Official: Stripping down A&E units is failing the elderly
THE urgent care centres that are replacing many casualty units across the country are unable to treat four in ten pensioners who come through their doors, according to a major study.
More than a dozen hospitals in England have lost fully-equipped accident and emergency departments in the last decade, usually to be replaced by urgent care centres staffed by GPs and nurses.
The Mail on Sunday has been campaigning against the closures, but NHS bosses frequently insist that the ‘UCCs’ will be able to deal with the vast majority of patients.
But new research by highly respected academics has found that two UCCs in London could not cope with 40 per cent of patients over 70 who turned up.
The elderly patients had to be redirected to A&Es or other departments instead.
Academics at Imperial College London made their findings after analysing where some 250,000 patients, who attended two centres between late 2009 and late 2012, actually ended up being treated.
Writing in the Emergency Medical Journal, lead researcher Thomas Cowling said around 60,000 of all the patients – almost 25 per cent of the total – could not be treated at the UCCs. But among over 70s the proportion was even higher, at 40 per cent.
He wrote: ‘The implications for these patients’ health outcomes and experiences, particularly those at higher risk of requiring speciality hospital care such as the elderly, are unclear.’
The two UCCs examined were at Hammersmith Hospital and Charing Cross Hospital. At the time of the study, both West London hospitals each had both an A&E and an urgent care centre on the same site.
‘It takes more tests and expertise to treat OAPs’
However, Hammersmith Hospital’s A&E was closed in September last year. Question marks remain over the future of Charing Cross’s A&E.
Andy Slaughter, the Labour MP for Hammersmith, said the study confirmed the fears of those who had argued all along that UCCs would be insufficiently staffed and equipped to treat many ‘vulnerable’ patients.
He argued UCCs were a ‘second class emergency service’, saying: ‘As soon as you remove the A&E, you are asking a lot of ill and often disabled people to travel further for care, or worse, you end up treating them inappropriately.’
Dr Cliff Mann, president of the Royal College of Emergency Medicine, said: ‘If you have a greater likelihood of serious illness and a number of health problems, as older people tend to do, then it just takes more tests and expertise to sort it out.’
The study’s results mirrored the college’s own research which found the older the patients, the less likely it was their emergency could be treated at GP-led units.
‘Trying to suggest that lots of elderly people who end up in A&E don’t need to be there is patently incorrect,’ he added.
Mr Cowling, a research fellow, told The Mail on Sunday there were currently no studies looking at how many patients who attended ‘standalone’ UCCs had to be transferred to another hospital.