Health Services in Mid Wales

The very important public consultation on the future of NHS services in Shropshire has recently ended (September 2018). Please find below my contribution to the consultation. We now await the result from the consultation and I will focus my efforts on ensuring that we have more planned care delivered locally.




I write in my capacity as the National Assembly Member for Montgomeryshire in response to the NHS Future Fit Consultation on a new model of care and the proposed options to change the hospital services provided at the Royal Shrewsbury Hospital and the Princess Royal Hospital, Telford.


According to the 2011 Census, the population of Montgomeryshire is recorded at 63,779 over a rural area spreading across 839 square miles.


The rural topography of Montgomeryshire currently presents significant challenges in accessing hospital services with too many residents in the constituency travelling over 1 hour to receive access to emergency care services in Shropshire.  Montgomeryshire has an ageing population with a higher proportion than the Welsh average of residents being of a retirement age.





I have undertaken my own survey in relation to this consultation within my constituency to enable their views to be portrayed in my response. I have received over 600 responses.  My survey asked a number of questions:


I asked:


“There will only be an emergency care service at one Shropshire hospital. Where would you prefer this to be located, Royal Shrewsbury Hospital or Princess Royal Hospital?”


95% of respondents preferred an emergency care service at the Royal Shrewsbury Hospital rather than the Princess Royal Hospital Telford.


However, the preferred option would also mean that some planned care services would move further away from Mid Wales; moving to the Princess Royal (PRH) in Telford. There are concerns from my constituents that under both options the proposed model of care would result in residents having to travel further for some of their care (emergency care under Option 2, or planned care under Option 1).









On balance, while my preference would be that no care should move further away from Montgomeryshire’s residents, I am in favour of the preferred option which has been put forward by the Shropshire and Telford & Wrekin clinical commissioning groups. This option would see an Emergency Centre located in Shrewsbury which is centrally located to serve the life-saving emergency healthcare needs of the wider region and those of us here in Montgomeryshire. 


It is crucial in my view that the Emergency Centre is located in Shrewsbury (as recommended) in order to retain life-saving emergency care without the need for additional travelling time for the people of Montgomeryshire. I also welcome the proposal to reinstate women and children’s services and stroke services, at RSH. 









Under Option 2, the Emergency Centre is located in Telford. This is a particular concern for Montgomeryshire residents, as the increased distance of over an hour travelling for emergency treatment is completely unacceptable. There are very few places in the UK in which people have to travel an hour to receive emergency treatment.  The ‘golden hour’ which is referred too many times is less likely to be achieved if the Emergency Centre was to be located at Telford.


There would be a significantly increased travelling time for family members to follow an ambulance to Telford from Montgomeryshire.  They would then face this extended journey – typically a 100 mile round trip - to visit loved ones in hospital whilst they continued to receive emergency and acute care.


My survey results show many residents have raised concerns that PRH is to far from Junction 6 off the M54, also the road layout including a number of islands, various lane changes required and insufficient signage has raised concerns regarding the Emergency Centre to be located at PRH. Other concerns raised include the regular heavy traffic congestion and frequently stationary traffic on the A5 between the three island junctions at Montgomery, Bishops Castle and at the A49 Island. Also, with the A5/M54 being the main road route from Mid Wales to Telford, our communities face considerable access challenges if this road is closed due to incidents or repairs.


There is huge concern from ambulance staff who would need to get to Telford for those emergency situations.




While the planned surgery received at Gobowen is not affected and neither are most of the outpatient appointments, outpatient procedures, diagnostic tests, scans and complex planned surgery currently provided at the Royal Shrewsbury Hospital, more of our day case surgery and routine planned surgery, as well as endoscopy, would move.


Therefore, I firmly believe that, alongside the proposed reconfiguration of services in Shropshire, it is essential that some planned care is delivered locally in our local community hospitals in Llanidloes, Newtown, Welshpool and Machynlleth, including a surgical theatre, endoscopy facilities and more use of video and remote technology to prevent the need to travel out of county see a consultant; even day case surgical procedures such as cataract operations.  I would be keen to understand how SaTH might work in partnership with Powys Teaching Health Board to achieve this.


NHS services should be delivered as close as possible to home and I have previously called on the Welsh Government to allocate additional funding to Powys Teaching Health Board for minor injury units and develop a Community Hospital Development Fund to encourage the innovative use of community hospitals across rural Wales. I will be looking for the Welsh Government to revisit this suggestion following proposed changes to healthcare across the border in Shropshire.


In my view, patients should not travel significant distances for some planned care procedures when this type of elective healthcare can be delivered locally, making community hospitals more sustainable and to ensure that any additional economic, social and psychological burden of travelling further to access planned care or visiting friends and family is alleviated.


I believe the preferred option of the emergency centre located at Shrewsbury is essential. This option would also mean that some planned care would be delivered in Telford; this option presents opportunities for some planned care services to be delivered locally in Mid Wales


There are concerns over the availability of adequate parking facilities and concerns over public transport from RSH to PRH allowing patients who do not have transport to commute between both locations.  This is a further reason why I believe some planned care procedures can and should be delivered locally.  I would also wish to see the UK Government working with the Welsh Government to address the current inequity by which Welsh older person’s bus pass does not cover the costs of travel in England and vice versa. This creates a barrier to accessing cross-border healthcare for some of the greatest users of health services.