Future Fit: Stumbling towards disaster

10th August: The date health bosses take a decisive step towards the dismantling of the local NHS. Please look out for details of the meeting that will take the decisions on cuts and closures.

The Future Fit ‘Programme Board’ – meeting in secret – will decide today (Monday 31st July) which A&E to close down and which hospital to downgrade. The outcome is set to be made public on Thursday 3rd August.

On Thursday 10th August, a joint committee from our two NHS ‘Clinical Commissioning Groups’ will meet in public. Health bosses intend that this committee will endorse the closure plans. Are you free on 10th August? We don’t at this stage know the time or place of the meeting. What we do know is that this is OUR NHS, and we’re up against people who are destroying it. We need to tell them how strongly we disagree with what they’re doing.

And around a week after that, it’s likely that the Boards of Shropshire Clinical Commissioning Group and Telford and Wrekin Clinical Commissioning Group will meet, in their turn, to endorse this catastrophic nonsense.

Each meeting is a further stepping stone towards unnecessary pain, disability and death for local people. This is not about improving our healthcare. The agenda now is one of driving through cuts.

We don’t know yet which A&E is to be closed, and which hospital downgraded. Last time, Princess Royal Hospital was the target (but Shrewsbury would have lost all planned care). Since then, there has been a revised ‘impact assessment’ of the planned move of Women’s and Children’s back to Shrewsbury, and a review of the process that led to the decision last time around.

‘SaTH’, the organisation running the Princess Royal and Royal Shrewsbury Hospitals, is currently getting geared up to close the A&E at Princess Royal Hospital overnight, and it looks increasingly likely that they will attempt this in the autumn. This is meant to happen when they reach an ill-defined ‘tipping point’. They’re actually better staffed than they have been at many points in the past – but are at the stage now of dropping heavy handed hints that the tipping point is almost upon us.

We have to be clear: whichever A&E is closed, it is a defeat for all of us. The evidence is that A&E closure and longer journeys to hospital lead to an increase in unnecessary deaths. It is unthinkable for either of our communities to say ‘Save us, let them die instead’ – and utterly disgusting that health bosses have been willing to play those divide and rule games. It’s also worth remembering that the hospital that keeps the A&E is intended to lose ‘planned care’ – meaning that all of us face longer journeys for some of our care.

The real agenda is much, much nastier, though, even than closing the A&E, and ending acute care at one of our two hospitals (and closing Telford’s Women’s and Children’s Centre too, if it’s Princess Royal in the firing line). Future Fit is about cuts, and cuts on a scale that will come close to destroying our local NHS. It is part of a bigger cuts package called the Sustainability and Transformation Plan. Rural communities are set to be devastated by this, with rural urgent care on nobody’s agenda, £3.8 million cuts to community hospitals on the way, and ‘Value for Money’ reviews taking place of Minor Injuries Units, community hospital inpatient beds, and rural Midwife Led Maternity Units. The plan for all of us, urban and rural residents alike, is that healthcare will be savagely cut. The intention is that we will be ‘empowered’ to care for ourselves. When we can’t do that, a semi-mystical process called ‘community resilience’ will apparently fill all the gaps left by cuts to NHS services and social care.

The cuts are on a dizzying scale. The latest figures haven’t been published yet – but last December, Future Fit was part of plans for: QIPP savings of £32 million; efficiency savings of £45 million; Carter review savings of £8.8 million; transformation savings of £32 million; reconfiguration savings of £15 million; rationalisation of services savings of £4 million; and community hospital savings of £3.8 million. The names don’t matter – these are just fancy titles for cuts. Cuts to NHS spending, cuts to NHS staff, and cuts to the healthcare we will receive in Shropshire, Telford and Wrekin.

Is there an alternative? Yes, of course. The NHS in England is underfunded, and gets way less money than comparable European countries. Within that, our area – Shropshire, Telford and Wrekin – is even more underfunded, and gets far less money than the national average for England. There’s no rhyme or reason to this one, and it’s extraordinary that our local MPs aren’t up in arms about the local shortfall of over £80 million each year. We have above average health needs locally, alongside rock bottom funding. It’s no wonder the sums don’t add up.

Future Fit lurches from crisis to crisis: close to collapse in October 2015, when NHS England said the cuts weren’t deep enough; voted down by Shropshire CCG in May 2016; on the brink of being abandoned altogether in October 2016; voted down by Telford and Wrekin CCG in December 2016. The problem with Future Fit is not that it has ‘taken too long’. The problem is that it’s shoddy, it is not evidence-based, and it is no longer remotely credible. There are better models of healthcare out there that are being ignored; there’s a catastrophic withholding of the core NHS funding we need in Shropshire, Telford and Wrekin; the shambolic remnants of Future Fit bear little resemblance to the original project of the same name.

It’s time to pull the plug on Future Fit. Let’s start from patient need, and ask our politicians to lobby for the funds to pay for an NHS that works. This is the decision that should be taken on 10th August.

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