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(1) what clinical evidence Sir Bruce Keogh provided to substantiate his claim that allowing Lewisham to retain its accident and emergency facility would help reduce the level of increased demand at hospitals with larger accident and emergency services;
(2) what clinical evidence Sir Bruce Keogh has provided to substantiate the claim that the new emergency care service at Lewisham Hospital could continue to see up to three-quarters of those currently attending Lewisham A&E.
The draft report by the Trust Special Administrator (TSA) proposed that the accident and emergency (A&E) department at Lewisham hospital should be downgraded to a non-admitting Urgent Care Centre.
The draft report estimated that around 77% of Lewisham hospital's current A&E activity would remain at that site. The figures are based on activity data supplied to the TSA by Lewisham Healthcare NHS Trust. In light of consultation and further analysis, the TSA revised this figure to “at least 50%”.
Sir Bruce Keogh advised the Secretary of State for Health, my right hon. Friend Mr Hunt, that Lewisham hospital should retain an admitting A&E service with senior emergency medical cover. His estimate that the site could manage nearer to 75% of activity with these changes is based on the Lewisham Healthcare NHS Trust's admissions data and flowing from this that the A&E service would have the clinical capacity to safely treat this number of patients. Treating more patients at Lewisham means a reduced number of patients going to other A&E sites in the local health economy.
The TSA's original analysis is in his draft report which is available at:
Sir Bruce's advice is available at:
Both the TSA analysis and Sir Bruce's advice can only be estimates based on the best available information at the time. Managing activity levels across the different sites will need to be a key part of implementation planning involving Clinical Commissioning Groups, NHS providers and the NHS Trust Development Authority.