Shropshire A&E closure 'tipping points' are discussed
Health leaders have met with patient representatives to discuss the "tipping points" that could lead to the temporary closure of one of Shropshire's two A&E departments overnight.
The Shrewsbury and Telford Hospital NHS Trust (SaTH)– which runs Princess Royal Hospital in Telford and the Royal Shrewsbury Hospital – says it wants to ensure it can keep services running safely ahead of a decision by NHS Future Fit, a shake-up on the county's health services for the long term.
A staff crisis affecting care: The trust talks of irretrievable gaps in staffing that would lead the service to become unsafe. It talks of sustained non-availability of medical staffing.
Issues involving problems experienced with hospital buildings, described as irretrievable failure of estate or infrastructure. This could be an issue involving a department no longer fit for use.
Medical issues that could compromise care within A&E. The trust speaks of the issues as an irretrievable failure of essential clinical adjacency in critical care or diagnostics.
But that could mean temporarily closing an emergency department overnight should services become too stretched.
The "tipping points" that could cause this might be an 'irretrievable' gap in staffing that would lead the service to become unsafe, issues involving problems experienced with hospital buildings, described as 'irretrievable failure of estate or infrastructure', and also any medical issues that could compromise care within A&E.
The trust speaks of the issues as an 'irretrievable failure of essential clinical adjacency in critical care or diagnostics'.
As part of that contingency planning, SaTH leaders – including doctors, nurses and support staff – met with healthcare partners and patient representatives this week.
Its aim was to look at what scenarios should be considered should a "tipping point", where safe services could no longer be maintained.
Debbie Kadum, chief operating officer at SaTH, said: "We must emphasise that we are doing everything we can to avoid reaching a tipping point, including continued national and international recruitment and extending the recruitment of emergency nurse practitioners.
"We are also reviewing shift patterns in order to best meet times of high demand.
"Continuity planning is part and parcel of normal business and we have continuity plans for a whole range of scenarios in our hospitals, but emergency departments have a much higher profile than many of the other things we discuss.
"The discussions are about looking after our patients and looking after our staff. It is about responding if – and only if – a tipping point was reached so that we can continue to fulfil our obligations to our patients and communities.
"This is not something we ever want to implement and is absolutely not part of our winter plan or a way of closing one of our A&E Departments 'by the back door'.
"We do not pretend we have all the answers, and this meeting provided some excellent views for us to look at in greater detail. What the meeting emphasised is that there is no easy answer. That is why we set out on the journey with NHS Future Fit to begin with."
