Why do we need to change our hospital services? A surgeon explains...

NHS Future Fit is about improving the hospital services provided at the Royal Shrewsbury Hospital in Shrewsbury and the Princess Royal Hospital in Telford to meet the needs of our communities across Shropshire, Telford & Wrekin and mid Wales. To do this, we have developed a proposed new model of hospital care. But why can’t things just stay as they are? Below, Mr Mark Cheetham, Consultant Surgeon at The Shrewsbury and Telford Hospital NHS Trust (SaTH), explains why healthcare in the area needs to change…

Mark Cheetham for website 4Every patient has the right to expect high quality, safe NHS care, now and in the future – but to do this, we need to change the way we deliver our hospital services.

We want to make sure that patients are seen by the right person at the right time in the right place. As a surgeon working across both hospitals, I know first-hand that this isn’t always happening.

People in the UK are living longer than ever, which is good news. But they are living longer with ill health, which is creating increasing demands on the health system.

When I first qualified as a doctor, my typical patient would be someone in their 50s who has had a heart attack, but had nothing else wrong with them. Now, many people admitted to hospital are in their 80s with several long-term conditions, such as diabetes, heart disease or chronic kidney disease. This is particularly true in Shropshire, which has a higher proportion of older people than most counties in England.

Healthcare today is better than ever; improvements in medicine and technology mean that we can provide treatments that would not have been possible before. Of course, this means that people’s expectations of healthcare are higher – and rightly so.

They expect to have prompt healthcare, delivered by specialists. This is mirrored in national guidance and how hospitals are inspected. These higher standards can only be met by more care being delivered directly by fully trained consultants.

In the 1980s (when our current local hospital system was set up), doctors were much less specialised than now, which meant that a surgeon or a physician could deal with pretty much all emergencies.

Nowadays, diagnosis and treatment is more complicated – this means that more specialists are needed to deal with emergencies. For example, in the 1980s, a district general hospital, like the Royal Shrewsbury Hospital, would have about four general surgeons; we now have specialist teams in vascular, colorectal, upper gastrointestinal and breast surgery.

When someone comes into a hospital with an emergency, it may not be obvious what is wrong with them and which specialist doctors they need. Currently, we do not have all our speciality doctors in both of our hospitals. For example, we only have emergency surgeons in Shrewsbury and children’s doctors (paediatricians) in Telford. This means it’s really difficult to look after children who need emergency surgery.

It can also mean that patients are sometimes admitted to the wrong hospital, which creates a delay as they need to be moved to the right hospital to meet their needs. What we want to do is to create a specialist emergency site that contains all of our specialist doctors. This would mean patients are seen more quickly by the right person at the right time, resulting in better care and better outcomes for our patients.

At the moment, patients requiring planned surgery can get a raw deal. Operations are often cancelled at short notice due to beds being taken up by an emergency patient. Over the past year, around 500 people had their planned operations cancelled on the day. By splitting our services across two hospitals, it will not only mean that it is highly unlikely for an operation to be cancelled due to an emergency admission, but it will also reduce the risk of patients picking up infections after surgery.

The Future Fit model of care has clear advantages, it will provide better care and better results for our patients – and ensure that our two hospitals can continue to serve the people of Shropshire, Telford & Wrekin and mid Wales for a long time to come.

You can follow Mark Cheetham on Twitter at @MarkCheetham


We want your views

The Future Fit consultation is your opportunity to tell us how these proposals will affect you. We really want to hear from you, so please find out more by looking at an overview of our proposals, reading our consultation documents and completing our survey. You can also visit one of our public exhibition events to speak to doctors, nurses and other healthcare staff and ask any questions you have about the Future Fit proposals and how they may affect you and your family.