Concern Over A&E Closures

A Fragile State

On 27 September 2018 the Shrewsbury and Telford Hospital NHS Trust agreed to temporarily suspend overnight A&E services at the Princess Royal Hospital (PRH) in Telford. It was reported that the 8pm until 8am overnight closure would begin during November 2018 and last for at least six months.

It appears that the major contributing factor necessitating the closure is concerning staffing level as Inspectors described that considerable workforce challenges remain in a ‘fragile state’. The Royal College of Medicine recommends that between the Shrewsbury and Telford A&E departments there should be 20 emergency medicine consultants and 32 middle grade doctors. However, it is thought that the former number currently stands at a mere 10 and the latter only 11, therefore meaning the staffing levels are less than half what is recommended. A lack of nurses is also a concern and; the Trust has been relying heavily on agency nurses and currently has 24 vacancies.

What does this mean?

Understandably, the national headlines have been worrying for the local community. It means that after 8pm, ambulances will be diverted to neighbouring Trusts and those with health concerns will have to travel the 18 mile difference to Shrewsbury’s A&E department instead.

Leaders from Shropshire and Telford & Wrekin councils have expressed their anxiety for the safety of their residents and launched a petition entitled ‘Organise a rescue plan to prevent the avoidable overnight closure of PRH’s A&E’ which urges the government to intervene.  The petition has currently been signed by over 20,500 residents, meaning that the government will have to respond.

Councillor Davies stated, “We need to do all we can to pressure people into taking action. I would also urge people to write to their local MP and to the Secretary of State for Health and Social Care urging him to intervene.”

Interestingly, Shropshire and Telford & Wrekin councils launched a similar petition as far back as 2016 entitled, “Keep A&E services at Telford's PRH. A reduction of services is not acceptable”. Unfortunately, it appears that this petition went largely ignored; gaining only 2,849 signatures and the situation is now at crisis point.

Just on 16 October it was reported that both Shrewsbury and Telford Hospital’s A&E departments were at full capacity with a backlog and all ambulances were on divert to Stoke for a two hour period between 1pm and 3pm save for paediatric and GP referral cases. Councillor Davies said that this was a serious escalation and; “If you’re a patient in Ludlow, Oswestry or Powys, your nearest hospital was Stoke which is absolutely catastrophic”.

More Doctors and Nurses

It has been reported that PRH’s A&E could be maintained in the short-term if the Trust had an absolute minimum of seven additional level middle grade doctors and 15 more registered A&E nurses.

Recruitment efforts are currently continuing and consultants at SaTH have issued an open letter reassuring the people of Shropshire, Telford & Wrekin and Mid Wales that they “now have a clear vision for the future of our hospitals. This year, we have appointed many new consultants to the Trust who want to make their home here and help us realise this vision”.

Solution

Here at Lanyon Bowdler we work with many clients whose care has been affected by a delay in treatment, or lack of attention due to the unavailability of staff at A&E departments. The number of cases that have presented themselves to us over a long period of time has been greatly concerning. We hope that a solution will soon be found so that patients in the area can be treated promptly with dignity and care.

Although we can help people who have suffered unacceptable injuries due to falling standards we obviously seek to prevent failings happen in the first place, because all local residents are potentially at risk.  We shall be writing to our local MPs requesting action and we would urge any person reading this to do the same.