About NHS Future Fit

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.

After listening to the views of thousands of local people over the last four years, our doctors, nurses and other healthcare staff have developed a proposed new model of hospital care – for one hospital to become an Emergency Care site and the other hospital to become a Planned Care site, with a 24-hour Urgent Care Centre at both hospitals. There are two options on how we deliver this model of hospital care and we are asking for your views.

We Want Your Views

NEW interviews with Dr Edwin Borman and Graham Shepard

People Feature

edwin-bormanInterviews with:
Dr Edwin Borman, Medical Director, Shrewsbury and Telford Hospital Trust and NHS Future Fit Acute & Episodic Care Lead (left)
Graham Shepard, patient representative, NHS Future Fit Acute & Episodic Workstream (right)

graham-shepardOverview

This is an interview with Dr Edwin Borman Graham Shepherd about their hopes and aspirations for the Future Fit Programme. This interview gives a clinical and public perspective by asking the same five questions to both Dr Borman and Mr Shepherd.

Dr Borman:

What do you hope the Future Fit programme will do for local acute and community hospital services in Shropshire and Telford & Wrekin?

I hope that Future Fit will live up to its name and plan for the health and care needs of our population for the next quarter of a century. Rather than being stuck with the problems of the past, we need to look forward with open minds.

How radical do the clinicians and members of the public involved in the programme need to be when creating a vision for the future?

Radical to me means thinking differently about how medicine, nursing and care for patients will be provided in the future. The one thing we do know is that it won’t be the same as it has been in the past: patients will be living longer and quite reasonably will have higher expectations, there will be more sophisticated equipment, and there will also be better and safer treatments. So radical means planning as best we can for the future needs of our population.

People will always question whether there has been genuine engagement and consultation with staff and the public when services are reviewed like this with a view to changes being made. Do you feel this programme began with a plan already in place?

Having been involved in public consultation at my previous trust that led to the building of a magnificent new hospital I am very aware of the importance of encouraging everyone to be involved in this process. This is particularly important in Shropshire, Telford & Wrekin and mid Wales because we have such a large geographical area to cover. I can honestly say that none of the people that I have spoken to about Future Fit have preconceived plans. I encourage the involvement of anyone who constructively wants to contribute to this process.

For you, what is the most important part of this review?

For me, this review is about our commitment to the next generation. It is about us providing for those who will follow us. It is about our children and perhaps our children’s children being able to access the best possible care in our county. Yes, we also will face the challenge of caring for our parents and ourselves needing care during this period, but most important of all it is about handing over from one generation to the next the best that we can achieve.

What, if any, do you think are the key risks to this review of services being successful?

As with any process of change it is absolutely essential to bring along as many people, ideally everyone, feeling that this is change that they are a part of and can support. So the involvement of the population we serve and of all members of staff is crucial. In addition, we should recognise that this is a once in a generation opportunity so we should not be afraid to ask for the appropriate funding if we can show that radical change is required.

Mr Graham Shepherd

What do you hope the Future Fit Programme will do for local acute and community hospital services in Shropshire and Telford & Wrekin?

Provide a fully integrated health care system across both urban and rural areas, which provides an unprecedented level of care with dignity. The aim should be to achieve a 24-hour, 7-day, 52-week service in all disciplines at all points of entry.

How radical do the clinicians and members of the public involved in the programme need to be when creating a vision for the future?

This is an unprecedented opportunity to structure our local health care services such that they provide the level of care which our patients need and deserve. It is therefore essential that all options should be investigated without having any preconceived solutions, while also ignoring the past and present situations.

It must be radical and financial constraints should not limit any views being included at this early stage of the process. My thoughts in this area are that the provision of a new purpose built hospital equipped to treat recognised “acute” patient needs specifically, is and should be seen as a radical opportunity.

This would then necessitate that additional clinical support facilities would be needed to provide the care for those patients who currently occupy acute beds which fall outside of recognised remit of requiring acute treatment.

People will always question whether there has been genuine engagement and consultation with staff and the public when services are reviewed like this with a view to changes being made. Do you feel this programme began with a plan already in place?

This is always an issue with different interpretations on what is meant by engagement and consultation. With Future Fit it is felt that there was no meaningful involvement in the preparation to the Programme Execution Plan which is the document driving this programme forward. This plan is headed, Future Fit – Shaping healthcare “together!!” so I feel that this could be interpreted as “this programme began with a plan already in place”.

Having determined the plan, patients are now being introduced into the various workstreams, but there is still concern that the number and make up is not truly representative, and this view has been brought to the attention of the CCG.

From my point of view having sat on the Clinical Design Group, debating Acute and Episodic Care, I was fully involved in the debate which was very open and fully engaged all the different disciplines present. There was definitely no “hidden agenda” with very wide ranging options being considered. Having been engaged with the Urgent Care Strategy for over three years the majority of options raised had been debated previously, but unfortunately were never implemented. The reasons for this should not apply to the Future Fit project.

For you, what is the most important part of the review?

This is an excellent opportunity to introduce a viable health care strategy tailored to meet the current and predicted level of care needed over the next decade. In order to ensure that we achieve this, it is vital that as wide a consensus of input is acquired from all interested parties including providers, staff at all levels, voluntary organisations, patient organisations and the general public.

This involvement should continue throughout the process right up to the final solution.

What if any, do you think are the key risks to this review of services being successful?

I think that there are definitely a number of areas which could have a significant bearing on our aspirations.

The inability to recruit the number of quality staff required across all disciplines, either due to their unavailability or lack of money to recruit them. If we are going to go down the radical change route, then finance for capital spending will be essential and this could also prove to be a major challenge. By integrating services which should remove duplication, which is still currently significant, then savings will be made, but not sufficient to meet the major re-configuration of services required.

During my time of involvement with urgent care, my views on available financial resources has changed from believing that major inefficiencies within the system were a significant cause of this, but although there is still significant scope in this area, I feel that more funding is essential and should be made available to our CCGs in order to meet our current demands, let alone the increase level of care which will be needed year on year, due to our ageing population and the rural community. The present method of arriving at the annual increase awarded does not account for these major issues.

If we cannot get existing and future recruits to accept that a significant change in culture is essential and not an option then any hope of arriving at a fully integrated service is doomed to failure.

Our patients, particularly in the urban areas have been used to having access to a hospital within easy reach, and as we have seen recently any relocation of services is resisted, therefore if the final proposal results in major relocation changes, then there will be a patients revolt, unless you engage with the public/patients properly over the next six months or so prior to the official consultation process. This will enable people to have time to think about what the population can realistically expect for the money available. I recognise that reaching the majority of the public is very difficult.

Last but not least, is the possibility of a change of government at the next election. This could result in major changes yet again into how the NHS is operated.

Future Fit - have your say

Listen to our CCG leads talking about the consultation and urging you to have your say

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An overview of NHS Future Fit

For a brief overview of NHS Future Fit is and how we're aiming to meet the health needs of the population please watch this short video.

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