Photograph by Graham Richardson
NHS chiefs have proposed an overhaul of services including a radical change to a two-tier A&E system in England.
The review [PDF], published by NHS England, suggested that the biggest 40-70 A&E units would become “Major Emergency Centres” specialising in heart attacks, strokes, and trauma, leaving the other 70-100 units as “Emergency Centres” to address less serious conditions.
The review also proposed greater co-ordination between the different sections of the NHS such as GPs’ surgeries and pharmacists, and changes to the practices of ambulance teams and the 111 phone service to “decongest” A&E units, which are currently struggling under the volume of cases.
The number of patients visiting A&E has grown by 50% over the last decade, with some units failing to meet their four hour waiting time targets last year. This year, it has been reported that NHS A&E departments are already struggling to meet waiting time targets, with the peak winter volume still to come.
NHS medical director Prof Sir Bruce Keogh, who led the review, told BBC News:
“A&E is creaking at the seams. It is not broken, but it is struggling…We need to change the way we work. But what we are suggesting here already exists in places, we are just trying to formalise it so it is available for everyone.”
Extra funds have been set aside to help the NHS cope in this 2013-2014, but NHS chiefs are looking for a long-term solution. This review highlights the programmes that have already been working in pilot schemes around the country, and proposes rolling them out across England.