Future Fit: Telford & Wrekin Council responds to independent review

The review, conducted by KPMG, was requested by the NHS following serious concerns raised by the Council that the decision-making process called ‘Future Fit’ wasn’t legal, fair or transparent.

Concerns had also been raised within the NHS itself about Future Fit with its own Gateway review also recommending this.

Future Fit had recommended Shrewsbury should be the site for a single Full 24/7 A&E for the county and the Women and Children’s Centre, which opened in Telford less than three years ago at a cost of £28million.

Telford & Wrekin Council argued that this conclusion was based on evidence that was presented and decided upon in a flawed manner.

The independent review, carried out KPMG, acknowledged the Council’s “valid criticisms” of how evidence was evaluated to reach this recommendation.

But while the report acknowledges the Council’s concerns, it doesn’t say what should have been done, nor should be done, say the Council’s Leader and Managing Director in their joint letter responding to the review’s findings.

Their letter further points out that:

- KPMG made clear there was no consistent approach to training of the panel appraising the evidence and whose scoring was key to supporting a preferred option.

- KPMG agreed there was no criteria advised to the appraisal panel meaning there was no guidance on how to score the evidence.

- While KPMG said Future Fit’s evaluation of financial and non-financial evidence was done in a “valid” way, the review does not challenge the Council’s own interpretation of the data, which recommends keeping the Women and Children’s Centre and full 24/7 A&E in Telford.

- The appraisal panel heard that if the full 24/7 A&E were to be based in Telford, the hospital would lose its Trauma Unit status. KPMG pointed to a number of pieces of evidence including from the West Midlands Clinical Senate that the Princess Royal Hospital could potentially be given that status if it met the necessary criteria.

Earlier this week, the Future Fit board recommended to the two Clinical Commissioning groups to go forward with a consultation recommending that full 24/7 A&E service and the Women & Children’s Centre are move to the RSH. The Council’s concerns were raised at the meeting but were not addressed.

Subsequently, The Leader and Managing Director have formally written to the officers leading the Future Fit process why these issues, identified by KPMG, are not considered material factors which made the overall process fundamentally flawed in the way that it had identified a preferred option.

On Thursday 10 August, Shropshire and Telford & Wrekin Clinical Commissioning Groups (who decide and pay for hospital and health services) will jointly meet to decide whether or not to go ahead with a public consultation and on what basis.

The Council’s letter adds: “The Council recognises the crisis in the local health economy and the need for timely decisions…It’s important that the Joint CCG Committee makes its decision in an open and transparent way in public.

Decisions must be taken in the correct way using all available objective evidence to make both the recommendations and the best decisions.

“Decisions need to be made in a way that is rational, fair and free from the appearance of bias and should not be seen as pre-determined or the bodies that take them are open to legal challenge.”

Since the letter was written, the venue for the Joint Committee meeting on Thursday 10 August at 6pm has been confirmed as Shrewsbury College, London Road SY2 6PR.

Cllr Shaun Davies added: “In our letter, we asked that this meeting be held in Telford given that the communities that will be most affected by this decision are in Telford and Wrekin and eastern Shropshire, It’s very disappointing that the meeting is not being held here.

“Given SaTH’s clear pre-determination of this issue, no doubt many people will draw their own conclusions from this decision.”