Future Failed? Future Farce? Fit for Nothing?

Whatever we call it, Future Fit is a project in chaos – but health bosses STILL plan to close an A&E

It’s been clear for many, many months that the Future Fit NHS project has been failing. All the good ideas of care closer to home, joined up care, proactive management of long term conditions and so on have long since disappeared. Investment into community services is intended to be negligible. Community hospitals are being run down. Rural Urgent Care Centres have been kicked into touch. Most recently, the two very senior NHS bosses who are the architects of Future Fit have suddenly disappeared from their jobs. It’s become crystal clear that Future Fit is about two things: closing an A&E and closing a hospital, to save money, and with no regard at all for the needs of our area.

On October 1 local NHS leaders were due to take a decision on which A&E and hospital they were going to close down – the Royal Shrewsbury or Telford’s Princess Royal. Their decision was… no decision! After two years of work and endless glossy events trying to convince the public that closing an A&E is a good idea, they have achieved – precisely nothing. Their only conclusion is that they don’t know what to do. Even the timetable for implementation is in chaos, with public consultation delayed from early December this year to the summer or autumn of 2016. What a disgraceful waste of public money – and what an insult to the members of the public and the overworked NHS staff who have sat through the time-wasting meetings and engagement events.

Future Fit starts to look quite a lot like the Monty Python ‘Dead Parrot’ sketch. It has every appearance of being absolutely, compellingly and one hundred per cent dead. Our local NHS bosses are still bravely insisting that it will continue – but the combination of utter shambles and repeated delaying tactics suggest that there is little to be salvaged here. Future Fit had become nothing more than a cuts project. If it is indeed finished, that can only be a good thing.

The massive threat to one of our A&Es

There’s a new and very urgent threat to healthcare in Shropshire – and the reports from today’s meeting confirm it. The organisation running the two hospitals (SaTH) is in deep financial crisis, and is desperate to save money by closing an A&E. They’ve been threatening to go it alone, to force through the closure of one of the two A&Es to save money, without even the minimal services of Future Fit put in place to fill the gaps. Their pretence will be that this is on clinical or patient safety grounds. No – it’s about money. This is the exact same trick as health bosses played to justify closing down a ward at Ludlow Hospital.

We know they plan to close an A&E. Directors of the hospital trust have spoken about it. The Chief Executive of the hospital trust talked about it in a meeting on Monday! We know also that they’ve threatened to crack on and close an A&E ‘in weeks or months’. Sadly, they’ve suddenly become very coy. They’ve received a Freedom of Information request asking them what their plans are – and they’ve refused to respond, saying it’s not in the public’s interests to know!

We need to unite for both our A&Es

Campaigners have taken an absolutely consistent and principled position from the outset: we have two A&Es and two acute hospitals because we need them; we will oppose the closure of either site with equal commitment.

Future Fit has fallen apart because of the overwhelming public opposition to their plans. Their original intention was very clearly to close down the A&E and hospital in Shrewsbury. They met serious, organised, informed opposition. In the last few weeks, they’ve been scrabbling around wondering if they might close Princess Royal instead. They would have had exactly the same fight on their hands. There can be no question that organised opposition has tipped Future Fit into chaos, and that this accounts at least in part for the retreat of health bosses today.

Now we have to be very clear about the threat to an A&E, and very determined that both A&Es will stay open for the simple reason that we need them. We don’t know yet which one they will close; it makes no difference to our determination to keep the healthcare we need.

What next?

We’re expecting health bosses to outline new cuts plans before the end of October. We know, and they know, that they intend to close an A&E. We hope that they will be honest enough to say so, and honest enough to spell out that this is about spending cuts.

There are some really important issues for us, as supporters of the NHS.

There isn’t enough money in the local healthcare system. Today’s statement from NHS bosses talks about ‘financial realities’ and states that ‘the financial climate for the NHS has changed dramatically in the last year’. This points strongly to local NHS cuts purely and simply because the money isn’t there. Back in April 2014, NHS funding for rural areas was cut. Doctors’ leaders have warned that rural areas are underfunded to the tune of hundreds of millions of pounds. At the same time as rural funding was cut, there were NHS funding cuts to the money allocated to areas with a high proportion of older people. That’s been a devastating double whammy for Shropshire. At a time when the whole of the NHS is being squeezed financially, it is rural areas like Shropshire that are being catapulted into complete chaos. We need our MPs to go back to NHS England and explain the absolute crisis that we face without additional funding. This isn’t an issue that will go away.

It is of course completely unacceptable for an A&E and an acute hospital to close, whether it’s badged as ‘Future Fit’ or happens as a quick and dirty cost-cutting measure by the hospital trust. Longer ambulance journeys lead to unnecessary deaths. That’s what the research shows. We will build the biggest possible campaign to defend whichever A&E and acute hospital they target. There is no place for the divisive ‘Shrewsbury versus Telford’ games on an issue as important as this.

There’s something else that we can do though. Opposing the loss of an A&E and acute hospital doesn’t mean calling for ‘no change’. There are real strengths to local healthcare. We have an excellent GP service. We have a network of community hospitals. We have dedicated and hardworking health workers. We need to build a model of healthcare that starts from these strengths and builds on them, an approach to change that is ‘bottom up’ and focused on patient needs. We need our hospitals to change, too. It isn’t good enough for our hospital trust to say ‘We can’t recruit easily so we’ll close services’ – the excuse we’re expecting from them. There’s a need for a very different approach to hospitals that transcends artificial boundaries, creates ‘clinical networks’ across sites and organisations, and seeks always to offer care that has patients at its very centre.

We’ll be working on that alternative vision for Shropshire’s NHS. We’ll be inviting the widest possibly number of people to work with us.

Gill George, Chair
Julia Evans, Secretary
Shropshire Defend Our NHS
Download our Briefing Notes on Future Fit