Closing Hartlepool hospital's A&E hasn't caused more deaths, say researchers

The University Hospital of Hartlepool is one of those which were studied to see if downgrading A&E departments led to more deaths.

But downgrading or closing units may heap pressure on local ambulance services, the researchers found.

They set out to examine the impact of five emergency departments in England that were downgraded between 2009 and 2011, including the University Hospital of Hartlepool.

Researchers have found that downgrading emergency departments does not lead to a spike in deaths - despite patients having to travel further for emergency care.

Closure of emergency departments is a hot political topic, sparking much debate among communities - but there has been little research into the actual impact of closing an A&E unit.

Units can be downgraded - changing from a 24-hour consultant-led unit to a minor injuries or urgent care unit - or closed as services are disrupted by issues such as staffing problems.

The study by a team from the University of Sheffield - which also evaluated units in Bishop Auckland, Newark, Rochdale, and Hemel Hempstead both before and after their emergency departments were downgraded - found no overall increase in the number of deaths.

"This suggests that any negative effects caused by increased journey time to the ED [emergency department] can be offset by other factors.

"For example, if other new services are introduced and care becomes more effective than it used to be, or if the care received at the now-nearest hospital is more effective than that provided at the hospital where the ED closed," the authors wrote.

However, they said that there were implications on other NHS emergency care providers, such as an influx in the volume of calls to ambulance services.

They noted an increase in the number of incidents that were dealt with by the ambulance service and an increase in the time taken to get to hospital, according to the study, published by the National Institute for Health Research.

The authors pointed out that in four of the five areas studied, the emergency department was replaced with an on site urgent care facility.

Emma Knowles, from the School of Health and Related Research at the University of Sheffield, said: "The public, in particular, require reassurance that the closure or downgrade of an ED does not result in increased death rates."

The study's co-author, Professor Jon Nicholl, added: "It is important to highlight that we didn't find the better outcomes for patients that planners hoped to see from closing these small departments either.

"This means it isn't clear that the disruption and anxiety that can be caused by closing emergency departments is worthwhile."

Hartlepool's A&E department closed in August 2011, with urgent cases referred to the University Hospital of North Tees in Stockton.

It too, has come under the spotlight as part of reshuffling of NHS services, but health chiefs recently said a downgrading is off the table for now.