24 October 2018

Overnight emergency services at The Princess Royal Hospital (PRH) in Telford could be temporarily suspended on 5 December if efforts to recruit more staff are unsuccessful and assurances are made that every patient pathway is safe.

The Board of The Shrewsbury and Telford Hospital NHS Trust (SaTH), which runs PRH and The Royal Shrewsbury Hospital (RSH), will receive an update of the Trust’s Emergency Department Implementation Programme at its meeting tomorrow (Thursday). This includes the possibility of extending the department’s opening hours from 8am until 10pm should an overnight closure be necessary.

The A&E department at PRH currently remains open 24-hours-a-day, seven-days-a-week, however if the recruitment of additional staff is not possible the Board have agreed that an overnight closure will be unavoidable because of the impact staff shortages are having on patient safety.

Simon Wright, Chief Executive, said: “Safe patient pathways have been approved, or are in the process of being approved, for the majority of our patients, but more work still needs to be done for head and neck patients, paediatric emergencies and cardiology patients.

“Having listened to feedback from numerous patient groups and our own staff we are looking at measures we can put in place to keep the Emergency Department at PRH open for an additional two hours from 8am until 10pm. This will mean fewer patients having to travel out of the county to receive care. We are also looking at how we can improve the service provided by the Urgent Care Centre at PRH.

“We have always been clear that we won’t do anything that compromises patient safety, and while we know we cannot continue as we are, we also won’t consider changing the service until we are completely assured that watertight plans are in place for every patient to receive the safest pathway of care. We have asked our clinicians who are leading the programme to work towards an implementation date of 5 December, but before then we will conduct a major desktop exercise in November to test all of our pathways to make sure they are safe. We also have a wide range of stakeholders and patient representatives at our weekly communication and engagement meeting and are planning meetings in the community with affected groups.”

While clinicians at SaTH, with the support of neighbouring trusts and our regulators, NHS Improvement and NHS England, continue to develop the pathways, SaTH will continue to look at ways of avoiding the potential overnight closure.

Clinicians at SaTH believe that both A&E Departments – at PRH and at the Royal Shrewsbury Hospital (RSH) – could be maintained in the short-term if the Trust had:

  • An absolute minimum of seven additional levels Middle Grade Doctors – taking staffing levels up from 11 to 18.
  • An absolute minimum of 15 more Registered A&E Nurses.

SaTH is continuing in its efforts to recruit more staff to its A&Es. The two MPs, Lucy Allan and Mark Pritchard are working hard with NHS Improvement, Health Education England and ministers to support efforts to keep the ED open by sourcing additional support for SaTH.

Last week Simon Wright, along with Telford & Wrekin Council leader Councillor Shaun Davies, attended a meeting with the Indian Consulate in Birmingham to ask if they are able to help provide any staff from India and prior to this Councillor Davies launched an appeal to businesses to help refurbish three houses at the PRH site. These will be used to accommodate junior and middle grade doctors for free, to encourage more staff to come to the Trust.

It would make SaTH the only hospital trust in England to offer free on-site accommodation to staff.

The Trust is also in the process of creating a new Doctors’ Mess at PRH that would allow access to sleeping pods and much better rest facilities.

Recruitment attempts include:

  • Consultant posts advertised six times in the last 12 months.
  • Middle Grade posts advertised nine times in the last 12 months.
  • Recruitment of registered nurses, including open days and recruitment events run as a ‘one stop’ event with interviews and assessments on the same day.
  • ED has also invested in specific nursing campaign which ran throughout May 2018 via the RCN and Nursing Times. In the last 12 months, 21 appointments have been made.

Latest recruitment successes include:

  • SaTH has appointed three new A&E consultants – a net increase of two substantive A&E consultants.
  • 22 new Consultants have joined SaTH across the specialities since the beginning of the year.
  • Funding has been secured for 30 additional Junior Doctors over the next two years.
  • 32 newly qualified Staff Nurses joined the Trust in September, and a further 23 have been offered jobs.
  • More than 100 Staff Nurses have joined SaTH across the specialities since the beginning of the year.
  • More than 30 Student Nurses have been offered ‘Golden Tickets’, meaning they are guaranteed a job following graduation.