Overnight closure threat is backdoor closure of PRH’s 24/7 A&E without consultation

It is believed that steps towards the overnight closure of Telford’s Princess Royal Hospital’s A&E department on safety grounds could be just weeks away.

Overnight closure threat is backdoor closure of PRH’s 24/7 A&E without consultation

The Leader of Telford & Wrekin Council claims this would be a “backdoor closure” of the full 24/7 A&E service without any consultation because it would be on safety grounds and the consequent impact on the PRH’s Women and Children’s Centre is therefore uncertain.

Cllr Shaun Davies warns this would be “slippery slope” descent towards downgrading the PRH.

The future of both services are due for a public consultation on proposals outlined by the Future Fit programme on the area’s hospital services after its preferred option was backed by the area’s two CCGs in August 2017.

But almost six months later, there is still no sign of the Future Fit consultation starting or even if the money has been secured to make any changes.

Future Fit says that a Women & Children’s consultant-led unit, such as that at the PRH, must be at a hospital with full 24/7 A&E services. Its preferred option would see the PRH’s Women’s & Children’s consultant-led services move to the Royal Shrewsbury Hospital to sit alongside full 24/7 A&E services there. The preferred option would also see the PRH’s full 24/7 A&E a 24/7 urgent care centre.

The Women & Children’s Centre at PRH opened just three and a half years ago at a cost of £28 million and was sited at PRH because of proven clinical need.

A letter dated 29 January from NHS Improvement to the Shrewsbury & Telford Hospital’s Trust chief executive Simon Wright and seen by the Council highlights that moves towards likely overnight closure of the hospital’s A&E services at PRH could begin by 1 March.

The letter looks at the Trust’s “workforce fragility” and the impact of the resignation of one Emergency Department consultant who is part of the on-call rota.

The letter warns that unless a new locum consultant is recruited by 1 March who is part of the on call rota and agrees to an enforceable 6 week notice period, this would likely result in the overnight closure of PRH due to safety concerns.

Cllr Davies says overnight closure on safety grounds would effectively pave the way for this to happen without any need for a public consultation. He said: “In March 2017 we warned that overnight closure of A&E risked becoming a downgrading by the backdoor of our hospital and I was accused of crying wolf. Well that wolf is now well and truly at the PRH’s doors.

“A closure on the grounds of clinical safety can be made without any public consultation.

“Future Fit argued time and time again that changes were needed because workforce and recruitment issues were risks to services. Yet despite Future Fit agreeing its basis for consultation almost six months ago, nothing has happened.

“Equally it appears that despite this looming crisis SaTH has done very little – the letter states they have not yet clearly articulated their workforce plan particularly for emergency care and there are concerns about bringing junior doctors through and their educational support.

“These are problems that SaTH very clearly flagged a long time ago but has done little to effectively address.

“This should be a final warning to everyone who uses the PRH – this would downgrade services at PRH and concentrate services away from our borough and east Shropshire, which has the largest population and the biggest health needs.”

“We will continue to do all we can to protect much needed services at PRH, services such as the Women & Children’s Centre, that the NHS itself says are based here because of clinical need.”

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