Lord Darzi’s plans to reconfigure A&E services, shifting huge numbers of patients to polyclinics and urgent care centres across the country are based upon inaccurate estimates of patient usage, a report reveals.
Many trusts are exploring how they can deal with more patients into primary care inorder to avoid financial crisis.
In London, one of the key assertions of the strategic planning guidance issued to PCTs in the capital last year is for “60% of A&E activity to shift to polysystems”. Up to 12 A&E departments across the capital face possible downgrading to urgent care centres, with more patients being directed towards polyclinics.
However, a Department of Health-commissioned report released today shows that no more than 30% of patients attending A&E departments could be classified as needing only primary care. It may be a little as 10%.
These proportions are much lower than the levels assumed by managers and health chiefs. It followed Lord Darzi’s suggestion, in 2007, that 50% of less serious A&E cases could be dealt with by polyclinics.
The report, by the Primary Care Foundation, investigates the use of GPs and primary care professionals in A&E. It finds that the increasing number of GPs and primary care nurses working in A&E can improve the quality of patient care. However, it found little evidence for claims that this approach drives down costs or avoids inappropriate hospital admissions.
Dr David Carson, joint director of the Primary Care Foundation, said: “Patients know who their GP is and where the nearest emergency department is. So, it’s vital to get the service right.”
Dr John Lister, information director of campaign group London Health Emergency, said: “This new report shoots plans for A&E closures and hospital rationalisation in London, and in many other cities, out of the trees.
“It is clear that diverting the least serious A&E cases away from hospital A&E departments would affect less than half the number of cases that managers had assumed - and that little or no money would be saved.
“This document means that every plan to scale back A&E services to “Urgent Care Centres” or polyclinic level needs to be torn up and revised. NHS London needs to go back to the drawing board.”
Read the full report.
Tags: A&E, GPs, Polyclinics
