1. Presentation to Boards 24 th September 2009

2. Remit of the Clinical Leaders Forum “To review the evidence in respect of the options and to make recommendations for the future pattern of clinically safe general hospital services, serving the populations of Shropshire, Telford & Wrekin, and the catchments of the provider organisations. To consider options and make recommendations to Shrewsbury and Telford Executive Group of an overall picture of the future shape of hospital services, within the context of a modern NHS. To give early consideration to A&E services, services for children and also to cover maternity and neonatal services, emergency surgery and urology services.

3. Principles Making Sense Clinically oHealth, Well Being and Equity oQuality, Safety And Effectiveness oSupporting and Developing the Workforce Making Sense to the Communities We Serve oInvolving People in Making Decisions about their future Health Services oAffordable, Sustainable, Fit for Purpose oPersonalised Services and Access to Care, Closer to Home

4. Engaging Patients, Public and Key Stakeholders Membership of key groups Workshops and Seminars Roadshows Briefings and Website Criteria and Weightings Scoring

5. Programme of Work 1 Defining the Problem ‘07/08 2 Developing the Clinical Options ’08/09 345678 Social, Governance and feasibility Assessments Consultation Reconfigure Services to Address Safety Issues (2-3 years) Option Appraisal Single Site Consultation – Single Site for Seriously Ill and Injured Implement Single Site for Seriously Ill and Injured 2009’09/10’10–13’10-112012’13-’20

6. Phase 1: Key Strategic Issues Health of the Population increasingly number of elderly people prevalence of long term conditions (Shropshire) mortality rates from circulatory disease, smoking and teenage conception rates (Telford and Wrekin) rising levels of obesity Access to Services rurality and deprivation services closer to home balance of services across communities, and between RSH and PRH similar catchment populations of the two hospitals Clinical Viability ability to provide high quality emergency care out of hours developing specialist services recruitment and staffing issues, EWTD, attractive jobs, training Financial Viability healthcare costs of elderly population opportunity cost of subsidising access cost of duplication of services the estate

7. Strategic Objectives: The prevention of disease and the promotion of healthy lifestyles and independent living Services at home or as close to home as possible Sustainable and accessible acute hospital services

8. Clinical Service Options: 3 - 4 Years (2012/13) PRHRSH 1Level 3 A and E, urologyLevel 2 A and E with acute surgery, inpatient paediatrics, obstetrics and neonates 2 Level 3 A and E, urology 3Level 3 A and E with inpatient paediatrics, urology Level 2 A and E with acute surgery, obstetrics and neonates 4Level 2 A and E with acute surgery, and inpatient paediatrics Level 3 A and E, obstetrics and neonates, urology

9. Single Site (2020) Options Baseline This will be the configuration of hospital services agreed for implementation in 2-3 years Option 2Under Option 2 the main A and E is based at RSH with outpatient, day case surgery, MIU, midwife unit and specialist community services at PRH Option 3Under Option 3 the main A and E is based at PRH with outpatient, day case surgery, MIU, midwife unit and specialist community services in RSH Option 4There will be a new acute hospital between Shrewsbury and Telford dealing with all seriously ill and injured patients. The sub options identify a number of possibilities for the two existing hospitals.

10. Phase 3: Technical, Financial and Social Studies 2012/13 Option Appraisal 2020 Technical and Financial Feasibility Study Equality and Diversity Impact Assessment

11. Summary of Findings Phase 3 2012/13 Option Appraisal Option 1 scored more highly than the other options on non-financial implications, had the lowest capital cost and the shortest construction period. 2020 Feasibility Study All three options for the 2020 single site have the potential to be technically and financially feasible. Equality and Diversity Study The assessment concluded that while there are equality impacts associated with each of the proposals, there are none which differentiated between the options and no option emerges as having a more significant overall impact than others.