patients would be stabilised before being transferred to ‘an appropriate facility’.

Urgent treatment services will be available at all times throughout the day. Any further details are yet to be revealed.