Patient safety

Continued STP hospital closures risk A&Es reaching ‘danger point’

The performance in North West London A&E departments has suffered considerably following the closure of two emergency departments in the area, sparking concern about the effect that 24 potential closures across STPs in England could have on national performance and patient safety.

In the ‘Can we afford to close any more A&E departments?’ report released today by the Centre for Health and the Public Interest (CHPI), it was revealed that following the closure of the A&E departments, performance in North West London hospitals has seen a considerable drop, with performance against the 95% four hour waiting time target falling to as low as 60% in some hospitals.  

The research found that before the closure of Central Middlesex A&E and Hammersmith A&E, the performance of Type 1 A&E departments across North West London hospitals met the four-hour target between 78% and 95% of the time during the winter months.

However, immediately following the A&E closures this fell to between 60% and 80% – meaning that in some hospitals 40% of patients needing serious emergency treatment had to wait more than four hours to be assessed and admitted into an appropriate bed.

The report stated: “In this respect North West London is further down the STP pathway than any other region in England and there are important lessons to learn.

“One is that in these high-density city areas the closures aggravate already existing health inequalities.

“Another is that the overall quality of emergency care, which is already deteriorating nationally, will be pushed to danger point and beyond if further closures such as those planned for North West London are proceeded with.”

CHPI’s findings also revealed that the risk of emergency departments being downgraded directly correlated with levels of deprivation, meaning that residents in poorer areas were more likely to be affected by the potential downgrade or closure of A&E departments.

The report follows a number of warnings for the government to make more money available to support emergency departments, as NHE last week reported NHS England figures which showed A&Es failing to hit targets over the “worst winter on record”.

 And back in March, care providers also stated that hitting A&E targets for next year was already “mission impossible” due to an increasingly unbridgeable gap between targets and poor funding.

The study also comes in the same week that DH announced the allocation of £55.98m of the £100m capital funding for A&E departments that chancellor Phillip Hammond announced at the Spring Budget.

Back in March, when the extra funding was announced by the government, many health leaders criticised the government as £2bn was put aside for social care over the next three years, but there was very little provision for ailing healthcare services.

“Despite a dangerous deterioration in A&E performance since the closure of two local A&E departments, the North-West London STP still envisages closing a further two A&E units at some point in the future,” said author of the report, Doctor Gurjinder Singh Sandu.

“Future planning needs to learn lessons from the reconfigurations that have already taken place and not continue with A&E closures based on assumptions which have not been borne out in reality.”

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