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
    +3

    Comment number 636.

    First, the people were described as foolish for going to A/E (Ken Clarke). Then, we are now being told that the solution is to close down more hospital beds by Mr Prior (former Tory MP), who is now in charge of enforcing "standards". I suppose once the beds are closed, the people will get it and stay at home. Some lucky ones will go private. The rest of us will quietly fade away. Out of sight..

  • rate this
    -1

    Comment number 635.

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

    What a load of crap, a few months ago my cousin collapsed at work due to abdominal pains, it was a Friday afternoon when he was rushed to hospital by ambulance. It was Tuesday evening before he saw a Dr. - from Friday to Tuesday he was doped out of his eye balls on morphine with out seeing a Dr - 80+ hours.

  • rate this
    -1

    Comment number 634.

    @kinglouis..I am the the man that will keep the red flag flying..and I have kept it flying from the 60s..but having met some of the t****** that are in the NHS recently..a near young family death..has proved to me that it aint about the NHS anymore.its about ME ME ME ME ..and What about my money..THATS NURSES >>DOCTORS>>AND ALL THE REST OF THE T*******..THAT NEARLY KILLED MY DAUGHTER**ALL OF THEM

  • rate this
    0

    Comment number 633.

    NHS problem fixes invariably shunt difficulties elsewhere and it will need a special 'trick' to make sure that sorting A&E doesn't perpetuate this. I'm sure the GP hours factor isn't the sole culprit and that John Reid (the Minister who brought in nGMS in 04) never envisaged such consequences. In the interim, robust triage needs applying at A&E doors and malingerers and time wasters sent packing.

  • rate this
    +2

    Comment number 632.

    It's next to impossible to get a GP to visit, even between 9-5. They say go to A&E when it's something that old-style GPs used to deal with routinely, like stitching a cut. They won't even stitch a cut if you attend their surgery, but send you to A&E. My life was saved by a GP when I had severe flu, if it happened nowadaysI would have to call an ambulance. No wonder A&E is overloaded.

  • Comment number 631.

    All this user's posts have been removed.Why?

  • rate this
    +2

    Comment number 630.

    603.Libert_arian
    I voted your comment up!

    Many seem to fear personal responsibility. Like children, we like someone else to look after us, instead of us taking charge of our own affairs. Freedom is personal responsibility, slavery is being denied it.

    As Voltaire said:
    "It is difficult to free fools from the chains they revere."

    620.BBC
    Yes!

    627.mrwobbles
    You're saying suicide saves the NHS?

  • rate this
    +3

    Comment number 629.

    Hey BBC why don't you stop running this rubbish and constant insults about our NHS, we all know where you get your info from...government. This disgusting government will try at all costs to mis-name our amazing NHS so they can allow their friends to take over with Private companies they no doubt have shares in. STOP AIDING THEM

  • rate this
    +1

    Comment number 628.

    617. Sally
    8 MINUTES AGO
    611.paulmerhaba
    If you claim a lot, your premium rises. Make good choices, avoid accidents.
    ==
    Ok, if you accidentally run me over and the insurance companies can agree, the doctors will save my life. Thanks, but no thanks.

  • rate this
    +1

    Comment number 627.

    617. Sally
    It would be neither spurious nor misleading to suggest that smokers dying earlier reduces the burden on the NHS as this is quite evidently the case.

    Luckily I was not suggesting that, I was merely highlighting the costs to the NHS in treating smoking and comparing that figure to the revenue gained from tobacco duty.

    I'm glad you highlighted the further saving smokers offer the NHS.

  • rate this
    +1

    Comment number 626.

    This is a government obsessed with cover-ups. They have known their policies were putting the NHS at risk from the start but chose to hide it until they could put on some political spin.

    They desperately tried to block a Freedom of Information request that showed NHS at risk from their damaging policies:
    http://www.gponline.com/News/article/1131950/DH-face-legal-challenge-risk-register-veto/

  • rate this
    0

    Comment number 625.

    Ok let's address the elephant in the room then hear the squeals. GPs need to offer 24/7 services. End of!

    Monday to Friday, one set of GPs run normal services and preventative medicine clinics from 8am till 6 pm. Out of those days and hours a different set/sets run urgent care.

    They will squeal because they can do both and get paid for both.

  • rate this
    +2

    Comment number 624.

    Some idiot had a not so bright idea that the thing to do was allow Gp's to opt out of 'out of hours' contract with a pay rise. Then the thing to do, would be to spend millions on New build walk in centers that could treat people as long as they weren't really ill or injured. Waste of money. Money that was needed by A&E. How do I know ? 12 years on the ambulance servce. The Nhs is being dismantled.

  • rate this
    0

    Comment number 623.

    If patients numbers have increased it's because they aren't being seen by someone else that they were able to go to previously, that is where the answer lies and out of hours seems to be the reason.GP's have to stop and look at why they came into the NHS in the first place. There's a disconnection and outsourcing OoH is not the answer. Having practices should have meant more flexibility it doesn't

  • rate this
    -1

    Comment number 622.

    People don't know what A&E is used for. It's for emergencies but most people turn up with minor complaints, no wonder the NHS can't cope. And GPs are so fussy now, apparently they will only see a patient for ONE complaint. So you can wait weeks to see your GP and when you get there you're told to discuss one problem. If you have another ailment, make another appointment!

  • rate this
    +2

    Comment number 621.

    @599 Migster..Also being a Royal..and being over 90yrs old lets you survive..as in Prince Philip being flown to the best Cardiac unit in the country with chest pains..or when he had weeing problems being admitted to hospital...when my 66yr old dad before he died was told to see his own gp on Monday..IT AINT what you are ITS WHO YOU ARE as in Royal..or not..open your hospitals to US !!!!! we need !

  • rate this
    +1

    Comment number 620.

    The wheels are off the wagon and the NHS A&E is an open house for all and sundry. Like a pool car no one respects the value of anything free.

    I'd like to see a charge for use off A&E for "minor" problems - higher ones for those who come in drunk.

  • Comment number 619.

    All this user's posts have been removed.Why?

  • rate this
    +1

    Comment number 618.

    602.paulmerhaba
    11 Minutes ago
    --
    That's probably down to Holby and Casualty, scandal abounds.

    +++

    Or the hope of appearing on BBC's Bizarre ER or Real Rescues when ITV's Jeremy Kyle Show is far more appropriate.

  • rate this
    0

    Comment number 617.

    611.paulmerhaba
    If you claim a lot, your premium rises. Make good choices, avoid accidents.

    609.mrwobbles
    I suspect that information, possibly accurate, is misleading. If you're relying on the IEA report, it justifies such a spurious statistic upon smokers dying early, before aged care is required. The NHS would save money if its patients die. Sounds like management's motto at Stafford Hospital.

 

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