HSJ’s round-up of the day’s must read stories and debate

Where now for emergency care?

HSJ’s analysis suggesting 24 emergency departments, around 15 per cent of the national total, could be closed or downgraded in the next four years gives first post-STP estimate of the number of A&Es which could be re-classified.

It was never going to be a straightforward exercise, but we can take a straightforward lesson away from it: NHS England’s vision for between 40 and 70 of the existing 185-odd A&E departments to become “major emergency centres” and the rest becoming “emergency centres” has simply not materialised.

The reclassification plan was the cornerstone of its 2013 urgent and emergency care review. But over three years since its publication, the flurry of A&E reclassifications has simply not happened.

As the King’s Fund’s director of policy Richard Murray noted, the NHS appears to be “caught betwixt and between”. The number of potential downgrades, he said, “is not high enough to conclude we are seeing a radical redrawing of urgent and emergency care, but it is high enough to suggest a lot of political noise and require a lot of potentially noisy public consultations.”

The intense pressure caused by demand, workforce shortages and financial constraint are all unlikely to abate soon – and amount to a very hard environment in which to make decisive policy.

A government announcement on emergency and urgent care policy is expected later this week. There is much to address, especially as new money is highly unlikely.

NHS scammer pleads guilty

A consultant radiologist has pleaded guilty to defrauding the NHS out of £24,000 after consistently carrying out additional contract work within his normal working hours.

John Coffey was responsible for reviewing and reporting on medical scans at Lancashire Teaching Hospitals Foundation Trust, but was not contracted to study plain film scans from standard x-rays.

However, he agreed to do so at a rate of £4 per film, outside his working hours, to help his department to clear a waiting list backlog.

In one day in March 2014, the 53-year-old reviewed and reported on 100 plain film x-rays during a session at the Royal Preston Hospital, when he was supposed to be doing his normal work, NHS Protect said.

It said the series of frauds between autumn 2013 and autumn 2014 increased Coffey’s earnings by £23,916, and he has now admitted to a ‘rolled up’ charge of fraud by false representations.

Mr Coffey, of Goose Lane, Chipping, Preston, is due to be sentenced on 3 March.