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Centralised A&E plan for Shropshire is “building death into the system” (18 August 2014)

Date: 18/08/2014
Duncan Lewis, Personal Injury Solicitors, Centralised A&E plan for Shropshire is “building death into the system”

Campaigners across Shropshire, Telford, Powys, Wrekin are protesting at A& E closures, which could see just one emergency unit to cover 600,000 people across the region.

The Mail on Sunday reports that thousands of NHS patients will be forced to access A&E services via Skype consultations – which campaigners say is “building death” into the NHS Accident and Emergency (A&E) care system.

Shropshire Clinical Commissioning Group (CCG) is planning to either close or downgrade A&E services across the county, meaning who might require urgent treatment could be left having to use walk-in medical centres.

Mail on Sunday reporters have seen a draft copy of proposals to downgrade Shropshire’s A&E services, under which patients with conditions such as chest and abdominal pains, pneumonia and fractures would be sent to walk-in centres to see a GP rather than attend A&E units at hospitals.

The changes could result in delays in treatment for patients requiring emergency care – potentially with serious or even fatal results.

If further care is needed, a consultation by Skype or via the Internet might be arranged with a consultant at a local hospital.

However, currently patients attending A&E have to be triaged within 40 minutes. They have to be treated within four hours of arriving at an NHS A&E department.

In the case of serious fractures, brain injuries or life-threatening conditions such as thrombosis or infections like Streptococcus A or meningitis, delays in diagnosis could be fatal – or result in life changing injuries, including loss of limb in the case of serious infection like Strep A and meningitis.

Shropshire CCG is planning to centralise services in the region. Under the plans – contained in the minutes of a July board meeting – the remaining A&E unit would be for “ambulance only” cases with other cases being directed to a Urgent Care Centre (UCC) – including children with a fever.

Under the Manchester Triage System, A&E patients are priortised as:

1. Immediate – Red – zero waiting time
2. Very Urgent – Orange – within 10 minutes
3. Urgent – Yellow – within 1 hour
4. Standard –Green – within 2 hours
5. Non-Urgent – Blue – within 4 hours

Shropshire CCG acknowledges that staff at UCCs may not have the specialities required to diagnose and treat A&E patients.

Paramedics would also have to decide whether to send patients to A&E or UCCs, the proposals say.

Even patients who might have attempted to take their own life would be taken to a UCC, the documents say – meaning that patients with complex physical and/or mental health conditions would be assessed by staff who potentially have not been trained in that area of healthcare or A&E healthcare.

Mental health services are already under pressure as some trusts struggle to cut 20% from their budgets – meaning beds in acute care units are being lost in favour of more seven-day telephone support for mental health patients who might be at risk of self-harming or suicide.

Some mental health patients are turning to A&E services for support – and more elderly patients are also reported as using A&E services for support. Many towns and cities in the UK are also experiencing a significant growth in population, placing pressure on local health services and A&E units.

Because staff at UCCs will be facing a wide range of complex cases, the plans say that specialists would need to be placed on the rotas at UCCs – or available via Skype.

The Shropshire Defend Our NHS campaign group has called the proposals “terrifying”.

The Mail on Sunday has been campaigning for two years to challenge the government’s closure of A&E units across the country – there are currently 18 under threat.

The Labour MP for Telford, David Wright, said:

“Residents are extremely concerned to yet again see a review of A&E at a time of large-scale growth in the town.

“We want to see full, 24-hour A&E services at our hospital – and this process brings massive uncertainty.”

A spokesman for Shropshire CCG said:

“Doctors and health professionals believe one single emergency centre in the area – supported by UCCs – is the safest way to treat the most seriously ill patients”

Urgent Care Centres usually deal with minor injuries and urgent medical care requirements and were introduced to ease pressure on A&E services.

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