There has been a lot of discussion at public meetings and in the papers about the condition of the women and children's building at RSH.
The first thing to say is that the staff do a fantastic job, and patients can be justifiably proud of the care they receive. The facilities are safe, and the standards of clinical care are high, and we keep the facilities under ongoing review to make sure that they continue to be safe. If they were not then we would take urgent action to address this.
But, there are real risks in the future, and each day it becomes more challenging to provide services in an environment that our staff can feel proud of.
When I first came to The Shrewsbury and Telford Hospital NHS Trust in July 2010, I was given a file of information about dilemmas and challenges facing your local health services: dilemmas and challenges that it would be my job to address.
One of these documents was a 2007 site survey of the women and children's services building at the RSH.
This report is also available from this website as part of the background information to the work that took place in 2008/09.
It does not make good reading. Many parts of the building were rated as Category C (major repair or replacement is needed to make it operationally safe) or Category D (operationally unsound and in imminent danger of breakdown).
Now, I know that remedial and backlog maintenance work has taken place to address some of the immediate risks identified in this report. For example, the Ward 20 roof has been replaced, there have been upgrades to the electrical infrastructure, and the asbestos in the roof of the building was re-encapsulated in 2008 to make sure that it remains safe for the time being. It will need to be re-encapsulated regularly to ensure that it continues to be safe.
But, for me the report is a clear indication of the condition of the oldest building on either of our two hospital sites, a building that does not have a long term future, and why we need to make some very difficult decisions about how and where services are provided.
There has been a long debate about changes to local hospital services. Most recently, in 2009, the local NHS was looking at plans both for medium-term changes to hospital services (by 2012/13) as well long term plans for a single main acute site (by 2020). The plans for 2020 included moving completely from the deteriorating women and children's building at RSH.
No decisions were made at that time, which means that the Trust has needed to focus on the most immediate risks facing the building without being able to plan for the longer term future. Yes, we could spend more money on refurbishment now but this capital funding would not be available for other services, and we would rightly be questioned on the wisdom of spending millions of pounds improving a building that we must move out of.
Our staff do an excellent job in very difficult circumstances. Women and families are rightly proud of the care they receive, but midwives, nurses, doctors, therapists and other NHS staff are increasingly concerned about the space and environment in which they provide clinical care. The women and children's building at the Royal Shrewsbury Hospital was built in 1969 and is in a very poor condition. Services have outgrown the space available. The cramped environment is not good for patients and makes it difficult for staff to offer the best care.
Even if significant money is spent to refurbish the building then realistically its future life span is limited to between five and ten years. We need to move out of this building so that we can provide the quality of accommodation, fit for the 21st century, that matches the quality of care and patient experience.
In 2009 we looked at a range of options for the building. This included a fully costed option for re-providing the services in that building in new accommodation to modern space standards on the RSH site. Our estimates at that time, with independent advice from planning consultants and chartered surveyors, were that it would cost in the region of £60m to re-provide the services at the RSH site. Information about this work is also available from the archive section of the website. The economic climate has changed significantly and we are simply not in a position where we can borrow and pay back this type of capital loan. Instead we need to look creatively about how best we can use our existing hospitals to provide safe and sustainable services, working with GPs and ambulance services to also make sure that people have timely access to safe care in an emergency.
If you feel that the challenges facing the building are not real or are overplayed then I would encourage you to have a look through the report and take this into account when responding to the consultation.
More information about how to respond is available from the Have Your Say page.