Future Fit updates

Updated 16 December

The NHS Changes Task Group met on 10th November. It was agreed that our response to the Future Fit proposals should be an action plan for improvements in healthcare services for southwest Shropshire and eastern Montgomeryshire. The focus is to unleash the potential of the existing Community Hospital to create a fully integrated Urgent Care Centre – Local Planned Care facility – Community Health Hub that are key elements of the Future Fit plan. The Task Group recognised the imperative of submitting a strategic business case to the Future Fit team early in the New Year. This is to ensure that the ‘Bishop’s Castle Option’ is included on the Future Fit short-list which will be decided in early February.

We have continued our series of meetings with key influencers (also see previous update below). At a political level we were pleased to welcome Glyn Davies MP for Montgomeryshire to the Community Hospital. This allowed him to see at first hand the excellent facilities available and to debate our ideas for an Urgent Care Centre. Meetings have been held also with Jane Dodds, Parliamentary candidate for Montgomeryshire and Cllr. Charlotte Barnes, Parliamentary candidate for the Ludlow constituency. We plan to meet all Parliamentary candidates.

A very useful joint meeting was held with the Montgomeryshire Community Health Council and its counterpart Healthwatch Shropshire. We also met Joy Jones, the Powys County Councillor who is making the case for an Urgent Care Centre in Newtown.

Because of the importance of a cross-border (Montgomeryshire – Shropshire) solution we submitted evidence to the House of Commons’ Welsh Affairs Committee’s inquiry into cross-border healthcare (published elsewhere on the website).

We value greatly effective working with the Future Fit team. Meetings have been held with Dr. Caron Morton, senior responsible officer for Shropshire Clinical Commissioning Group and Mike Sharon, the Programme Director.

We are delighted that Bishop’s Castle Town Council has awarded the Patients Group a £500 grant to enable us to convene public meetings and to engage residents in Future Fit.

The Mayor of Bishop’s Castle Town Council, who is an active member of the Task Group, has kindly agreed to convene a meeting of all southwest Shropshire Parish Councils at the Community Hospital on 12 January. This will allow us to gain a wide input to our proposals and communicate what Future Fit is seeking to achieve. Also the Mayor is seeking to engage with her opposite number in eastern Montgomeryshire.

Other meetings in hand are with adjoining Patient Groups and the leaders of Shropshire and Telford Hospitals and the Shropshire Community Hospitals. We are meeting also the BC Doctors before engaging GPs from surrounding surgeries.

Jan Arriens and Pat Morrison from the Task Group are carrying out special investigations respectively into the ‘111 – Shropdoc’ and the ‘Welsh and West Midlands Ambulance Services’. Karin Johnson is reviewing the GP contract and the changes planned by NHS England. These areas are of importance in their own right and also in the context of our Future Fit proposals.

A Public Meeting to discuss Future Fit and the opportunities for Bishop’s Castle and the surrounding region will be held on Tuesday 3 February, 7.00pm, in the Public Hall. The keynote speaker will be Dr. Bill Gowans, the author of the Future Fit clinical model.


Updated 09/11/14

On Tuesday 4th November, Gren Jackson, Nick Hutchins and Jean Rice updated the Town Council on Future Fit. Papers presented to the Council may be downloaded here.

On Friday 7th November, Nick Hutchins, Gren Jackson and Jean Rice spent an hour with Philip Dunne, MP, to discuss Future Fit and the possibility of creating an Urgent Care Centre at Bishop’s Castle.

Further meetings are planned with Glyn Davies, MP and Caron Morton, CCG Responsible Officer and one of the two heads of the Future Fit project.

The NHS Changes Task Group will meet 10th November to discuss how to promote the possibility of Bishop’s Castle Community Hospital forming one of the planned Urgent Care Centres for the area.New members of the NHS Changes Task Group include Mayor Karen Bavastock and Jan Ariens. This meeting will also be attended by one or both of the partners from BC Medical Practice.

Update 31/08/14

Four people from BC ( 3 x steering group members, plus one spouse) attended the first of the public meetings announced below and posted around town. Nick Hutchins took notes and these are reproduced below for your information (note that they are notes, rather than minutes or a script, so please accept them as such). Please see update 05/08/14 (or click here) for information about the next meetings in September. This is an important project which will affect us all: it’d be well worth attending to get better informed about Future Fit.

Future Fit Workshop August 22, Newtown Powys

The event was introduced by Andrew Cresswell, Montgomery Health, Powys County health board.
Managed by Louise Booth, Participate.

19 people present, less four facilitators, less at least one observer (how many public?). Most attendees seemed to be connected to the council or health organisations.

Dr Mike Innes, chair CCG Telford and Wrekin
Background to Future Fit.
Now at clinical model stage. Now approaching the question of where we provide care.
Principles of Future Fit:
Right level of care
Support to remain independent
Medical staff supported
Communities supported.

A case for change quiz identified the following facts for Shropshire and T&Wr:
1 50% arrive at A&E by ambulance, twice national average
2 82% using A&E do not need to be seen at A&E
3 Powys over 65 population increased by 37% over past 10 years
4 cardiovascular disease is highest killer at 32%
5 Population = 234 per sq mile in Shropshire, 68 in Powys

Bill Gowans, Joint Chair of the Future Fit Clinical Design Group
Reasons for change:
Longer lives
Higher patient expectations
Most of us will have a long-term illness
Medicine can help keep us alive
Technology helps keep us alive
Costs are growing and funding is finite
All started with Call to Action, involving extensive feedback from patients and clinicians.

Rural and urban area
Two hospitals, but we need specialists working together driving up care, not dispersing too much
Accessibility is an issue with long journeys
So aiming to get people to hospital only when they need to.

Clinical model
Clinical model is the work of 300 clinicians
Initial charge was to look at hospital services, but it soon became apparent that it was necessary to look at whole care system.

Two themes
Centralising some aspects of care (specialist teams needed), usually needed only once or twice per lifetime
Majority of care needs to be delivered closer to home, not needing hospitals.

‘Emergency care’ = needed now: time critical
‘Urgent care’ = treatment today
‘Planned care’ = eg hernias, etc. not time sensitive, not an emergency
‘Long term care’. Needs to take into account time scale and quality of life.

[Powys wants people treated locally, via GP practices, community hospitals, etc. for example via local enhanced services. Powys about to launch a consultation exercise about plans after 18 Sept.]

Long term conditions
A lot of admissions to hospital not necessary. Older people should have alternatives. Need excellent reliable treatment and rehabilitation.
Most people want to die at home, but care is patchy and too many people end up being hospitalised. Care can be fragmented at the moment – you have to tell the story lots of time, you don’t feel supported back at home. FF will join up care, involve you from the beginning, only admitted to hospital when required, but when needed care will be quick.

Planned care
Planned surgery. Currently go to hospital for consultation before and after surgery. In new model only go once to hospital – pre- and post-care closer to home. Currently operations are often cancelled at last minute. Single diagnostic and planned care unit for planned care, this will avoid cancellations. Only 20% of surgery is complicated and will need to be done near the acute hospitals, so 80% can be carried out in diagnostic and treatment centre.

Emergency care and urgent care
Single emergency care centre backed up by urgent care centres. Emergency Centre won’t have walk in service. A number of Urgent Care Centres will deal with walk in problems such as cuts and bruises, plus, pneumonia, IV antibiotics, broken bones, etc. Most urgent care provided by GP and out of hours services.

Stephen Williams Future Fit
This is the clinical model being proposed:

1 x emergency centre
1 x diagnostic and treatment centre
Up to 10 x Urgent Care Centres
Up to 10 x health hubs
Up to 10 x Local Planned Care Centres
Up to 10 (10) x Community Units.

Location of all elements to be agreed – rest of meeting focused on locating all the elements and the reasons for so doing… each table was given patient data and then asked to plan location of each element in relation to population statistics, etc.

Overall, those who attended from Bishop’s Castle felt that it was a useful meeting which helped to clarify points and to show the basis on which decisions need to be made: the patient demographics were very interesting and helped to highlight the complexity of decision-making required.

Workshop information pack on the elements of the clinical model can be found here.

Nick Hutchins August 27th 2014


Update 05/08/14
At the BCPG annual meeting in June we promised to keep everyone up-to-date with developments in Future Fit and we now want to let you know about public meetings that are to be held in the next few weeks which aim to inform us on progress in the project and to seek opinions about options. These meetings are important to us: it’s our opportunity to hear about the options and to have a say about the location of hospital services. There are a lot of  rumours doing the rounds – why not go along to one of the meetings and find out what’s really being considered? See meeting dates and venues here.

Please also feel free to invite others to attend (but note that you need to book attendance).
Future Fit is a review of local NHS hospital services serving patients across Shropshire, Telford and Wrekin and mid Wales. For further information you can read an informative leaflet here. Much more information about Future Fit is available here.

A May 2014 update bulletin is available here.

A description of NHS England’s views on Urgent Care Centres is readable here.

The final report from the work stream considering potential clinical models for Shropshire can be read here.

We will add further information on this website as it becomes available. Please let us know if you want specific references to documents relating to Future Fit: we’ll do our best to track them down.