Fears over plans to cut emergency admissions

Patients' groups have raised fears that hospitals will be forced to cut services before it is safe to do so.

Patients' groups have raised fears that hospitals will be forced to cut services before it is safe to do so
Health watchdogs have warned that pressures on hospitals are “out of control” with a steep rise in the numbers turning to Accident & Emergency departments Photo: Getty Images

Lives could be put at risk by NHS plans to slash the number of people admitted to hospital as an emergency, patients groups have warned.

Health officials have ordered hospitals to scale back admissions to levels not seen for a decade, as almost £2bn is diverted from their budgets to fund community and social services.

Ministers say the changes are needed so that more patients, especially the frail elderly, get help earlier, meaning fewer end up being admitted to hospital.

But patients groups say the rapid timescale planned means overstretched hospitals will have to cut back their services before safe alternatives are in place.

Health watchdogs have already warned that pressures on hospitals are “out of control” with a steep rise in the numbers turning to Accident & Emergency departments.

Plans drawn up by NHS England say hospitals will need to cut emergency admissions by 15 per cent within two years - which means reducing activity levels to those of 2004, when 780,000 fewer patients a year were admitted.

Katherine Murphy, chief executive of the Patients Association, said she was concerned that the target would mean hospital patients being denied care, without alternatives being put in place.

“Reversing demand back to 2004 within two years is unrealistic and impractical,” she said. “We do not have the services in the community to safely care for patients. We are concerned that this initiative will take time to implement and any fast tracking to save money will have an adverse impact on the care and treatment provided to patients.”

NHS managers said privately that the scale of change would be “impossible to achieve” without compromising safety.

A poll of hospital managers by think tank the Kings Fund found that none thought their organisation would achieve the reduction in admissions.

Prof John Appleby, the think tank’s chief economist, said: “It’s not realistic or feasible. We just asked exactly this question in a poll of 42 finance directors working in acute trusts and not a single one thought it could be done.”

He said hospitals would try to find other ways, which could include job cuts, to save the £1.9bn a year which is being transferred from the NHS to a “Better Care” budget for community services.

Prof Appleby said: “Hospitals will look at how to reduce their costs, which probably means employing fewer staff, because that is the biggest cost in their budgets.”

Tomorrow Simon Stevens, the new chief executive of the NHS is due to be questioned by the Commons health select committee, when MPs expected to raise the matter.

Sarah Wollaston, a Conservative member of the committee, said: “We really can’t slash the hospital budgets without puttting the investment into the community first, especially when we know that hospitals are under such great pressure. We will want a clear message from Mr Stevens about how this is going to be handled.”

Earlier this month a report disclosed that Britain has fewer hospital beds than almost any country in the Western world.

A study by the Organisation for Economic Co-operation and Development found that among 23 European countries, the UK has the second lowest number of hospital beds per capita.

Separate figures show that hospitals have repeatedly breached recommended safe occupancy limits.

Jeremy Hunt, the Health Secretary said yesterday that the future of the NHS relies on improving the quality of out-of-hospital care, and that it was a “false economy” to deny investment to community services.

He said: “ The big reform that we need in the NHS, if it’s going to be sustainable in coming years, is to transform out-of-hospital care .. if we don’t help to keep people healthy and happy while they’re at home, they’re going to end up in hospital and that’s going to cost us even more money,” he said.

Chris Hopson, chief executive of the Foundation Trust Network, which represents NHS hospitals, said hospitals supported the idea behind the plans, but had some concerns about the timetable.

He said: “To roll back 10 years of emergency activity this quickly is a stretching challenge - last winter, despite the mildest weather for a century, emergency admissions rose by three per cent.




Plans to shut NHS hospitals could trigger a wave of A&E closures

  • Under the proposals, billions of pounds are to be diverted from hospital budgets to help pay for better care homes 
  • There are fears that the plans could lead to the closure of medical wards 
  • Since 2007, eight English A&Es have been closed
  • Ministers are due to approve the ward closures by April 21


Controversial plans to shut NHS hospital wards across the country – which could trigger a fresh wave of A&E closures – are quietly being drawn up by health bosses, The Mail on Sunday can reveal.

Billions of pounds will be diverted from hospital budgets to help pay for better care homes and home help under the proposals, which are set to be signed off by Ministers within weeks.

But according to official plans seen by this paper, it will force the imminent closure of emergency medical wards, surgical wards and dementia wards.

Frontline doctors also fear the massive shake-up will cause more A&E departments to close – at a time of rapidly rising demand for emergency care.

Since 2007, eight English A&Es have been closed or downgraded. Another 14 are known to be under threat and last year there were a record 3.8million emergency admissions.

The £3.8billion Better Care Fund is meant to ensure that the sick and elderly only end up in hospital when they really need to be there and stop them staying in a ward for longer than necessary



But NHS England calculations have shown that the scheme will ‘transfer’ at least £2billion a year from the health service budget. 

Ministers are due to approve the ward closures by April 21. One leading A&E doctor warned last night that the plans would ‘break the system’, leaving emergency patients without beds.

Dr Chidi Ejimofo said handing so much NHS money to social care was ‘like robbing Peter to pay Paul’, adding: ‘I think there’s every chance this could lead to a new wave of A&E closures.’

Elderly: Under the proposals, billions of pounds will be diverted from hospital budgets to pay for care homes

The consultant, who last year helped save A&E at Lewisham Hospital in South-East London from the axe, went on to say: ‘These plans are extremely worrying given that hospitals are already in a precarious state. We are on the edge of an unmitigated disaster.’

The Government has tried to deny that the Better Care Fund amounts to an NHS cut – and continues to insist it has no policy of shutting A&Es.

But NHS England has claimed that the fund will lead to a 15 per cent drop in emergency admissions after it kicks in next April, and GP-led clinical commissioning groups, which deliver services, have been asked to model ‘savings’ in their budget accordingly.

They have been told to ‘clearly identify where the NHS savings will be realised’ – and will have to show where they could each make an estimated £16million worth of cuts.

Organisations bidding for the fund’s cash are also required to state how they think hospital services will have been ‘reconfigured’ in five years’ time.

An NHS England PowerPoint presentation reminds the applicants of the need to convince staff and the public about the benefits of ‘major service changes as a result of five-year strategy plans and the Better Care Fund’.

But critics have warned that the money will simply disappear into council budgets.

Doctors have also claimed that its aims – while ‘laudable’ – are wildly optimistic.

Labour health spokesman Jamie Reed said: ‘David Cameron promised not to cut the NHS, but he is now raiding it to fill the holes his £2billion cuts have left in social care.’

But Care Minister Norman Lamb insisted: ‘This is not about “cuts” or taking money away from hospitals – it is about providing better joined-up care closer to home. The Better Care Fund is a major step to making this a reality.’

Read more: http://www.dailymail.co.uk/news/article-2603385/Plan-shut-hospital-wards-threatens-new-wave-A-E-closures-break-system.html#ixzz2yqzIywty 
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A&Es patients left waiting as targets missed

Hospital campaigners: 'Don't fool with our NHS'

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Save Our Hospital members protest in eccentric costumes on April Fools' Day

Campaigners wear silly outfits to highlight this serious cause

‘Don’t fool with our NHS’ was the message from hospital campaigners who dressed up in silly outfits on April Fools’ Day.

Members of Save Our Hospitals protested in eccentric costumes, including Father Christmas and handmade designs, outside Charing Cross Hospital today but their message was serious.

The campaign continues to fight against NHS proposals to close A&Es and cut services at Charing Cross, Hammersmith, Ealing and Central Middlesex hospitals.

Desiree Cranenburgh, who has worked in social services for 40 years, said: “This is April Fools’ Day but this is not a time to fool about with our health. It’s serious. We need to get together as a community and help save our local health care.

“Our main thing is getting the patient voice heard, lots of us are patients and carers.

“We’re a growing group, we have tables in Chiswick, Shepherd’s Bush and Hammersmith. We’re still getting support. People still come to us because they can’t believe anyone would want to close a hospital down.”