‘Involve Doctors And Patients In Decisions On Emergency Care’

Commenting on reports published by the Department of Health on the need to change how emergency care in England is provided, Dr Jonathan Fielden, Chairman of the BMA’s consultants’ committee said: “Doctors want to ensure that as medicine advances patients have access to high quality, safe care based on the best available evidence. Where the Government and NHS managers are also party to this patient centred agenda we will work with them.

“Patients with very serious or complex conditions benefit from having better access to specialist treatment. However, patients must still have local access to emergency care for dealing with other less serious problems or injuries.

“All too often change is driven by politics or the need to balance the books rather than what is in the best interests of patients. It is absolutely vital that there is meaningful dialogue both nationally and locally to ensure the right services are available at the right time and place.

“Delivering effective emergency care will rely on hospitals, GPs and other primary care clinicians, working collaboratively to plan how services will be provided. This is impeded when at the same time hospitals are being encouraged to compete against each other to attract more patients to maintain financial viability in a market based healthcare system.”

Mr Don MacKechnie, Chairman of the BMA’s Emergency Medicine Committee said: “There is no “one size fits all” reconfiguration solution that will meet the various health needs of different communities across the country. Each locality must be given the time and opportunity to discuss what proposed changes in emergency care will mean for their local health service and be properly informed about the risks and benefits.

“Changes to emergency care will have an impact not just on individual hospitals, and the other services they provide, but also on the ambulance service and primary care. Any proposed reorganisation of services will not provide short term financial benefit as to ensure continuing safe delivery of emergency services, the initial costs may be greater than at present. It will take time to develop networks of care and local clinicians and managers will want to examine the evidence very carefully to ensure the quality of care that can be provided.

“Other key NHS reforms such as the new funding mechanism of “payment by results” and the increased movement of patient activity out to independently run treatment centres will also have an impact on how effective any reorganisation of emergency care will be. There is a risk that these Government policies will destabilise and fragment NHS care and the ability to reorganise services to meet the needs of patients is actually reduced.”