Professor Sir Bruce Keogh reported plans for a 'two-level' setback administration with 'super A&Es' managing life-debilitating conditions and with this, an enormous shake-up of medicinal services procurement was proclaimed the previous evening by the NHS' top specialist.

Feelings of trepidation are developing that his changes will just expedite disarray around patients, who won't know which clinic to go to.

The three key boards of his changes will set up refinement between super A&Es and standard A&Es, ask GPs to furnish more same-day errands and in addition opening surgeries in the nights and at weekends and support the
111 helpline with additional specialists, medical attendants and drug specialists addressing the telephone.

They will give specialised nurture the casualties of strokes, heart assaults, suspected mind haemorrhages and other life-threatening disorders.

Sir Bruce's vision is situated out in a report, distributed today, on the best way to enhance A&E and other 'critical consideration, for example GP administrations. The Government asked him the previous winter to draw it up.

In the most amazing shake-up in A&E divisions for 40 years, up to 50% of the 140 units in England will be changed into 'major crisis centres'.