NHS chiefs could axe 24 A&E wards as part of huge shake-up: Units will be replaced with 'urgent care centres' in bid to save millions
Health bosses are planning to close or downgrade 24 A&E units as part of a huge NHS shake-up, experts warned last night.
The controversial plans, set to be enacted within four years, have been confirmed at seven English hospitals – and another 17 are in the balance.
A&E units are set to close in east London, West Bromwich and Birmingham – and comprehensive emergency departments elsewhere will be replaced with ‘urgent care centres’.
Health bosses are planning to close or downgrade 24 A&E units as part of a huge NHS shake-up. Changes have been confirmed at seven units and another 17 are in the balance
The plans are part of a scheme to streamline the NHS in a bid to improve efficiency and save millions of pounds.
Every hospital trust in England was ordered last year to identify departments which could be closed or merged with other institutions. Bosses at NHS England have divided the country into 44 regions, with each told to draw up a ‘sustainability and transformation plan’ to share resources between hospitals.
In most areas, this will involve sharing specialist units such as rheumatology, dermatology or urology.
A&E units are set to close in east London, West Bromwich and Birmingham – and comprehensive emergency departments elsewhere will be replaced with ‘urgent care centres’
But research by the Health Service Journal has revealed 24 hospitals where A&E units are also at risk.
This means 14 per cent of England’s ‘type one’ emergency units – consultant-led, comprehensive 24-hour services – might be lost.
Closing A&E units has always been considered politically toxic.
When plans were announced to close Lewisham’s A&E in south London in 2013, a legal appeal was taken all the way to the High Court before the idea was abandoned.
But in the face of the mounting financial pressures and booming patient numbers, NHS England has ordered managers across the country to look again at their emergency services.
Units which are performing badly are most likely to close – with NHS managers encouraged to consider ‘consolidating’ services with better hospitals nearby.
Most A&E units will turn into ‘urgent care centres’ instead, which will still treat patients for most ailments but might not have extensive resuscitation facilities and may not be able to admit people for overnight care.
According to the analysis, seven hospital trusts have confirmed they are considering changes to their A&E unit.
Another 26 are in the running for closure or downgrade, but the plans have not yet been announced.
Of those, changes will be made at only 17 at the most, as the downgrade of some would mean the retention of others.
Dr Chris Moulton, vice president of the Royal College of Emergency Medicine, said: ‘Even hospitals that could cope with a large increase in emergency attendances do not have sufficient bed numbers or other facilities to care for the accompanying surge in admitted patients.
This means 14 per cent of England’s ‘type one’ emergency units – consultant-led, comprehensive 24-hour services – might be lost
'No emergency department downgrade should take place without due consideration for patient safety.’
An NHS spokesman said: ‘The number of people seeking urgent care is on the rise so overall we expect the range of services available to them to expand over coming years.
'Within that overall expansion, it may be possible to improve care and save lives with some concentration of specialist urgent services.
‘However, we do not expect significant numbers of A&E changes in the years ahead.’
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