The Biggest Review Of The Evidence Found One Thing Clearly: For Some Emergencies, Distance Can Cost Lives
The most thorough review of the evidence on hospital reconfigurations found no general effect from extra distance — except for heart attacks and, more thinly, trauma. That's the category our kids' emergencies fall into.
We keep saying minutes matter. We wanted to know what the actual evidence says — not just our own instinct as parents — so we went looking for the most rigorous review anyone has done on it.
It's a 2020 systematic review commissioned by the National Institute for Health Research, covering 44 studies on what happens to patient outcomes when emergency care gets moved further away. It's not a campaign document. It's independent academic evidence, and it doesn't tell one simple story.
What it actually found
For the general population, the review found no clear evidence that increased distance after a reconfiguration raises mortality risk. If that were the whole finding, it would cut against our case, and we're not going to pretend it doesn't exist.
But the review didn't stop at "the general population." It looked at specific conditions too, and there the picture changes. For heart attack patients, greater travel distance was linked to a real increase in mortality risk — most pronounced in the first one to four years after a service moved. For trauma patients, the evidence pointed the same way, though the researchers describe it as thinner and less certain than the heart attack findings.
Why that's the category that matters here
Heart attacks and trauma have something in common that "the general population" doesn't: they're time-critical. Minutes of delay can change the outcome. A child arriving after a serious injury, a bad asthma attack, a head trauma from a fall — those are trauma-shaped emergencies, not the kind of routine care where an extra fifteen minutes rarely changes anything.
Ormskirk's children's A&E is currently 10 to 20 minutes closer than Southport to the specialist centres at Alder Hey, Whiston and Aintree that the most serious cases get transferred to. The review doesn't tell us exactly what that gap means in lives — no study we've found does, for this specific move — but it tells us the category of emergency where distance has been shown to matter most is exactly the category a children's A&E exists for.
We're not going to invent a number this evidence doesn't give us. We are going to say plainly: the strongest independent review available found that, for time-critical emergencies, extra distance is linked to worse outcomes. Nobody publishing the case for moving our children's A&E eight miles further away has told us how they've weighed that.
What we're asking for
We're asking NHS Lancashire and South Cumbria to publish, in full, whatever clinical safety case they hold on time-critical paediatric transfers and increased distance — and we're asking the Health Secretary to weigh this evidence before any final sign-off. If the answer is that the risk has been properly assessed and mitigated, show us the assessment. Right now, all we have is the evidence review, and it doesn't say this move is safe by default.
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