Wednesday, September 30, 2009

Shropshire (and Montgomeryshire) NHS - Part 2

Follow up to yesterday's post about location of 'serious' A & E services in Shropshire. I'm pleased that a bit of interest and concern has been activated. Its a complex issue that could not be included in a singe post. It would be an essay. Anyway, here's another take on it.

There are three time frames to consider. a) - 2010/11, b) 2012/13 and c) 2020+. Let's consider these in turn.

Firstly, there's the need to provide a clinically safe service in the immediate future. There are potential problems arising from a shortage of consultants. Two reasons for this. Firstly, there's the introduction of the Working Time Directive. And secondly, there's the trend for consultants today to be more 'specialised' than 'general'. More consultants are needed to provide the same level of service. The only way to deliver greater certainty of a clinically safe service is more consultants - which needs more money - from somewhere. I hope that every effort is being made to rejig finances to deliver on this.

The second time frame is connected to the first. Even if extra consultants are appointed, it will be no more than a 'sticking plaster' which puts a more radical resolution off for two or three years. There will need to be what we can call an 'interim' reorganisation around 2012/13. . The proposals about what this should constitute is what the current row is about. It will not be possible to deliver the full A & E service at both Telford and Shrewsbury. Serious emergencies will have to be concentrated on one site, and the currently proposed location is the Royal Shrewsbury Hospital - on grounds of carefully considered appropriateness and cost. To locate at Shrewsbury will cost less than £20 million, while to locate at Telford will cost getting on for £50 million.

The third time frame involves building a new acute services hospital, probably on a new site somewhere between the two towns. The cost of this development may well be £500 million,and even if a decision to proceed was taken now, it would take until 2020 until the project was delivered. Big decision! Big money!

Now back to what I want to happen. The opinion that I've been putting forward is that every effort should be made to retain full A & E services at Shrewsbury and Telford for as long as possible. When the decision to concentrate serious A & E services in one location has is made, it would be much more acceptable if a commitment to proceed with the new 2020 hospital were to be made at the same time. My fingers and legs are crossed that the short term problems can be sorted before Nov 2nd, and that the proposed consultation can be postponed for a couple of years.


Unixman said...

Location at Shrewsbury will be much more acceptable for those people who live in the Welshpool up to Oswestry area rather than Telford. However some lateral thinking could be involved: how about reviving the A&E facilities at the RJAH with a view to forwarding on to the Maelor. I spoke to my brother who lives in Hengoed and they use the Maelor in preference to the RSH. If Telford "wins" the argument then this would be a preferred solution for lots of NW Shropshire and Mid-Wales. Already the RJAH acts as a district hospital for Oswestry and its hinterland and so expanding its services will help.

I know that this will only effect some of the people of Montgomeryshire - mainly as i said those living north of Welshpool (the A483 is a reasonable road!)

Sarah Millington said...

Having lived in Telford for all of my childhood and for the first couple of years of my son's life, I have first hand experience of the PRH and having a child who for the first few years of his life required regular trips to a & e for his epilepsy, because he had fitted and needed medical attention I can quite catergorically state it is simply not feasible to have a & e major emergencies concentrated on one site. There will I have no doubt come a time where someone living in Telford will require urgent assistance, immediate treatment and vice versa and as such the distance between the two hospitals is simply too great, it will be putting lives at risk. There were a couple of times where my son was admitted to icu at PRH because his fits were so severe. He could not of travelled the extra distance by car or ambulance without putting his life at risk.

They have a duty of care to all paitents and must ensure a equal service is provided everywhere, not in one place because they can't find the cost savings to enable it to happen in both places.

Anonymous said...

Thank you for bringing this issue to our attention, Glyn. We must marshal our forces to campaign for the retention of A&E at Shrewsbury. It would be a disaster for anyone living in MidWales to have to travel all the way to Telford. I remember the agonising journey with my son from Newtown to Shrewsbury after he had a bad fall - to wait to get to Telford would be life threatening for many. It is shame that we cannot retain both Telford AND Shrewsbury. Perhaps if a Conservative Govt diverted funds from the £40 million per day to the EU or the wasteful Foreign Aid budget, we could do!

Anonymous said...

Well said Roman Jones Esq, if it wasn't for the EU we woudn't be in this position!!