Future Fit would address Shropshire hospital failings – SaTH chief

Simon Wright, chief executive of Shrewsbury and Telford Hospitals NHS Trust, said it had only been possible to keep the A&E units at both hospitals running through the 'discretionary' efforts of staff who gave up their time.

He spoke out following a call for him to resign.

This week the Care Quality Commission issued an 'urgent enforcement notice' on the trust, which has imposed conditions on how the trust is managed. If the trust does not comply, the CQC has the power to suspend it.

Writing exclusively for the Shropshire Star, Mr Wright added that the trust would do all it could to avoid overnight closure at one of its A&E units.

Mr Wright said he and his staff had been concerned about the issued raise by the Care Quality Commission for some time.

He said the hospital was working hard to address staff shortages, but had found it difficult to recruit enough middle-grade doctors to provide a satisfactory service.

And he said the controversial Future Fit programme, which would see either Telford or Shrewsbury lose its A&E unit, would address many of the problems raised by the CQC.

"The decision to confirm the £312 million of capital funding for the NHS Future Fit programme means we will be able to address the service configuration problems that have been recognised by the CQC," he said.

"Patients and staff will have state-of-the-art facilities and we will be able to further reduce our reliance on agency staff so that we can provide the care that all of us want and need."

But Gill George, of the Defend Our NHS campaign group which opposes Future Fit, called for the resignation of Mr Wright and trust medical director Edwin Borman.

She said: "Did they not know about the shortage of beds and staff, and the dreadful care provided as a direct result? Were they not aware of the shocking levels of baby deaths?

"If they did not know, they are not competent. If they did know, and chose to put cost cutting and secrecy ahead of patient safety, they are not fit to hold their jobs.

"The solution to unsafe services cannot be to close them down."

Read Simon Wright's piece in full:

The news of enforcement action from the Care Quality Commission (CQC) is, of course, of concern to us and will understandably cause anxiety amongst our patients and staff.

However, the recent inspection by the CQC, and its findings, serve only to shine a light on areas of concern which we have ourselves been highlighting for over a year.

For the past 12 months, we have been working together with our commissioners, Health Education England and our regulators because of the trust’s escalation of concerns around the staffing fragilities in our A & Es and the impact this might have.

We have made repeated requests for additional staff but, to date, we have not received the additional middle grade doctors we require. As a consequence of this – and the fact that our A & Es are being kept running by the huge discretionary efforts of our hard-working staff at both sites, we have been increasingly concerned by the risks to the patient experience with our A & Es and our ability to maintain safe, considerate care. This has been evident in our escalation meetings, where these aspects have been discussed.

The consequence of this has been the continued development of our business continuity plans for our emergency departments, which has been ongoing since 2015. As we have made clear, even before our latest inspection by the CQC, at our September board meeting we will have arrived at a decision with regard to the configuration of our emergency departments to best manage this risk. If SaTH is unable to obtain the appropriate level of middle-grade support we require, we will have to make decisions to safeguard our patients and ensure that our concerns around the current levels of risk do not continue as a result of the fragility in our workforce numbers.

Some would have you believe that this decision has already been taken. That a date has been set to close a specific A & E overnight from a specific date. These same people were saying the same thing more than 12 months ago, but both of our A & Es remained open. We have spent months battling against overnight closures but the selfless efforts of our workforce cannot continue forever.

Recruitment is still happening at our hospitals. During September, more than 60 new nurses and nurse associates are due to join the trust. Interviews are also taking place to recruit more consultants across various specialties, to add to the 18 we have appointed recently. This shows that we continue to be an attractive place for people to want to come to work and live.

The decision to confirm the £312 million of capital funding for the NHS Future Fit programme means we will be able to address the service configuration problems that have been recognised by the CQC.

Patients and staff will have state-of-the-art facilities and we will be able to further reduce our reliance on agency staff so that we can provide the care that all of us want and need.

That great care applies to all areas of our hospitals. We know many people may be anxious by the latest headlines about our maternity services and this is, of course, completely understandable. The death of any baby is an unimaginable tragedy; especially if that death could have been prevented.

That is why we are committed to being open about the scrutiny of our services both internally and by external experts.

Following the announcement of the Secretary of State’s review into historic deaths at our trust other families came forward with questions over their care.

Some families came directly to us, others were referred to us by the independent midwife leading the review by NHS Improvement on behalf of the Secretary of State. These cases cover a 19-year period. We established a clinical review group to examine those cases which were not included in the Secretary of State’s review to ensure a robust process and complete transparency.

As a result, 12 families were advised there was potential for further learning and were asked for permission for their cases to be reviewed by independent clinical experts to ensure absolute objectivity around any learning. This information was made public and presented to our trust board in June and we will continue to share information publicly.

We are committed to the continuous improvement of safety in our maternity services and were recently praised by NHS Resolution for meeting all 10 targets in its maternity incentive scheme, launched in conjunction with maternity safety champions Matthew Jolly and Jacqueline Dunkley-Bent, to support the delivery of safer maternity care.

We are not denying that SaTH is facing challenges. We have been shining a spotlight on them for many months and, in some cases, years. However, we know and I know that our staff provide great care day in, day out and I would like to personally thank those who have taken the time to share their stories with us; this means a great deal to our teams.

We will continue to work with our health and care partners and with the public to address these. Our priority and commitment remains the treatment and safety of the people we serve. And we will continue to take every action necessary to maintain this.