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Revealed: NHS confirms 'A&E Local' details for Telford's Princess Royal Hospital

By Dominic Robertson | Telford | Health | Published:

'A&E Local' details for Telford have been confirmed by NHS England, and reveal a service some way short of that which would be offered in Shrewsbury.

A&E at Telford's Princess Royal Hospital

The plans have led to strong reactions from local politicians, with the Labour leader of Telford & Wrekin Council describing the move as a "political stunt".

It comes as NHS England has written to the Health Secretary, Matt Hancock, confirming what services would be provided in an 'A&E Local' at Princess Royal Hospital (PRH), Telford.

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In their letter, Professor Stephen Powis, national medical director for NHS England and NHS Improvement, and Pauline Philip, the organisation's national director of emergency and elective care, say PRH will continue to provide A&E services.

They write: "This model means PRH will continue to provide A&E services. We are satisfied that this meets the proposed A&E Local model outlined above and will work with SaTH (Shrewsbury & Telford Hospital Trust) and their partners in the development of the model and a timeline for implementation."

See the full text of both letters below

The request to make PRH an A&E Local came from Mr Hancock after he decided to press ahead with the Future Fit reorganisation of the county's major hospitals, PRH and Royal Shrewsbury Hospital (RSH).

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Under that plan Royal Shrewsbury Hospital becomes home to the county's main A&E and consultant-led women and children's services, which are currently based at PRH.

The latest proposal for PRH to be an 'A&E Local' would be an upgrade on the previous Future Fit plan for the hospital to become an 'Urgent Care Centre'.

But it will only be open for "core hours", and would deal with emergency ambulance cases such as 'low risk chest pain', pneumonia, DVT or cellulitis.

'More progress to be made'

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The hospital would have an emergency medical consultant for "defined hours" but ambulances would take seriously ill patients elsewhere for treatment, and seriously ill 'walk in' patients would be stabilised before being transferred to "an appropriate facility".

The changes also mean that plan for consultant-led women & children's services to move to Shrewsbury from Telford would go ahead.

Lucy Allan, MP for Telford, who is crowd-funding for a legal challenge to the plans, said there is "more progress to be made".

She said: "I am pleased to see ministers are listening and taking on board the concerns of Telford residents. This is a step forward. Clearly we need to see more movement around 24/7 access and the residents’ legal challenge continues."

She added: "I am confident there is more progress to be made."

Wrekin MP Mark Pritchard said: "I am glad it is now in black and white that the A&E is saved. That is fantastic news. The next step is to get the finer details on what the new A&E Local model consists of. This is a massive step in the right direction."

However, Councillor Shaun Davies, Labour leader of Telford & Wrekin Council, said: "This is a political stunt. Clearly – it is outlined in both letters from the Health Department – our A&E will still be downgraded to a part time Local A&E that will take some patients, some of the time.

"Our women & children's unit will still close. Nothing has changed apart from the political spin operation."

He added: "It is all about the finer detail and when you read below the headline from the clinical experts they are clearly explaining our A&E will be downgraded and our women and children's unit will close."

Letter from Matt Hancock MP, Secretary of State for Health, to Lucy Allan and Mark Pritchard

"Dear Lucy and Mark,

I’m delighted to write to you today to confirm that the A&E at the Princess Royal Hospital (PRH) in Telford will remain open.

Following my decision last month that the NHS should implement the advice of the IRP on the £312 million Future Fit project with the assurance that the A&E at PRH could remain open as an A&E Local, the enclosed letter from the National Medical Director and National Director of Emergency and Elective Care of NHS England confirms that the NHS will deliver on this.

This welcome news comes on top of the extra £4 million in winter capital funding we are providing to PRH, which I announced last week, to help it prepare for this winter and reduce pressure on the A&E.

I am copying this to the Leader of Telford and Wrekin Council.

Yours ever,

Matt Hancock"

Letter from NHS England and NHS Improvement to Matt Hancock

Dear Secretary of State,

Referral to the Secretary of State under Regulation 23(9) of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 of changes to healthcare services in Telford and the Wrekin through the ‘Future Fit’ programme

Thank you for your letter regarding the Independent Reconfiguration Panel (IRP) advice in relation to this case. You asked for advice on how the Princess Royal Hospital (PRH) could be served through an ‘A&E Local’. NHS England and NHS Improvement have been working with the Shrewsbury and Telford Hospitals Trust (SaTH) to understand how they could enable as much clinically appropriate care to be delivered at the PRH as possible, in line with IRP recommendation five.

An A&E Local will enable an enhanced service that is distinct from an urgent treatment centre. During core hours the trust’s proposed A&E Local would include the following enhanced functionality:

a. Emergency medicine consultant delivery for defined hours

b. A same day or ambulatory emergency care service for defined clinical pathways e.g. cellulitis, DVT, low risk chest pain and pneumonia

c. Frailty assessment service

d. Other urgent treatment services.

To ensure patient safety is paramount at all times, this will be underpinned by:

a. Comprehensive pathways and protocols agreed with ambulance service for blue light transfer and diversion

b. The ability to stabilise any seriously ill “walk-in” patient of any age for transfer to an appropriate facility

c. Comprehensive local communication of the service offer, including clear signage of hours operating as “A&E”.

d. Comprehensive service information within the Directory of Service to ensure patients are appropriately referred

e. Clinical governance and leadership to ensure emergency medicine consultants have necessary professional support.

The trust and local commissioners will further develop a framework of options for outside these core hours, which will include agreed protocols for blue light divert or transfer, direct admission protocols where appropriate. Urgent treatment services will be available at all times through the day.

SaTH have put forward a model that would increase the volume of activity that would safely be delivered through the proposed Urgent Treatment Centre on the planned care site at PRH. They propose an emergency medicine consultant presence during core hours, a consultant led ambulatory emergency care service for specific pathways and additional diagnostic presence.

This model means PRH will continue to provide A&E services. We are satisfied that this meets the proposed A&E local model outlined above and will work with SaTH and their partners in the development of the model and a timeline for implementation. We also intend to involve the Royal College of Emergency Medicine in this development.

Yours sincerely,

Professor Stephen Powis, National Medical Director, NHS England and NHS Improvement

Pauline Philip DBE, National Director of Emergency and Elective Care NHS England and NHS Improvement"

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