To receive an update from Dr Caron Morton (CCG) about the Future Fit hospital consultations.

Paul thanked the Committee for its invitation to speak to them and gave a brief back ground on the Future Fit programme. It was based in the assumption that hospital services needed to change if they were to meet the changing needs of the population in the 21^st century, whilst also meeting the budgetary restrictions placed on the health service. Some of the key issues it addressed were people living longer, with life long illness; the need to provide top quality care for people suffering trauma injuries or illness; and to reduce illness caused by obesity, smoking and diet.

Future Fit looked at how services could be offered in Shropshire and Telford and Wrekin, and included emergency care, long term care and also preventative care. The long list of proposals looked at how urgent care, planned care and community based services could be delivered.

Clinically hosting emergency care (A&E) at one centre provided the best care, and allowed the service to recruit the best staff and offer the best service. This could be located at Shrewsbury; Telford or possible a new site in between the two towns. Urgent care centres for less serious emergency care cases could be located in both Shrewsbury and Telford, as well as between 2 and 5 other locations in the county.

The Future Fit programme also suggested setting up a separate planned care unit, where planned operations could take place. By separating this from the A&E unit the quality of service would improve and appointments wouldn’t be cancelled as doctors wouldn’t be diverted to deal with emergencies.

However the location of the emergency care unit was a very difficult issue to resolve. Hosting the service at Shrewsbury would make it easier to access for people from South Shropshire and mid Wales; but there was a higher population in Telford so it also made sense to locate it where there were more people.

Paul stressed that every service currently available in the county would remain in the new proposals. Some major trauma cases will go to Stoke, Birmingham or Wolverhampton, as they do now – but the number of patients that have to have this level of care are very small.

A long list of options for the future of hospital services in Shropshire has been drawn up, and these would be reduced down to a short list of 3-4 which would be consulted on again at the start of 2015. Any proposals were based on the service not receiving any more government funding, so if new sites were built they would have to be funded by cost savings from other areas. However purpose built sites were cheaper to run and could offer significant revenue savings. New services would be unlikely to start until 2018 at the earliest.

Councillor Sandbach (formerly chief executive of Telford and Wrekin hospital) suggested that while the Future Fit plans had some issues, he felt they offered theopportunity to create a very effective health care service in the county. Separating emergency and planned care up was a very important change that could bring big benefits. However he preferred the option of locating emergency care at Shrewsbury, as it provided quicker access to services for people to the west of the county. Committee members agreed with this, and felt that while Telford had a larger population they also had more alternative hospitals near-by such as Wolverhampton, Birmingham and Stafford.

Members of the public asked about the location of clinics, as many people with long term conditions have to travel to Shrewsbury or Telford for treatments and consultations and this is difficult for people in rural areas.

Paul responded that more local centre’s, and wider ranges of services at local surgeries were being looked at to help this issue. Local centres could hold clinics which consultants visited for appointments, and increasing skills of surgery staff to undertake services such as blood tests, dressing changes, and elements of minor surgery were being looked at. Some members of the audience suggested this sounded like a return to cottage hospitals. Paul also felt that new technology could also help deliver solutions locally or even in people’s homes, with video consultations and even some treatments now being possible remotely using computers.

Members of the Committee commented that ambulances were also an issue in Shropshire, and in rural areas response times were often way below national averages and agreed targets. Paul said these issues were being considered as part of the programme. Improving ambulance response times was important, but this had to be balanced against the cost. Hundreds of new ambulance staff would be needed to reduce response times, and clinically it might be better to invest this money in hospital services to provide better outcomes for patients.

The work of Community First Responders and having defibrillation units available in communities was also an effective way of providing immediate emergency care at a local level, and making sure the voluntary sector was included in the discussions was important.

Further consultations on the Future Fit shortlist would take place in 2015 and Paul encouraged communities to get involved and give their views and also offered to provide further updates via the LJC’s in the future.