Contingency plan for a closure of Telford A&E at night to be worked out

The Shrewsbury and Telford Hospital NHS Trust board today agreed to work up a detailed contingency plan for a closure of Telford A&E overnight if it becomes necessary due to staffing shortages.

Services at the Princess Royal Hospital A&E could be suspended between 8pm and 8am if the Trust is unable to recruit more A&E Consultants or Locum Doctors within six months.

Emergency cases would be dealt with at the Royal Shrewsbury Hospital during those hours, whilst an Urgent Care Centre would be available in Telford, which could take non-emergency walk-in cases.

The Trust said the proposal is a last resort and would be used if staff were on call one day out of every three rather than the current one day in four.

Speaking on Wednesday ahead of the meeting, SaTH Chief Executive Simon Wright explained the situation:

“The safety of our patients is our first priority and unless the number of doctors we have for our A&E Departments improves, we will have to take action later this year to temporarily suspend A&E services at PRH overnight.

“The fragility of emergency care was a major issue when the NHS Future Fit programme started in 2014 and the staffing fragilities have worsened since then.

“I wrote an open letter in January 2016 in which I explained about the fragility of our A&E Departments at PRH and the Royal Shrewsbury Hospital. This has been a consistent theme at our Board meetings, at meetings of Shropshire Council and Telford & Wrekin Council’s Joint Health Overview and Scrutiny Committee and in the media.

“We have tried to improve staffing, including holding discussions with neighbouring Trusts across the area in the hope of seeking support to maintain adequate staffing to retain two 24-hour A&Es. We have also advertised for two joint Consultant posts with another hospital. We also approved the appointment of a further two locum Consultants until substantive appointments can be made.

“We need to plan now before we reach a crisis point. Our paper proposes that we start planning for an overnight suspension of A&E services at PRH. We will continue to review this, taking every step possible to avoid suspending these services, but if we are unable to recruit or ensure stability for our A&E Departments within six months, we will unfortunately need to take action to safeguard our patients.

“This is not the downgrade of PRH by the backdoor. We absolutely do not want to take this action, which is why we’re not making a final decision for six months. This plan means that we can step back at any point over the next six months if the situation improves.

“This is not being done on a whim. We have been very clear publicly – and in meetings with councils, commissioners and the wider public – about the pressures our Urgent and Critical Care system is under. We have been very clear that we have explored all the options open to us and that, having ruled many out, this is the only option that is left open to us to ensure the safe care of all of our patients, no matter where they come from. We have talked about this at length in the councils’ Health Overview and Scrutiny meetings, our Board meetings and at meeting of the local A&E Delivery Group.

“This will give us more time to try to recruit the Consultants or Locums that we need to prevent us having to take the action outlined in the Board paper to close A&E at PRH overnight.

“Over the next six months we will work closely with our doctors and other frontline staff to ensure the safety of our service. We will also work with our health partners, including Healthwatch, the Community Health Council, the police and ambulance services and other patient representative groups over the coming months to ensure people are involved in the implementation of this plan.

“We are taking definitive leadership in opening this issue up for discussion publicly and no stakeholder can honestly say that they were not aware of this risk.

“We are not committing to a change. Rather, we are preparing in case a change is needed without a crisis having to be introduced.”