Health chiefs in Shropshire have set out their position regarding the county’s hospitals.

This briefing is published on behalf of NHS Telford and Wrekin, Shropshire County PCT and the Shrewsbury and Telford Hospital NHS Trust

A new report sets out the findings of a study of options to ensure clinically safe and high quality NHS hospital services across the county over the next five years. The report also outlines the feasibility of options for a single site hospital in the longer term, to 2020 and beyond.

The report is based on work led by senior local doctors, nurses and healthcare professionals to improve clinical care.

No decisions have yet been made on any of the options, and they would only be made after public consultation has taken place to help inform those decisions.

THE NEXT FIVE YEARS – THE NEED FOR CHANGE

Last November, senior local doctors, and nurses, working with local authorities, community organisations and patient and public representatives, set out the reasons why change is needed in the next five years in certain hospital services.

They recommended that while the majority of services at PRH & RSH could and should remain there in the medium term, including an accident and emergency service at both hospitals, a small number of services – especially for the seriously ill and injured – should be concentrated at one hospital or the other.

This was in order to improve the quality of patient care by having specialist care concentrated on one site where it can be readily available round the clock, and help develop more specialist services in the local area rather than patients needing to travel to regional centres elsewhere.

This means consolidating some services (emergency surgery, accident and emergency care for the most seriously ill and injured, inpatient children’s services, obstetrics and urology) at either PRH or RSH in the next five years, and developing a single acute hospital for Shropshire, Telford and Wrekin in the longer term.

In all the options there would continue to be a range of community health services, including community hospitals and clinics, providing care closer to home for patients right across Shropshire, Telford and Wrekin.

SAFE AND SUSTAINABLE: ACCIDENT & EMERGENCY AND EMERGENCY SURGERY

Patients across the country are benefiting through increasing medical specialisation – for example senior doctors and surgeons’ skills are increasingly focussed on specialist branches of surgery.

This leads to very high standards of care, but makes it difficult to provide all types of expertise at both RSH and PRH round the clock, especially for seriously ill patients needing urgent care, and ensuring that those specialist clinical staff will continue to treat a wide enough range of patients to maintain the highest level of skill.

Emergency surgery and A&E care for the most seriously injured would therefore be provided at either RSH or PRH under these proposals.

The other hospital would offer A&E dealing with most medical emergencies and trauma, but not multiple trauma.

For the most complex A&E, patients would continue to go to specialist centres like Birmingham, and Stoke, as now.

SAFE AND SUSTAINABLE: CHILDRENS’ SERVICES

Senior doctors and nurses who led the work on childrens services recognised the need for changes there also, to maintain the quality of care for children.

A spokesman said: “Very few children need to stay in hospital locally overnight and children with serious illnesses already need to be treated in regional childrens’ hospitals, so we can best improve care for children in the county by developing childrens’ assessment units at both hospitals to be the ‘front door’ where parents bring their ill children for tests and treatment.

“We would also develop a ‘hospital at home’ service caring for sick children throughout Shropshire, Telford and Wrekin. Once those are in place, we can develop a better quality service for children who need to stay overnight by concentrating specialist staff, skills and equipment at one hospital.”

ASSESSMENT OF OPTIONS

The new report sets out the findings of technical, social and financial assessments carried out over recent months of the options for where these hospital services should be located over the next five years.

Each option has been considered against a range of factors, especially the quality of care and ease of access for patients, and potential to support good staff training that in turn provides the best quality patient care.

Options were scored by a combination of local senior clinical staff, patient and public representative and health managers. A social impact assessment of the options, and an evaluation of the cost of implementing each one, were also taken into account.

NEXT STEPS

• The report will be considered initially by the Boards of both PCTs and the Shrewsbury and Telford Hospital Trust. No decisions will be made without prior public consultation. The next step will be for the PCT Boards to meet again shortly to consider the report’s findings alongside proposals for the immediate term from the Shrewsbury and Telford Hospital Trust, with a view to making proposals for public consultation.