Keogh to investigate ''fragmented'' A&E

18 January 2013

The NHS's medical director Sir Bruce Keogh is to look into what he called the "fragmented and complex" accident and emergency (A&E) services. His review will be carried out for the NHS Commissioning Board.

Claiming that the current set-up was confusing to people, Keogh said reform was essential if people are to get the best emergency care possible – and yes, reform could mean closures in some cases because it is now recognised that many common conditions, such as a heart attack or stroke, are better treated in specialist centres where there is dedicated staff and equipment.

"At the moment we have some trauma centres around the country functioning very well at international standard and A&E departments that are variable in what they are and are not able to treat," Keogh said. "We have urgent care centres, walk-in centres – 11 or 14 names for these things. It confuses me, let alone people who want to interact with the NHS."

Mike Farrar, chief executive of the NHS Confederation, said: "There is no getting away from the fact that the current structure of urgent and emergency care services needs to change if we are to secure the best quality patient experience, improve clinical outcomes and, ultimately, save lives."

The very latest figures show that in the week ending 13 January, there were 387,963 A&E attendances and 98,096 emergency admissions. There were 29 A&E diverts in place during that week, with patients taken from one hospital to other A&E departments.

In terms of delays of over 30 minutes between ambulance arrival at A&E and handover to A&E staff, there were 5,422 last week. At the same time there were 2,797 beds unavailable due to delayed transfers of care from hospital.