Bristol could end up with just one A&E
BRISTOL could end up with just one accident and emergency department as part of plans to rearrange health services across the city.
The Post understands that there have been discussions about the possibility of one of Bristol's A&E departments closing as part of wider discussions over the possible merger of Bristol's two large hospital trusts.
University Hospitals Bristol NHS Foundation Trust, which runs the city centre hospitals, and North Bristol NHS Trust, which is in charge of Southmead and Frenchay, announced last month that they were going to look in more detail at the possibility of a merger with the aim of reducing waste and saving money where their services are currently duplicated.
A spokeswoman for the two trusts said detailed work on the integration has not begun yet.
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She said: "The NHS, like all public sector organisations, is having to manage its costs really carefully while maintaining quality, and this is a real challenge for us all.
"We have to find completely new ways of working, and that might mean as one organisation, together, or separately with a totally different configuration of services – or one or two organisations pretty similar to what we have now. We simply do not know.
"The two trust boards are very sure that whatever the future plan is for healthcare across the city (and beyond) it has to deliver for patients, first and foremost, and it must be secure for services and for finances."
The Post understands that work on the future of A&E would come after more detailed work on the possibility of an overall merger.
The new £430m hospital being built at Southmead would be the most likely site for a single A&E.
A regional trauma centre, which deals with serious head injuries, multiple bone breakages, knife and gun shot wounds is currently based at Frenchay and due to transfer to the new hospital in 2014.
The A&E at Frenchay currently deals with about 65,000 patients a year while Bristol Royal Infirmary's emergency department sees more than 60,000. The city centre hospital trust also deals with heart attack patients who attend the Bristol Heart Institute for emergency treatment.
A final decision about whether the two trusts should merge is due to be made in January or February and could see the new organisation being created by the end of next year.
The trusts say a merger could simplify the way patients are treated when their care involves more than one hospital in the city and make it easier for service changes to be made across the city.
The health trusts said they could not rule anything out at this stage but that no lists of duplicated services have yet been drawn up for consideration as part of a potential merger.
A project team is being put together to look in more detail at how an integrated organisation would work, following a review led by the vice chancellor of the University of the West of England, Steve West.
The trusts have declined to release the full report, citing commercial confidentiality.
But they said the report concluded that "a combined trust would be better placed to identify savings and operate more effectively with greater operational capacity", as they seek to make an extra £17 million in savings over five years.
A summary of the report prepared for UHBristol's governors said that the two trusts currently suffer from competing organisational interests.
It said benefits to patients from changes in the way services are delivered would be more quickly and fully achieved by a single organisation rather than two. And the risks of a possible merger, including the larger size of an integrated organisation, were expected to be outweighed by the benefits.
Plans to create single urology, breast and head and neck cancer services for the city have already been drawn up but more could be considered as part of a merger of the two organisations.
The hospital trusts told the Post that the clinical case for change would be considered as part of more detailed work over the coming months, "specifically service consolidation, increased flexibility of services, the potential for removing barriers to care and both organisations' strategic vision and ambition".
It is understood that discussions with the trusts and the NHS foundation trust regulator are due to take pace this week.