Future of Shropshire health care

By Andy Giddings
BBC Shropshire

Some proposals have attracted a fierce response from politicians and residents

The people running Shropshire's two main hospitals and Primary Care Trusts (PCTs) all agree that in the long term, they need to focus on one main hospital for the county.

They believe that focusing their efforts on one site will give you a better quality of service.

The medical director at the Royal Shrewsbury Hospital and Telford's Princess Royal Hospital, Steve Evans, said their specialists are spread too thinly across the two hospitals at the moment.

Early responses from local politicians and council leaders have expressed concern about extra travelling time to get to hospital. But the people running the NHS in Shropshire say that on balance they would accept slightly longer journey times if it meant getting the best care when you reach the hospital.

Crucially the time it takes an ambulance to reach you, and start delivering treatment, shouldn't be affected.

Future of hospitals: Your views

NHS strategy for health and health care in Shropshire and Telford and Wrekin

So what are they proposing? They're aiming to move to a single site somewhere around 2020, but haven't yet decided whether this super-hospital should be in Shrewsbury, Telford or in a brand new location. Serious discussions on that aren't expected for another couple of years.

Between now and 2020 they have another, medium-term plan to focus some of the services at just one of the hospitals. That would either be at the Royal Shrewsbury Hospital (RSH) or Telford's Princess Royal Hospital (PRH).

Some services at the Princess Royal Hospital could be downgraded

They are particularly looking at the major trauma unit in accident and emergency, children's inpatients and acute vascular surgery. The aim is to do this around 2012 to 2013.

They have spent months carrying out research to see where best to focus these services. And which one should have services downgraded as a result.

The recommendation before the PCT and hospital boards on Tuesday, 22 September was that Shrewsbury is the best option for the medium term, because it has the "lowest cost and shortest implementation period".

The NHS research suggests the difference in the cost is considerable. Focusing those services at the Royal Shrewsbury Hospital would cost around £18 million. Choosing to put them at Telford's Princess Royal Hospital would cost around £47 million.

The report also says it would make more sense to focus the services in Shrewsbury, because it would leave all the options open in the long run.

Ideally, the NHS in Shropshire would like to wait until 2011 before deciding on its medium-term plans. That is when they are due to discuss their long-term plans for services beyond 2020.

It would make a lot more sense if they could make the two decisions at the same time. For instance, if they decide that the long-term aim is to make Telford the site for a "super-hospital", then they can also make Telford the place where they focus services in the medium-term.

If they make the decision now, they might end up focusing services at one site in the medium term and then having to move it all over to the other one at a later date.

So they are trying to introduce some stop-gap measures to address their staffing issues until 2011. For instance they are bringing in an extra four consultants.

If the Trust boards decide that this is working, they will vote to wait until 2011 until starting to consult on their medium-term plans for accident and emergency and paediatrics.

But, if they decide those stop-gap measures aren't enough, they will vote to start the ball rolling with consultation exercises in November. And they will be asking you what you think of the Royal Shrewsbury Hospital as the site to have accident and emergency major trauma, children's inpatients services and acute vascular surgery.

The NHS trust boards will meet again at the end of October to decide which path to follow.