Shropshire Star

Future Fit: Shropshire A&E plans in place because previous ideas were 'unaffordable'

The current plan for the future of Shropshire's hospitals was put in place after previous ideas proved "unaffordable", it has been revealed.

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Simon Wright, chief executive of Shrewsbury and Telford Hospital NHS Trust, said the state of hospital services across the county needs to change.

He said the trust lost 24,062 bed days because 4,767 patients who were medically fit to leave the hospital could not be moved as there were no community beds open.

Previous ideas suggested around the time of the launch of the Future Fit programme in 2013 included building a "super-hospital" between Shrewsbury and Telford to specialise in providing emergency care. But the plan was later scrapped for being too expensive.

Mr Wright, writing in today's Shropshire Star, has explained the current strategic outline case for the future of the hospitals and why it is needed.

The Future Fit blueprint for the restructuring of services at the Royal Shrewsbury and Princess Royal hospitals proposes one single fully-staffed and equipped emergency centre either at RSH or PRH.

Artist's impression of the proposed A&E department if at the Royal Shrewsbury Hospital

This would be supported by a diagnostic treatment centre at the other hospital and urgent care centres at both Telford and Shrewsbury hospital sites.

Mr Wright said that changes need to be made across the board, and not just at the two hospitals in order to improve care on the whole for patients.

But he said he recognised that the current plan had been put together to find a more affordable solution for the future of the hospitals, which forecast a deficit of £17.2 million for 2015/2016.

Artist's impression of the proposed A&E department if at the Princess Royal Hospital, Telford

Mr Wright said: "The proposed solutions describe an alternative way of implementing the options previously identified within NHS Future Fit. Previous solutions proved unaffordable.

"The revised solutions provide a much more evenly balanced distribution of services which would deliver recognisable, vibrant hospital sites 24/7 within the communities we serve."

Full text from Shrewsbury and Telford Hospital NHS Trust chief executive Simon Wright:

"We're committed to providing the best service possible for our patients who are at the heart of everything our staff do, every single day of the year.

It's been well documented that we – like many acute trusts across the country – are facing daily challenges that impact on the services we provide for our patients.

Our accident and emergency (A&E) departments, in particular, have seen unprecedented demand over the winter. Patients are waiting longer than they should to be admitted, treated or discharged and we regularly have dozens of patients who no longer need the specialist care that hospitals provide, but for whom there is no bed available in the community.

During 2015 we had 4,767 patients medically fit to transfer resulting in 24,062 lost bed days as they were unable to be discharged because no beds were available in the community.

This can't continue and we need to explore more sustainable ways of providing not just A&E and critical care services but all health and community services.

So, we have produced a strategic outline case (SOC) for our sustainable services programme. It describes the trust's plans to address the significant challenges to the safety and sustainability of patient services specifically in emergency and critical care.

Firstly, it's important to recognise what an SOC is and what it is not; there appears to be some misunderstanding which has created some unnecessary concern among patients and the wider public. The key is in the word "outline".

This is not the final plan for our future, any more than a draughtsman's initial sketches represent a finished building.

Rather, it's a relatively brief preliminary document that introduces a basic project concept and contains enough detail to support an informed decision on whether to proceed to an outline business case. It is effectively the first stage of a project and no final decisions are made at this point.

For a project to become a reality after an SOC we would produce an outline business case – which would include more detail and analysis – and the full business case which would include the final proposals.

I fully recognise that any changes to hospital services, particularly to A&E and critical care, cause concern and that the people of Shropshire, Telford & Wrekin and Mid Wales want to let us know their views, hopes and concerns. There will, I assure you, be plenty of time for this to happen.

There will be a full public consultation during 2016/17 on the firmer solution proposals, when everyone will be able to see the solutions we propose in more detail, and I look forward to hearing people's views at that time.

Now we need to firm up these plans in more detail so that we can share with everyone the information they need about the proposals later in the year.

Our SOC demonstrates that there are potential solutions which address the trust's workforce challenges in A&E, critical care and acute medicine by developing a single emergency centre, a single critical care unit and a diagnostic and treatment centre with urgent and planned care service provision at both the Princess Royal Hospital in Telford and the Royal Shrewsbury Hospital.

This is in line with the NHS Future Fit clinical model and the options developed in partnership with clinicians, staff, patients and the general public. The proposed solutions describe an alternative way of implementing the options previously identified within NHS Future Fit. Previous solutions proved unaffordable. They were also viewed as being too stark in terms of the differences between the two hospital sites; with one very large and busy and one much smaller with lots of redundant space.

The revised solutions provide a much more evenly balanced distribution of services which would deliver recognisable, vibrant hospital sites 24/7 within the communities we serve."

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