Future Fit: What does 'A&E Local' mean for Telford hospital patients?
Health Secretary Matt Hancock has tasked the NHS with looking at how an ‘A&E Local’ will work at Telford’s hospital – as it emerged even health bosses are confused by what the term means.
Under the £312m Future Fit scheme, the county’s emergency centre will be based at Royal Shrewsbury Hospital, with Princess Royal Hospital in Telford taking over responsibility for planned care.
Both hospitals were also due to get urgent care centres, but Mr Hancock has now asked NHS England to provide advice on how the ‘urgent care model’ at PRH can be delivered through an ‘A&E Local’. The minister, who visited the PRH in March, is expecting a report back within a month.
In the meantime health bosses in Shropshire say they are yet to understand what this will entail.
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- Shrewsbury's reaction to Future Fit: Relief, but sympathy too
- Telford's reaction to Future Fit: Anger, confusion and concern at impact of changes
- Shropshire Star comment: Let’s tie up loose ends of Future Fit saga
Speaking to Shrewsbury & Telford Hospital NHS Trust board, its chairman Ben Reid said he expected the new model to be guided by national expertise.
He said: “We have to understand what that means. We don’t know what that means at the moment.
“The Secretary of State has asked for feedback in a month.
“Hopefully by the next board meeting we will have a bit more clarity.”
He also said the trust is hoping to submit its outline business plan in the “not too distant future”.
Plans for A&E Locals are being developed by NHS England and Improvement, but the scope of services involved is yet to be defined.
The NHS Long Term Plan also talks about exploring the idea of an ‘A&E Local’ where urgent and planned care are separated at hospital sites, but the references remain vague.
Mr Hancock made his request to NHS England this week following a recommendation from the Independent Reconfiguration Panel (IRP).
The panel was asked to consider whether the Future Fit decision needed to be reviewed and interviewed health bosses, clinicians, council officials and other interested groups in July, before reporting back on its recommendations.
The IRP’s letter to the Health Secretary, which has now been published, states the emergency care centre would be better located at RSH and ‘the new model of hospital care should be implemented without delay’.
It also says ‘the urgent care model should enable as much clinically appropriate care to be delivered at PRH as possible’.
IRP chairman Lord Ribeiro writes: “The panel has previously commented about the confusion caused by the inconsistent use of names and models across the NHS and it is hoped that the current national policy to implement a standard urgent treatment model will improve matters.
“Although national policy must be implemented at RSH and PRH in the interim, the panel shares concerns expressed that a more appropriate and ambitious model must be developed and implemented to complement properly the single emergency centre at RSH. Accepting the constraint that acute admissions will not be available at PRH, the panel agrees that the aim should be to provide as much clinically appropriate urgent care and treatment as possible at the hospital.
“In this context, the future model must consider the range of diagnostics available to be used, ambulatory emergency care and frailty assessment.
“This will both serve local needs better and when replicated at RSH will ensure the single emergency centre is used only when necessary and not by default.”
In conclusion, Lord Ribeiro says: “Since the new model of hospital care was first articulated in 2014, the simple message that it will provide something that the population currently do not get – access to consistently safe, high quality emergency care and treatment 24 hours a day, seven days a week – has not changed but has got somewhat lost.
“The opportunity to bring the benefits of sustainable, high quality emergency care to this population, and with it a critical mass of clinical expertise that will underpin and sustain other services in the area, must not be squandered.”
This week’s ruling by Mr Hancock has been met by a mixed reaction locally. Mr Hancock says changes are ‘rightly based on clinically led decisions at a local level’, but added: “Having listened to and accepted the advice of independent clinical experts, I have asked NHS England to come forward with proposals within a month on how they will keep the A&E in Telford open as an A&E Local so that the PRH can continue to deliver the urgent and emergency care the residents in the growing town of Telford need.”
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