Bid to block Future Fit hospital plan fails - but 'A&E Local' name 'should be dropped'

Telford & Wrekin Council had asked the government to reconsider plans for the much-delayed 'Future Fit' hospitals transformation process planned for Royal Shrewsbury Hospital (RSH) and Princess Royal Hospital Telford (PRH), both of which are managed by Shrewsbury & Telford Hospital NHS Trust (SaTH).

The proposals represent major changes to the operation of the county's hospitals and will see RSH become the base for the county's only 24-hour A&E unit, alongside consultant-led women and children's services, which will move to Shrewsbury from their current base in Telford.

PRH will then become the centre for the county's planned care, while both hospitals will also have 'urgent care centres'.

In response to considerable opposition to the loss of A&E at Telford the government announced in 2019 that PRH would have an 'A&E Local'.

But, now independent experts asked to review the plans say the term 'A&E' should not be used for the service because it will not meet the level set for A&E by the NHS across the country.

They say confusion caused by the issue could lead to a "risk to patient understanding and safety".

The comments come in a letter from the Independent Reconfiguration Panel (IRP), which had been asked by the government to look at Telford & Wrekin Council's concerns over the plans.

Writing to the government Professor Sir Norman Williams, Chair of the Independent Reconfiguration Panel said: "It is the panel’s view that the A&E Local concept has been the source of some confusion and debate."

He added: "In the IRP’s view, the service proposed for Telford is a 24/7 urgent treatment centre enhanced by wraparound services on the Princess Royal Hospital site.

"The panel is reassured by the level of care contained in the proposal for paediatrics, frailty, same day emergency care and diagnostics.

"It is anticipated that this will support primary and community care services in the locality and contribute to better emergency and planned services for the whole population served.

"However, it is important that the public are aware of the limitations of the service and understand that it will not provide emergency care to the same level as a Type 1 consultant-led major emergency department."

In its response to Andrew Stephenson MP, Minister of State for Health, the IRP said that the Future Fit plans are the 'best way forward' for healthcare in the county – but it has issued a raft of recommendations.

They include consideration of whether PRH should have a permanent ambulance ready to take patients to Shrewsbury for treatment, and a full information campaign to ensure the public know which service its provided at which hospital.

Councillor Shaun Davies, leader of Telford & Wrekin Council, said the decision not to block the plans was a "bitter blow" for the borough's residents.

He also welcomed the call to end the use of 'A&E Local' for the service to be provided at PRH.

He said: "I would like to thank the panel for their work in re-looking at Future Fit plans and for the new recommendations they have made.

"Their advice recognises the need for further capital funding for our hospital buildings and to ensure residents are involved in the development of transport and travel plans to improve access to both sites.

"It also calls for the use of the term A&E Local to stop. The Princess Royal will be left with an enhanced urgent treatment centre. You can’t call something an A&E if it isn’t one. It’s confusing for people and potentially dangerous if they go to the wrong place expecting to receive the emergency care they need.”

Regarding the term 'A&E Local' Professor Sir Norman Williams, Chair of the Independent Reconfiguration Panel said: “The panel shares the view of the Royal College of Emergency Medicine that the use of the term A&E for anything other than a Type 1 emergency department presents a risk to patient understanding and safety."

Councillor Davies added: “Despite this, confirmation from the government that plans to downgrade emergency care at the Princess Royal will go ahead is a bitter blow for people in Telford and Wrekin. I am beyond disappointed that the minister has chosen not to halt the plans.

“If he came to Telford to speak with people in the borough, he’d hear first-hand the impact that Future Fit changes will have on them.

“When parents are making four hour bus journeys each day just to be with their sick children, when people lose loved ones because they can’t get to Shrewsbury in time, it will be too late. Our residents will have to live with the consequences of this decision for generations to come.”

Councillor Paul Watling, the council's Cabinet Member for Adult Social Care and Health Transformation, added: “When residents were consulted on Future Fit plans in 2018, two in three people disagreed with moving emergency care to Shrewsbury. They were ignored.

“We have done everything we can to get the government to sit up and listen to Telford and Wrekin’s residents on this issue, delivering over 20,000 signatures right to the door of No 10 Downing Street and challenging the outdated plans with the latest data.

“The government’s decision is bad news for people in our borough. We deserve better.”