London: The NHS’s top doctor will this week call for a new network of “super A&Es” to be created - sounding the death knell for local emergency departments.
Professor Sir Bruce Keogh, the NHS medical director, is expected to argue that the most seriously ill patients should be taken to bigger super-centres - bypassing local units altogether.
The Urgent and Emergency Care Review, due to be published later this week, will define the future of emergency care in England. And Sir Bruce has made it clear patients should be taken to larger hospitals, with specialist doctors, even if it means they have to travel further.
Sources say the report will not actually say smaller A&Es should be downgraded, but it will make clear local NHS organisations will have to make decisions about how to “redistribute” doctors, money and equipment as they see fit.
Campaigners claim that means local A&Es will be left to wither until they are closed or turned into walk-in centres with fewer facilities. Dozens of A&Es across England are already earmarked for closure, and critics fear Sir Bruce’s report will lead to more departments facing the axe and closing sooner.
In his report, Sir Bruce will recommend that patients who have suffered heart attacks, strokes and those who are severely injured should be ferried to super A&Es with the latest high-tech equipment.
His proposals will mirror what is already happening in London, where four major hospitals now cater for serious trauma cases - with just eight specialist units to treat strokes.
But some doctors say letting smaller A&Es fall by the wayside will not work outside big cities. Dr Onkar Sahota, chairman of the Save Ealing Hospital campaign, said: “This plan is a dangerous road on which to travel. Over time intermediate A&Es will be eroded, losing their facilities.”
He said that would lead to many becoming urgent care centres, led by just one GP. He also argued that splitting A&Es into so many different “tiers” would confuse patients over where to go for treatment.
For example, an elderly patient could attend his local - downgraded - unit because he thought he had serious stomach ache when, in reality, a major blood vessel was about to burst with fatal consequences. “Either you have an A&E or you don’t have an A&E,” Dr Sahota argued.
Last night Sir Bruce declined to give any details of his review. However, he did say he wanted it to “open a debate” on the future of emergency services in England.
