Health leaders to meet on next step to delivering safe and sustainable hospital services

Health leaders will meet next week to discuss the next steps towards providing safe and sustainable hospital services for patients from Telford & Wrekin, Shropshire and Powys.

On Monday the Future Fit Programme Board agreed that there has been no material evidence presented in the Independent review of the Option Appraisal or in the Women &Children’s IIA Reports that should change the original four recommendations to the Joint Committee as set out in December 2016 and therefore they should be reaffirmed.

This included a recommendation with regard to a preferred option to go to public consultation on the proposed changes to hospital services.

The recommendation will be considered on Thursday August 10 by the Joint Committee, at 6pm at Clayton Hall, Shrewsbury College, London Road, SY2 6PR.

The Joint Committee is formed of board members from the two CCGs, two independent clinical panel members who are senior hospital consultants, and an independent chair (see below for more details on the independent chair and panel members). All with be voting members of the Joint Committee.

Following the Joint Committee, and in line with best practice, assurance will be sought from local scrutiny boards and the NHS England assurance processes prior to going to public consultation. .

The Future Fit proposal is to change the services provided at the Royal Shrewsbury Hospital and the Princess Royal Hospital, Telford. This will mean:

  • One of our hospitals becomes a specialist site for planned care. Adults requiring routine surgery including day case and short stay (excluding complex surgery) or procedure (eg routine endoscopies) will go to the planned care site
  • The other hospital becomes a specialist site for emergency care. Patients with potential life or limb-threatening injuries or illnesses, such as a stroke, heart attack or severe blood loss, would be treated at the Emergency Care site. They would be taken there directly by paramedics in an ambulance or transferred immediately from one of our two new urgent care centres
  • Both of our hospitals will have a new urgent care centre providing care 24 hours a day, every day of the year for illnesses and injuries that are not life or limb-threatening but require urgent attention.
  • Women and children’s services would also be available at both sites:

Midwife-led unit, including low-risk births and postnatal care

Maternity outpatients including antenatal appointments and scanning

Gynaecology outpatient appointments

Early Pregnancy Assessment Service (EPAS)

Antenatal Day Assessment

Children’s outpatient appointments

Neonatal outpatient appointments.

When a formal public consultation is launched, the CCGs will ask local people their views on which hospital would become the Emergency Care site and which hospital would become the Planned Care site.

David Evans, Chief Officer for Telford and Wrekin CCG and Simon Freeman Accountable Officer for Shropshire CCG, said: “With any transformation of this scale we recognise that there will be different opinions across stakeholders.

“As local health leaders we are committed to ensuring our decisions are clinically led and that any public consultation will be open and fair.

“It is disappointing to hear speculation that the CCGs’ decisions are predetermined, as this is wholly unfounded. The public is aware of the open challenge and scrutiny our decisions have gone through over the last four years.

“The Programme Board reviewed an independent report on the process undertaken so far and an impact assessment on the women and children’s services, before reviewing their recommendation made in November 2016.

“The Programme Board determined that there was nothing in the reports that materially changed their decision and therefore is making a recommendation to the Joint Committee to progress to public consultation on all clinically and financially viable options. This includes a preferred option of the Emergency Care site at the Royal Shrewsbury Hospital and Planned Care site at the Princess Royal Hospital.”

Health leaders are also offering reassurance that under the proposals women and children would still receive the majority of care and treatment in the same place as they do now.

It is vital that women and children’s high risk services (when women and children need to stay in hospital overnight or need specialist care) are based alongside the Emergency Care site.

David Evans and Simon Freeman added: “We recognise the proposed changes will mean that some people may have to travel further for their treatment. However, most people attend our hospitals for outpatient appointments. Under our proposal, the majority of these appointments will continue to take place where they do now.

“Any final decision on the future of hospital services will not be made by the CCGs until after the views from the public consultation are reviewed. We recognise it will be a difficult decision for all involved, however our priority is to do what is best for people across the whole of Shropshire, Telford and Wrekin and mid Wales.”

The meeting on the 10 August will be held in public. Further details and the independent assurance reports will be published as part of the papers for the Joint Committee. Notes to Editors:

Emergency Care site: What services would be based there?

Patients with potential life or limb-threatening injuries or illnesses, such as a stroke, heart attack or severe blood loss, would be treated at the Emergency Care site. They would be taken there directly by paramedics in an ambulance or transferred immediately from one of our two new Urgent Care Centres.

Emergency Department (ED): A new purpose-built 24-hour single Emergency Department would deliver high quality emergency care to adults and children

Critical Care Unit: A state-of-the-art unit for patients would be provided for patients who are critically unwell and need the highest level of care

Ambulatory Emergency Care Unit: A large unit for patients that need same-day emergency care would be created where patients can be assessed, diagnosed, treated and go home the same day

Emergency surgery: All patients that need an operation in an emergency would be treated on the Emergency Care site

Complex Planned Surgery: Some patients are classed as higher risk and so need their planned care at the Emergency Care site with easy access to critical care services

Emergency medicine: Inpatient beds would be available for patients with specialist health needs and need to stay in hospital overnight. This includes cardiology, stroke, respiratory and acute medicine, amongst others

24-hour Urgent Care Centre: A new centre would be provided at both hospital sites for patients that have an injury or illness that is urgent and cannot be treated by their GP practice

Outpatients: Outpatients appointments, including a Fracture Clinic, would take place at both hospital sites

Diagnostics: Facilities such as x-ray, ultrasound, CT and MRI scanning would take place at both hospital sites

Day Case Renal Unit: Kidney dialysis treatment would be available for patients at both sites

Cancer services: Patients would be able to access cancer services, including day case treatment such as chemotherapy

Women and Children’s Services:

Consultant-led Maternity Services: Inpatient facilities would be provided for pregnant women who need specialist care. This includes antenatal and postnatal wards, delivery suites and a neonatal intensive care unit

Midwife-Led Unit: Midwife-led services for pregnant women and their babies would be provided at both sites. This includes, low-risk births and postnatal care

Maternity outpatients: Pregnant women would be able to access outpatient appointments and scanning at both sites

Early Pregnancy Assessment Services (EPAS): Care for women with complications in early pregnancy up to 16 weeks will be provided at both sites

Children’s services: All Children’s inpatient services (if your child has to stay in hospital overnight) would take place here. This includes a Children’s Assessment Unit and children’s cancer and haematology services. Children’s outpatient appointments would take place at both hospital sites