When the Daily Mail published Shocking proof A&E closures cost lives: Death rate jumps more than a THIRD after department closes, I asked for the exact Freedom of Information request they had submitted so I could obtain comparable figures for Wycombe from Wexham Park and Stoke Mandeville.
We sent the requests on 4 June. The Act requires a response within 20 working days. I received figures from Heatherwood and Wexham Park Hospitals NHS Foundation Trust (HWPH) on 13 June (ZIP). I am still waiting for figures from Buckinghamshire Healthcare NHS Trust. HWPH had an online form; we had to send post to Bucks. We prompted Bucks today: apparently the request arrived at the relevant office on 20 Jun…
Here’s what we know for HWPH:
The death rate for all emergency admissions to HWPH has been falling. However, the rate for people admitted to HWPH in emergency from Wycombe has mostly been rising since we lost A&E in 2005.
However, death rates for Wycombe people admitted to HWPH in emergency have worsened towards the same rate as all patients. Tempting as it is, I’m not jumping to conclusions without seeing more data. I have already seen too many arguments about mortality statistics to leap to a bad conclusion.
What is much clearer is the increased number of people from Wycombe going to HWPH, both after A&E shut in 2005 and again in 2012 as the downgrading of the Emergency Medical Centre to a Minor Injuries and Illness Unit approached – see the green line marked with triangles. It bears out another Daily Mail article centred on Wycombe: Proof that A&E closures cause huge increase in patient waiting times and lead to hundreds of cancelled operations.
There is much to do. We need the data for Stoke Mandeville. We need Sir Bruce Keogh’s report into excess mortality rates in Buckinghamshire and elsewhere. We need a transformed Care Quality Comission to drive up standards. We need our local Clinical Commissioning Groups and the Health and Wellbeing Board to grasp the problem of emergency care. We also need Bucks County Council’s Health and Adult Social Care Select Committee to rise to the serious challenge of holding the NHS to account on behalf of local people.
I’ll be in close touch with all those issues.
If that was all that was going on with admissions I’d expect to see stepped changes at the time of the 2 events, there also appears to be an underlying increase is admissions between events, making it somewhat more difficult to imply causality.
Also, is the fall in overall mortality rates a totally separate factor or could there be some effect from the reallocation of resources?
Unfortunately data only tends to show so much, especially when it’s retrospective rather than being collected specifically to monitor particular sensitivities.
Is there anything available re mortality rates for A&E admissions versus proximity of patients to the nearest available A&E dept?