As some of you may be aware from recent media reports, in January 2023 the national NHS (known as NHS England) issued a letter to NHS Shropshire, Telford and Wrekin concerning the Shrewsbury Health and Wellbeing Hub.
The letter instructed that the Cavell Centre Programme, and its six pilot programmes, should be paused pending approval of the national business case – a process which secures capital funding (money for building new premises) for developments such as this.
At this point, the Programme Team for the Shrewsbury Health and Wellbeing Hub (the local name for the Cavell Centre Programme) took the decision to continue work on the site options appraisal, which was already underway, to identify a preferred location.
The team honoured its contractual agreements with technical experts, supporting this piece of work to see it through to completion, whilst awaiting further instruction on the likely length of the pause.
As part of the final site appraisal stage, and a key milestone to progressing to formal consultation, it was the Programme Team’s intention to hold a multi-stakeholder workshop, which would include local councillors, to identify a preferred site option and prioritised site list.
It is important to note that the pause is an instruction from NHS England for all six pilot programmes, and that these local projects as part of the Cavell Centre Programme cannot influence the decision.
We have received no further communication of when the business case will be going forward for approval. We are also aware that even if the business case did go forwards, there are still no guarantees that the funding would be available in the current economic climate.
Given that indications now point to the pause being medium to long term, NHS Shropshire, Telford and Wrekin has reluctantly taken the decision to pause all further work and expenditure at this point. The stakeholder workshop has also been cancelled whilst the team await further national instruction.
Clearly, this is a hugely disappointing position given the significant amount of work that has been undertaken and the very clear case for change. NHS Shropshire, Telford and Wrekin and the Programme Team maintain its commitment to the project and to pursuing the right sustainable solution for General Practice in the South of Shrewsbury.
This does pose an extremely challenging situation to our practices if we are not able to access the £40-60m national capital funding for the programme. As has previously been shared, the case for changing how General Practice needs to be sustained over time has not altered.
At this point, there is no means of securing this level of funding which means we now need to plan for an alternative future. As part of that, it is important to recognise that the uncertainty over the future of this development further emphasises the uncertain future for our practices and patients.
Our primary care estates strategy is currently under review, and we will need to consider the real prospect of not receiving this funding and addressing the current fragility of those respective practices. As a health and care system we will do all we can to avoid practice closures, but we will need to consider the consequences of practices that may no longer be able to continue to provide services, and as a result hand back their contract. Our considerations will need to include how this will affect patients, staff and neighbouring practices should patient lists be dispersed.
To inform this thinking, we are now in discussions with the six practices about next steps and revisiting each practice individually to explore what could be achieved to support them going forward. However, it is important to note that this will be to stabilise the practices as best we can. It is not about futureproofing or sustaining them in the way that the development of the hub approach would have allowed given the very limited amount of capital funding that is available to NHS Shropshire, Telford and Wrekin.
We will keep you informed of any developments as and when we learn more.