CLOSING or downgrading emergency departments does not lead to a spike in deaths despite patients having to travel further, according to the first scientific study into the controversial trend.
Increased journey times to A&E appear to be offset by factors such as new services being introduced or the care at the alternative hospital being more effective.
However, the researchers cautioned that the study also failed to find evidence of the improved outcomes which policymakers have used to justify closing smaller departments, and noted that emergency department closures appeared to have driven an increase in workload for local ambulance teams.
In Scotland, there have been a number of local backlashes against changes to A&E departments including proposals a decade ago to close the emergency units at Monklands Hospital in Lanarkshire and at Ayr Hospital, both reversed when the SNP came to power.
However, Scotland's new Health Secretary Jeane Freeman recently signed off on a reorganisation of surgical care in NHS Tayside which will see all emergency patients in the region who require an operation admitted to Ninewells Hospital in Dundee instead.
The move has sparked an outcry from opposition parties and campaigners in Perth who insist the decision will put patients at risk and reduce Perth Royal Infirmary to "little more than a minor injury clinic".
Although the new study is based on evaluating five emergency departments in England which were shut down between 2009 and 2011, its findings have implications for health planners across the UK.
Researchers from Sheffield University evaluated the units at Newark, Rochdale, Hartlepool, Bishop Auckland and Hemel Hempstead two years before and two years after they closed, and compared them against socio-economically similar control populations.
They found no overall increase in the number of deaths.
The authors state: "This suggests that any negative effects caused by increased journey time to the emergency department can be offset by other factors; for example, if other new services are introduced and care becomes more effective than it used to be, or if the care received at the now-nearest hospital is more effective than that provided at the hospital where the [A&E] closed."
However, they said that there were implications for other NHS emergency care providers, such as an influx in the volume of calls to ambulance services.
They noted an increase in the number of incidents that were dealt with by the ambulance service and an increase in the time taken to get to hospital, according to the study, which was published by the National Institute for Health Research.
The authors pointed out that in four of the five areas studied, the emergency department was replaced with an on-site urgent care facility.
Emma Knowles, from the School of Health and Related Research at the University of Sheffield, said: "The public, in particular, require reassurance that the closure or downgrade of an emergency department does not result in increased death rates."
The study's co-author, Professor Jon Nicholl, added: "It is important to highlight that we didn't find the better outcomes for patients that planners hoped to see from closing these small departments either.
"This means it isn't clear that the disruption and anxiety that can be caused by closing emergency departments is worthwhile."
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