Dithering over Shropshire NHS Reform.

This week it's my turn to write the 'Politically Speaking' column for the County Times. So I've decided to get a few things off my chest. As follows;

Not for the first time, my 'Politically Speaking' column concerns the Shropshire NHS services available to patients in mid Wales. The current position is deeply worrying.  In 2014 all management groups in Shropshire and Mid Wales agreed reform of A&E service provision has to be reformed to remain clinically safe and sustainable. Both Clinical Commissioning Groups (CCGs), SaTH (Shrewsbury and Telford NHS Hospital Trust, and Powys agreed to set up an organisation called 'Future Fit' (a weird confusing title) to recommend how reform should be taken forward. They decisively recommended that there should be one Emergency Centre, located at Shrewsbury, which would handle about 20% of those currently turning up at A&E - the 20% that are life-threatening emergencies. It would also handle complex births and paediatrics. 'Future Fit' took 3 years and investment of £2 million pounds to arrive at its recommendation - only for Telford and Wrekin CCG to reject it last Christmas. This was a stunning blow to those of us who want to see thriving hospitals at both Shrewsbury and Telford, serving Shropshire and Mid Wales patients.

For a few days the two CCGs and 'Future Fit' were like rabbits in headlights. Eventually it was decided the only way forward was to commission a report to establish the credibility and soundness of the 'Future Fit' report which had been rejected. This should have been produced many weeks ago, in order that the next stage of public consultation could begin. We are still waiting! I become increasingly fearful that the Chief Executive of 'Future Fit' is not capable of delivering this report in time. The current dithering and delay is simply not acceptable. Unless there is real progress in the next week or two, the Chief Executive of 'Future Fit' should be replaced. The NHS serving Shropshire and Mid Wales is too important to be left floundering because of a failure to deliver. We have waited long enough. Patience has been exhausted.

And another important change is needed. The two CCGs who could not reach agreement should both be scrapped, and replaced by one Shropshire CCG. It seems that this change is on the agenda, but it should happen now. It's clear that the territorial instincts inherent in the current CCG structure is incapable of making decisions for the overall benefit of Shropshire and Mid Wales patients. If it's accepted that merger is the only way forward, and I think it is, why not get on with it and sort it now. While all this dithering and posturing continues, it is the patients who suffer.

In situations like this, it's easy to just let things drift. But 'drift' has serious implication for the NHS serving Shropshire and Mid Wales. The refusal to commit to reform which all the clinicians, (and those not seeking to pursue political interests) know are crucial to a safe and sustainable future, make both Shrewsbury and Telford Hospitals look unsustainable to the rest of the UK (even the world, where quality consultants often come from). They will not come to work in Shropshire. We know that two weeks ago, neurological services for all new patients were transferred with immediate effect to Wolverhampton. I'm president of both the local branches of Motor Neurone Disease and Parkinson's so appreciate the implications of this. The reason is inability to attract suitable skilled consultants. More and more services will be transferred to Stoke, Wolverhampton and elsewhere. It’s happening now. 

And finally there's the availability of Government money to finance the reform of emergency services. It will need around £200 million. Currently, we have a small window of opportunity to access the money. Further delay will see this window close, see reform stifled for the long term, and Shropshire hospitals lose services to further afield. And it's the injured, the seriously ill and the frail who will pay the price for dithering. It's utterly shameful.