The next 12 months will see two major milestones in plans for the Royal Shrewsbury Hospital (RSH) and the Princess Royal Hospital (PRH) in Telford, both run by the Shrewsbury & Telford Hospital NHS Trust (SaTH).
The £312m Hospital Transformation Process (HTP), formerly known as ‘Future Fit’, is closer than ever to completion, and trust officials say they are focused on the next stage of making it a reality.
It’s a key project for the trust’s staff, which has been in special measures since 2018 and has some of the worst A&E backlogs in the country. The proposal cleared a major hurdle earlier this year when the government approved the Strategic Outline Plan and it has the backing of all county MPs.
The trust is currently working on the next key phase of the project, the business case outline, which is expected to be presented at Easter and reviewed by the government in the summer.
The third phase, the full deal could close by the end of 2023, with work starting in 2024, marking significant progress for a project that dates back years and has been plagued by repeated delays.
It comes as the NHS as a whole is under the most pressure in its history, from GPs to ambulance services, along with problems in community care.
The aim of the proposals is to make the Telford site the base for planned care and the Shrewsbury site the center for emergency care.
Nigel Lee, the trust’s chief strategy officer and director leading the HTP scheme, said change is vital and the ambition is to create “two thriving hospital sites”.
He said: “We know we can’t continue as we are because it’s not helping us and it’s not helping our patients.
“The bottom line is creating a more clinically sustainable site of acute services for the population and it is very much about looking to improve care for all our residents in Shropshire, Telford and Wrekin, and parts of Powys. We are absolutely focused on delivering two thriving hospital sites.”
Dr Ed Rysdale, the trust’s emergency medicine consultant, said the proposals were focused on ensuring that the trust’s patients receive the best possible care. He said: “People say we are degrading care, we are not, we are improving care. As physicians, we wouldn’t be doing anything that wouldn’t improve care for our patients. It is about providing the best care possible to all of our patients.”
Mr Lee said the plans would help reduce waiting lists and cancellations of planned operations through the key approach of planned care at PRH, with improved emergency medicine at RSH. He also outlined plans for urgent care sites at both sites, which would be available 24 hours a day.
Dr. Rysdale said that focusing specialties at individual sites is key to bringing in and retaining quality staff, and providing treatments for which patients currently have to travel out of county.
He said: “Right now, for example, with emergency medicine, you can work in pretty much any hospital because there are openings all over the country and what puts people off is split-site services. Other places like Stoke or Wolverhampton are more attractive because the services are in one place”.
He said enhanced services would also be key to attracting and keeping trainees, adding: “These are the consultants of the future. If trainees go through this system, they are more likely to want to stay with us.”
Echoed the sentiment, Mr Lee said: “With workforce challenges, it means we’re not creating a clinically sustainable set of services, which means for a number of key areas it’s not attractive to join because staff want to join a thriving team, they can see it’s a great place to work, where they can provide the care they want.”
Dr. Rysdale said that while the plan would not solve all health care problems in the county (as discharge from community care remains a key problem in freeing up living space in hospitals), it would help reduce waits for ambulances and would relieve some of the main pressure seen in recent months.
He said: “Currently, the pressure in our emergency department is as high as I have ever known it. They’re as bad as I can remember and the waits in our department are getting longer than I remember, and I got to work before the four hour goal hit. It is very, very difficult for our nursing staff, who spend many hours caring for patients in the ER. They are effectively providing hospital care that would normally be provided in a ward, but because patients are in A&E for a long time, they provide it there.
“That puts a lot of pressure on our nursing staff because they want to do emergency medicine, that’s their job. We don’t want the patient waiting that we are having, to determine who comes next, and sometimes it is a difficult decision.
“For me it is the most difficult part of the job, the ambulance waits outside. The biggest thing that will make a big difference is that if we have a patient who needs to be transferred to Stoke, or to Shrewsbury from Telford, or from Shrewsbury to Telford, we may be waiting hours for an ambulance because they are stuck outside or I can’t get one. , and that’s a real strain on the team. All of that will go with HTP because all the services will be in one place.”