Ex hospital chief outlines concerns over Shropshire healthcare shake-up
The former chief executive of a Shropshire hospital told medics he is "more than worried" about current plans to re-organise health care in the region.
David Sandbach, former chief executive of the Princess Royal Hospital in Telford, voiced his concerns after attending the latest Future Fit meeting attended by more than 100 clinicians, health professionals, patient representatives and members of the voluntary sector.
The 'Clinical Reference Group' was organised to concentrate on developing plans for transforming hospital, primary and community based services in Shropshire, Telford and Wrekin and Mid Wales.
It was a private meeting, but afterwards Mr Sandbach said: "The room was full of non-clinical people as well as some very senior doctors."
He said the meeting discussed the concept of 'warm' and 'hot' hospitals as part of the proposed changes for the PRH and Royal Shrewsbury Hospital.
The 'hot' hospital would house the county's only A&E and the other hospital would be 'warm' – a reference to it not having an A&E but still providing extensive care including surgery.
Mr Sandbach said there were still many unanswered questions.
He claimed original plans included downgrading the hospital without an A&E department so that it had just 20 in-patient beds. But now, he says, the plan is for the non-emergency hospital to have 302 beds, which he described a "big shift".
He said: "The downside is they do not know what the beds will be used for.
"I am more than worried about the sustainability.
"I think there is a commitment of rural urgent care centres and they are open to suggestions.
"They have done a lot of work understanding what is happening in the community so that is positive.
"However with ambulances queuing up outside A&Es and how busy the departments have been, I am more than worried about the plans not being finished in time and not being sustainable."
The meeting also talked about fears of the effect of closing one of Shropshire's A&E departments on the county primary care GPs, who say they are already under pressure and cannot cope with an influx of new patients, describing it as the "elephant in the room".
He said: "Of the two 'metaphorical' daggers pressing down on the throat of the local NHS the most dangerous one in my mind is the issue of primary care sustainability.
"I think it is fine to talk about the sustainability of a hot and warm hospital model sometime in the next seven years but what is more important to me is a clear sustainability plan for primary care.
"From the meeting I did not get the impression that the primary care sustainability issues is being factored into the debate about the wider local health economy plans.
"If people do not factor primary care sustainability into the equation as soon as possible then very bad things will happen."
Health officials today said the meeting was 'very positive' and re-established some of the basic principles behind the NHS Future Fit programme.
These included an emphasis on prevention, centralising services and the fact that doing nothing is not an option.
Dr Julian Povey, chairman of Shropshire CCG, said: "It was a brilliant meeting, bringing together many partners, with lots of enthusiasm and giving us clear steps to go forward."
Dr Jo Leahy, chairwoman of Telford & Wrekin CCG added: "There was a well balanced mix of reality, honest challenge, passion and energy and everyone who attended made a valuable contribution."
And Dr Edwin Borman, Medical Director for Shrewsbury and Telford Hospital NHS Trust said: "We all want the safest possible care for local patients and the Clinical Group confirmed that Future Fit principles are the best way of achieving that."
Feedback from the event will be considered soon at extraordinary meetings of Shropshire and Telford & Wrekin Clinical Commissioning Groups.
Both the county's CCGs deferred decisions over backing Future Fit proposals which would recommend the creation of one A&E for the county.
Board members of Shropshire CCG said they had concerns about the impact of the changes on rural care, while the Telford organisation said it felt "uneasy" and wanted more information.
Both said they will make decisions in public after the Clinical Reference Group meeting.
