CCG leaders expect surge in A&E reconfiguration

Fifty-four clinical commissioning group chairs and accountable officers responded to the CCG Barometer, carried out with Capsticks, in January and early February. They represent around a quarter of the 209 CCGs in England.

In December, national regulators indicated that, with five years until the next general election, it was the right time for local NHS leaders to press ahead with major service reconfigurations, which are often unpopular with the public and politicians.

The survey asked CCG leaders whether they or their main providers expected to either implement, or to publish plans or consult on, a series of major service changes in the next 12 months.

In relation to “downgrading or closing at least one hospital’s accident and emergency service”, of the 50 CCG leaders who answered the question, 16 said they were expecting to publish plans or consult, and two said they were expecting to implement such a change. Together, these respondents represent 36 per cent of those who answered.

There have been a relatively small number of A&E closures or downgrades, which are almost always controversial moves, in recent years. Therefore if 18 or more areas were to press ahead with plans in the next year it would represent a surge in activity.

The most commonly planned reconfiguration was for “small specialty surgery”, which 45 per cent of respondents said they were expecting to publish plans for, consult or implement.

The results for reconfigurations of other services were:

HSJ asked respondents how confident they were that any controversial service reconfiguration plans would be supported by local and national politicians. Seventy-eight per cent of respondents to that question said they had low or very low confidence; leaving 22 per cent with high or very high confidence.

Oxfordshire CCG chief executive David Smith told HSJ that many other areas were probably planning change to emergency services, “but that doesn’t necessarily mean that will result in closing hospitals departments or emergency surgery”.

“If you’d asked the question, ‘are you planning to change the services in your A&E department?’ the [number planning to] would probably be very high. But [that] wouldn’t in our terms lead to downgrading or closing,” he said.