NHS medical director proposes two tier emergency service

Hospital emergency departments in England should be remodelled within the next five years to differentiate between smaller emergency centres and larger major trauma centres treating patients with the most serious needs, a major review has recommended.

The plan is the first plank of a major review of urgent and emergency care services led by NHS England’s medical director, Bruce Keogh,1 which was commissioned to help tackle the ongoing pressure on emergency departments and the wider NHS.

The first phase of the review, Transforming Urgent and Emergency Care Services in England,2 proposes introducing the two levels of hospital based emergency care as part of a “system-wide transformation” over the next three to five years.

Under the plan, smaller units, provisionally called “emergency centres,” would …