'Two-tier' A&E proposals

NHS Medical Director Sir Bruce Keogh has unveiled his proposed changes to emergency care across the NHS, calling for a "two-tier" A&E service offering specialised care to ease pressure on an "emergency service at its limit."

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Keogh's NHS: 'Best services, close to people's homes'

Summarising his proposals, NHS Medical Director Sir Bruce Keogh broke his plan into two parts.

"The first part is to provide the very best possible services and as many services as we can close to people's home - in some cases in their home.

"The second part of the vision is that where people have very serious conditions, we ensure they are treated by clinical teams who have the best expertise and are supported by the best equipment."

Keogh proposals aim to 'improve outcomes' for patients

Prof Sir Bruce Keogh said the proposals were about "improving outcomes" for patients.

It is about improving the outcomes for patients with very serious conditions - let me be absolutely clear, that two tier system already exists.

By serious conditions what I mean are trauma, heart attack, stroke, to name three of them.

Ambulances already when they pick up somebody with major injuries take them to designated trauma centres, they already take people with heart attacks to specific designated heart attack centres and similarly for strokes.

We have shown that when you do that, that despite initial concerns that the additional travel time would create problems, that the outcomes for patients are significantly better.

– Professor Keogh speaking to BBC Breakfast


Labour: Public left with no alternative to A&E

Labour's shadow health secretary Andy Burnham welcomed the new report into improving A&E services in the NHS, but said the government's cuts to the health service had left people with no alternative but to inundate A&E units. In a statement, Mr Burnham said:

We welcome Sir Bruce Keogh’s important report and share much of his analysis, but we deplore the Government's attempt to avoid presenting it to Parliament and abdicate all responsibility for the crisis in A&E.

This Prime Minister has made it harder to get a GP appointment, closed NHS Walk-in Centres and scrapped NHS Direct leaving people with no alternative but to go to A&E.

Ambulances 'should be mobile urgent care centres'

Ambulances responding to 999 calls should become "mobile urgent treatment services, not just urgent transport services", NHS Director Sir Bruce Keogh said today.

Paramedics could treat patients inside ambulances, instead of bringing them to A&E, the review suggested. Credit: PA Wire

Announcing his findings of a major review into how to ease pressure on services and improve A&E care he said ambulances could treat people inside the vehicle, instead of bringing them to hospital.

He suggested more training for paramedics so the vehicles could operate safely as urgent treatment centres, and said closer links need established between the ambulance service and GPs and community health teams.

111 non-emergency service to be enhanced under plans

The new NHS 111 non-emergency service, which has been beset with issues since it launched earlier in the year, would be enhanced under new proposals to ease pressure on struggling A&E units released by the medical director of the NHS today.

Read: 111 service in turmoil as key provider NHS Direct pulls out

The idea is to treat more people at home, or at the their local primary healthcare provider and keep them out of A&E. Under the proposals:

  • The non-emergency service would be enhanced to provide people with a "one stop" service over the phone - and it would be staffed by trained medical practitioners
  • Medical records would be on hand so that all the right information is shared between practitioners
  • Workers at 111 woudl be able to book appointments for patients at their local A&E for urgent care
  • Doctors and pharmacists could provide prescriptions ready for patients to collect

Major health review backs 'two-tier' A&E services

A two-tier A&E should be created to ease pressure on an "emergency service at its limit", according to a major review conducted by NHS Chief Sir Bruce Keogh.

The new 'two-tier' system would enable those who need it to get specialist help, and encourage others to 'self care'. Credit: PA

The current emergency care system within the NHS is under "intense, growing and unsustainable pressure" caused by increasing numbers of people turning to A&E, an ageing population and "confusion" over existing services.

His report calls for an overhaul of the system in England to treat more people in their own homes and keep them out of A&E.

For those that do need to go to hospital for emergency treatment, he said two types of health service options should be available, offering specialist care.


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