New Two Tier A&E

NHS Chiefs say that a two-tier A&E system should be created in England to improve services.

NHS England carried out a review and suggested that 40 – 70 of the biggest units specialising in heart attacks, strokes and trauma should become major emergency centres. This would leave the remaining A&E departments to deal with less serious conditions.

It also suggested changes to the way ambulance crews and the new 111 phone service work to alleviate the pressure on A&E departments.
The review also expressed there was a need for greater integration of services so that GPs, pharmacists, walk-in centres and minor injury units work together to provide 24/7 access to care to relieve the pressure on A&E.

NHS Chiefs say that patient numbers have risen by 50% in the past decade. These changes would mean that 140 A&E units are divided into two categories – major emergency centres and emergency centres.

Many of the proposals are already in operation somewhere and the review is calling for this to be formalised across the system. For example, there are already a number of A&E units that act as major centres. NHS medical director Professor Sir Bruce Keogh, who led the review, said “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.”

The changes will now be consulted upon and the review team will spend the next six months looking at the cost and staffing implications before producing another report in the spring. It is likely to take three to five years before the overhaul is completed.

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