Impact of closing Emergency Departments in England (closED)

closED Logo

In recent years a number of Emergency Departments (EDs) have closed, or been replaced by another facility such as an Urgent Care Centre. Currently, there is little research evidence to inform decision making about these closures. The main benefits of this study is to inform the re-organisation of emergency care in England by providing the general public, the NHS, and policymakers with evidence to enable them to make informed decisions.

closED will look to identify if local populations and emergency care providers are affected by such closures, focusing on five EDs which closed or were downgraded in recent years. To enable analysis, five control EDs will also be selected.

A resident catchment population will be identified for each target ED (both intervention and control). Catchment populations will be identified from Hospital Episode Statistics (HES) Accident & Emergency (A&E) attendance data.

Routine data will be drawn from a number of sources (Office for National Statistics, HES A&E attendance, HES Admitted Patient Care, and NHS Ambulance Service Computer Aided Despatch datasets) to calculate a series of population and emergency care indicators for each resident catchment population. These indicators relate to ‘death’ and ‘risk of death’, ‘A&E attendances’, ‘emergency hospital admissions’, ‘condition severity’, and ‘ambulance service performance’.

For all the indicators, data will be analysed using a time series of monthly values (for a minimum of 48 months spanning the closure of the ED).

Research Team

Dr Emma Knowles (Lead investigator)
Lindsey Bishop-Edwards (Research Associate)
Professor Jon Nicholl (co-applicant)
Professor Suzanne Mason (co-applicant)
Enid Hirst (PPI representative)
Linda Abouzeid (PPI representative)


Health Services and Delivery Research Programme


January 2015 to September 2016

For further details about this research, please contact Richard Campbell, study administrator at