Fit for the Future

This engagement is an opportunity to talk about ways services could
be organised so that you can get the very best urgent advice, support
and care across the county and benefit from two thriving specialist
hospitals in the future in Cheltenham and Gloucester.


If you would like information for an event you are holding, or a member of the project team to attend, please contact us at


As well as the survey and public ‘drop in’ events (see listing on website) there are number of other ways you could get more involved.

Locality Development Workshops: Making sure everyone can access community ‘same day’ urgent care services – Autumn 2019

If you would be interested in participating in a Locality Workshop (Cheltenham, Cotswolds, Forest of Dean, Gloucester, Stroud and Berkeley Vale, Tewkesbury) please register your interest by emailing and request an expression of interest form to complete. Places are available for local residents at each workshop. Deadline for expressions of interest to participate in a Locality Workshop: 20 September 2019.


Locality Date and time
Gloucester Tuesday 8 October (9.00-12)
Cheltenham Tuesday 8 October (14.00-17.00)
North Cotswolds Tuesday 15 October (9.00–12.00)
South Cotswolds Tuesday 15 October (14.00–17.00)
Forest of Dean Wednesday 16 October (9.00-12)
Tewkesbury Wednesday 16 October (14.00–17.00)
Stroud and Berkeley Vale Thursday 17 October (9.00 12.00)


Engagement Hearing – 24 October, between 11.30am and 5pm at the Chase Hotel, Shurdington Road, GL3 4PB

The hearing is an opportunity to present your ideas to a panel of clinicians and other health professionals who have to develop local solutions.

Hearings are independently chaired and are a public opportunity for you to share your thoughts and ideas about what you think should be taken into account, what you think is essential in arriving at the best solution, plus any new ideas or
alternative proposals you may have. Hearings are live events held in public, live streamed to the internet, and recorded. They are an opportunity for good quality discussion and debate.

If you would like to attend you will need to book a timeslot; you will have a maximum of 30 minutes to put your point of view across and then there will be an opportunity to discuss what you have shared. If you want to book a timeslot (and submit
information beforehand/ this is optional) you can do so – please send an email to
telling us your name, organisation or group (if applicable), daytime phone number and email address
by 30 September 2019.

The Hearing is being live streamed and is available to view at:

Citizens’ Jury – Improving specialist hospital services and developing Centres of Excellence – January 2020 (TBC). Venue (TBC).

The independent Citizens’ Jury 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 consider staff and public feedback including survey findings, outputs from events, service workshops and the engagement hearing.

They will also hear evidence from expert witnesses on the need for change, access to services and best clinical practice.

After careful assessment of this information, Jurors will make recommendations about the benefits and drawbacks of a wide range of potential solutions and the evaluation criteria as part of a Jurors Report which will be published days after the Jury ends.

The potential solutions will be narrowed down during an appraisal exercise in public and will then be subject to further review.

Gloucestershire residents have until midday 2 December 2019 to express an interest and apply to become a Jury member through

Solutions Appraisal Exercise – dates and venue to be confirmed

The Appraisal Exercise will be completed by clinicians and other health professionals, together with some members of the public who have been involved in developing the proposed solutions to be appraised.

Any significant options or changes proposed that follow on from the engagement period will be subject to full public consultation as required in 2020.




These fact sheets have been created this year (August 2019) to provide more detailed information to support the Fit for the Future engagement.


Q.  Is this a consultation?

A.  No. This is a period of engagement that will extend into the autumn. It’s an opportunity to discuss ideas and involve people in developing potential solutions to meet future health and care needs

There are a number of innovative ways we will be involving local people, from a survey and drop in events to workshops, an engagement hearing and a Citizens’ Jury

Through sharing information and exchanging views, the engagement will provide a wealth of feedback to inform future planning. The public and staff will be consulted on any significant changes proposed that follow on from this engagement programme.

Q.  How can I get involved in the engagement conversations?

A.  There are a number of innovative ways we are involving local people, from a survey and drop in events to workshops, an engagement hearing and a Citizens’ Jury

We would urge local people and community partners to get involved in the Fit for the Future conversations and share their views over the summer and autumn. You can find out more at

Q.  What conversations are being had about community urgent care?

A.  Here in Gloucestershire, we want the best possible network of same day urgent care services across our communities – giving people ready access to the right expert staff and great equipment and facilities

Healthcare is changing, with more people now able to get same say urgent illness advice and services from local pharmacies and GP surgeries in the day time, evening and the weekends

Together with local people, we need to look at what other same day urgent illness and injury services are provided across our communities, in GP surgeries and hospitals, based on local circumstances, needs and the desire to provide outstanding care.

Q.  What are centres of excellence?

A.  We want to provide truly outstanding care comparable to the best in England – putting your health, your safety and your experience first and giving our great staff the best possible working environment

To get the best for our patients, one idea is to consider a greater separation between emergency care and planned care and this could include creating centres of excellence

Across the UK and the world, doctors recognise that this way of organising services can improve care and health outcomes for everyone

For planned care, it can reduce the number of booked operations that get cancelled, reduce waiting times and reduce the risk of hospital acquired infections

For emergency care, it can improve your chances of survival and recovery, reduce the amount of time you have to spend in hospital and sometimes even avoid a hospital stay altogether

This period of engagement is an open dialogue. It’s about discussing ideas and involving local people in developing potential solutions

This means that contrary to some reports, no decisions have been made about the future range of urgent and emergency care services in the county, including at Cheltenham General Hospital

The public and staff will be consulted on any significant changes proposed that follow on from this engagement programme

Ensuring the best possible care for our patients is at the heart of our ambition.

Q.  Are you going to close Cheltenham A&E?

A.  No plans have been drawn up to close A&E in Cheltenham and the current engagement is an opportunity for people to have their say on how best to deliver outstanding specialist hospital care in the future, including the nature of local A&E services

One idea for discussion is to create a Centre of Excellence for Emergency Care in Gloucestershire treating critical life and limb threatening conditions. It would be one way of ensuring scarce specialist staff, expertise and facilities were always on hand to get the right treatment started whatever time of day or night and support survival and recovery

We see both Cheltenham General and Gloucestershire Royal hospitals continuing to provide a range of same day, walk in, urgent care services 24 hours a day, 7 days a week for local patients. Whatever form that ultimately takes, the majority of patients who need urgent hospital care, would continue to access services as they do now

This period of engagement is an open dialogue. It’s about discussing ideas and involving local people in developing potential solutions

This means that contrary to some reports, no decisions have been made about the future range of urgent and emergency care services in the county, including those at Cheltenham General Hospital

The public and staff would be consulted on any significant changes proposed that follow on from this engagement programme.

Q.  Is Cheltenham A&E currently ‘closed overnight’?

A.  No. Between 8pm and 8am, a walk in service is in place at Cheltenham General Hospital run by specialist emergency nurse practitioners.

Between those hours, ‘blue light’ ambulances are sent to Gloucestershire Royal Hospital’s Emergency Department. If you are assessed as not needing life-saving care, paramedics also have the ability to refer you directly to an assessment unit at Cheltenham General Hospital.

Gloucestershire Royal Hospital is currently a specialist centre for a number of services – trauma, stroke, children’s emergency care and high risk maternity services.

Q.  Is this about cost cutting?

A.  This is not about saving money, it’s about delivering outstanding services in the future and responding to the challenges facing us now and in the future

In providing outstanding services, we want to give people access to the best possible facilities, equipment and staff skills.

Q. How are General Surgery services currently organised?

A. General surgery services are predominantly based in our main (acute) hospitals – Cheltenham General (CGH) and Gloucestershire Royal (GRH). There are also some services provided in the community hospitals.

All of these services are currently provided by Gloucestershire Hospitals NHS Foundation Trust. The same staff provide emergency and planned care, although the staff are separated into four teams (two teams at each site), providing either emergency or planned care at any one time. Many of the staff provide care at both hospitals.

Currently the way in which general surgery is provided across both hospital sites does not meet national standards, and is falling behind the best centres nationally. This has an impact on your care, the well-being of our staff and our ability to attract and keep the very best staff.

Q.  What and why do we need to consider changing (General Surgery)?

A. Our priority is to deliver care that meets national standards and is comparable with the best centres in the country. We are considering whether to centralise emergency general surgery on one site.

If we do this, our doctors believe a greater number of patients who are unwell would be able to see the right specialist first time, 7 days a week and receive prompt senior assessment, treatment and surgery.

In simple terms, this means that those patients presenting with symptoms and conditions affecting their upper gastrointestinal tract, such as oesophagus, stomach and gall bladder would see an Upper GI specialist surgeon and those presenting with problems of the lower bowel, would access a specialist colorectal surgeon. Rapid access to the right specialist not only leads to better care, but can significantly reduce the length of your hospital stay.

We have also been thinking about the best way to organise planned general surgery (care that can be planned in advance) in the future to improve outcomes, reduce waiting times, ensure fewer cancelled operations and improve your experience.

There are several possible variations for how we could organise our services in future. For example, we could separate day surgery from longer planned surgery, and there are variations for the ways we could arrange our services across the two sites. We look forward to hearing your ideas about how we could develop services with you. You can find out more about General Surgery by reading the FACT SHEET at

Q.  Did 57 senior medical staff sign a letter of objection against these proposals?

A. In October 2018 a letter signed by 57 senior medical staff from Gloucestershire Hospitals NHS Foundation Trust was shared and subsequently published in the local press.

The letter was supportive of the idea of having two centres of excellence, one for planned care and one for emergency care and confirmed there is clinical agreement on how emergency general surgery should be organised in Gloucestershire.

The letter also expressed differences between colleagues on how planned general surgery should be organised and went on to describe a potential model of care for planned general surgery care in Gloucestershire.

The views of our medical staff, along with the views of patients, the public and our partners will all be taken into account as we develop potential solutions through this engagement phase and we would like to confirm that no decisions have been made.

The letter can be viewed here.

Q.  Why is the chart in the hard copy of the booklet, relating to the local NHS Long Term Plan (page 5), different to the one on-line?

A. Unfortunately, there is a typographical error on page 5 of the hard copy booklet that we did not pick up during proofreading.

The chart on page 5 for “Do you think we have set out a clear way to develop advice, support and service locally?” should read:
– 62.8% Yes,
– 15.2% No,
– 22% Don’t know.

Please accept our apologies. We have rectified this error in the on-line version.