24 January 2017

Consultants in Shropshire today shared how they have explored the benefits and pitfalls of transforming emergency care from other organisations which have been through similar experiences.

The Shrewsbury and Telford Hospital NHS Trust (SaTH) proposes creating a single Emergency Centre at either the Royal Shrewsbury Hospital (RSH) or Princess Royal Hospital (PRH) in Telford with Planned Care provided on the other site.

Most patients would still go to centres at their local hospital to receive 24/7 urgent care. Only life and limb-threatening conditions, some of which are currently transferred outside of Shropshire, would be treated at the new single Emergency Centre.

There have been suggestions from members of the public that a new hospital should be built between Shrewsbury and Telford or that nothing should change leaving A&E services as they are now.

Other organisations throughout the country have gone through similar experiences of moving to a single site for the most serious emergency cases, and SaTH is learning from these experiences – both the good and the bad.

Mr Mark Cheetham, a Consultant Surgeon and Scheduled Care Group Medical Director at SaTH, said: “I and colleagues have visited Northumbria, where a new specialist care hospital opened in 2015, and we learnt that consolidating emergency admissions on one site allows a consultant-delivered service 24/7, which ultimately improves patient care.

“Our experience locally, and our visit to Northumbria, confirms that a large proportion of patients going to A&Es now, do not have a life or limb threatening injury or illness so don’t need to be treated in an Emergency Centre – they could be treated through Urgent Care Centres at either of our hospitals, which is what we’re proposing in Shropshire. Northumbria have learnt from experience that having these other urgent care services alongside an Emergency Centre is key and are looking to adapt their model. Their new model is consistent with what our doctors are proposing for Shropshire.

“We have also learnt of the benefits of introducing Advanced Clinical Practitioners, roles which we have begun to introduce in Shropshire, as they can replace Junior Doctors in many situations and help with ensuring a sustainable workforce. These Practitioners are highly skilled and experienced Nurses, Paramedics and Therapists who hold the same skills as Junior Doctors”

Mr Cheetham said that Northumbria had also shown things that wouldn’t work in Shropshire.

He said: “There have been suggestions that we should follow this model and open a new hospital, somewhere between Shrewsbury and Telford.

“NHS Future Fit, which our Sustainable Services Programme feeds into, looked at building a brand new emergency hospital for Shropshire, which would have operated alongside services at RSH and PRH, on the long-list of proposals. But this was ruled out early on in our discussions and didn’t make the shortlist of proposals. 

“We already provide a number of additional services not present in Northumbria, such as Vascular Surgery, Urology, Radiotherapy, Renal Dialysis and inpatient Paediatrics, so we are continuing with the very best of what we have, whilst learning from other hospitals on how we can improve.

“It would cost a lot more now to build a new hospital than it did when the project in Northumbria was approved, and adding a third site would not help with any of the backlog maintenance issues we have at our two current acute sites. We also need to consider how people get to our hospitals. Public transport links cause problems for us now, and would be worse if a new greenfield site was built.

“In short, I think we can learn from the experiences of Northumbria and other similar examples. Our model has been developed by doctors and other frontline staff and it’s time that we go to public consultation for people to have their say and help us to refine our proposals so that we can move forward.”

Dr Kevin Eardley, a Renal Consultant and Unscheduled Care Group Medical Director, added: “It’s been suggested that we should do nothing and keep the status quo.

“We’ve been clear that doing nothing is not an option. We need to make changes to our hospitals to improve standards and waiting times for patients care and also improve the experiences they have. We also need to ensure the sustainability of our hospital services for the next 20 years and more. These changes need to happen to ensure we keep health services local and in the county.

“We have spent a long time thinking through, developing and refining our model.  Doctors, Nurses, Therapists and other clinical staff from our hospitals and the community have developed the proposed model – a single Emergency Centre at RSH or PRH to treat life and limb threatening conditions, supported by Urgent Care Centres at both hospitals.

“We want to discuss these proposals and continue to refine them with the public and it’s important that we can take the options forward to a public consultation.”

More information about the proposals for the Emergency Centre and Planned Care site can be found at www.sath.nhs.uk/sustainableservices