THE Royal College of Nursing is concerned that a lack of focus on out-of-hospital care while A&Es are closing will result in an even worse healthcare crisis.

Nurses are concerned patients are not getting the right out-of-hospital care for the NHS to justify closing A&Es in west London.

Frontline nurses today called for the suspension of the west London hospital reorganisation programme until further guarantees can be given about out-of-hospital care.

The Royal College of Nursing (RCN) is asking Imperial College Healthcare NHS Trust and the government to suspend its Shaping a Healthier Future programme which has seen Hammersmith Hospital’s and Central Middlesex’s A&Es being closed with more changes to come.

Members are worried patients are suffering from a lack of investment in out-of-hospital care to make up for the closures as they believe it is currently not at a safe level.

The RCN, which focuses on patient needs, today submitted evidence based on local frontline members’ feedback to a review being held by Michael Mansfield QC on behalf of Hammersmith and Fulham, Brent, Ealing and Hounslow Councils.

Local nurses said there were increased waits for ambulances outside hospitals in the area and dangerous diversions were being made due to capacity problems.

They also said patients and carers do not understand the new Urgent Care Units which have replaced A&Es at Hammersmith and Central Middlesex Hospitals. One member said: ‘Patients and particularly their carers are frightened and confused about the A&E closures.’

Members added that pressure on GP services means practice nurses cannot carry out preventative health interventions meaning people are going to A&E who should have been kept well earlier in the system.

Under the Shaping a Healthier Future programme it was argued fewer A&Es were needed if people could be kept out of hospital by preventative health measure.

As well as patients becoming frustrated, nurses themselves said they are ‘burnt out, tired and frequently unable to get time for the next study days’.

RCN London regional director Bernell Bussue, said: ‘The RCN will always support service reorganisation which delivers improvements in the quality of patient care. However, it is just not clear that patients have seen any benefit from these changes so far.

‘The positive case for the Shaping a Healthier Future programme was based on an increase in out of hospital care to enable more patients to be kept well or treated at home to reduce hospital admissions.

‘In practice, little seems to have been done to boost capacity elsewhere in the system to make up for the closures. Proper replacement services, transition arrangements, funding and a workforce plan should have been in place before the existing units were cut.’