#8. The future for A&E


Full, un-edited version of what first appeared in Highley Forum and Highley News, January 2015

The ongoing debate about the future of local A&E departments should really have informed public opinion and got people seriously thinking, not just about what we have but what we’re going to need in the foreseeable future – and arguably beyond.

There are a few who are taking on board what our clinicians are saying, but to date most of the people who really ought to know better are merely pandering to popular expectations because there are votes in pandering to popular expectations.

Voices of reason are being shouted down in an acrimonious exchange of views owing more to an emotional attachment to an historical situation than any acknowledgement of the reality of our situation.

Once you take on board the College of Emergency Medicine’s recommendation of a minimum of 10 A&E consultants in your A&E department, things start to look a little different. There are just 5.5 (in contractual terms) consultants over BOTH the Royal Shrewsbury (RSH) and Princess Royal (PRH) sites.

I won’t go into the arguments pro and con either RSH or PRH or the central site in the Atcham area (which I’m reliably informed is already in the ownership of NHS England), but will go into the reasons why we have this problem.

A&E consultants naturally prefer to work in a high-spec hospital with modern facilities that allow professional development, not just because of the benefits to them personally but to the people who have such high expectations of them, patients like us.

The shortage of A&E consultants is a national one, but it’s why the shortage of consultants in Shropshire is particularly acute.

With A&E consultant staffing figures like we have in the county, A&E consultants face being on call one day in every three. For comparison, if they worked at North Staffs they’d work one day in thirty.

So you can see, it genuinely isn’t about money, about how much you’ll pay someone to overlook all the major professional shortcomings.

We need to change the way we do things. The RSH and PRH are brilliant at some of the things they do, but in some areas each is better than the other, they’ve become that way because specialties have been located at each to make the best use of resources without spreading them too thinly across the two sites.

But before we can change the way we do things we need to acknowledge the reality of what we have and stop wishing for the retention of something we haven’t actually had for some considerable time now. Once we do that the planning for a more sustainable future can start.