I received the following flyer yesterday morning:
A Beginner’s Guide to Future Fit: the plans to cut hospital care in Shropshire, Powys and Telford and Wrekin. For more information, please get in touch with us at info@shropshiredefendournhs.org
We need two A&Es and two hospitals. We need properly funded NHS care, in hospitals and in our communities. We have to reject the divisive ‘Shrewsbury & Telford’ battle that NHS bosses encourage and politicians fall for. Shropshire Defend Our NHS is campaigning hard for a high quality NHS that delivers for all of us – Shropshire, Powys, and Telford and Wrekin. It’s election year, and that gives us a voice. We’re confident we can win.
‘Future Fit’. It’s the name used by NHS Bureaucrats for a massive restructuring of healthcare in Shropshire and Telford and Wrekin. (It will also affect the Powys residents who rely on the Royal Shrewsbury Hospital).
When you go to public engagement meetings, the NHS bosses make Future Fit sound wonderful. They promise that they are improving acute and community hospital services. Often, they promise much more: ‘care closer to the home’, a ‘network of centres providing urgent care’, ‘partnership care’, ‘proactive care’, ‘integrated care’, ‘prevention’, ‘collaboration’, ‘wellbeing’... We are sold a vision where fewer of us get ill, and when we are sick, there will be a brilliant NHS community services and social services to make sure we don’t need to go into hospital.
Is any of this going to happen? No. The money isn’t there. In practice Future Fit has been reduced now to closing down an A&E, slashing the number of hospital beds, and reducing access to planned care (hernia repair, hip replacements, cataract surgery etc). This is ‘Phase 1’ of Future Fit – the stuff the NHS bosses want to push through quickly to save money. Everything else is locked into ‘Phase 2’ and beyond, with no identified timescale and no ring fenced budget. This is about NHS cuts, dressed up in all sorts of fluffy rhetoric.
There’s a financial crisis in our local NHS. Our local hospital trust (SaTH) is effectively bankrupt now – borrowing money just to keep the doors open at the Royal Shrewsbury and Princess Royal. The Chief Executive of the hospital trust has just resigned – NHS chief executives come and go quickly around here. We know that NHS England thinks that Shropshire’s NHS gets too much money! That leaves NHS bosses facing future losses of around £13 million a year, on top of the terrible funding squeeze that is going on nationally. And back in 2013, the Chief Executive of Shropshire CCG – the organisation that plans and buys local healthcare – said that there would be a shortfall of £82 million by 2016/17.
This is why two District Hospitals (the Royal Shrewsbury and Telford’s Princess Royal) is suddenly described by health bosses as ‘duplication’. If you offer every hospital service from one hospital not two, of course that saves a lot of money. That doesn’t mean we have ‘duplicate’ now. We have two District General Hospitals for the simple reason that we need two District General Hospitals: for 540,000 people living across 2000 square miles. These plans are about driving through cuts, not improving patient care.
Don’t believe it? Look out for the word ‘sustainable’. If you ever go to a meeting on Future Fit or read the leaflets and bulletins about Future Fit, keep your eyes open for the magic word ‘sustainable’. It’s the new code word for cuts. A ‘sustainable NHS’ is one that is getting completely inadequate funding, so NHS bosses resort to desperate attempts to salami slice NHS care.
What are they planning to do with hospital closures? Health bosses have been trying to kid us that we’ll have a brand new ‘super hospital’ built between Shrewsbury and Telford. This is just misinformation. They know and we know there is no possibility at all of this happening. The cost of building a new hospital would be over £500 million – followed by huge repayments on what would almost certainly be a variant of PFI. It’s on their ‘short list’ of options, but this is just to string us along. There will be no new hospital.
They initially wanted to close down the Royal Shrewsbury almost completely, and concentrate all services at the Princess Royal. Moving Women’s and Children’s Services to Telford was the first step in this.
They faced more opposition than they expected – so the new plan is to close down half of the Royal Shrewsbury and half of the Princess Royal. Presumably NHS bosses think we won’t notice the cuts because neither hospital will vanish completely!
It is a virtual certainty that the decision has already been taken to close the A&E at the Royal Shrewsbury. As part of the same cuts around, the plan is to get rid of critical care, and all the acute hospital beds at RSH (i.e. all the facilities for seriously ill people). We know the Royal Shrewsbury Hospital is top of the hit list because they say the ‘Emergency Centre’ – the new name for A&E – has to be on the same site as Children’s Services. Last year they spent £28 million moving Women’s and Children’s Services from Shrewsbury to Telford. Are they really going to spend a similar amount of money moving them back again? Of course not.
Longer ambulance journeys lead to unnecessary deaths – the research evidence shows this. Losing our A&E would be a disaster for residents of Shropshire and Powys. Again and again we’re hearing reports of critically ill patients waiting an hour or more for an ambulance. Now the plan is to create longer journeys to hospital. There is no question that this would lead to more patients dying. We simply can’t let this go ahead.
Is the NHS plan a victory for the Princess Royal? No! The Princess Royal would have all its ‘planned care’ stripped out and moved to Shrewsbury. ‘Planned care’ means operations that are booked in advance – hernia repair, cataract surgery etc; and also diagnostic tests done in hospital. Telford people face worse access and longer journeys as they travel to the Royal Shrewsbury.
It gets worse. The A&E at the Princess Royal is already under huge pressure. How could it cope if it served a population more than twice the size? It’s worth looking at the example of Stoke. Stoke’s A&E declared a major incident and shut its doors in January. They simply couldn’t cope with the increased patient numbers from Stafford’s A&E being closed down. A&E closures lead directly to A&E crisis.
The A&E at the Princess Royal isn’t intended to be a top ranking Major Emergency centre, either. It’ll be a lower grade Emergency Centre with less funding, less consultant cover, and less access to diagnostic procedures.
The nearest Major Emergency Centre will be at Stoke – yes, the A&E that is already at the point of collapse.
Hospital beds are set to close. We’ve had one informal report that the number of beds could be slashed from 750 to 450. This cannot possibly work. The ‘Future Fit’ vision is that fewer patients will be admitted to hospital and we’ll be discharged much, much sooner. The money being put into community NHS services and social care is woefully small, though, so what’s going to happen? A discharge back home. Apparently ‘home is normal’ – it’s one of the Future Fit mantras. At one meeting, Bill Gowan – Clinical Lead for Future Fit – said in all seriousness that when people are ill, we should talk to our neighbours or go to the library! He explained that this is about ‘resilient communities’ – a good deal cheaper than doctors and nurses.
Too few hospital beds means rotten care for patients who need hospital treatment – and is a disaster also for A&E, with ambulances queuing up outside because patients can’t be admitted. This is not the way to go.
NHS bosses promised a ‘network of Urgent Care Centres’, but they want only two: one at the Royal Shrewsbury, to replace the A&E, and one at the Princess Royal to act as gatekeeper to the A&E. There has been real games playing, with rural Urgent Care Centres promised but then set up to fail. After strong resistance from local communities, NHS bosses are now talking up the prospects of urgent care in rural areas – but they won’t commit to a timescale and there’s no ring fenced budget. Urgent Care Centres will replace our existing Minor Injuries Units and Walk In Centres (at Bridgnorth, Ludlow, Oswestry, Whitchurch and Telford) – so we are probably still looking at less care, further away.
There are countless other problems:
There has been no modelling of the increased ambulance journey time to take patients to Telford – and there is to be no additional investment in ambulance services. Our data show an average of 15 minutes longer for each ambulance call out in Shropshire – so without enough ambulances, we face even longer waits.
Our Community Hospitals are at risk if their Minor Injuries and diagnostic services are stripped out.
How can GPs cope with the 33% increase in work that’s coming their way with Future Fit? They already face a workforce and workload crisis.
The leading clinical experts in the West Midlands don’t think Future Fit will work. A ‘Clinical Senate Review’ – carried out by expert doctors in the West Midlands – found in January that the evidence for ‘Future Fit’ is just not there, and there are significant risks to patients if these plans go ahead.
Future Fit? It’s not fit for purpose. The NHS belongs to us, the people. If we don’t defend it, we’ll lose it. Pressure from below has already led to significant changes in the Future Fit plans. Now’s the time to escalate the pressure.
