Shrewsbury & Telford NHS Trust Sustainable Services Programme Update Mid Wales Healthcare Collective -12th March 2018

Aims of this presentation To share: A brief update on Sustainable Services Programme (SSP) and the wider Future Fit programme and a quick reminder of the key elements of the clinical model Plans of the proposed emergency and planned care sites and a high level description of what goes where as described in the Outline Business Case (OBC) 2

The options for consultation – balanced hospital sites Option 1 (Emergency Care at RSH, Planned Care at PRH) ED and Critical Care at RSH Majority of planned care at PRH 24 hour Urgent Care Centre, Outpatients, Diagnostics at both RSH and PRH Option 2 (Emergency Care at PRH, Planned Care at RSH) ED and Critical Care at PRH Majority of planned care at RSH 24 hour Urgent Care Centre, Outpatients, Diagnostics at both PRH and RSH Option 1 – identified as the preferred option by the Future Fit Programme Board 3

Sustainable Services Programme update Future Fit: Pre Consultation Business Case approved by CCGs Public Consultation – CCGs currently awaiting approval from NHSE to progress For the Trust (in addition to supporting the above): Considering deliverability options in terms of phasing and affordability – positive discussions regionally and nationally Progressing the workforce transformation – 5 year plan Final submission of OBC – following the outcome of consultation 2018

Sustainable Services Programme – improving patient experience and flow Current Future RSH PRH Emergency Care Site Planned Care Site A&E AMU A&E AMU UCC Day Case Short stay ED/ UCC CAU SAU AEC CAU Inpts Critical Care Inpts CDU AEC Inpts CDU AEC/ CDU CAU Day Case Inpts ITU Day Case ITU Short stay Short stay Uncoordinated flow of patients Coordinated & cohorted flow of patients

The Potential OBC Solution - Essential Service Change (Options 1 and 2) Service balance based on clinical adjacency needs and resolving workforce issues Emergency Care Site Both Sites Planned Care Site Elective and Day Case Surgery Endoscopy Beds approx 350 Including: 240 inpatient beds and 110 day case / endoscopy beds Elective Orthopaedics Breast Service Frailty and Elderly Care Rehabilitation Emergency Department Critical Care Unit (HDU, ITU) Ambulatory Emergency Care (AEC) Beds approx 510 beds Including: Acute Stroke Unit Coronary Care Unit Women and Children’s Orthopaedic trauma Acute Medicine 24 hour Urgent Care Centre Outpatients (including Fracture Clinic) Diagnostics Day Case Renal Unit Integrated Care Pathways – LTC, Frail and Elderly etc NB Inpatient bed base does not include Neonatology and Critical Care numbers

Emergency Site ·Emergency Department RSH Site PRH Site · 24 hour Urgent Care Service · Critical Care Unit · Ambulatory Emergency Care (AEC) · Approximately 510 beds including: · Acute Stroke Unit · Coronary Care Unit · Women and Children’s inpatient services · Orthopaedic Trauma · Acute Medicine · Complex planned care · Outpatients · Diagnostics · Day Case Renal Unit   PRH Site

Emergency & Urgent Care Services Complaints/conditions to be treated at the Emergency Department are those that threaten life and limb and include: anaphylaxis and life threatening respiratory problems stroke severe chest pain severe trauma to chest and abdomen open or multiple fractures moderate burns poisoning and drowning Complaints/conditions to be treated within Urgent Care Centre are those accidents and illnesses that need same day treatment: sprains and simple fractures cuts and scrapes asthma ENT conditions scalds bites and stings

Planned Care Site ·24 hour urgent care centre PRH Site RSH Site · All adult Day Case procedures · All planned surgical procedures for patients not requiring Critical Care · Approximately 350 beds including: · Elective Orthopaedics · Single site Breast Service · Medical beds for stable patients requiring acute care closer to home · Frailty and elderly care · Rehabilitation · Outpatients · Diagnostics · All planned Endoscopy · Day Case Renal Unit  · Women and Children’s Services, including: Maternity Outpatients, Scanning and Day Assessment Unit Midwifery Led Unit (MLU) Children’s and Neonatal outpatients Early Pregnancy Assessment Service (EPAS) Gynaecology outpatients and procedures   RSH Site

For more information or to get in touch… SaTH Sustainable Services Group Email: sustainableservicesgroup@sath.nhs.uk Phone: 01743 261183 Web: www.sath.nhs.uk Post: Stretton House, Royal Shrewsbury Hospital, Shrewsbury Thank you 11