Emergency care reforms are ‘putting lives at risk’

Patients are being put at risk by reforms that are designed to relieve pressure from overstretched A & E departments, doctors have warned.

The reforms have paved the way for new ‘urgent care’ centres where patients can seek help for a range of ailments and injuries in the same way A & E departments do.

Dozens of the centres are planned for NHS trusts across the country in a bid to reduce the burden on A & E departments. The urgent care centres will deal with minor, non emergency cases, allowing A & E departments to direct their resources to the most serious cases.

However, it has been reported that two patients have already been endangered after staff failed to recognise their symptoms, a survey found.

The College of Emergency Medicine, which represents A&E doctors, found that a man who had a stroke was sent home from an urgent care centre because staff could not work out what was wrong. He was eventually admitted to hospital and recovered.

Urgent care centre staff also failed to spot that a baby had meningitis. Emergency treatment was delayed but the child made a full recovery.

The survey, of A&E staff working alongside the centres, did not name which ones were at fault.

John Heyworth, president of the College of Emergency Medicine, said: ‘These are worrying examples of things going wrong in urgent care centres.

‘In emergency departments we are used to seeing patients who may develop serious complications.

‘We want to make sure GPs appreciate the risks and handle things very carefully.
‘Speaking to colleagues around the country, our concern is that having a barrier to people actually getting in to A&E is not helpful.’

He added: ‘Patients tend to know when they are very sick and although around 10 to 20 per cent of patients may use the service inappropriately, the majority will go to their GP if they have a minor problem.’

Preliminary discussions to open the centres are currently underway at nearly all of the 270 A & E departments across the UK.

NHS managers maintain that by stopping just 15 ‘inappropriate’ attendances at A&E per day a local primary care trust could save £328,000 a year.

If three patients a day were stopped from being admitted to a ward when they would be better off at home, a trust could save £6,000 a day, or £2million a year.

The Department of Health has published a number of strategy documents, including the Direction of Travel for Urgent Care, which make clear that the creation of more urgent care centres is seen as the best way to improve service to patients.

Dr Richard Vautrey, of the British Medical Association’s GPs’ committee, said: ‘We should not assume that GPs are less able to assess risk but we need to recognise that patients themselves are usually able to select the area of the health service they need to access, depending on the severity of their condition.’

A Department of Health spokesman said: ‘ Urgent care centres play an important role in providing emergency care for non-patients without taking up valuable A&E resources.

‘It is for local NHS organisations working with local people to decide whether urgent care centres are a good idea when organising their services.

‘We have been clear that any changes to existing services should be based on what is best for patients.’

The urgent care scheme is already running in Maidstone in Kent, Portsmouth and South-East Hampshire, Huntingdon in Cambridgeshire and Nottingham.