This document provides information about proposed changes to hospital services in Shropshire, Telford and Wrekin. It summarizes the context requiring changes, including difficulties retaining specialists and an aging population. Four options for changes are outlined, with the preferred option being to move some services between existing hospitals. Specific proposals include consolidating children's and maternity services at the Princess Royal Hospital and acute surgery at the Royal Shrewsbury Hospital. Public consultation on the proposals is open from December 2010 to March 2011. Feedback is invited online, by letter, or by attending public meetings. The changes aim to improve safety and quality of services for the long term.
Providing access to interventional
radiology services, seven days a week
Interventional radiology procedures are low volume and have a number of complex challenges. The service configuration at each Trust differs and is dependent on the number and the skill mix of interventional radiology consultants in the Trust. It is a service that supports a wide range of clinical pathways.
Based on the work of the NHS England Seven Day Services Forum and NHS Improving Quality’s Seven Day Services Improvement Programme (SDSIP), the focus for the 2013/14 interventional radiology programme has been to develop networks to deliver seven day access for nephrostomy, embolisation for haemorrhage and embolisation for post-partum haemorrhage.
Nephrostomy is a core interventional radiology service required for patients with a potential to deteriorate and require urgent intervention. Embolisation for haemorrhage usually, but not exclusively, is performed as an emergency/urgent intervention.Embolisation for post-partum haemorrhage may involve predelivery planning and be performed as an emergency/urgent intervention.
Dr David Maltz: The challenge of length of stayNuffield Trust
In this slideshow, Dr David Maltz, of The Oak Group, explores the challenge of length of stay and opportunities for improvement.
Dr Maltz spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September 2014.
A presentation by Dr Imran Waheed, Consultant Psychiatrist, on strategies to reduce the length of stay of psychiatric inpatients. Delivered in Birmingham, UK in July 2010.
Lessons learned from changing the consultant workforce model in acute medicine.NHS England
Dr Mark Roland, Associate Medical Director from Portsmouth Hospitals NHS Trust describes how the hospital changed their general medical consultant workforce model to improve care and flow. Despite challenges, this has improved care, flow, support for junior teams and staff satisfaction.
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Providing access to interventional
radiology services, seven days a week
Interventional radiology procedures are low volume and have a number of complex challenges. The service configuration at each Trust differs and is dependent on the number and the skill mix of interventional radiology consultants in the Trust. It is a service that supports a wide range of clinical pathways.
Based on the work of the NHS England Seven Day Services Forum and NHS Improving Quality’s Seven Day Services Improvement Programme (SDSIP), the focus for the 2013/14 interventional radiology programme has been to develop networks to deliver seven day access for nephrostomy, embolisation for haemorrhage and embolisation for post-partum haemorrhage.
Nephrostomy is a core interventional radiology service required for patients with a potential to deteriorate and require urgent intervention. Embolisation for haemorrhage usually, but not exclusively, is performed as an emergency/urgent intervention.Embolisation for post-partum haemorrhage may involve predelivery planning and be performed as an emergency/urgent intervention.
Dr David Maltz: The challenge of length of stayNuffield Trust
In this slideshow, Dr David Maltz, of The Oak Group, explores the challenge of length of stay and opportunities for improvement.
Dr Maltz spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September 2014.
A presentation by Dr Imran Waheed, Consultant Psychiatrist, on strategies to reduce the length of stay of psychiatric inpatients. Delivered in Birmingham, UK in July 2010.
Lessons learned from changing the consultant workforce model in acute medicine.NHS England
Dr Mark Roland, Associate Medical Director from Portsmouth Hospitals NHS Trust describes how the hospital changed their general medical consultant workforce model to improve care and flow. Despite challenges, this has improved care, flow, support for junior teams and staff satisfaction.
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Prof David Oliver: older people and acute care. Nuffield Trust
In this slideshow, Prof David Oliver, Consultant Geriatrician, Royal Berkshire NHS Foundation Trust, presents on how we can shorten and improve hospital care for older people with complex needs.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
The evidence for Prehospital Ultrasound: Luke ReganSMACC Conference
Luke Regan presents the emerging evidence for prehospital ultrasound and telehealth in his talk from the SMACC stage.
Luke has a personal interest in improving prehospital care. He lives in the north of Scotland. It is an austere and challenging environment, far from technology. Compounding this, it is underserviced and there is an absence of critical care with no critical in reach.
Unfortunately, the morbidity and mortality of the area does not match the spread of care. Therefore, it is one of the motivations for his research.
That being said, he is not alone in his desire for this research. Pre-hospital ultrasound topped the list of technology-based research priorities in pre-hospital critical care, as determined by a European research collaboration. This is in large part because much of what is done in pre-hospital care still exists in an evidence free zone.
Luke discusses the extended pre-hospital patient journey in his practice. This presents a challenge, but also an opportunity. If time zero is further back, testing a pre-hospital intervention becomes very achievable. There is precedent for this. Benefit of pre-hospital interventions have been highlighted by the relative benefit of stopping and performing roadside ECG in transit. This has allowed road crews to receive updated treatment advice based on that ECG.
This bundle of care is similar to what is possible with pre-hospital ultrasound. Currently, there is a very apparent practice creep when it comes to the use of ultrasound. This means there is an increase in the use of pre-hospital ultrasound around the world. However, it remains an evidence poor area.
Luke describes two studies conducted in Scotland looking to answer the big questions in pre-hospital point of care ultrasound (POCUS). Firstly, can it make a difference? Secondly, does it take too long? Finally, who should do it and how long does it take to train them? This is done in large studies, with lots of patients and inputs from a diverse meeting of minds.
Join Luke Regan as he discusses the evidence behind the application of pre-hospital ultrasound and telemedicine.
For more like this, head to our podcast page. #CodaPodcast
View the latest newsletter from the national CUR team to learn about the progress on CUR roll out and see the early data published from the national Early Implementer sites.
Overcoming the challenges of delivering 7DS for Echocardiogram and Ultrasound...NHS England
This webinar recording will provide you with a practical example of delivering echocardiography services from East Sussex Healthcare, a model for delivering ultrasound service from Salisbury NHS Foundation Trust and a national update on the strategy for delivering sustainable echocardiography services from Giancarlo Laura, Programme Manager, 7 Day Hospital Services, NHS England
Kalkidan clinic is a private clinic from Ehiopia Amhara region North Wollo Lalibela the historical holy place that serves both the local community and travelers. the clinic gives primary and secondary health care.
Abay wodaje call us +251913378285
Email kalkidanclinic@yahoo.com
Dr Ian Sturgess: Optimising patient journeysNuffield Trust
In this slideshow Dr Ian Sturgess, Director at IMP Healthcare consultancy, explores how we can better understand admitted flow streams and optimise patient journeys.
Dr Sturgess spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Osuuskunta yritysmuotona on kokemassa renessanssin. Osuuskunta on tulevaisuuden yritysmuoto, ja YK:n juhlavuoden 2012 mukaisesti: ""Cooperatives build a better world."
Prof David Oliver: older people and acute care. Nuffield Trust
In this slideshow, Prof David Oliver, Consultant Geriatrician, Royal Berkshire NHS Foundation Trust, presents on how we can shorten and improve hospital care for older people with complex needs.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
The evidence for Prehospital Ultrasound: Luke ReganSMACC Conference
Luke Regan presents the emerging evidence for prehospital ultrasound and telehealth in his talk from the SMACC stage.
Luke has a personal interest in improving prehospital care. He lives in the north of Scotland. It is an austere and challenging environment, far from technology. Compounding this, it is underserviced and there is an absence of critical care with no critical in reach.
Unfortunately, the morbidity and mortality of the area does not match the spread of care. Therefore, it is one of the motivations for his research.
That being said, he is not alone in his desire for this research. Pre-hospital ultrasound topped the list of technology-based research priorities in pre-hospital critical care, as determined by a European research collaboration. This is in large part because much of what is done in pre-hospital care still exists in an evidence free zone.
Luke discusses the extended pre-hospital patient journey in his practice. This presents a challenge, but also an opportunity. If time zero is further back, testing a pre-hospital intervention becomes very achievable. There is precedent for this. Benefit of pre-hospital interventions have been highlighted by the relative benefit of stopping and performing roadside ECG in transit. This has allowed road crews to receive updated treatment advice based on that ECG.
This bundle of care is similar to what is possible with pre-hospital ultrasound. Currently, there is a very apparent practice creep when it comes to the use of ultrasound. This means there is an increase in the use of pre-hospital ultrasound around the world. However, it remains an evidence poor area.
Luke describes two studies conducted in Scotland looking to answer the big questions in pre-hospital point of care ultrasound (POCUS). Firstly, can it make a difference? Secondly, does it take too long? Finally, who should do it and how long does it take to train them? This is done in large studies, with lots of patients and inputs from a diverse meeting of minds.
Join Luke Regan as he discusses the evidence behind the application of pre-hospital ultrasound and telemedicine.
For more like this, head to our podcast page. #CodaPodcast
View the latest newsletter from the national CUR team to learn about the progress on CUR roll out and see the early data published from the national Early Implementer sites.
Overcoming the challenges of delivering 7DS for Echocardiogram and Ultrasound...NHS England
This webinar recording will provide you with a practical example of delivering echocardiography services from East Sussex Healthcare, a model for delivering ultrasound service from Salisbury NHS Foundation Trust and a national update on the strategy for delivering sustainable echocardiography services from Giancarlo Laura, Programme Manager, 7 Day Hospital Services, NHS England
Kalkidan clinic is a private clinic from Ehiopia Amhara region North Wollo Lalibela the historical holy place that serves both the local community and travelers. the clinic gives primary and secondary health care.
Abay wodaje call us +251913378285
Email kalkidanclinic@yahoo.com
Dr Ian Sturgess: Optimising patient journeysNuffield Trust
In this slideshow Dr Ian Sturgess, Director at IMP Healthcare consultancy, explores how we can better understand admitted flow streams and optimise patient journeys.
Dr Sturgess spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Osuuskunta yritysmuotona on kokemassa renessanssin. Osuuskunta on tulevaisuuden yritysmuoto, ja YK:n juhlavuoden 2012 mukaisesti: ""Cooperatives build a better world."
This is a presentation I created for the Food Lion grocery chain when I was a Key Account Manager w/ J&J. I used Cat-Man principles and consumer insights to educate the customer. I pulled and compiled all data and even created the POG myself. Besides J&J items, I suggested adding more private label items in the set and a competitive Colgate sku that was performing well in the market. My approach resulted in 7 incremental sku's for J&J and an easier shopping experience for the consumer. The customer, as well as all vendors, would benefit from the “rising tide”. Please focus on slides 6 - 9.
Patient Safety Collaboratives - Dr Chris Streather, Managing Director, South London AHSN
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
Rebecca Rosen: Supply-induced demand in primary careNuffield Trust
In this slideshow Dr Rebecca Rosen, Senior Fellow, Nuffield Trust, discusses the concept of supply-induced demand as it relates to primary health care. She discusses the factors driving demand for increased service access and the unclear nature of the relationship between increased access and continuity of care.
Dr Rosen spoke at the event: "Supply induced demand as it relates to general practice" (http://www.nuffieldtrust.org.uk/talks/supply-induced-demand-it-relates-general-practice) in March 2014.
Working together for Better Care in Richmond HW_Richmond
Presentation from Richmond CCG, Healthwatch Richmond, Hounslow and Richmond Community Healthcare, Kingston Hospital, West Middlesex University Hospital and the Richmond GP Alliance on the changes happening to community services in Richmond.
Elizabeth Stephenson and Carol Ewing: child health policy updateNuffield Trust
Elizabeth Stephenson, Children and Young People Policy Lead at NHS England, and Dr Carol Ewing, Vice President of the Royal College of Paediatrics and Child Health, give an overview of the national policy making landscape for child health.
By Marc Newell, MD. A discussion about the rapidly evolving TeleHealth program at Minneapolis Heart Institute that promises to increase access to and timeliness of specialty care in communities across the region. “This is an innovative strategy that allows more patients to be seen closer to home, and have more access to subspecialty care. We need to transform how and where we deliver care so we can focus on prevention and chronic disease management.”
Presentation by Terry Whalley, Director of Delivery, Cheshire & Merseyside Health & Care Partnership at ECO 19: Care closer to home on Tuesday 9 July at Deepdale Stadium.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Keeping it in county
1. Have YOUR say
about the future of our local
hospitals
Keeping hospital services in Shropshire,
Telford and Wrekin
PUBLIC CONSULTATION
Telford 2010 – 14 March 2011
9 December & Wrekin LINk
2. Keeping it in County
Securing the future of hospital services in Shropshire
RAISING PUBLIC AWARENESS
- the need for change
- the options + benefits of
reconfiguring hospital
services
- the consequences of not
taking action in the near future
3. Keeping it in the County
Securing the future of hospital services
in Shropshire,Telford and Wrekin
The case for change
4. The context
1. The level of external scrutiny 2. Difficulty in
by independent regulators, recruiting (and
professional bodies/colleges retaining)
AND patient „watchdogs‟ is specialists
greater than ever
3. A drift of services
„out of county‟ –
this could become
even more of an
issue
5. The purpose of the changes
“The proposals reflect what the doctors who
provide the services, and the GPs who send
their patients to use them, think should be done
to improve safety and quality and make sure
these services are provided within Shropshire,
Telford and Wrekin for a very long time to
come.”
“They are most definitely not aimed
at saving money or cutting services.”
6. THE PRINCIPLES
underpinning the proposed reconfiguration
• Two vibrant, well-balanced,
successful hospitals
• A commitment to having an A&E on
both sites
• Access to acute surgery from both
sites
10. Population Demographics
• Serve a population of over 500,000
• An ageing population
• Deprivation – rural and urban
• Long Term Conditions and lifestyle related illness
Shropshire Telford & Wrekin Powys
170,000; fast-growing
290,900; ageing population;
62,000 of 131,900;
Ageing; Increasing birth rate Ageing
Rural deprivation Densely populated; high Rural deprivation;
High life expectancy; levels of deprivation; Sparsely populated;
Higher than Higher than average Good health status
average/ rising levels of obesity, compared to Welsh
levels of LTC‟s smoking-related
• Shropshire admissions and deaths
averages
and cardio-vascular
disease
12. Ageing buildings….. not fit for purpose
Even if money is spent on the building, its future life span is limited
to between five and ten years.”
13. Providing the right level of
care for children in hospital
With reduced numbers of children‟s specialist
doctors nationally, our paediatric consultants
are increasingly concerned about staffing our
two existing children‟s units with the right level
of doctors.
14. SURGICAL CARE - 24/7
• Surgeons specialise today – so carry out a
smaller range of more complex operations than
in the past
• Increasingly skilled surgeons are able to deliver
better results – patients benefit.
• BUT leads to fewer general surgeons which
makes it difficult to organise services so that
the right specialists are available at any time
of day or night.
16. HOW were the proposals
developed?
• Specialist doctors,
nurses and GPs other
health professionals
responsible for running
the services concerned.
Patients and carers
and a wide range of
organisations that
represent them
17. 4 key tests
BEFORE publishing their proposals an Assurance Panel was asked
to check that the PCTs proposals met the 4 KEY TESTS laid down by
the Secretary of State for Health:
1. local GPs (who will be responsible for commissioning
services) support the proposals;
2. local patients and patient representatives are involved
3. the need for reconfiguration is supported by clinical
evidence ;
4. the changes proposed will enhance patient choice.
AND ALSO: how far they believed the proposals would improve outcomes
for patients in the future, and are affordable and sustainable
.
18. 4 options
Option 1: Do nothing and Option 3: Concentrate all
maintain all services as they services on one site, either
are. in a brand-new hospital - or
in one of the existing two
hospitals.
Option 2: Move some Option 4: Concentrate all
services from PRH to RSH major urgent inpatient and
and vice versa to make the emergency activity on the
most effective use of staff, site of one of our existing
equipment and buildings. two hospitals,with planned
activity at the other
19. Option 1: Do nothing and
maintain all services as they are
“If we did nothing, we expect it would result in
services being moved out of the Shropshire,
Telford and Wrekin area altogether. In those
circumstances, many patients would end up
travelling greater distances to receive their
hospital care.”
“This does not provide a practical and
satisfactory solution to the problem
we have outlined.”
20. Option 2: Move some services
from PRH to RSH
“It would enable us to continue to provide all
the hospital services we are currently
providing. Most patients would receive their
care at the same hospital as they do now.
For some inpatient services, some people
who currently use the Princess Royal
Hospital would go to the Royal Shrewsbury
Hospital and vice versa.”
This is the PCTs preferred option
21. Option 3: Concentrate all services on one site,
either in a brand-new hospital or in one of our
two existing hospitals
Building a brand-new hospital to replace both PRH and
RSH would be the ideal.
new facilities from scratch
up-to-date equipment
purpose-built accommodation
all our staff and services together
This would cost = £350 - £400 million +
This was looked at in a feasibility study in 2009.
In the financial climate now facing the nation, that
money is not available – so it is is not affordable or
feasible
22. Option 4: Concentrate all major inpatient and
emergency activity on one site, with planned
activity at the other
Many potential benefits – and strongly supported by clinical
staff.But in practice there is more urgent and emergency
activity than elective or planned activity.
If we were to implement this option one site would not have
very much work, but the other site would very busy - and
without significant expansion in facilities, the service would
be overwhelmed.
Neither affordable nor feasible
24. Under the proposals, some specialist services
would move from the Royal Shrewsbury Hospital
to the Princess Royal Hospital in Telford, and vice
versa
Most outpatients
would continue to go
to the same hospital
as now
Most „day case‟
patients
would go to the
same hospital
as now
25. The PCTs „Preferred Option‟ for PRH
Midwifery Led Units would remain on BOTH SITES
All women would receive their antenatal and postnatal appointments
at the SAME LOCATION AS NOW
• Establishment of a Women‟s and Children‟s
centre on the PRH site
– The obstetric unit would move from RSH to PRH.
– The Neonatal Intensive Care Unit would move
from RSH to PRH and be co-located within the
Women’s and Children’s centre
– Consolidation of inpatient paediatrics onto a
single site at PRH with enhanced Paediatric
Assessment Units on both sites
• Head and Neck services would transfer from
RSH to PRH due to the high level of paediatric
activity
26. Childrens services at PRH
• Inpatient children‟s services would be concentrated at
PRH site, with both sites providing children‟s
assessment units
• Children attending hospital as an outpatient (the
majority of children who use hospital services) would
continue to go to the same hospital as they do now.
* The neonatal intensive care unit (for newborn babies
needing intensive care) currently on the RSH site would
move to PRH site, so that it is in the same place as the
consultant-led maternity unit and inpatient children‟s services
27. Gynaecology + ENT services
INPATIENT gynaecology services would be concentrated in future at
the women‟s and children‟s centre within PRH.
OUTPATIENT or day care gynaecological services would go to the
same hospital as now.
Head and neck services including specialist surgery for
cancer patients,
+ Ear, Nose and Throat problems would be seen at PRH -
800 children each year
28. PRH RECAP
24-hour A&E department
Outpatient clinics
Day case procedures
Emergency medical service (e.g. heart attacks, serious
chest infections)
Midwife-led maternity unit
Emergency and inpatient orthopaedic surgery
Children‟s inpatient unit
Children‟s assessment unit (24 hours)
Consultant-led maternity unit
Neonatal unit
Inpatient head and neck services, including ear, nose and
throat
Inpatient gynaecology services and breast surgery services
29. The PCT‟S Preferred Option – for RSH
Improved facilities in the
midwifery led unit at RSH
Acute inpatient surgery at
RSH site
The establishment of a
vascular surgical centre at
RSH
Improved facilities for
cancer patients at RSH (with
the support of Lingen Davies)
30. RSH recap
24-hour emergency surgery
Emergency and planned inpatient vascular surgery
Emergency and planned inpatient colorectal surgery
Emergency and planned inpatient upper gastro-intestinal surgery
Emergency and inpatient orthopaedic surgery
Emergency medical service (e.g heart attacks, serious chest infections)
Major trauma (such as road traffic accidents) 24-hour A&E department
Outpatient clinics Midwife-led maternity unit
Day case procedures Children‟s assessment unit (not overnight)
31. All urgent medical cases
including strokes, heart attacks and
serious chest infections
would go to the same hospital as now –
supported by non-resident senior
surgeons
32. A&E services
• The maintenance of a
24 hour A&E service
on both sites
• Major trauma would
continue to be seen at
RSH
• Long bone trauma
would be seen in both
A&E‟s
33. Stroke Services
Urology services
Urology involves treatment of the kidneys, bladder,
urinary tract and prostate. Work is currently taking
place to determine at which of our two hospitals
inpatient urology should best be concentrated in
future.
The PCTs also want to discuss the local pattern of
stroke services, taking into account how best to
introduce new techniques and develop services in line
with modern standards.
Views are being sought about both services as
part of the consultation.
34. ISSUES which still need to be addressed
• Extended travel time for a minority of patients
• Patient pathways will need to be agreed and
understood by all
• Paediatrician cover at RSH for acutely ill and injured
children being taken to the RSH out of hours (NB
severely injured children are transferred to Birmingham
now – this will continue)
• The potential need to transfer children safely
between the two sites
• The needs of rural communities need to be responded
to under a new configuration e.g. Powys and parts of
Shropshire
Improving The Health
Of Our Community
37. Revenue implications
• No additional £/funding from
commissioners
• Whilst not solving the Trust‟s financial
challenges, the changes will give
opportunities to strengthen the Trusts
financial position
• Will remove the current hold up on
making changes- and create a new
opportunity to look at current models of
care and working practices
38. Capital Costs
• New build at PRH - Women‟s and children‟s centre
• RSH - refurbishment of existing facilities
• Both in the range of £27 - £30 million
• Discussions with NHS West Midlands regarding the
level of capital support – likely to be in the form of a
loan, repayable over 25 years
Improving The Health
Of Our Community
40. Planning the changes
Phase Objective Timescale
1a Discussion and Developing a robust proposal August to
Design Option modelling November 2010
1b Assurance and Assurance process November 2010
Consultation
Public consultation December 2010
to March 2011
2 Planning for Planning, securing finance and April 2011 to April
Implementation undertaking procurement 2012
3 Implementing the Implementation commences Phased approach
Change from April 2012
Improving The Health
Of Our Community
41. WHAT HAPPENS
at the end of the consultation ?
• By the end of MARCH 2011 - all three boards
will decide, in the light of the outcome of this
consultation, whether and how far to proceed
with the proposals.
• If the boards agree changes will start this Spring
• All the changes would be implemented by 2014.
Not all the changes would necessarily take place at the same
time or at the same pace. Patient safety would be a top
43. Consultation questions
What do you think about the overall proposals?
What do you think about the specific proposals for
inpatient children‟s services?
What do you think about the specific proposals for maternity services?
What do you think about the specific proposals
for ACUTE surgery?
Are there any comments you would like to make about
the location of urology? Or about the future pattern of
local stroke services?
Are there any other comments you would like to make?
44. HAVE YOUR SAY
This public consultation runs
from 9th December 2010 to
14th March 2011.
During that time the PCTs want to hear
the views of as many people as
possible about their proposals.
45. How you can get a copy of the
full document OR SUMMARY
full and summary consultation documents
are available on request. EasyRead or large
print are also available.
• Call 01952 580478 or 0800 032 1107
• Or download from
www.shropshire.nhs.uk
www.telford.nhs.uk
www.sath.nhs.uk
www.ournhsinshropshireandtelford.nhs.uk
46. Feedback ONLINE :
• www.shropshire.nhs.uk
• www.telford.nhs.uk
• www.sath.nhs.uk
• www.ournhsinshropshireandtelford.nhs.uk
or EMAIL to:
ournhsinsat@nhs.net
47. Write a letter setting out your views
FREEPOST RRZR-SZAA-BUBZ
Reconfiguration of Hospital Services,
Oak Lodge, William Farr House,
Shropshire County NHS PCT,
Mytton Oak Road,
Shrewsbury SY3 8XL
or EMAIL ournhsinsat@nhs.net
48. ATTEND A PCT MEETING
• Thursday 13th January 7pm - Shrewsbury Town
Football Club
• Thursday 20th January 7pm - Oswestry Memorial
Hall
• Wednesday 9th February 7pm - Craven Arms
Community Centre
• Wednesday 16th February
7pm - Holiday Inn, Telford
49. Please copy your feedback to
Telford & Wrekin LINk
Suite 1, Conwy House
St Georges Road
Donnington
Telford TF2 7BF
01952 614180
enquiries@telfordandwrekinlink.org.uk
or take part in an online discussion about Keeping it in
the County at www.telfordtalks.com