A Doctor writes - why we should wait before shutting A and E's.


    FROM OUR FILES

15    

   THE HIDDEN TRUTH  

This article is a quote from a ‘Mail on Sunday’ Article published on 11/5/13 and written by David Rose. I’m going to post the rest when I’ve edited it down to a more manageable amount.

Dr Claire Gerada is starting to turn up in all kind of places, making a stand. I heard her trying to be heard above a din of prejudice on the BBC Radio 4 Today programme.

Here she is pointing out in The Mail, that we need some research done before any more A and E’s are closed. Afterwards it is too late and too expensive to put it all right;

 

By Doctor Clare Gerada, chairman of the Royal College of General Practioners

We are facing a national crisis in emergency healthcare. The whole system  is under great strain – and this crisis  is not limited to hospitals. It also affects community and primary care.

Patients are waiting much longer to be seen in emergency departments. Trolley-waits, which had largely disappeared over the past decade, are returning.

GPs have seen consultation rates explode in recent months and now routinely see up to 60 patients a day – something which, in my 25 years’ experience as a GP in inner London, might usually occur in only exceptional circumstances, such as a flu epidemic.

In this context, The Mail On Sunday’s investigation into rising death rates among emergency patients from Newark, where the A&E department closed two years ago, is hugely important – and may well be only a portent of what will happen on a bigger scale when A&Es close elsewhere.

Without further analysis, it is impossible to conclude categorically that the increase in death rates is due to the A&E closure. But this would appear to be the most obvious and compelling explanation – especially when one factors in the impact of longer journeys to hospitals elsewhere.

Research led by Professor Jon Nicholl, at Sheffield University, has already shown that mortality increases with distance.

In his study, 5.8 per cent of patients who travelled less than 6.2 miles to A&E died before being discharged from hospital. Among patients who travelled more than 13 miles, almost nine per cent died – and it is around 20 miles from Newark to King’s Mill Hospital, near Mansfield, or Lincoln, where most Newark patients are now sent.

It is perhaps no coincidence that both King’s Mill and Lincoln are currently being investigated because of their overall excess deaths.

The former chairman of the Lincoln Trust warned in 2009 that A&E was under severe pressure and that closing Newark would only make matters worse.

Unfortunately, he was ignored. It is good that the Government has finally recognised that urgent and emergency care is not as accessible as it should be.

But in doing so, they are unfairly blaming GPs by claiming that a new contract, introduced almost a decade ago which allowed GPs to opt-out of providing out-of-hours care, has led to the current crisis.

This lazy accusation masks more obvious reasons why some A&Es can barely cope.

One far more likely explanation is A&E closures put more pressure on remaining A&E services. The patients who would have used them won’t simply disappear. It makes no sense to close yet more A&E departments – unless sufficient resources are provided to pick up the inevitable shift in workload when closures occur.”

As I said, the rest of the Daily mail article will follow – it’s an important one.

Neil Harris

(a don’t stop till you drop production)

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