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National review of A&E services announced


Health officials are planning to review the way A&E services are run in England, it has been announced.

The review, unveiled today by the new NHS Commissioning Board, has been tasked with developing a national framework for the best way of organising A&E services to ensure “high quality, consistent standards are offered across the country”.

Future service reconfigurations should take account of the review’s conclusions, the commissioning board said. It is also intended to help the new clinical commissioning groups fund the right balance between services for serious complex emergencies and those for less serious problems.

The board also hopes to improve public understanding of the best place to go for care.

Experts have said that urgent and emergency services need to adapt to meet rising demand.

The review will be led by commissioning board medical director Sir Bruce Keogh and could recommend that heart attack and stroke patients are treated at specialist centres instead of local A&E centres.

Sir Bruce said: “The NHS is there for all of us and should offer appropriate, effective and rapid care whenever and wherever it is needed.

“Treatments for many common conditions such as heart attacks and strokes have evolved considerably over the last decade and are now best treated in specialist centres. Yet we know people want their A&E nearby.

“This makes me think we need to review the increasingly complex and fragmented system of urgent and emergency care, so that sick, anxious and often frightened people can get what they need, when they need it.”

NHS Confederation chief executive Mike Farrar added: “Local urgent and emergency care services are seeing demand rising, year on year.

“There is no getting away from the fact that the current structure of these services needs to change if we are to secure the best-quality patient experience, improve clinical outcomes and, ultimately, save lives.

“Advances in medicine mean the best response to a heart attack or stroke might see a patient taken to a regional specialist unit.”

The commissioning board added that it wants to improve public understanding about the best places to go for urgent care.

The announcement follows a controversial report earlier this month on the future of the troubled South London Health Trust. As well as splitting up the trust, it recommended that the A&E unit at neighbouring Lewisham Healthcare Trust be downgraded to an urgent care centre.  

Terms of reference for the review will be published shortly, the commissioning board said, with “emerging principles” expected in the spring.

The work forms part of plans for more seven-day NHS services, which were unveiled at the end of last year.

Royal College of Nursing chief executive and general secretary Peter Carter said he welcomed the move to “simplify the system of urgent and emergency care”.

“Many of the problems currently being experienced in urgent and emergency care are caused by an increased demand and a reduction in the number of beds in the acute sector. This is set to become a growing challenge for the health service over the coming decades.”

But he added: “We would also urge the government to focus on ensuring there are adequate numbers of healthcare staff to deliver the best possible patient care.”


Readers' comments (3)

  • Patients have a narcissitic view of what is 'urgent' and this seldom tallies with what is clinically urgent.

    It is my job in the ED to 'rapidly assess' presenting patients and 'stream' to the most appropriate health care option which is more often than not their local pharmacy for analgesics, nit lotion, pile cream, indigestion meds or band aids.

    Occasionally, the ED is the right place for their presentation and when this is the case, we need to ensure we have space for them and staff to look after them.

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  • tinkerbell

    'National review of A&E services announced'

    Could be code for more closures.

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  • Centralized centers of emergency care are required and do exist, acute MIs to PCI centers multi-trauma patients to centers equipped to deal with, along with specialist services for neuro, burns and peads patients.

    The vast majority of whats left (non life threats) could be safely managed in strategically located and appropriately resourced urgent care services. NHS111 and clinical pathways to direct patients to definitive care, with an enhanced out of hours visiting service for those too ill or frail to visit.

    A great opportunity to show case how effective and clinically sound nurse practitioner services are.

    Mike Paynter

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