Threat to A&E could be ‘disastrous’ says health union

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Senior health professionals are warning that major shake-up plans of the NHS could have “disastrous” consequences.

Dozens of accident and emergency units are facing closure or being downgraded under Sustainability and Transformation Plans (STPs) including Hartlepool’s nearest A&E at the University Hospital of North Tees.

Local plans includes a reorganisation of local hospitals that would see either Darlington Memorial Hospital or North Tees hospital lose their A&E department by 2020.

NHS bosses behind the plans, as part of efforts to plug a £22 billion hole in the health service budget by 2021, say the concentration of specialist urgent services at fewer sites could save lives.

A nationwide investigation by the Mail’s parent company Johnston Press has launched the Great NHS Gamble investigation which has revealed that 24 casualty units from our region down to Somerset have been marked for potential closure, despite record demand for A&Es and serious overcrowding across the country as the NHS goes through its most severe winter crisis since records began.

Last month produced the worst performance for A&E waits nationally in 13 years.

Dr Chris Moulton, vice president of the Royal College of Emergency Medicine (RCEM), said: “The suggestion that you can close A&E departments and then somehow fewer people will become ill is clearly ridiculous.

“And anyway, it is not people with minor illnesses but elderly patients with serious conditions who are the ones lying on A&E trolleys waiting for beds and then languishing on the wards awaiting social care.

“The problem is that the STPs are trying to design the health service around the fallacy that you can downgrade A&E departments and then not provide comparable capacity elsewhere.

“They are predicting a pattern of falling demand when A&E attendances have consistently risen for decades.

“There is no clear indication as to how this miracle might be achieved. We have a rapidly growing and ageing population and therefore the idea that the health service won’t have to deal with even higher numbers of people requiring emergency care and hospital admission in the future is like hoping that the River Nile will run backwards.”

Under the five-year project to plug the hole in the NHS budget in England, STPs have been drawn up for each of 44 regions to remodel services.

This area’s, led by Alan Foster of the North Tees and Hartlepool hospital trust, covers Durham, Darlington, Teesside, Hambleton, Richmondshire & Whitby.

Campaigners and experts warn that widespread closures will result in longer journeys to the nearest emergency units and place an unsustainable burden on remaining services.

Dr Taj Hassan, RCEM president, said that while the STPs had “admirable” ambitions they were in their present form “unworkable”.

He said: “If it were to come to pass that one in six emergency departments are downgraded, the effects would be disastrous.

“Closure of any emergency department will naturally require more beds to be found elsewhere - patients do not just disappear when an option for care is removed.”

And Deborah Harrington, of the National Health Action Party which is fighting for a public NHS free at the point of delivery said: “In 2013, we had 144 full A&E hospitals in England.

“When the STPs are complete, there will only be between 40 and 70 left.”

According to leaked figures, some 780 people last month waited more than 12 hours for a bed while in A&E - compared to 158 in January 2015.

COMMISSIONING GROUP’S ‘DIFFICULT DECISIONS’

A local health leader says advances and specialisation in medicine means not all hospitals can provide all the care patients need.

Dr Boleslaw Posmyk GP from Hartlepool and Stockton Clinical Commissioning Group said “difficult decisions” have to be made to make sure people get the best care possible.

Dr Posmyk told the Mail: “We know that, over the next few years, demands on our services – both NHS and social care – are set to increase, and we need to take action to address this.

“Around 100 doctors, nurses and other health staff have been looking at how we provide services and improve results for patients, as part of the Better Health Programme.

“They believe more care should be outside of hospital, in the community, or in a patient’s home. This will help us to avoid long hospital stays, because we know that patients recover better at home.

“For example, in Hartlepool, a hospital at home team is caring for people with breathing problems, avoiding 999 calls and hospital stays.

“They also believe that, in serious emergencies patients should be treated by experienced teams, seeing lots of patients with similar problems 24/7.

“In the past, most hospitals could provide the care needed. Advances and specialisation in medicine mean that this is no longer true.

“So if we want everyone in our region to get the best care, we have to make some difficult decisions about where care for the most seriously ill or injured is provided while making sure that patients continue to receive most care in their local towns and communities.

“A detailed assessment will lead to a formal public consultation once we have an agreed set of proposals.

“As clinicians, our commitment is to make sure that you, our patients, get the best possible services for the future.”