'Pretty angry' CEO accuses neighbouring trust of poor planning

David Loughton, chief executive for the Royal Wolverhampton, has claimed the closure of the A&E department in Telford, run by Shrewsbury and Telford Hospital Trust, could have been prevented.

Last month the SaTH board voted to close the department overnight due to staffing and safety concerns. Although Royal Shrewsbury Hospital retains its A&E, Telford is geographically located between Shrewsbury and Wolverhampton. Mr Loughton says Wolverhampton will have to take on between 13 to 18 additional ambulances each night.

Mr Loughton told HSJ: “I’m certainly not happy about it [the closure], this has been coming for two years and there has been missed opportunities to address things that are now too late to do.”

Mr Loughton said his trust had offered SaTH the opportunity to join its clinical fellows’ programme, which would have given it access to 140 clinicians, but the offer was declined.

He said: “They’ve [SaTH] been having staffing difficulties amongst doctors for quite some time, and they are saying this closure at night will be until March. I don’t believe it will just be until March. If they started on the clinical fellows’ programme now they would see no benefit until probably the third quarter of next year.

“They could’ve started on it a long time ago, they were offered to join in with it. What really narks me now it is my staff that are going to suffer from this…

“It will affect my [trust’s] performance. What makes me pretty angry is this is going to use up all of my winter capacity that should’ve been going to use for my own residents. My winter ward will now get consumed with this.”

HSJ understands the closure of Telford A&E, which is at Princess Royal Hospital, is planned to happen by the end of November.

In response, SaTH said it is hoping to develop fellowship posts in early 2019, and that plans to suspend Telford’s overnight emergency service would not be finally approved until “the board are assured that watertight plans are in place”.

Royal Wolverhampton previously had to take on additional activity following the closure of Stafford A&E, during the Mid Staffordshire scandal.

Mr Loughton said: “The other thing that concerns me about the closure is that in the meetings we’ve had, there’s been nobody from community services there and nobody from mental health there.

“What we did with Stafford was we really bolstered up the community services. We’ve seen half the ambulances that used to come to Stafford for the past six years, but that was well planned and involved a range of people. SATH is not well planned.”

A spokesman for SATH said: ”Claims that SaTH has not engaged with or involved partners in mental health and community services is factually wrong. They are part of the Regional Flows Meetings, which Royal Wolverhampton Trust is a member of. These are meetings specifically set up to involve partners from across the health and social care system including community and mental health services, to ensure partners are fully involved in the closure plans.”

They added: “The pathways are being worked through by our clinicians in regular conversations with neighbouring trusts and our regulators, NHS Improvement and NHS England. We are continuing to work with all of these organisations to ensure, that in the event of us having to suspend overnight emergency services at PRH, we are able to deliver the best outcomes for our patients and neighbouring trusts.

“SaTH is continuing its efforts to recruit to its emergency departments. Over the past 12 months the trust has placed six adverts for consultant posts and nine for middle grade doctors, but a shortage of emergency care doctors in the UK means people are choosing to work in the bigger centres.

“We did explore the link with Wolverhampton University when approached by Royal Wolverhampton Trust to develop fellowship posts as part of the solution to the recruitment of middle grade doctors. But at that stage we were not able to make progress.

“We have revisited this working directly with Wolverhampton University and are likely to be taking that partnership forward to offer fellowship posts early in 2019. They are challenging posts that test skills that are not the focus of most clinical training roles, yet are highly relevant and transferable to senior clinical roles.”

He suggested that good progress has been made in recruiting consultants, junior doctors and nurses, but the recruitment of middle grade medics was proving more problematic.