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NHS preparing to cut A&E and maternity units

Published on 14/09/06 at 03:27pm

The new chief executive of the NHS, David Nicholson, is drawing up plans to close a series of key hospital departments in order to improve services.

In his first interview since taking up the role he told the Guardian the proposed reconfigurations will see specialist A&E, maternity and paediatric services concentrated in fewer hospitals than at present.

"Undoubtedly, there will be tough decisions to make over the next 12 months to reflect changing services," he said.

"The changes will affect all of the 10 Strategic Health Authorities and are aimed at delivering care which is predominately closer to home," Nicholson added.

Each SHA will have around six service reconfigurations to consider. Some of the changes are designed to ease the NHS's troubled finances, but most are targeted at improving patient care.

Plans so far include taking patients with major injuries to specialist trauma centres, but encouraging those needing only minor treatment to go to walk-in clinics.

Such a move then calls into question the need to retain a full A&E department in every district general hospital.

Maternity and paediatrics patients would also be best served by departments large enough to offer a more specialised service, Nicholson told the Guardian.

Some hi-tech services would be concentrated in specialist centres, with other treatments offered in community clinics and GP surgeries  patients would then understand the reforms were about improving services, not cutting them, he said.

Conservative MPs Peter Bottomly and Tim Loughton are campaigning against the closure of the Worthing and Southlands Hospitals. They wrote to Guardian criticising the plans, saying more needed to be done to take public concerns into consideration.

"Local people are quite open to modern health services and care closer to home, but the fact is they do not want to see vital services like A&E slashed and for journeys to be longer for patients, visitors and staff," they said.

The reconfigurations received more support from the health service, however.

Nigel Edwards, director of policy at the NHS Confederation, representing NHS organisations in the UK, said: "We need to get away from the fixation with buildings. We should recognise that services can be delivered in many settings and that proximity to a hospital may be less important than the ability to access the right services for a patients needs.

Better outcomes for patients are likely to be achieved by creating health services capable of handling complex and specialist cases. Changes in healthcare mean that it is not possible for every hospital to do this, currently. It is not a matter of money."

The proposals Nicholson outlined would be in line with government plans announced in April to open dozens of new GP surgeries over the next three years. The surgeries will be placed in all-in-one health centres - purpose-built centres that will also include services such as community and district nurses, pharmacies, midwifery and dentistry.

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