Saving Our A&Es

Destroying the A&E costs how much?

Just over £5 million according to hospital trust SaTH. That’s £3.4 million in lost ‘business’, as local patients get packed off to out-of-county hospitals. And another £1.7 million for the extra ambulances to take them there, according to Shropshire CCG last week. That’s OUR money, by the way.

This is absurd. SaTH needs only five middle-grade doctors to keep BOTH A&Es open overnight. If they’ve really got £5 million to throw around, how about spending it on getting those staff in place instead of overnight closure of the A&E at Princess Royal?

The reality of course is that SaTH wants to run down the A&E. It’s the first step in implementing Future Fit, with its massive cuts and closures – and we can expect this to be followed quickly by further service changes at both hospitals. For SaTH’s senior management team, it’s about ‘investing’ £5 million to balance the books more easily over the next few years. The current decision on part-closure of Princess Royal’s A&E was taken by SaTH in July, disclosed to the BBC by a SaTH Consultant, and confirmed by another SaTH doctor. SaTH didn’t come clean, because if they had, people might have concluded that the Future Fit consultation was a con trick.

Not Safe

The overnight closure plans are plainly unsafe, particularly for children. Simon Freeman, boss of Shropshire CCG, confirmed last week that our concerns about the safety of children are shared by him and by the CCG Board. Overnight closure leaves Telford and Wrekin people in a healthcare desert at night – made even worse by the recent cuts to Shropdoc.

All local people face being shuttled around the West Midlands in search of an A&E and hospital with capacity to treat us in an emergency. This affects Shropshire and Powys people, as well as Telford folk – because of the way services are divided up between hospitals. The pretence is that Wolverhampton and Stoke are infinitely flexible and can pick up the extra patients, but their own figures on A&E performance, trolley waits, and ambulance handover times tell a different story.

Telford people able to travel or be brought to A&E by a family member are told to go to Shrewsbury A&E. That’d be the Shrewsbury A&E that routinely diverts patients to Telford, would it? This is nonsense. The capacity is not there.

And there are two possible plans for kids – as bad as one another. One plan is that all sick children will have to go to Wolverhampton or Birmingham. That’s a long way for any child in our patch, but ludicrous for Powys or South Shropshire children.

And the other plan is that some children will travel out-of-county, and others will be seen at Shrewsbury. Except the Princess Royal has the specialist doctors and facilities needed to treat sick children, and the Royal Shrewsbury does not. It also creates a complete disconnect between services that belong together. It can be very hard to ‘intubate’ small children – that is, to insert a tube to help them breathe in a life-threatening emergency. This is particularly the case if a child has severe burns or trauma. Those children need specialist input from ENT experts – and they need it quickly. But the plan is for those experts to stay at Princess Royal while the children who desperately need their help are shipped every which way – long journeys out of county, or Shrewsbury without the right doctors there.

These plans are a disgrace. They risk lives. For these plans to even be considered shows a Senior Management Team that is no longer fit for purpose.

Is There an Alternative?

Yes. And for the £5 million SaTH wants to spend on closure, they could maybe try just offering £1 million each to the first five suitable middle-grade doctors to come along!

We talked to a senior doctor, though, about how to attract staff on a sustainable basis. There is a national shortage of doctors – and unsurprisingly, they go to hospitals that make them the best offer. SaTH could attract middle-grade doctors who wish to develop to Consultant level by offering them more sessions in which they can develop their skills – a win-win situation for staff and the hospitals. SaTH could do much more to offer accommodation for doctors and their families (and the latest initiative from Telford and Wrekin Council is welcome here). SaTH could pay for visa costs for Commonwealth doctors, and for their family members. SaTH could try ending the culture of bullying that has haunted the Trust for far too long. And short-term, while SaTH gets its act together, there are of course doctors there between now and Christmas if they are offered enough money.

This is our letter to Secretary of State Matt Hancock. This is a practical solution that can STOP the part-closure of the A&E at Princess Royal.

A Shambles of a Trust

The problem is a Trust that is beset by crisis on every side. The hospitals have fantastic and committed staff – but too often, they’re being let down by a system that doesn’t work. The CQC findings in August were genuinely frightening, with staff at every grade and in every area telling hospital inspectors of care that was ‘unsafe, demeaning, undignified, and disgusting’.

And the Ockenden Review into maternity care is now investigating over 100 cases of death or significant harm to babies, and four deaths of mothers. Behind those stark numbers lie a myriad of individual tragedies and incalculable loss. We believe the outcome of the review will be damning – and that it will identify systemic failure. That’s the responsibility of the people at the top.

The SaTH Board is simply not doing its job of holding hospital leaders to account. The Chief Executive and Medical Director have failed to ensure patient safety, and failed to create an open and transparent culture where staff can speak out on clinical risk. We think they should go.

Demonstrate and Lobby!

Things to do:

• Support Telford and Wrekin Council’s march and rally against for the A&E to stay open. This will be in Wellington on Sunday 4^th November, time to be confirmed.
• Sign the petition here. Please share this as well. It’s about safeguarding healthcare for all of us.
• And send a quick email or letter to your MP. The solution to this crisis is not ‘special measures’ – which typically means more cuts and less accountability. We need the doctors now, and it’s within the power of NHS England (and behind them, the government) to make this happen. And we need enough money for our local NHS that current cuts will stop.