Shropshire’s Health bosses have launched a new charm offensive to try and convince us that closing down one of our A&Es and acute hospitals is a good idea. They’ve got a lot of work to do if their first contribution to the new strategy is anything to go by!
A few days ago, the Future Fit website published an important article[i]. They say ‘The following blog provides the views of the three clinicians leading NHS Future Fit in Shropshire and Telford & Wrekin. It is a discussion on the balance between travel time access and clinical outcomes in advance of the planned future consultation on the reconfiguration of hospital services within the county. It is from Dr Stephen James, Clinical Director of Information and Enhanced Technologies, Shropshire Clinical Commissioning Group; Dr Michael Innes, from Telford and Wrekin Clinical Commissioning Group; and Dr Edwin Borman, Medical Director at The Shrewsbury and Telford Hospital NHS Trust’.
Unfortunately, these three leading clinicians make an astonishingly basic error that could put lives at risk. Part of their justification for increasing the journey times to A&E is that paramedics will treat patients with clot busting drugs, so the time taken to get to hospital doesn’t matter. They say, ‘With the professional support of a paramedic comes the opportunity to start treatment at the scene, bringing care closer to people and reducing time to treatment. Increasing amounts of evidence, especially from rural Scotland, have demonstrated that this can actually improve care further. For example, people living further away from a hospital can have clot-busting treatment administered at home faster than those conveyed to hospital… This is particularly relevant for the county of Shropshire and beyond, where travel times and distance can be significant.’
Back in 2005, GP practices lost the responsibility for providing their own Out of Hours GP care. A variety of new approaches sprang up around the country – some of them good, some of them absolutely rotten. When GP Out of Hours services don’t work well, patients can die. It’s important that GP Out of Hours care is effective. This is the service you contact when you’re ill, scared – and you don’t know whether to go to A&E or go back to bed. Good clinical advice from a doctor you trust is as important as it gets.
In Shropshire and Telford and Wrekin, we’re very, very lucky. Our GP Out of Hours service is provided by Shropdoc. It’s a GP cooperative, staffed by local doctors who know their patients and know the area. When we ring Shropdoc, we can pretty much rely on speaking to a doctor with little or no delay. Shropdoc provides phone advice, and face to face appointments. It’s a valued and trusted service. A CCG survey found that 88% of respondents know about Shropdoc, and 82% of those had used Shropdoc themselves. Satisfaction rates were extraordinarily high: 94% of those who had used the service were satisfied or very satisfied, with just shy of four out of five being ‘very satisfied’. It’s a service that works well. The 94% of users satisfied with Shropdoc stands in sharp contrast to the 33% satisfaction rate of NHS 111 users.
Shropdoc under threat
Most of us will have found this out by accident – but our two NHS Clinical Commissioning Groups (‘CCGs’, the local organisations that plan and buy NHS care) have been discussing changes that could lead to the end of Shropdoc. They think they’ve run ‘an extensive engagement programme’ with the public. Feedback from members of the public is that most of us regard this as a ‘semi-secret engagement programme’. It’s particularly remarkable that their engagement exercise didn’t actually mention that Shropdoc was at risk! The feedback they’ve had from the public, once we worked out what the plans were, is that Shropdoc has to stay.
Where are we now?