Shropshire, Telford & Wrekin Defend Our NHS

What do we know?

We know for sure now that NHS bosses want to close down the A&E at the Royal Shrewsbury Hospital and get rid of most of the services provided by the hospital. We know this from the small print of the ‘Future Fit’ paperwork, and from the information now emerging from Future Fit workstreams.

Maternity and in-patient children’s services have already been moved to the Princess Royal Hospital at Telford. NHS bosses want a single ‘Emergency Centre’ to replace our two A&Es, and they’ve decided it must be on the same site as maternity and children’s units – so that means Telford. They’ve decided to replace our two District General Hospitals (at Shrewsbury and Telford) with a single ‘high acuity’ hospital for the sickest people and a single ‘Diagnostic and Treatment Centre’ for people needing planned care such as hip replacements or cataract surgery. Guess what? These will be in the same place as the Emergency Centre – so they will be at Telford too.

It’s very clear: our two A&Es and our two District General Hospitals are intended to be replaced with one A&E and one big hospital centre, and everything will be based in Telford. Minor surgery for lumps and bumps? Telford. Radiotherapy and other cancer care? Telford. A life threatening emergency? Telford. NHS bosses claim that no decision has been taken. Technically that’s true. Officially, no decision will be taken until after a brief period of public consultation in about a year from now. Behind closed doors, they’ve already decided on how to push through massive cuts to our NHS – and that’s by getting rid of almost all the services at the Royal Shrewsbury Hospital.

We don’t think this is a battle between Shrewsbury and Telford. Our hospital services cover a population of over 500,000 people across Shropshire, Telford and Wrekin, and Powys. The geographical area served by our local NHS is vast (around 1235 square miles just in Shropshire). Patients in South and South West Shropshire already face some of the longest journeys in England to get to hospital. Ambulances already fail to meet target response times. We need both of our existing hospitals and both of our A&Es, in Shrewsbury and Telford. If we close either hospital, people will die.

It gets even worse! Under national plans, the single Emergency Centre in Telford won’t be a fully staffed or equipped ‘Major Emergency Centre’ or ‘Specialist Emergency Centre’. It will be a smaller A&E with less funding and fewer staff. Patients with heart attacks and strokes will be transferred to the North Staffordshire Hospital at Stoke-on-Trent. NHS bosses say we’re just scaremongering – but we’ve been tipped off that these changes are already happening, and they’ve somehow forgotten to tell anyone! Under their plans, patients will face waits of three hours or more before they get specialist treatment. For heart attacks and strokes, this is a catastrophe.

1. What can you do?
   Contact your MP and your councillor. We’ve written to Shropshire Council councillors, and we’re getting in touch with town and parish councillors and with MPs. They need to know that people care about the NHS, and that we want our elected representatives to stand up and be counted when it comes to keeping a working NHS in Shropshire. You can contact councillors and MPs through the website https://www.writetothem.com/ . Do you need more information? Our letter to councillors is here:
   https://shropshiredefendournhs.org/wp-content/uploads/2014/09/councillor-letter.pdf.
2. Their first step in closing down the A&E at the Royal Shrewsbury Hospital is to privatise 60% of it, giving it to a private company called Malling Health. At the same time, they’ll be closing down a valued walk-in centre at Monkmoor. They want to do all this with no consultation at all, and to get it all done by Christmas. NHS bosses have called a meeting about this on Tuesday 2nd September at 6.30 pm, Lord Hill Hotel, Abbey Foregate, Shrewsbury SY2 6AX. Come and tell them what you think.
3. There are other ‘public engagement’ meetings called by the NHS – they want to tell us that closing hospitals is a wonderful idea. To book a place at any of these meetings, please ring 0121 612 2805 or email nhsfuturefit@nhs.net . Here are the meeting details:
   OSWESTRY: Thursday 18th September, Oswestry Cricket Club, 5.00 pm to 9.00 pm
   NEWPORT: Friday 19th September, Cosy Hall, Newport, 1.00 pm to 5.00 pm
   NEWTOWN: Monday 22nd September, The Monty Club, Newtown, 5.00 pm to 9.00 pm
   LUDLOW: Tuesday 23rd September, Ludlow Assembly Rooms, 10.00 am to 2.00 pm
4. Public Meeting
   And finally… Shropshire People’s Assembly has called a public meeting on defending our NHS on Thursday September 11th at 7.30 pm at Shrewsbury Baptist Church, Claremont Street SY1 1QG (doors open at 7.00). Speakers include Dr Kambiz Boomla, GP and campaigner; Mark Lyons, Vice Chair of Unite, and Gill George, local NHS campaigner. Please come along to this if you can.

Gill George, Chair
Joyce Brand, Secretary
Shropshire Defend Our NHS

Privatisation begins of A&E at Royal Shrewsbury Hospital

A key council committee was dramatically divided today (14^th July) in a vote on approving a major change to A&E services at the Royal Shropshire Hospital.

Shropshire CCG – the body that runs NHS services – has decided to close the Monkmoor Walk-In Centre in Shrewsbury, used by 34,000 people a year. The private company running the Walk-In Centre, Malling Health, will be given a contract extension – but will run a sharply different service instead: an Urgent Care Centre to be based alongside the A&E Department at the Royal Shrewsbury Hospital. The decision on the Urgent Care Centre pre-empts the work of the Future Fit NHS reorganisation plans, which have not yet been consulted on.

The Council’s Health and Adult Social Care Scrutiny Committee split by 5 votes to 4 on supporting the plans. An alternative motion to defer for more information and consultation was lost by 4 votes to 5. A central concern for the councillors who voted against the plans was the lack of consultation.

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Shropshire Defend Our NHS has always been concerned that the whole exercise of consultation around Future Fit has been a sham – and that the key decisions have already been made. The latest decision of Shropshire CCG is proving us right. The CCG are seeking approval for opening an Urgent Care Centre at the Royal Shrewsbury Hospital site with only a few days notice to the public, with the Shropshire Star of 10^th July reporting that “a decision will be made on July 14”. It is of huge concern, too, that the CCG have decided to give the work to a profit making private company, Malling Health. This is to be a new service, resulting in a fundamental change to how the existing A&E department at the Royal Shrewsbury Hospital works. This cannot be seen simply as the extension of an existing contract.

The absence of consultation is shocking. We have been told repeatedly that no decisions have been made yet about how to implement the local ‘Future Fit’ proposals for major reorganisation of NHS services. There is supposed to be public engagement about a short list of options in the autumn of this year, and a formal public consultation after next year’s General Election. Now, though, the CCG are simply bypassing all of their own commitments to consultation and are steamrollering ahead with their plans.

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I’ve recently been fitted with NHS hearing aids. I was given a choice of audiology services – I could go to a high street shop, or I could have an appointment at my local community hospital. I believe in the NHS. I’m opposed to people making a profit out of healthcare. So I plumped for the local hospital.

Imagine my surprise when I discovered, at my appointment, that it wasn’t an NHS service at all. Shropshire Clinical Commissioning Group have commissioned a private company, Regional Hearing Specialists (RHS), to provide audiology services.

On the face of it, RHS are a small company with headquarters in Cornwall, and only formed in March 2013. But they are a subsidiary of a large conglomerate. In the UK they are owned by Bloom Hearing Specialists who run a chain of high street stores selling hearing aids and accessories. Bloom, in turn, are owned by a Danish company, Widex. According to the Financial Times, “Widex is among the world’s six largest manufacturers of hearing aids, with a global market share of about 10 per cent.”

So my choice wasn’t really between a high street shop and the NHS – it was between two massive commercial chains.

Why does it matter? Well, the hearing aids are free, but the private companies make their profits from the fees they get from the initial testing and fitting. Providing NHS aftercare, a key benefit of NHS services, just eats into their profit margins. I was offered a home repair kit at £20 so I could do my own maintenance on my hearing aids. And I was given an order form to take away so I could mail order cleaning materials from RHS. It wasn’t suggested that I buy stuff from voluntary organisations. Action on Hearing Loss (the new name for the Royal National Institute for the Deaf) offers similar items to RHS but they cost a third less. RHS don’t want me to come back with any maintenance issues – they want to sell me over-priced “accessories” instead.

RHS prominently display the NHS logo on all their materials. Patients could be forgiven for thinking that they really are the NHS. If the NHS tells us we need to buy expensive cleaning tissues, many of us will, even if we can’t really afford to. So the service moves from “free at the point of delivery” to “additional charges at the point of delivery.”

That breaks all the ethos of the NHS. As the doctor’s journal, the Lancet, said in an editorial in the 1940’s during the debate on the founding of the NHS:

“The truth is that the doctor-patient relationship in its modern form needs improvement rather than preservation: it can never be wholly satisfactory while the doctor is not only a friend in need but also a friend in need of his patient’s money; nor while there is competition rather than co-operation between him and his colleagues.”

Successive Governments have brought competition and a quest for profits into the NHS. The Lancet was right over 60 years ago. Healthcare is too precious to be left to the market.

An open letter to Dr Helen Herrity, Chair of Shropshire CCG and Dr Michael Innes, Chair of Telford and Wrekin CCG

Dear Dr Herritty and Dr Innes

We are writing this open letter on behalf of the Shropshire Defend Our NHS campaign.

On the question of two A&E departments in Shropshire, we know we disagree. We believe that there is a need for two centres to cover this large geographical area; you believe that only one is needed. That is not the focus of this letter.

The national review of urgent and emergency care makes a distinction between ‘Emergency Centres’ and ‘Major Emergency Centres’. These – like Urgent Care Centres – will not be commissioned by local CCGs, but by much more remote bodies called Strategic Urgent Care Networks¹. Each of these will cover ‘a wide geographical area’, according to initial information from NHS England. We regret that these crucial decisions on urgent and emergency care will no longer be made locally, and we believe that this sharply reduces accountability to NHS users. We are of course aware of the planned changes to urgent and emergency care nationally: that many of the patients currently seen at A&E departments will visit Urgent Care Centres instead, while the two different levels of Emergency Centres will see the most seriously ill people, those with potentially life threatening conditions².

From information given by Caron Morton to the Future Fit meeting in Welshpool on 9^th June, we understand that there will not be a Major Emergency Centre in Shropshire. Caron indicated to the meeting that the Major Emergency Centre would be at the North Staffordshire Hospital at Stoke-on-Trent. This has been confirmed elsewhere.

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NHS bosses in Shropshire have released the first draft of plans for ‘Future Fit’, the reorganisation of local NHS services.

It’s a double whammy for Shropshire patients. Instead of the two A&E departments we have now, there will be only one ‘Emergency Centre’ (the new name for A&E). And instead of the two hospitals we have now, there will almost certainly only be one, alongside the A&E¹. That means that critically ill patients have longer ambulance journeys, with all the risks this carries.

It gets even worse than that. Our Emergency Centre in Shropshire will just be a very basic one, that tries to stabilise patients and start treatment. Patients who need any kind of specialist care – including people who have had strokes or heart attacks – will be transferred on to a Major Emergency Centre. The Major Emergency Centre will be at the North Staffordshire Hospital at Stoke-on-Trent^2,3.

Gill George, speaking for Shropshire Defend Our NHS, said, ‘This is really bad news for Shropshire people, and for the Welsh residents who depend on the Royal Shrewsbury. Our two A&Es get rolled into one, and then on top of that, it gets downgraded! For a lot of people we’ll be looking at journey times of three hours or more before they get the specialist treatment they need. Centralising specialist care isn’t so bad in cities, but it needs re-thinking for our rural area. You can have the best healthcare in the world, but it’s of no use to you if you’re dead by the time you get there’.

References

1. Futurefit Clinical Design Workstream, Final Report May 2014, Models of Care
2. The status of the Shropshire Emergency Centre and North Staffordshire Hospital as our ‘link’ Major Emergency Centre was reported verbally by Shropshire CCG Accountable Officer Caron Morton at a Future Fit engagement meeting on 9^th June and confirmed verbally at the Board meeting of Telford and Wrekin CCG on 10^th June.
3. Transforming urgent and emergency care services in England – Urgent and Emergency Care Review End of Phase 1 Report, November 2013. This national document outlines the relative status of Emergency Centres  and Major Emergency Centres (e.g. in the diagram on page 23), and elsewhere in the text).

The Future Fit Clinical Design document and the Urgent and Emergency Care Review are linked.

Press Release 28/04/2014

At last Friday’s Shropshire Health and Wellbeing Board, the Chair, Karen Calder, the Cabinet Member for Health, refused to commit Shropshire Council to supporting the continuation of an Accident and Emergency service at the Royal Shrewsbury Hospital, or at anywhere else in the local authority’s area.

The head of the Shropshire Clinical Commissioning Group, Caron Morton, confirmed at the meeting that the NHS ‘Future Fit’ programme, conducted jointly by the Shropshire and Telford and Wrekin CCGs, planned to have only a single Emergency Department in the near future – meaning either the RSH A&E or the PRH A&E in Telford will close or provide a greatly reduced service.

Councillor Calder attacked the unanimous decision of the Telford and Wrekin Council to support keeping a full 24-hour A&E service at the PRH in Telford.

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The Government says it’s ‘liberating the NHS’. That’s liberating the NHS of adequate funding and a workable structure, maybe. Locally, we’ve got an NHS that’s sliding deeper and deeper into crisis. Health bosses have gone to war with one another, as they try to shift the blame and the cuts onto someone else. Who loses? We do.

So what goes on?

Shropshire and Telford Hospital Trust runs the PRH and the Royal Shrewsbury. They finished the last financial year £4 million in deficit and had to be bailed out by the NHS nationally. In March, hospital bosses refused to set a budget for the new financial year from 1^st April – because of a £6.2 million gap between what patients need and the income the organisation is expecting to get. Their financial crisis explains why they want to close one of our two A&Es, and turn one of the two District General Hospitals into a local community hospital instead. Neat way of saving money, that. Continue reading →