Local leaders row back on A&E downgrade plans

The significant concession by the mid and south Essex success regime leaders raises fundamental questions about how it will deliver its forecast savings and the ambition to “separate out emergency care from planned operations”.

The reconfiguration proposals, which require further work and public consultation, involve Basildon and Thurrock University Hospitals Foundation Trust, Southend University Hospital FT and Mid Essex Hospital Services Trust.

A statement from the success regime said: “[Following consultation] health leaders have now decided to develop a revised model that would enable all three current A&E departments to continue to treat people who need emergency care, including continuing to receive blue light emergency patients with serious conditions.

“It would rule out the blanket redirection of all blue light ambulances to Basildon, as in previous options.”

The area’s sustainability and transformation plan said two of the three type one emergency departments would be downgraded, and one – later revealed to be Basildon – would be upgraded to a “specialist emergency hospital”.

Southend and Mid Essex would have been downgraded to what the STP called “selective A&Es” and times when ambulances would be accepted would be restricted.

Under the new option set out on Thursday, patients will be “assessed, stabilised and treated in their local hospital, with the most unwell patients transferred to a specialist team, if that’s what they need”.

“The ‘norm’ would be for people to go to their local hospital in an emergency. As before, all three A&E departments would continue to be open 24 hours a day, seven days a week and run by consultants,” the statement said.

A small number of people “who are very seriously ill would go straight to a specialist centre to get the best treatment (for example, people suffering severe burns already go to Broomfield in Chelmsford)”, it added.

The statement also said: “Senior doctors are currently looking in detail at the clinical evidence to see if there are other severe conditions that may require this approach – for example, for people suffering from burst blood vessels in the brain or heart, or people with very severe abdominal bleeding requiring urgent emergency surgery. This work is not yet complete but doctors are focusing on it over the next few months.”

Clare Panniker, chief executive of Basildon, Broomfield and Southend hospitals, said the plan was still to “separate out emergency care from planned operations and treatments needing an overnight stay, to reduce the number of times we have to cancel planned operations”.

Ms Panniker added: “We know when this happens it is frustrating and difficult for those patients and their families. We also want our three hospitals to work together, offering different specialist services at each of our sites. We know specialising in this way for those with the most serious conditions and illnesses gives better chances of recovery to our patients.

“In the feedback from over 100 local discussion events, we have heard very clearly that some people have significant concerns about all blue light ambulances going straight to Basildon.

“We have been thinking how we could address these concerns, and still improve patient care with different specialist teams across our three hospital sites and the separation of planned and emergency care.”

Success regime independent chair Anita Donley said: “The aim still stands to develop specialist centres across our three hospital sites and to separate planned operations and treatments from emergency care. We know from national evidence that this can improve the quality of care and patients’ chances of survival – particularly with very serious cases.

“No decision on the future pattern of services has yet been taken. We will only decide what changes to make after a full public consultation.

“We are determined to find the very best solution for delivering excellent, safe, high quality hospital care, within our available funding, into the long term for people in mid and south Essex.”