Letter from Adam Cairns for publication in the Shrewsbury Chronicle

Dear Editor

I am writing to update your readers on the current “Keeping it in the County” consultation on the shape of hospital services, and address any misunderstanding that may have arisen from letters in these pages on 16 December.

Local clinicians have developed proposals that aim to keep safe, high quality services as locally as possible. Consultation began on 9 December and continues until 14 March. We will shortly be advertising a series of public meetings in the New Year where local residents can find out more and make their views known. Look out for advertisements in future editions of the Shrewsbury Chronicle, or contact ournhsinsat@nhs.net to ask to be included in our email distribution list.

I would like to reassure your readers that these proposals are driven by the need to maintain the safety and quality of local hospital services. They have been developed by local clinicians, focused on keeping services in the county and providing the best care in the right place at the right time for patients across Shropshire, Telford & Wrekin and mid Wales.

They are not driven by financial considerations, and in particular, there are no plans to make savings in our maternity services (Letters, 16 December). In fact, the Board agreed in November to increase spending in this key area by appointing three additional obstetricians, seven extra senior doctors, 15 additional midwives, five additional theatre nurses and a number of additional support staff.

But, we still need to address some very real challenges facing our maternity services.

Firstly, the maternity building at RSH is over forty years old and is in a very poor condition. Services have outgrown the space, and the cramped environment is not good for patients and makes it difficult for staff to offer the best care. The fabric of the building is deteriorating and even if money is spent then its future life span is limited to between five and ten years. This is simply not the standard of accommodation we want to offer mums and babies in the 21st century.

Also, we currently only have a single obstetric theatre, and need to provide a second theatre for the number of births we see across Shropshire, Telford & Wrekin and mid Wales.

We face major challenges to the safety of our services in other areas too, such as inpatient surgery and inpatient children’s services. Our children’s specialists (paediatricians) agree that continuing to run two inpatient units will not be possible very far into the future. They face a continual struggle to ensure that they have enough doctors available to look after the children in their care and it looks like this is going to get even more difficult in the future. I do not want us to reach the position where these services reach crisis point because we have failed to take action.

There has been a long history of debate on the shape of hospital services in the county. It has always been a lot easier to agree what problems we face, than to find solutions that keep services in the county and that are workable for clinicians and acceptable for local communities.

We have already lost the battle to keep some services local – such as gynaecological cancer surgery and upper gastro-intestinal cancer surgery – but I want to make sure we’ve got the best chance to keep services in the county in future.

Since I was appointed as Chief Executive of The Shrewsbury and Telford Hospital NHS Trust earlier this year, local residents have told me of their pride in the Royal Shrewsbury Hospital. Local politicians have made very clear that they expect the RSH to have a vibrant future.

Our commitment as part of this consultation is to find ways to improve the quality of the services we provide, and to continue to have a safe, sustainable and successful Royal Shrewsbury Hospital. If the proposals in the consultation document are put into action then we can continue to build on the Royal Shrewsbury Hospital’s reputation as our local Cancer Centre, with the much valued support of the Lingen Davies Cancer Appeal. RSH will also become our main centre for acute/emergency inpatient surgery including life-threatening trauma, vascular surgery, colorectal surgery and upper gastro-intestinal surgery. These services are currently provided at both RSH and PRH but in future they would be concentrated at the Royal Shrewsbury Hospital. RSH would also develop as the centre for abdominal aortic aneurysm (AAA) screening.

Importantly, most patients would be able to carry on receiving most of their care exactly where they do now – including most outpatient appointments, day case procedures, A&E services, medical emergencies and admissions, midwife-led maternity and the diagnostics, imaging, critical care and other services that support these.

Whilst some services will move from PRH to RSH these proposals will also see others move from RSH to PRH. This includes the consultant-led maternity unit with neonatal intensive care and overnight inpatient children’s services. I know that these are the issues that will be of most concern to people in the Shrewsbury area.

As I mentioned earlier, the proposals in this consultation are being put forward above to maintain the safety and quality of local hospital services, and keep services in the county, and are not driven by financial considerations. I would urge everyone to read the consultation document to find out more about the reasons why these changes are being proposed, and the alternatives that have been considered. Please also let us know your worries and concerns and how these might be addressed.

Before consultation we felt that these proposals were of such importance that we held an additional Trust Board meeting on 2 December solely to discuss these proposals, as did the two local Primary Care Trusts. The papers from this meeting are available from our website, and there will be further discussion at our next meeting in January.

During January and February there will also be a series of public meetings across the county so that local residents and find out more and make their views known. Information about the proposals is also available from our website at www.sath.nhs.uk  and copies of the consultation document and summary are available be calling 0800 032 1107.

Yours sincerely

Adam Cairns, Chief Executive, The Shrewsbury and Telford Hospital NHS Trust

Notes:

  • This is the text of the letter sent for publication in the Shrewsbury Chronicle on 30 December 2010.  The published version of the letter may differ slightly from the text above.
  • As the letter was intended for publication in the Shrewsbury Chronicle it included the telephone number for Shropshire County PCT Patient Advice and Liaison Service (0800 032 1107) and did not include the telephone number for Telford and Wrekin PCT Patient Advice and Liaisonn Service (01952 580478). Enquiries can be directed to either number or via email to ournhsinsat@nhs.net. More information about how to contact us is available from the Have Your Say page.
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