Closure & Downgrading of Local A&E Services

Jake Moses has spent a weeks work experience with Lucy Small and myself at our Ludlow office, before heading off to Aberystwyth University. Jake was enjoyed his week with us and wrote the following blog:

Shropshire, Telford, Wrekin and Powys residents may be left with further travelling times to Accident & Emergency facilities, GP’s taking advice from more experienced doctors over Skype and paramedics deciding whether patients should be taken to A&E or to the Urgent Care Centre (UCC) under proposals to close and downgrade Accident and Emergency departments.

According to the source the ‘Daily Mail’, under draft plans from the government three options are being examined – locating a single A&E at either the Royal Shrewsbury or the Princess Royal in Telford, or building a new single A&E at a site between Shrewsbury and Telford. This means patients will have up to travel an additional 18 miles – around 30 minutes – for A&E services.

Patients could have their condition diagnosed by more experienced doctors via Skype if the plans go ahead. This is because the centres will be staffed with less qualified medics so they will need to seek further advice from more experienced / qualified doctors remotely. The proposal is being considered by the Shropshire Clinical Commissioning Group (CCG), which is planning to centralise emergency services in the region in order to cut costs.

Other proposals in this draft include:

  • A&E could be ‘ambulance only’ – so walk-in patients would be diverted to an UCC.
  • Unwell or feverish children would need to go to an UCC rather than A&E – but the report acknowledges that ‘not all GPs and generalists have the skill set to treat them’.
  • Paramedics may have to decide on the scene whether patients need to go to hospital or an UCC. But reports also say studies have found paramedics cannot ‘safely and accurately’ predict this.
  • Patients who have attempted suicide, are suffering from potentially life-threatening deep vein thrombosis, and children having a wheezing fit would all be brought to UCCs.
  • UCCs will be dealing with more serious cases, so staff will need specialists on the rota or ‘timely access’ to them via Skype.

The proposals are the latest planned cuts to casualty units up and down the country, and come despite a new independent report insisting A&E provision needs to expand to meet rising demand for services. The latest threats mean there are now 18 units across England facing the axe.