Government will not stop Future Fit plans but panel say use of the term A&E Local must stop

Andrew Stephenson MP, Minister of State for Health, has confirmed that the government will not stop Future Fit hospital transformation plans but an independent panel says use of the term A&E Local must stop because it is “a risk to patient understanding and safety.”

Government will not stop Future Fit plans but panel say use of the term A&E Local must stop

The advice comes following reconsideration of Future Fit plans by a government appointed Independent Reconfiguration Panel because Telford & Wrekin Council urged them to take another look in view of the latest population and health data.

In a letter to the council, Andrew Stephenson MP confirmed that plans to downgrade the A&E at the Princess Royal Hospital and to move consultant-led emergency care for women and children to Shrewsbury would still go ahead, subject to a raft of new recommendations made by the panel.

Leader of the council, Councillor Shaun Davies (Labour) said: “I would like to thank the panel for their work in re-looking at Future Fit plans and for the new recommendations they have made.

“Their advice recognises the need for further capital funding for our hospital buildings and to ensure residents are involved in the development of transport and travel plans to improve access to both sites.

“It also calls for the use of the term A&E Local to stop. The Princess Royal will be left with an enhanced urgent treatment centre. You can’t call something an A&E if it isn’t one. It’s confusing for people and potentially dangerous if they go to the wrong place expecting to receive the emergency care they need.”

Professor Sir Norman Williams, Chair of the Independent Reconfiguration Panel said: “The panel shares the view of the Royal College of Emergency Medicine that the use of the term A&E for anything other than a Type 1 emergency department presents a risk to patient understanding and safety."

Councillor Davies continues: “Despite this much needed clarity, confirmation from the government that plans to downgrade emergency care at the Princess Royal will go ahead is a bitter blow for people in Telford and Wrekin. I am beyond disappointed that the Minister has chosen not to halt the plans. 

“If he came to Telford to speak with people in the borough, he’d hear first-hand the impact that Future Fit changes will have on them.

“When parents are making four hour bus journeys each day just to be with their sick children, when people lose loved ones because they can’t get to Shrewsbury in time, it will be too late. Our residents will have to live with the consequences of this decision for generations to come.”

Councillor Paul Watling, Cabinet Member for Adult Social Care and Health Transformation (Labour) said: “When residents were consulted on Future Fit plans in 2018, 2 in 3 people disagreed with moving emergency care to Shrewsbury. They were ignored. 

“We have done everything we can to get the government to sit up and listen to Telford and Wrekin’s residents on this issue, delivering over 20,000 signatures right to the door of No 10 Downing Street and challenging the outdated plans with the latest data. 

“The government’s decision is bad news for people in our borough. We deserve better.”

The recommendations in full

Telford & Wrekin Council requested that the government appointed Independent Reconfiguration Panel reconsider Future Fit Hospital Transformation Plans on 20 March 2023. The thirteen recommendations of panel, set out in Minister Stephenson’s letter to Telford & Wrekin Council, were received on 21 December 2023. 

1. The healthcare needs of the residents of mid-Wales must continue to be considered as part of the Shrewsbury and Telford Hospitals Transformation Programme.

2. The risks related to the residual estates issues and maintenance backlog must be monitored and their mitigations kept under review by the NHS Trust.

3. The hospital estate should be a priority for further capital funding. The NHS Trust should continue to consider the options available to access capital investment to ensure the estate is fit for purpose and to reduce the risks to both the clinical service delivery and the negative impact on staff and patient experience.

4. The NHS Trust and the NHS Shropshire, Telford and Wrekin Integrated Care Board need to continue their communication and engagement programme to keep the public, stakeholders and clinicians within the integrated care system informed and updated about how the enhanced urgent treatment centre at the Princess Royal Hospital in Telford will operate. This includes its clinical leadership and supervision, staffing, opening hours and how it works with other services within the Trust and wider system.

5. Before implementation of the enhanced urgent treatment centre, a public information campaign and appropriate signage will need to be in place to ensure that people know where to go to receive the right care at the right time and in the right place.

6. Ambulance conveyance protocols for the Princess Royal Hospital and the Royal Shrewsbury Hospital must continue to be developed and updated by the NHS to ensure the safe and timely transfer of patients.

7. To support the Hospitals Transformation Programme, the revenue funding consequences for emergency ambulances must be reviewed regularly to ensure that the appropriate capacity is available when needed for transfers. Whether this would involve an ambulance being permanently on standby at the Princess Royal Hospital is for the NHS Trust to consider locally in agreement with the West Midlands Ambulance Service.

8. The NHS Shropshire, Telford and Wrekin Integrated Care Board and the NHS Trust must together review their escalation procedures to ensure that in times of limited bed capacity at the Royal Shrewsbury Hospital, acute patients are not inappropriately held at or admitted to the Princess Royal Hospital site temporarily because of the significant risk to patient safety and the impact on the delivery of planned care in Telford.

9. The NHS Trust's equality and health inequality impact assessments should continue to changes in demographics, levels of deprivation and healthy life expectancy, as well as access to healthcare, the patient experience and health outcomes.

10. The Hospital Transformation Programme's work on mitigating inequalities must continue as part of a system-wide approach working in partnership with all health and care organisations within the Shropshire, Telford and Wrekin Integrated Care System to deliver joined-up and person-centred care for the whole population.

11. As part of the Shropshire, Telford and Wrekin Integrated Care System's wider inequalities strategy, the impact of the Local Care Transformation Programme in mitigating the effects of the Hospitals Transformation Programme needs to be regularly refreshed and reviewed.

12. To address the travel and transport impact of the Hospitals Transformation Programme the NHS Trust should continue to develop and update its action plan, with support from its established focus groups, to improve access to both hospital sites in Shrewsbury and Telford.

13. Subject to the recommendations in this report, the Hospitals Transformation Programme is the best way forward to improve acute hospital services for the Shropshire, Telford and Wrekin Integrated Care System