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Adult emergency services

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has identified that there is often inadequate involvement of senior medical personnel in the assessment and subsequent management of many acutely ill patients. Outcomes are therefore not as good as they could be, or as patients should expect.

More than half a million patients are admitted to London hospitals as an emergency every year. They should expect to receive consistently safe, high quality care. However, figures show that patients admitted at the weekend have a significantly increased risk of dying compared to those admitted on a weekday. For London, this equates to more than 500 lives a year.

The review is clinically-led by Professor Matt Thompson, Consultant Vascular Surgeon, St Georges Healthcare NHS Trust. Simon Robbins, former South East London Cluster Chief Executive, is the Senior Responsible Officer.

Two multidisciplinary clinical expert panels were established to support the development of the case for change and commissioning standards. The acute medicine panel is chaired by Professor Derek Bell, Professor of Acute Medicine at Imperial College, London, and Chelsea & Westminster NHS Foundation Trust. The emergency general surgery group is chaired by Mrs Celia Ingham Clark, NHS London’s Associate Medical Director, Whittington Hospital NHS Trust. The review was also informed by a patient panel.

The commissioning standards aim to address the clinical case for change and to provide consistently high-quality and safe acute medical and emergency general surgical care across all hospitals, seven days a week. The standards are minimum standards of care and not standards that hospitals may aspire to achieve over time. They represent the minimum quality of care that patients admitted as an emergency should expect to receive in every hospital in London that accepts patients on an emergency basis.

NHS commissioners, local doctors, nurses and other healthcare professionals are now considering how to meet these standards and improve services. This will also involve further discussions with patient groups across London.