This page contains FAQs relating to the changes to the Children's Services at The Shrewsbury and Telford Hospital NHS Trust.
Please also refer to the latest designs of the new Women and Children's unit and Looking to the Future Newsletters including Looking to the Future Special Issue Children Services - Sept 2011.
What are the challenges facing children’s services?
Why do you need to create a single inpatient unit? What new opportunities does this offer?
All the children’s specialists (paediatricians) in the county agree that continuing to run two inpatient units will not be possible very far into the future. They face a continual struggle to ensure they have enough doctors available to look after the children in their care and it looks like this is going to get even more difficult in the future.
Although they know this is a difficult decision to make, they believe that creating a single inpatient unit is the only way we can protect this service for the future. The alternative could be that children needing overnight care would have to be treated outside Shropshire, Telford and Wrekin.
We have to consider a wide range of factors, including:
- The resources available to us
- The profile of the population now and into the future
- Emergency access and providing care for children and families with complex needs
We propose to create a single inpatient unit at Telford. As well as keeping inpatient children’s services in the county, this could:
- Offer more privacy for boys and girls
- Create a better environment for teenagers
- Continue to offer a special environment for children with cancer
- Offer new opportunities to work in partnership with Birmingham Children’s Hospital, so that we can provide more services more locally and reduce the need for some children and families to travel to Birmingham.
Why are you moving children’s services to Telford? I thought the proposal in 2009 suggested they should stay in Shrewsbury?
In 2009 we were looking at a set of options and these did not get to the stage of public consultation. One of these options – which would have seen women and children’s services based in Shrewsbury in the short term – attracted a lot of media attention before any consultation was underway.
The option of women’s and children’s services being based in Shrewsbury was one of four options that was being considered as a short term change from 2012/13 to 2020. In some options, inpatient children's services were based in Shrewsbury. In others they were based in Telford.
As mentioned these options were intended as a short term change from 2012/13 until 2020. The NHS was looking at options for moving major health services to a single site by 2020. These options included major redevelopment of RSH as the main acute site (including obstetrics and inpatient children's services), major redevelopment of PRH as the main acute site (including obstetrics and inpatient children's services) or creating a new acute hospital site between Shrewsbury and Telford (including obstetrics and inpatient children's services). All of these options included moving from the deteriorating women and children’s building at RSH.
More information about the options discussed in 2009 is available from the Archive section of this website.
What children’s services will be provided at the Royal Shrewsbury Hospital?
We propose that a wide range of services will continue to be provided in Shrewsbury. This includes:
- Children’s assessment unit, offering tests, treatment and monitoring
- Outpatient clinics
- A&E department
This means that the majority of children needing to use our hospital services will continue to receive these from the same place as now. Children needing an overnight stay in hospital would as now continue to attend regional specialist hospitals (e.g. Birmingham) or where we provide the inpatient care they need locally, would receive their care in our single inpatient unit in Telford.
What children’s services will be provided at the Princess Royal Hospital?
The Princess Royal Hospital will offer an inpatient children’s centre. This includes:
- Children’s assessment unit, offering tests, treatment and monitoring
- Outpatient clinics
- A&E department
- Children’s inpatient care including inpatient cancer care
How much space will the new Women’s and Children’s Unit at PRH need?
We have done some initial modeling that suggests that a Women and Children’s Unit could be established at PRH, along with the other work needed as part of these proposals, for £26m to £28m.
Following the consultation we have worked this up into more detail, building on the feedback we had received from patients and carers to design the services.
A first look at the new Women and Children's Unit at PRH can be found via the Looking to the Future Newsletters including Looking to the Future Newsletter Issue 3 - Janaury 2012.
How do the costs compare between providing a new maternity unit at RSH and at PRH?
We estimate that it will cost around £60m to create a new women and children’s unit at RSH
It will cost in the region of £26m to £28m to create a women and children’s centre at PRH, as well as the other changes needed as part of these proposals. The newer estate at PRH, as well as options for using existing space, means that there are more options for creating this facility at PRH.
There is a very big difference in cost which we have to take into consideration when deciding how to solve the dilemmas facing local NHS services.
We have to borrow money to develop our buildings. The more money we borrow the more we have to pay back with interest taking money away from delivering care, not only to women and children but all the patients entering our doors.
It is also very doubtful that anyone would lend us the sum of money required for a totally new building in Shrewsbury and it would be very difficult to pay this back.
Options for what will happen to the maternity building at RSH are also being explored. Even though the building will not be fit for inpatient clinical care in the near future, there may be other support services that could be accommodated in the building in the medium term and so free up space within the main hospital buildings. We will have to make sure that the asbestos in the roof of the building remains safe.
Can consultant-led maternity services and inpatient children’s services be provided on separate sites?
We cannot provide these services on separate sites.
Firstly, neonatal services must be on the same site as consultant maternity services.
Secondly, we have strong clinical links between neonatal services and children’s services, including doctor’s rotas, skills and training. We would find it very difficult to provide the same level of neonatal services if these were not working in partnership with on-site inpatient children’s services.
This means that the majority of children needing to use our hospital services will continue to receive these from the same place as now. Children needing an overnight stay in hospital would as now continue to attend regional specialist hospitals (e.g. Birmingham) or where we provide the inpatient care they need locally, they would receive their care in our single inpatient unit in Telford.
Why will head and neck inpatient services also need to move to PRH?
We perform over 800 ENT procedures on children each year and the doctors delivering that care believe they should be located alongside children’s services to be able to safely deliver this service.
What about the Rainbow Children’s Cancer Unit?
We are incredibly grateful for the hard work by parents and members of the community to raise money to create this important unit.
However, it is attached to a building that is deteriorating. We need to move out of the women and children’s building at RSH before it fails. This means that we also need to plan to move the children’s cancer unit from its current location.
We also need to move to a single inpatient children’s unit, which means that in future inpatient children’s services can only be provided at one of our hospitals. The Cancer Unit must be at the same location as our other inpatient children’s services.
So, the Children’s Cancer Unit needs to move from its current location (because the adjoining building is failing) and it must be located on the site with inpatient children’s services. We will ensure that it is provided to at least the same standards as the current facilities, carrying on the fantastic legacy from everyone who has helped to bring this unit to the county. We will also not be asking people for additional fundraising to relocate the unit, and we invite the involvement of parents and families to help design the care environment.
We have carefully looked at the possible options within the resources available to us. We propose to establish a new Women and Children’s Centre at the Princess Royal Hospital. This will include the Children’s Cancer Unit.
We recognise that people will have concerns about moving from the current facilities. With the benefit of hindsight we would not make the same decision now to provide this unit in its current location because of the condition of the building it is attached to. It is important that we move forward and keep safe children’s services in the county, and continue to provide these vital children’s cancer services locally.
If we do not take action then we risk losing these facilities from the county, and children and families would need to travel further for their care.
What will the new children's cancer unit be like?
The new children's cancer unit will not be smaller, in fact, it will be a third bigger than the existing Rainbow Unit. It will also benefit from dedicated day treatment facilities and a larger outside space where children can play. We are working with parents and families of the Rainbow Unit to make the new unit even better. If you would like to get involved then please email future@sath.nhs.uk
What is a PAU?
PAU stands for Paediatric Assessment Unit (or Children's Unit). It is a special unit where children can be quickly assessed and treated. We will have a PAU at both RSH and PRH.
When does a child go to the PAU?
Unless it is an emergency situation, children are brought to the A&E department are directed to the PAU during opening hous to be assessed and treated. This will continue in the new PAUs.
What will happen to the existing PAU at RSH?
There will still be a PAU at RSH, however the plan is for it to be relocated next to A&E.
When will the PAU at RSH be open?
A special group which has been set up to discuss the opening hours of the PAU, which has looked at a wide range of factors such as the numbers of children who attend hospital at night. Due to the very low numbers of children seen at night, we have decided that we should not aim to keep the PAU open 24 hours a day at RSH.
The current thinking is that the PAU will be open for 13 hours each day. This will mean that the PAU is open during the hours when nearly all children needing the type of care provided by a PAU attend hospital. We are still developing these plans and welcome feedback.
What will happen when the PAU is closed?
When the PAU is not open there will still be a 24-hour A&E department at the RSH. Working with GPs, Shropdoc, ambulance services and other health services we will make sure that there is a clear plan to bring children children quickly to the best place to provide the treatment that they need.
If you call an ambulance for your child during the night when the PAU at RSH is closed, in the vast majority of cases they will be taken straight to PRH. In rare and extreme cases when ambulance paramedics believe that the child cannot get to PRH safely (airway obstruction for example), then they will be taken to the nearest hospital.
It's important to remember that no child will be ever turned away from A&E at RSH.
Any child who is brought to RSH during the night will be quickly seen and assessed by doctors and nurses in A&E. If the child needs to stay in hospital overnight, then, only when it is safe to do so, they will be quickly transported to PRH or, as now, to a regional specialist hospital if they need care that connot be provided in Shrewsbury or Telford.
How will the new arrangements actually work?
We have set up clinical working groups to develop the models of care in detail.
These groups include consultants, GPs, nurses, therapists, ambulance and other staff who work directly or indirectly in surgery and women’s and children’s services. We are also testing the ideas developed by these groups with patient representatives.
How can I get involved in the changes to the Children's services?
We would be very interested to hear from you if you would like to get involved in shaping our new Women and Children’s Unit. Over the next 12 months we will be looking to you to help us decide everything from the colour of the walls to the furniture and children’s play equipment. One way you can get involved is by taking part in one of our focus groups.
If you run or attend a group which you would like us to visit or you would like to take part in the focus groups , please email the project team via future@sath.nhs.uk.