SHROPSHIRE’S A&Es have fewer than half the national average number of staff and just over half the recommended number of consultants, NHS commissioners have heard.

Executive director of Quality Chris Morris said the Shrewsbury and Telford Hospitals NHS Trust has four emergency department consultants currently on staff and supplements these with seven locum consultants.

Lay Telford and Wrekin CCG board member Peter Eastaugh asked whether this was safe, given that the Royal College of Emergency Medicine recommend 20 for a trust the size of SaTH. Ms Morris said both the trust and the Care Quality Commission were concerned.

Former Princess Royal Hospital chief executive David Sandbach said the average number of employees per A&E was 135 to 140, but SaTH were running two with 132. He said the trust needed more staff, or had to close one of the departments down.

Ms Morris was updating the board on the fallout from recent CQC inspections of SaTH. In a report, she and Interim Executive Director of Quality Maggie Bayley said the regulator is considering action including imposing limits on A&E opening times or ambulance arrivals.

Mr Eastaugh said SaTH’s total of 11 consultants compared to a Royal College of Nursing recommendation of 20 for a trust SaTH’s size, while other bodies recommend 16.

David Evans, the chief officer for both the Shropshire and Telford and Wrekin NHS Clinical Commissioning Groups, said: “There is a national shortage of consultants.

“While we are in a position where both sites are operating a 24-hour service, that is always going to be challenging, until Future Fit is delivered.”

David Sandbach said the average number of people employed in an A&E department was “135 to 140”.

“Using published NHS documents I discovered the number at SaTH was 132, slightly less but about average,” he said.

“The difference is, these people were running two A&Es, not one.

“They need more staff, or the decision has to be made to close one or the other down and concentrate staff in one place.”

In their report, Ms Bayley and Ms Morris wrote: “Section 31 [of the 2008 Health and Social Care Act] allows the CQC to serve a ‘notice of decision’ upon a provider if it has reasonable cause to believe that, unless it acts, any person will or may be exposed to the risk of harm.

“Such a notice would suspend a provider’s registration for a period of time or impose, vary or remove conditions on registration.”

The report adds the CQC is “considering action including, but not limited to”, limiting on emergency department operating hours “at one or both locations”, limiting or halting the conveyance of children to PRH in all but life-threatening scenarios and restricting ambulance arrivals at one or both A&Es.

They added: “The CCGs need to continue to work closely with the trust, regulators and the CQC, along with Healthwatch organisations in the monitoring of actions and improvement plans.”