Two tier system proposed for English accident and emergency units
999 emergency departments would provide a full range of services, while 111 could be used for second rank emergency departments
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Wednesday 30 January 2013
A two tier system of accident and emergency units has been proposed for England as part of a major re-organisation of NHS emergency care.
Some units could be designated “999 emergency departments” providing the full range of services and able to cope with all cases while “111” (the new phone number for non-emergency care) could be used for second rank emergency departments, which would provide fewer services and less consultant cover.
The 111 units would have links to the top tier departments to transfer seriously ill patients swiftly when necessary.
The draft plan for a two tier national A&E service, leaked to the Health Service Journal, was completed in the autumn following a two year review. It says the existing system of walk in centres, urgent care units, out of hours GP organisations and A&E departments is “fragmented and confusing” and that a standard name should be used for each level of care.
The controversial proposal in a draft document from the Department of Health emerged as Jeremy Hunt, the health secretary, prepares to announce his decision on the fate of Lewisham Hospital’s A&E in south London, which has become a touchstone for reconfiguration decisions across the NHS.
The A&E unit at Lewisham has been recommended for downgrading, along with the maternity department, following the failure of the South London NHS Trust which is effectively bankrupt after running up repeated deficits, the latest being £65 million in 2011-12.
Although Lewisham is not part of the trust, there are full A&E departments at hospitals in Greenwich and Bromley, which are part of the trust, but which cannot be closed because they have expensive PFI deals which cannot be undone.
The proposed closure of Lewisham, on cost rather than clinical grounds, has infuriated local residents, doctors and politicians who say it is being sacrificed for the failings of the neighbouring trust and 15,000 marched in its support last weekend.
William Hague, Chris Grayling and Iain Duncan Smith are among coalition government ministers who have intervened to oppose threats to local A&E and other services in their constituencies.
- 4 #JeSuisEd: People share photos of themselves eating awkwardly in solidarity with Labour leader
- 5 Women think Irish men are the sexiest, survey finds
Italian police 'reveal' what Jesus looked like as a young boy
Mysterious 'X-Files' sounds heard miles above the Earth
Florida couple forced to register as sex offenders for having sex on public beach
Who should I vote for in the general election? Take The Independent's interactive quiz to find out which party is the right choice for you
General election: Conservatives mocked online over Boris Johnson's claim of SNP 'jockalypse'
In defence of liberal democracy
General Election 2015: Post-election 'shambles' looms as 70 per cent of voters say SNP 'should not be able to veto UK government policies'
The Rothschild Libel: Why has it taken 200 years for an anti-Semitic slur that emerged from the Battle of Waterloo to be dismissed?
General Election 2015: UK will be 'run for the wealthy and powerful' if Tories retain power, Labour warns
General election live: SNP suspends two members for disrupting Labour rally
Schools forced to act as 'miniature welfare states' with teachers buying underwear and even haircuts for poor pupils
£35000 - £40000 per annum + car and benefits: Ashdown Group: Marketing Manager...
£18000 - £20000 per annum: Ashdown Group: Helpdesk Analyst - Devon - £20,000 ...
£35000 - £50000 per annum + generous bonus: Ashdown Group: Business Analytics ...
£45000 - £50000 per annum: Ashdown Group: IT Project Coordinator (Software Dev...