STP proposals to close emergency departments concerning

The Royal College of Emergency Medicine (RCEM) has expressed concern at the potential closure of up to a third of emergency departments, as proposed by government commissioned Sustainability and Transformation Plans (STPs).

A survey of 99 CCG chairs and accountable officers revealed that 31 per cent believed that their STPs were likely to lead to the closing or downgrading of A&Es in the next 12-18 months. Additionally, almost half expected a reduction in beds, 23 per cent expected a reduction in full-time acute staff and 21 per cent expected that one or more hospitals would stop consultant-led maternity.

Dr Tajek Hassan, president of the RCEM, said that STPs could be ‘potentially catastrophic’ and could leave hospitals ‘unstable and unsafe’.

He said: “The multitude of problems facing emergency departments – including the worst four hour performance for a decade, staffing shortages and overcrowding – will not be solved by closing units and removing beds. Patients will not simply disappear. Nor is there any consistent successful track record of movement of such work into the community – in fact quite the reverse has occurred with a steady rise of ED attendances in most systems.

“If it is true that up to a third of EDs are planned for closure, based on attendances in 2015, where will over five million people go for emergency care and indeed who will provide that care? The hospital bed base is already one of the lowest per head in the Western world and to reduce bed numbers and close more EDs will not only add to the pressure but undoubtedly compromise safety in those that remain open. On this basis STPs will certainly not create sustainability and any transformation that results will not be safe, effective or patient centred.”

So far, Birmingham and Solihull, North West London and South West London have published their STPs.