- There is no commitment in the Health and Care Act 2022 to provide Emergency Care for all who need it. The Health and Care Bill Clause 15 gets rid of a key section of NHS Act 2006 that requires a Clinical Commissioning Group to arrange emergency services “for every person present in its area”.
- Therefore each Integrated Care Board constitution must specify that the Integrated Care Board will provide all patients, wherever their place of residence, with the full range of urgent and emergency care at the hospital or unit that is closest to them at their time of need. And it will NOT permit patients who need urgent or emergency care to be turned away from a cost-centre which doesn’t receive the funding for that patient.
- Even before the Health and Care Act 2022 was passed, patients had already been denied urgent care on the basis of postcode. This needs to stop before cost pressures in Integrated Care Systems drive this further.
In September 2021, the Northern Care Alliance Foundation Trust sent a woman with agonising burns away from TWO hospitals in Greater Manchester, after she fell foul of new rules meaning people have to get urgent care at a unit closest to home.
New Greater Manchester rules that people must get urgent care at a unit closest to home
In response to a Freedom of Information request, the Northern Care Alliance has confirmed that:
- Each of the four care organisations (Salford, Oldham, Bury and Rochdale) in the Northern Care Alliance Trust have their own budget and each care organisation bears the risk of overspending.
- In September 2021, the Bury Local Care Organisation (part of the Northern Care Alliance) and Bury Council, which together make up the Bury Urgent Care Programme, introduced a new Standard Operating Procedure for pre-Emergency Department streaming at Fairfield General Hospital, as a ‘test of change’ to ‘establish the model’ that requires patients seeking urgent care to be directed to a unit closest to their home.
- This was a Greater Manchester-led piece of work preparing for post-Covid recovery.
- It was part of the Greater Manchester Emergency Department 2 door model service reconfiguration.
- The final version of the ‘Pre-ED Streaming at Fairfield General Hospital Standard Operating Procedure’ says “This [programme] has been successfully tested at Fairfield General Hospital during October 2020, and in a number of other acute sites across the Greater Manchester area, most recently in Oldham and Salford, using a slightly different service model to the one proposed by Bury.”
How does sending a burns victim from pillar to post, on the grounds that Fairfield General Hospital was not treating people from Rochdale because of its postcode Standard Operating Procedure, amount to a successful test?
You can download the Standard Operating Procedure here, in case of interest:
Councillors and campaigners are demanding that Integrated Care Board Constitutions commit to arranging for the provision of comprehensive NHS health care for everyone, including urgent and emergency care, wherever they live.