Tuesday, December 13, 2016

Black Day for NHS Reform in Shropshire and Mid Wales

About 30 yrs ago, I first met a young consultant named Paul Brown at the Royal Shrewsbury Hospital. I'm told Paul was a brilliant 'guts doctor'. There is a ward named after Him at the Princess Royal Hospital in Telford today. I met Paul when he removed a coin that our youngest had swallowed with an endoscope - very new procedure in those days. It turned out that he was an enthusiastic squash player. We were well matched, and played each other many times and played for the same Shrewsbury School team in the Shropshire Squash Lg. We became very good friends.

When Paul realised I was involved in public life, he really laid into me about the new hospital that had recently been built in Telford. Paul was totally opposed to it. He had great foresight. He could see, even then, that in a fairly short time, Shropshire would not be able to sustain two District General Hospitals. I lost count of the number of times he told me that by building the Princess Royal, we would effectively, in the long run, be closing the Royal Shrewsbury. I think he was over-egging it a bit to make a point. It was Paul Brown who 'educated' me about the inevitable inexorable move to more distant specialist services and larger 'catchment' areas. Anyway, enough of the preamble.

Around ten years ago,I got to know the Chief Executive of the Shrewsbury and Telford Hospitals Trust, a good and bluff man named Tom Taylor, who became a friend . It was already clear reform was needed to deliver effective care, and to retain services in Shropshire. He tried reform, with help from me at the time. With little success. Later on he was succeeded by an Adam Cairns, who decided to focus investment on the Princess Royal, including a £28million investment in a new Women's and Children's Hospital. If he had stayed, I suspect, Shrewsbury would have been gradually run down. How I disagreed with Mr Cairns. How glad I was to see the back of him.

Then about 3 yrs ago the new NHS management structure in Shropshire (2 Clinical Commissioning Groups - the Shropshire CCG and the Telford and Wrekin CCG) established a new body (the Future Fit Programme Board) to make a serious assessment of how services should be reformed. It's reported to have cost about £2million - so far. Recently it met to decide and decide it did. Clearly and unambiguouslsly. It proposed that a new Emergency Unit should be built at Shrewsbury, including the Women's and Children's services currently delivered at Telford. It's proposals to reform A&E have attracted a lot of attention and comment, much of it untrue. The recommendation is that the new 'Emergency Centre' at Shrewsbury would deal with around 20% of most serious cases currently going to A&Es, while the other 80% would continue to be treated at what would be called 'Urgent Care Centres' at the two hospitals. The widespread claims that A&E would no longer be available at Telford is untrue and misleading - at best!

Tonight the two CCGs met to consider the recommendation, and despite the huge amount of work already put in, decided not to accept it. Instead they have asked the Future Fit Programme Board to do more work. This is a disaster for the Shropshire and Mid Wales NHS. Already the number of consultants available to man A&E are at the absolute minimum, including (so I'm told) one locum. It's on a knife-edge. I suspect clinicians will be in despair tonight. No-one knows where the process is now heading. ULooks a total shambles to me. No amount of smooth talking is going to cover that up. Suppose we'll have to let the dust settle and regroup. But it's been a very black day for the NHS in Shropshire and Mid Wales.

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