On Monday, February 18, Telford and Wrekin Council will be holding an Extraordinary Meeting to discuss referring the decision to proceed with Future Fit to the Secretary of State for Health and Social Care. This is a procedure laid down in the Health and Social Care Act of 2012 when a local authority believes that a decision by the health bosses is not in the best interests of local people. It will halt progress on Future Fit until the Secretary of State has ruled on the proposals and may result in the health bosses being told to look again.
In advance of the Meeting, Shropshire, Telford and Wrekin Defend Our NHS has written to each individual Councillor to urge them to support the referral, but to do so on the basis that we need both our A&Es. The letter is below.
We are writing to you in advance of the Extraordinary Council Meeting on Monday 18th February.
Firstly, and most importantly, we share your strong concerns over the outcome of the CCG Joint Committee meeting of 29th January. The meeting itself was in many respects shoddy, as was the consultation that preceded it. The decision will leave us with a hospital that is too small to meet demand, and with increased journeys to care that will cost lives. There is no question that the outcome is detrimental to healthcare for Telford and Wrekin people (as it is for Shropshire and Powys people). Continue reading
A meeting dominated by the A&E closure decision
When the SaTH Board met on Thursday 25th October, they were joined by around 40 campaigners, strongly opposed to the overnight closure of the A&E at Princess Royal Hospital.
The SaTH pretence on Thursday was that no decision had been taken on overnight A&E closure. Really? One brief exchange gave the game away:
One Board member said, “What happens when it closes?”.
“IF“, barked the Chair.
“Yes, what happens IF it closes”, said the Board member.
Despite the games playing, the Board was on the back foot for much of the meeting. Sharp challenges from campaigners forced them to tear up the planned agenda. The Chair started off by announcing that public questions on A&E closure would be taken at the end of the meeting – many hours away. There were shouts of “shameful”, and he was told he was treating the public with contempt.
He eventually backed down. The meeting was dominated by a public session on A&E closure that ran for about an hour. And these were not deferential ‘public questions’. These were sharp, well-informed – and angry – challenges to plans that put lives at risk.
Again and again, Board members looked anxious. They simply had no convincing answers. Yes, they still intend to push this massive attack through. But they were on the defensive, again and again and again.
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. Continue reading
This letter was handed to Matt Hancock, the current Secretary of State for Health at the Conservative Party Conference in Birmingham by a number of supporters of Shropshire, Telford & Wrekin Defend Our NHS. It contains specific proposals that would ensure there was no need to close either A&E.
2nd October 2018
Matt Hancock MP
Secretary of State for Health
Dear Mr Hancock
As residents of Shropshire, Telford and Wrekin, we are asking for your help.
You will know about the massive crisis in our local hospital trust, ‘SaTH’. The trust runs two A&Es and hospitals, at Shrewsbury and Telford. You are of course aware of the independent review of avoidable deaths and occurrences of harm in maternity. Our experience is that there is a continuing culture of denial at Board level. How is it possible to learn from mistakes if they are not acknowledged in the first place?
We assume, too, that you will know of the CQC inspection that has just finished. The leaked CQC letter has been widely reported, and it identified serious risks to patient safety. It cannot be acceptable ever in the NHS for a diabetic patient to be left without food or fluid for 15 hours, for a high dependency area to be left completely unstaffed for 15 minutes, or for a patient with signs of deteriorating sepsis to be left on a trolley in the corridor without adequate care. There is a desperate shortage of staff and beds at both hospitals, and current reconfiguration plans will make this much worse.
That’s the only possible view of the leadership of Shrewsbury and Telford Hospitals Trust following the farce of a Board meeting yesterday.
In the midst of overwhelming crisis, the Board had a brilliant plan: ‘Let’s ignore it’. The periodic injections of reality came from the many members of the public present, and from the one honourable Non-Executive Director who did a decent and principled job of challenging the positive spin.
The horrors of unsafe care exposed by hospital inspectors were touched on (momentarily) by Chief Executive Simon Wright. The Trust “will work closely with the CQC and ensure that we can evidence the learning and evidence those things where there may have been confusion”. Not a mention there of staff telling inspectors of unsafe and degrading care; of patients treated like ‘animals’ and ‘cattle’; of inspectors repeatedly going to the aid of patients because there weren’t enough staff. Members of the public expressed horror that staff have to speak to hospital inspectors about unsafe care because they don’t trust internal reporting mechanisms. There’s no evidence the Trust Board is too bothered about this.
In Shropshire, Telford and Wrekin Defend Our NHS, we welcome today’s intervention of the Care Quality Commission (CQC), and the issuing of an enforcement notice. The observations of hospital inspectors – leaked and widely publicised last week – were genuinely shocking.
It is wholly unacceptable that patients in our hospitals have been ‘boarded’ in inappropriate areas, because of a lack of beds – on corridors, in areas without access to call bells or oxygen, or on wards so crowded with extra beds that a resuscitation trolley could not be pushed through.
It is disgusting that hospital inspectors had to go to the aid of patients multiple times because of staff shortages. It is close to unbelievable that those patients included a diabetic patient left without food or fluid for 15 hours; close to unbelievable, too, that a high dependency area was left completely unstaffed for 15 minutes.
We applaud the courage of staff who approached hospital inspectors, and told them of the problems. It was staff who blew the whistle here. A letter from the CQC to hospital trust SaTH reported: “Staff across all areas and grades raised concerns with us about this practice (‘boarding’) and told us they felt it was unsafe, demeaning, undignified, and disgusting. Two staff members told us they felt patients who were boarded were treated like ‘animals’ and ‘cattle’.”
Something has gone very badly wrong at our local hospitals. Julia Evans is Secretary of Shropshire, Telford and Wrekin Defend Our NHS, and is a former A&E Nurse at the Royal Shrewsbury Hospital. She says, “NHS cuts lead to shockingly bad care – and that is the fundamental lesson that must now be learned from the crisis at Princess Royal and the Royal Shrewsbury Hospitals”.
The key questions are around what happens next. We call for the following:
Today, Wednesday (1st August), we have finally learned the plans for ‘Shropshire Care Closer to Home’ – community services in Shropshire – and the plans are as bad as they could be.
Future Fit relies on moving care out of the remaining acute hospital, whether that’s at Shrewsbury or Telford, and into community settings. There is a need for new and better community services. The bed, workforce and financial modelling of Future Fit are all dependent on this. The Pre-Consultation Business Case outlines plans for a 35,738 reduction in bed days, a reduction of 5,054 emergency admissions, and a bed base reduction of 110 beds. If community services fail to prevent poor health and to treat people in the community when they do become ill, then Future Fit will also fail.
Then and now – what a difference. In August 2015, Dr Caron Morton – as Chief Officer of Shropshire CCG – wrote to local GPs to inform them of new investment in community services. The plan was for the ‘transfer of financial resources into community provision – identified as £5.3 million recurrently per annum’.
And what has that £5.3m a year been replaced with? The ‘Care Closer to Home’ overview released by Shropshire CCG today states bluntly, ‘SCCG has no additional money to pay for this way of working’! Instead, the plan is to close existing community services to pay for new services – but that means taking community NHS care away from people who depend on it now.