Decision Time – Time to Fight for BOTH A&Es

After endless delays, it looks like a decision has been taken. It’s a decision that is part and parcel of a wider process of cuts and closures in local NHS services – and if you want to make your voice heard, skip to the end of this post for two important meetings.

Telford and Wrekin
Health bosses intend to close the A&E at Telford’s Princess Royal Hospital, downgrade the hospital, and move the Women’s and Children’s Centre from the Princess Royal Hospital to the Royal Shrewsbury Hospital. The Women’s and Children’s Centre was opened almost exactly two years ago, at a cost of £28 million. This is the decision taken at last Friday’s ‘non-financial appraisal’ meeting. This option was promoted vigorously by representatives of SaTH, the hospital trust. We have been told it is a virtual certainty that this will be endorsed by a financial appraisal panel, and rubber-stamped by a Future Fit Programme Board in early October.

It’s a U-turn on their plans in March 2016. It was clear from a document called the Strategic Outline Case that they wanted to close the A&E at Shrewsbury, and downgrade the Royal Shrewsbury Hospital. What happened? We’re told the external consultants working on Future Fit re-wrote their case and the advantages of the Princess Royal site disappeared.

This is incredibly bad news for people living in and around Telford. They’ll be left with an ambulance journey of 18 miles to reach emergency medical care in Shrewsbury. The average straight line distance in England is 4.4 miles from home to A&E. Telford people now face a journey more than three times the national average –a straight line distance of 14.6 miles. This journey distance is far enough to be life threatening for some patients. The closure of the A&E at the Princess Royal Hospital will lead to unnecessary deaths, and it’s essential to oppose it.

Women’s and Children’s services should never have been taken away from the Royal Shrewsbury – but the solution to that can’t possibly be to take the Women’s and Children’s Centre away from Telford.

Shropshire
Is this a victory for people in Shropshire? No, of course not. Hospital bosses always tried to create a Telford versus Shrewsbury battle, but most of us have had too much sense to fall for it.

For the Royal Shrewsbury, ‘planned care’ is to be stripped out completely. That means journeys to Telford for cancer care (including radiotherapy and chemotherapy), for routine surgery (for cataracts, hip/knee replacements etc.), and for diagnostic tests and scans. The evidence shows that if people have to travel further for chemotherapy, while they are already feeling unwell, they are less likely to go – leading to earlier and unnecessary deaths.

We all lose out in this, Telford and Wrekin, Shropshire, and Powys. Of course people in South Shropshire, the Oswestry area and Powys will be hugely relieved that the A&E at Shrewsbury will stay. Health bosses have pretended for the last two years that it’s completely irrelevant if you wait an hour for an ambulance to arrive and then spend another hour getting to hospital. They’ve finally, finally been forced by campaigners to acknowledge issues around rurality and long journey times. That’s good – but they are planning to build an Acute hospital that will be too small to meet existing demand, let alone future needs. There are no gains for anyone here. Shropshire patients will suffer just as much as Telford and Wrekin with a hospital that is too small. We’re all losers here

The claim of ‘two vibrant hospitals’ isn’t true
Six months ago, health bosses pretended we were going to have ‘two vibrant hospitals’, both of them offering acute care, both of them offering a wide range of planned care services too. They made a lot of noise about this, in an attempt to ‘sell’ the Future Fit plans. Ever so quietly, they have now changed their minds. Check out the March plans here, and the July plans here. Spot the difference!

Now, neither hospital will be fit for purpose, The new proposals mean that the Princess Royal Hospital won’t just lose its A&E and the Women’s and Children’s Centre. There will be no critical care, and there will be no direct emergency admissions at all. The only ‘acute’ care will be that some people are to be transferred to the Princess Royal from the Royal Shrewsbury after three days if they’re considered well enough. And for Shrewsbury, all of the routine healthcare – the planned care that makes up most hospital visits – is to be taken away. Both hospitals will be far removed from the District General Hospitals we have now. This is not the healthcare we need.

Wishful thinking, an A&E that will be too small, too few beds, and massive spending cuts
Future Fit plans were based on wishful thinking. Modelling work from 2014 has been used to predict how many people will become ill, how many people will require A&E treatment, and how many people will need admission to or treatment at hospital. The numbers bear no relationship at all to reality. This means the A&E will be too small, and there won’t be enough hospital beds, irrespective of location. For Future Fit predictions to be accurate, emergency admissions will have to fall by 22% over the next three years; they have risen by 24% over the last three years. There would need to be a 19% fall in elective (planned) activity over the next three years; there has been an increase of 15% over the last three years. Current Future Fit plans are for hospital bed numbers to fall by 11% and spending on hospital staff to be reduced by 10%. This is at a time when the population is both growing and ageing. It is entirely predictable that we will have an Emergency Centre that is far too small and a Planned Care Centre that is far too small.

You can find a detailed analysis of the Future Fit plans here.

The driver for change now is the desperate financial crisis in the NHS. The local plans are to reduce spending on NHS services by a shocking £147.5 million every single year. Future Fit is just a part of the cuts plans. We’re facing cuts to A&E; cuts to hospital care; more rationing of hip and knee replacements; cuts to community NHS services, particularly to services for frail elderly people; and cuts to services to people with mental health problems. The Finance Director of Shropshire’s Clinical Commissioning Group is now telling his colleagues to ‘think the unthinkable’ when it comes to cutting services. We are getting very close now to the dismantling of our NHS.

What can we do?
It’s our NHS. It doesn’t belong to health bosses. It belongs to all of us who use it, all of us who’ve paid for it, and to all the NHS workers who are angry about the cuts and closures. We have the right to reject the destruction of services that we and our families and friends depend on.

We need local NHS leaders to tell the truth – to stop pretending that there’s enough money in the system, and to go to MPs and tell them just how bad things are. We need our Councils to do a decent job of defending health services – and that means recognising the scale of the threat and working together to build a powerful united fight across Shropshire and Telford and Wrekin. And most of all, we need our MPs to stop playing ‘smoke and mirrors’ games pretending that the NHS is well-funded while the government drives through £22 billion NHS cuts. We want our MPs to go back to Jeremy Hunt and fight hard for the funding that is vital for the NHS in Shropshire and Telford and Wrekin.

We have to get organised and make sure our voices are heard loud and clear.

Two events to think about coming to, both on Thursday 29^th September

• 1pm. SaTH, the hospital trust, is holding a Board meeting. We need them to know that we defend BOTH A&Es and BOTH hospitals. Park Inn, Forgegate, Telford TF3 4NA.
• 6.30 pm for a 7pm start. Question Time on Ludlow Hospital and local services, led by Philip Dunne MP. Philip Dunne is now a Health Minister whose responsibilities include NHS finance and patient safety. Other panellists include Gill George from Shropshire, Telford and Wrekin Defend Our NHS. Ludlow School, The Burway, Bromfield Road, Ludlow SY8 1GJ. Organised by Ludlow Town Council and Ludlow and Clee Local Joint Committee. (The Question Time is preceded by a brief formal business session).