Shropshire’s future health care solution: the final one

Confucius say, ask the wrong question and you’ll probably get the wrong answer.

What are the key issues that require answers or at least proper detailed work?

1 What is the model for increased care in the community and primary care sectors in 2020 when 10% (?) acute activity is moved out of the acute sector?

2 How much funding will be required? How many staff and other resources will be required? And how is it planned to achieve these?

3 What exactly is the clinical model for acute care across two sites?

4 Is it really acceptable to the population that people living in west and south shropshire and east Powys will travel up to 50 miles to ED?

5 What actually is an urgent care centre? What degree of acuity will be dealt with there? Give examples that the public will understand. COPD exacerbation? Broken arm? Chest pain? Drug overdose? Bee sting? Twisted ankle? Head pain with confusion?

Then perhaps there will be an understanding that people can work with.

As it is, they cannot expect people, whether GPs, clinicians or Joe Public, to sit back and agree to walk into a foggy, dark night without a map.


Futurefit started with bottom up workshops about what the future provision model should look like, and where and how the different conditions should be treated and looked after. That was very promising. Bill’s LTC group did great work.

But that’s disappeared. And it’s now become an accountant’s model, with precious little solid reliable evidence to support the proposal.

Julian Povey has just said on radio that SATH may now just move ahead with its own reconfiguration because it has to resolve its staffing and financial challenges. Can they do that without CCG and Treasury/NHSE/NHSI approval and without public consultation? They could do some of the stuff David’s been suggesting for years, but not the new buildings work. But there would be uproar.

Julian also confirmed that shropshire could be seen as a basket case (my words). Yep. On the nail.

I know that the need for change is urgent, but (as Julian also said) it’s more important to get it right than to meet deadlines.

I really urge all involved to resurrect the Futurefit workstreams, including the community and primary elements, and work this out in the next three months. Then perhaps we can move forward together to a final solution.

Let’s be bold, innovative, challenging…a vanguard for change that improves care and outcomes for our Shropshire and Telford population.

It’s time to ditch vagueness, obfuscation, generalities, guesses, hit and miss forecasts. It’s time to ditch ridiculously optimistic public health improvement dreams.

Let’s get real and just get it done.

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