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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  • Comment number 876.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 875.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 874.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +2

    Comment number 873.

    Patients turning up at A & E should not be referred to as "time-wasters" and malingerers" if it turns out they're not "emergency". People are not there because they want to sit in a crowded waiting room for hours on end. They are there because they are worried, particularly if it's their child who is ill, and they have nowhere else to turn to.

  • Comment number 872.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +1

    Comment number 871.

    people get sicker as they get old
    the average age of the population is increasing
    the amount of hospital beds have been and are still being decreased
    hospital facilities and equipment are not being increased to match demand

    the way to fix it is higher taxes into healthcare

  • rate this
    0

    Comment number 870.

    866.Sally
    9th May 2013 - 23:59

    =
    If you put the government in charge of the Sahara, in 10 years there'd be a shortage of sand. ~Milton



    +++

    That would be brilliant. Returning the Sahara to fertility would be a great benefit.

  • rate this
    0

    Comment number 869.

    "Urgent action", no solution "quick"

    2.5m 'unemployed'
    More 'inactive'
    Millions early 'retired'

    In war they served (paid ready) who only waited
    Now we overload some - with work & pay
    Relegate even young - idle ruin

    Not even allowed to consider solution
    All secure, all available for work
    Front-line stronger
    With backup
    And, in 'idle moments', studying, debating, improving

    Call it democracy

  • Comment number 868.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +1

    Comment number 867.

    860.Sally

    Rodders AKA Dave doesn't speak for me. I think at least one of my posts was without a doubt a personal attack and I apologise for it. If any others were construed as such, no offence was meant.

  • rate this
    0

    Comment number 866.

    863.Rodders
    I yield, the error was mine.
    I felt under attack, I apologise if I chided u.
    G/night

    859.DAVID
    despite its faults it works and most people actually like it.
    =
    What about ever-longer waiting lists?


    Imagine how better... if X Y Z were run for the public good and not private profit.
    =
    If you put the government in charge of the Sahara, in 10 years there'd be a shortage of sand. ~Milton

  • rate this
    +2

    Comment number 865.

    60.Sally
    7 Minutes ago


    855.CURTAINS 2012
    I told you: none, well not a lot. But those names wanted the knowledge. I don't know how it has anything to do specifically with A&E. But they had a taste for an esoteric point...

    +++

    So, why did you write earlier that non-payment of a medical bill would lead to a criminal record?

  • rate this
    +2

    Comment number 864.

    859.DAVID MOYES

    Well said, David.

    We'd be able to afford the energy bills, for a start.

  • rate this
    +2

    Comment number 863.

    860.
    Sally

    throughout all of you attacking me all night.
    ___

    We weren't "attacking", just "questioning".

    Not too keen on you inferring attacks etc regarding what we posted, though tone does not come across (you would've heard disbelief more than anything).

    Anyway, have a good night.

  • rate this
    +2

    Comment number 862.

    I work in Primary Care. I have seen all the numbers and have reviewed case studies. The problem is not about A&E or GPs - the fundamental problem is irresponsible or stupid people clogging the system up with demands. people with real clinical need have to fight for access past these hordes of people who really need reducating about their responsibilities.

  • rate this
    +5

    Comment number 861.

    841.Camfan
    32 Minutes ago
    due to the amount of non UK people attending with their young children/babies, who "took priority". The system is exploited & this requires seriously addressing.

    +++

    The clue to their being prioritised is their age not ethnicity.

  • rate this
    +1

    Comment number 860.

    857.Rodders
    AH, you are right @668! I meant "civil" record. I got conflated with my correct response of "criminal" record @686 throughout all of you attacking me all night.

    855.CURTAINS 2012
    I told you: none, well not a lot. But those names wanted the knowledge. I don't know how it has anything to do specifically with A&E. But they had a taste for an esoteric point...

  • Comment number 859.

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

  • rate this
    +4

    Comment number 858.

    Ethnicity is not even taken for records until AFTER prioritisations have already been reached through symptomatic assessment. Anyone claiming that someone gets 'priority' for being non-white, or non-British, is only proving they know NOTHING about how the NHS works or the triage process. FYI, I carry out triage assessments for the NHS. Ethnicity is taken AFTER prioritisation is reached.

  • rate this
    0

    Comment number 857.

    854.
    Sally

    668. Rodders... (start of it)
    ___

    I think you'll find that (642.Sally) was the start, that being the "accident described earlier" to which I was referring in 668.

    The NHS staff do the best they can under extreme pressure. Pressured by both the public overuse of A&E and the political whims of the day.

    Both judge by different standards: the public by quality, the politicos by finance.

 

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