A&E facing serious problem, health minister admits

 

Dr Peter Carter, of the Royal College of Nursing: "This is a system under huge strain"

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A&E departments are facing a "serious problem", a health minister has said, after NHS chiefs ordered urgent action to tackle growing pressures.

Rising attendances have meant A&E units in England have started struggling to hit the four-hour waiting time target.

The problem has got so bad that NHS England has pledged extra money to help hospitals that are struggling.

But Health Minister Anna Soubry warned there would be "no quick and easy solution".

She said: "We have a serious problem, we've had a problem for a while.

"If you look at the number of people presenting to A&E it's grown by a million in just the last year.

"And unfortunately unless we take urgent action, which we've been doing, it's a problem which will grow. It's very complicated. There is no quick and easy solution."

It has been clear for some time that pressures have been growing in A&E.

For the past decade the numbers attending the units have been rising year by year. There are now more than 21 million visits annually - up 50% in a decade.

There is a combination of reasons why they have grown, including a rise in number of people with chronic conditions, such as heart disease, that end up having emergencies; the ageing population; and problems accessing out-of-hours GP care. A&E units have also had problems recruiting middle-grade doctors, which creates staffing problems.

But until recently, hospitals had just about been coping. The harsh winter seems to have tipped A&E units over the edge.

In the past few months, the waits that patients face have reached their worst levels for a long time.

The four-hour target - 95% of patients have to be seen to in this time - started to be breached in many places. Since the start of last month, the NHS overall has missed it.

There are signs that, with the weather improving so have the waiting times, but not as much as many would have liked.

The problem is that A&E is the safety net of the NHS: the place people go when there is no other option. If it breaks there is a real problem.

In recent months reports have emerged of hospitals setting up temporary waiting areas in car parks and storerooms to cope with queues.

Ambulances have also been forced to wait to drop off patients.

'Market failure'

The situation prompted the Care Quality Commission to issue a stark warning about the future of A&E.

CQC chairman David Prior said: "Emergency admissions through accident and emergency are out of control in large parts of the country. That is totally unsustainable."

He added that there was no cast-iron guarantee that there would not be a repeat of the situation at Stafford Hospital.

Mr Prior is also reported to have suggested the large-scale closure of hospital beds and investment in community services.

He added: "The patient or resident is the weakest voice in the system. It is a classic market failure. The user doesn't know nearly as much as the professionals, even with the internet."

Mr Prior is not alone in proposing a radical shake-up of A&E services.

The College of Emergency Medicine, which represents casualty department doctors, believes that between 15% and 30% of patients admitted could be treated elsewhere.

Soon after the CQC warning was made, NHS England announced it was asking regional health bosses to work together to ensure plans are in place for each A&E in their patch by the end of the month.

Health Minister Anna Soubry says lack of access to GP surgeries is "one of many factors" putting pressure on A&E services

Extra money is being made available where problems are identified.

Prof Keith Willett, of NHS England, said: "When pressure builds across the health and social care system, the symptoms are usually found in the A&E department.

"We need the whole NHS system, in the community and hospitals, to recognise the problems and help to relieve the pressure on their colleagues in A&E."

A review, led by medical director Sir Bruce Keogh, is already under way to address the issues in the long term.

 

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  • rate this
    0

    Comment number 616.

    Unfortunately many of the A&E departments have been closed, putting more pressure on those remaining. In our catchment area we are under two hospitals which did both have busy A&E departments. One has been closed, leaving huge pressure on the one remaining, which is in the process of being expanded. Surely this is something that should have taken place before closing the other.

  • rate this
    -1

    Comment number 615.

    OK down-voters for privatisation answer me this - food is more important than health so why do we not have a national food service? What would happen to quality, choice and availability if we had one state supermarket and food was free at the point of use? Supermarket sweep anybody?

    Eat your peas.

  • rate this
    +2

    Comment number 614.

    see 588 and 605
    It may be your parent or elderly friend that requires paramedic help or some lonely housebound old lady that falls and is on the floor for hours before and indeed if anyone is aware. If it is not that it is your tax payers money that is paying for the 90% of A and E calls caused by the elderly and lack of food and drink.

  • rate this
    +2

    Comment number 613.

    The problem is not that GPs are not open evenings and weekends when people aren't at work. The largest group of people that use GPs are the elderly and infirm who are, by nature, not in work and so can see the GP during the week. Also, you complain that GPs need to be open weekends otherwise people go to A&E. But if they need to see their GP surely the problem can wait until Monday?

  • rate this
    +1

    Comment number 612.

    at work right(gp surgery) now entering the read codes for a+e attendances.
    it is a matter of convenience.
    self care,Broken finger nail,constipation,headaches
    simple hygiene,conjunctivitis,infected wounds that is just today.
    if you asked a+e dept how many attendees are life threatening it would be about 20%.Our local area has an ucc...we get audited on its attendees and asked way they attend

  • rate this
    +1

    Comment number 611.

    598. Sally
    8 MINUTES AGO
    590.paulmerhaba
    Sounds a lot like national insurance...
    =
    It's not like NHS, as:
    You don't pay for when you don't use it.
    You don't get a bill for when a stranger user uses it.
    You only get a bill for when you use it.
    Wake up Geoff! Xx
    http://upload.wikimedia.org/wikipedia/en/3/38/Wake_Up_Jeff.jpg
    =
    What would happen to BUPA et al if everyone claimed?

  • rate this
    0

    Comment number 610.

    562.Alan T "Our healthcare system is run by and for the benefit of senior doctors ... The pressure on A&E is symptomatic of the unavailability of experienced senior staff outside of hours"

    Correct. Huge sums of cash have been squandered on colossal pay rises for GPs and consultants, leaving virtually nothing for juniors, nurses, porters etc. The overall effectiveness of A&E suffers as a result.

  • rate this
    +2

    Comment number 609.

    @578. Sally
    Last I checked treating smoking related illnesses cost the NHS around £3bn but revenue from tobacco duty was over £10bn. So to say that smokers are responsible for the burden on the NHS is false, in fact the opposite is true, smokers relieve the burden on the NHS.

  • rate this
    +2

    Comment number 608.

    504------- Your E111 card does not entitle you to free treatment in the EU, it only entitles you to the same terms of treatment as citizens of the country you're in, which in most countries in the EU means you have to pay , and it aint cheap!

  • rate this
    +1

    Comment number 607.

    The situation will remain critical all the while people with trivial injuries are treated as if they were life-threatening instead of needing a bandage or two, such as those with minor cuts and bruises. They need to be turned away, as should all the drunks that are carted into A&E Departments every Friday and Saturday night; they should be left in the street gutters, where they belong.

  • rate this
    +2

    Comment number 606.

    Given that in the transition from NHS Direct to the 111 system, HNG has halved, then halved again, then halved once more (for luck) the ratio of medical staff to call handlers, it's not surprising that the call handlers take the easy option of advising a call to 999 or a trip to A&E.

  • rate this
    +1

    Comment number 605.

    See 588
    there are campaigns for smoking, drinking and road safety. Yet 90% of all A and E emergency calls are for the elderly. There is a simple solution to the cause of these, eating and drinking. Dehydration is a at worse a killer for the aged.

  • rate this
    +3

    Comment number 604.

    Yes A&E are in crisis, half the time some folks don't know what an accident or emergency is!

    They come with a grazed knee, a splinter or non serious cases but alas, the good people there do not refuse to treat them.

    These people don't realize that these are not real emergencies yet I've heard them moaning because they had to wait. Yet those that are in dire need of treatment never moans.

  • rate this
    -3

    Comment number 603.

    Privatisation is the only real solution. Only when the principle of "user pays" applies will providers have to compete on quality and price.

    Get what you like or learn to like what you get.

  • rate this
    +2

    Comment number 602.

    596. CURTAINS 2012
    4 MINUTES AGO
    A visit to A&E can alos be seen as far more attractive with its attendant drama than a simple trip to a 24hr pharmacy that can advise on a lot of the minor stuff.
    --
    That's probably down to Holby and Casualty, scandal abounds.

  • rate this
    +4

    Comment number 601.

    Unthinking Politicians managed to break the GP system, now the law of unintended consequences puts A&E next.
    Time to BAN Political interferance in anything other than choosing the wallpaper for the toilets, (their own toilets , not mine)

  • rate this
    -1

    Comment number 600.

    It boils down to access. Have you tried to see your GP within 4 days? On Teesside its not possible. So people try to use the out of hours service but they are policed by little Hitlers who decide over the phone if you are suitable to visit them. What options do people have left? Its not rocket science is it? They go to A&E where they cant be denied. And were paying for the priveledge too

  • rate this
    +1

    Comment number 599.

    Healthier lifestyles mean we live longer and the ability of medical science to prolong life means the NHS is a bottomless pit.
    When it was first introduced, we didn't have the expensive equipment we have now or the vast range of drugs. Costs are spiraling out of control through no fault of any government
    There needs to be a radical change and if that means charging people for wasting time so be it

  • rate this
    0

    Comment number 598.

    590.paulmerhaba
    Sounds a lot like national insurance...
    =
    It's not like NHS, as:
    You don't pay for when you don't use it.
    You don't get a bill for when a stranger user uses it.
    You only get a bill for when you use it.
    Wake up Geoff! Xx
    http://upload.wikimedia.org/wikipedia/en/3/38/Wake_Up_Jeff.jpg

  • rate this
    +5

    Comment number 597.

    Is this surprising when you have a Govt. that is rushing to privatise the NHS.
    Has destroyed NHS Direct and replced it with call centres staffed by unqualified people(cheaper).
    Is encouraging private companies to run out of hours GP services who to make more prfit operate on a shoestring.
    Apalling, unnecessary and dogma driven. Its up to the electorate now.

 

Page 14 of 44

 

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