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Hunt opts to downgrade Lewisham A&E

Health secretary Jeremy Hunt has rejected plans to close Lewisham A&E and instead decided to downgrade it so that it does not treat the most urgent cases, after opposition from the local CCG.

Mr Hunt told Parliament today that a review by NHS Commissioning Board medical director Sir Bruce Keogh concluded that to maintain a reduced A&E in the hospital, which will treat up to 75% of the patients who currently use it.

But the local CCG said they were ‘disappointed’ in the decision and that the plans were ‘not a real solution’ for local needs.

Mr Hunt said the A&E department would no longer treat the most urgent cases including high-risk pregnancies, he said.

The trust special administrator appointed to look at the failed South London Healthcare NHS Trust, Matthew Kershaw, had recommended that the A&E should be replaced with an urgent care centre that would treat 50% of patients currently admitted.

This recommendation sparked ire among local clinicians, and became a test case for the power of clinical commissioners to influence the make-up of their local health economy.

Mr Hunt told Parliament: ‘The public campaign highlighted how important [the A&E department] was to the local community. I understand the sense of unfairness felt.’ He also acknowledged that these concerns were echoed by the CCG and local clinicians.

However, the health secretary estimated that the overall changes to south London healthcare – including the downgrading of Lewisham – would save around 100 lives a year.

Lewisham CCG chair Dr Helen Tattersfield told Pulse that Mr Hunt’s decision to retain Lewisham A&E at a reduced size ‘was not a real solution’ and it amounted to a ‘tweaked urgent care centre’.

She added: ‘I am not at all pleased and I am very disappointed. It is what everyone inevitably thought he would do. We had hoped for better. We gave very sound arguments about why the process was flawed and why the decision was dangerous.

‘They were reasoned arguments but none of them have been listened to.’

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Hunt refuted suggestions, most notably from Lewisham Council and shadow health secretary Andy Burnham, that the trust special administration legislation did not allow the administrator to reconfigure services outside the affected trust.

Sir Bruce said: ‘Healthcare in South East London is at a turning point. We need to strike the right balance between ensuring that all patients have access to the best possible specialist treatment whilst providing safe, effective and convenient services close to home.

‘I expect that balance to result in about three quarters of patients currently seen in Lewisham A&E continuing to receive complete care at Lewisham Hospital and about a quarter being transferred for more specialist treatment elsewhere.’