A SHOCK report today claimed that hospital casualty departments may need to be merged to improve patient care.
The Audit Commission said accident and emergency units were under terrific pressure due to increased demand and a shortage of qualified staff.
Its report says that, ultimately, casualty departments may have to be restructured because they cannot provide a sustainable high quality service due to their size and lack of specialist support on-site.
The commission says some hospitals receiving critically-ill patients by emergency ambulance, do not have the necessary facilities and expertise at all times.
More than half of accident and emergency units are within 10 miles of another hospital providing a full accident and emergency service, the report adds.
It says, therefore, that some services need to be reconfigured to improve care for patients.
The commission adds that "rationalising" hospital services is always controversial and needs good communication with the public.
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