Two London A&E units axed in huge NHS recast

London Evening Standard/London

The health secretary backed Hammersmith and Central Middlesex’s casualty units being downgraded into 24/7 urgent care centres. He said Ealing and Charing Cross would retain A&E units — though they could still lose some of the emergency services currently being offered.

The announcements are expected to spark fresh protests in communities whose A&E is being downgraded. But there may be some relief at Hunt’s promise that Ealing and Charing Cross will keep casualty departments.

Campaigners, however, will want to know what services these two units could eventually lose.

In a Commons statement, Hunt said that the reforms aimed to save lives and he wanted to end uncertainty hanging over the future of London hospitals.

“Changes to services across north-west London have been designed and driven by local doctors and healthcare professionals who know their patients best,” he added.

“When local doctors tell me that lives can be saved and patient care improved, I will not hesitate to act. These changes will put patients at the centre of the NHS in north-west London, giving them better access to care 24/7 at home, at GP surgeries, in hospitals and in the community.”

Further studies will now be carried out into the shape of A&E services at Ealing and Charing Cross. But Hunt stressed that the services will have to continue providing immediate access to specialist consultant opinion, a wide range of diagnostic services, and the ability to admit people for assessment, treatment and rehabilitation.

He endorsed an independent review of plans to focus acute services on five “super hospitals” in north and west London. This will see emergency care for about 2mn Londoners delivered at St Mary’s, the Chelsea and Westminster, West Middlesex, Northwick Park and Hillingdon hospitals.

It marks the end of a three-year battle to centralise services at a time the NHS is required to make £20bn of cuts across England but is having to cope with rising demand from an increasingly elderly and obese population, with a greater need to treat more patients out of hospital.

The downgrades at Hammersmith and Central Middlesex will happen after the winter. But ministers stressed the shake-up would mean more critical care consultants on duty 24/7 in north-west London.

Yesterday’s announcement comes on the back of Tuesday’s Appeal Court defeat for Hunt over Lewisham Hospital. Thousands of people have taken to the streets to defend services at Ealing and Charing Cross, which they fear will be at risk of total closure if their A&Es are gradually scaled down.

About 45,000 people a year use Ealing’s A&E.

The Independent Reconfiguration Panel, which was asked by Hunt to review the proposals, said in its report yesterday: “It is not in the interests of local people to delay progress of the programme.”

Currently, north-west London has most A&Es per head of population, but suffers uneven standards of care. The changes will mean Hammersmith, which has only a “very limited” A&E, will become a specialist hospital — while Central Middlesex, which shut its A&E at night since 2011 due to staff shortages, will become a local hospital and provide planned surgery.

Urgent care centres operating 24/7 and led by GPs will open at all nine hospitals.

However, this will redirect about 120,000 patients a year to a different A&E and increase ambulance travel times by an average of two minutes.

Labour MPs fear it will also place extra pressure on already busy units.

The IRP report said the package of changes, known as Shaping A Healthier Future, “provides the way forward for the future”.