Fit for the Future – Summary Update

Fit for the Future update – developing urgent and specialist hospital care in Gloucestershire

The Fit for the Future engagement was on ‘pause’ during the pre-general election purdah period and as we enter 2020, we are now ready to resume conversations.

We felt this was a good time to provide a summary of what’s happened to date and set out next steps.



We want local residents to have access to leading edge care and treatment, comparable to the best in England and for our great staff to have the best possible working environments. This means we need to consider how some of our services and sites are organised to ensure they are ‘Fit for the Future’.

The expectations of healthcare, the demands on health services, and the incredible progress made through science, technology and developing staff skills and expertise has dramatically changed the environment that we are operating in.

As a result, we need to make sure local services are sustainable and can meet the needs of patients, not just now, but long into the future.

As part of the engagement period over the summer and autumn, we set out some thoughts and ideas for how services could develop in an information booklet and supporting materials that can be found at:

We invited staff, partners and the public to share their own ideas and views and also thoughts on the criteria that will be developed to assess potential solutions.

Thousands of views and ideas were received through a range of opportunities, including a survey, other written submissions, drop in events, independently run workshops and an engagement hearing.

The Output of Engagement Report is now publically available on the website above. The contents of the Report will be reviewed in detail by NHS partners and will help inform the development of potential solutions and options for change.


Community urgent care

Together with local people, we have been looking at how same day urgent illness and injury services are provided across our communities, in pharmacies, GP surgeries and hospitals, based on local circumstances, needs and the desire to provide the very best care.

We arranged a number of local workshops to discuss community urgent care with health and care professionals, partners, patients and the public and the findings are included in the Output of Engagement Report.

Following extensive engagement over the last few years, there is also a lot of interest from local residents and staff in the development of the new hospital for the Forest of Dean.

Over the summer and autumn, we invited local residents and people who work in the district to share their views on the services provided in the new hospital and the Output of Engagement Report can be found within the wider report referred to above.


Specialist hospital services and centres of excellence – Cheltenham General Hospital and Gloucestershire Royal Hospital

The Fit for the Future engagement has also been about people considering together how best to develop outstanding hospital care in the future across the Cheltenham General and Gloucestershire Royal sites.

This includes using our resources such as specialist staff, equipment and facilities to best effect and ensuring that people who are very unwell experience care and outcomes that are comparable to the best in England.

Through the engagement opportunities described above, partners, the public and staff shared their ideas and views during the summer and autumn.

At the end of January 2020, an independently run five day Citizens’ Jury will be held to look at specialist hospital services to ensure we continue to hear what is important to local people and patients as we develop potential solutions.

Jury members will consider feedback from the Fit for the Future public and staff engagement, together with evidence on the need for change across Gloucestershire’s two main hospital sites – Cheltenham General and Gloucestershire Royal.

They will hear from NHS doctors, nurses and other staff about current services, from public and patient representatives and from a variety of other speakers on relevant topics.

They will consider, and be asked for their views on, a vision for a centres of excellence approach to providing
hospital services.

This approach reflects the way a number of services are already delivered across the Trust such as stroke, children’s services and trauma and orthopaedics, which is serving patients well.

They will also make recommendations on their priorities for development of three specialist hospital services – general surgery, image guided surgery and emergency and acute medicine.

The Jury will hear about how these services are currently organised, the case for change and the emerging ideas for future development of each.

The NHS in Gloucestershire has reiterated that Cheltenham A&E will remain open into the future.


Next Steps

Following the Citizens’ Jury, potential solutions for change will be narrowed down during an appraisal exercise in public in February and will then undergo further review.

Any significant options that follow on from the engagement period will be subject to public consultation as required later in the year.

In terms of the way Emergency General Surgery is organised, clinicians within the service continue to highlight pressing quality issues and the NHS will review the output from engagement, including the Citizens’ Jury, and discuss the specific timing of public consultation with community partners.

The NHS will also consider any next steps for consultation that may be required as we develop our plans for the new community hospital in the Forest of Dean.

We hope this is a helpful summary of the programme to date and we will keep you informed of developments. Thank you for your continued interest and involvement in Fit for the Future.


Yours sincerely

Dr Jeremy Welch
Urgent Care Lead
NHS Gloucestershire
Clinical Commissioning Group Trust
Dr Amjad Uppal
Medical Director
Gloucestershire Health and
Care NHS Foundation
Prof. Mark Pietroni
Medical Director
Gloucestershire Hospitals
NHS Foundation Trust