A&E crisis plans 'not good enough', MPs say

Patients waiting to see a doctor Pressures have been growing on A&E units for a number of years

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Plans put in place to relieve the pressure on A&E units in England are not good enough, MPs have warned.

The Health Select Committee said it had been given "confusing" and "contradictory" information about what was being done.

It prompted the cross-party group to question how prepared the NHS would be for next winter.

NHS England said it was considering various measures to take pressure off A&E units ahead of the cold season.

The MPs said staffing issues and rising attendances were among the main causes of the problems.

Their evidence found just 17% of hospitals had the recommended level of consultant cover, while difficulties with discharging patients and a lack of beds at times meant the flow of patients through the system was disrupted.

The report comes after the NHS missed its four-hour waiting-time target in the first three months of this year.

'Flying blind'

In the long-term, the MPs urged NHS England's medical director Prof Sir Bruce Keogh, who is leading a review of urgent and emergency care, to look at the weaknesses across the rest of the health service.

They said there was much more the primary care system, which includes GPs, urgent care centres and minor injury units, could do to prevent unnecessary visits to A&E.

The MPs also suggested ambulances could treat more patients at the scene to reduce the number of transfers to hospital, while the new 111 non-emergency phone number needed to get better at offering advice.

The A&E crisis

  • The four-hour waiting time target was missed across the NHS from January to March - the first overall breach for nine years
  • In total 94 out of 148 providers missed the mark
  • More than 300,000 patients waited longer than they should have - a 39% rise on the previous year
  • Only 17% of trusts could guarantee the recommended level of consultant cover
  • The new 111 non-emergency phone number was not yet offering "timely and effective" advice

Earlier this year NHS England announced urgent care boards would be created to form action plans and release money to combat the difficulties being faced.

But in the evidence sessions with senior people in the health service, the MPs were left unclear whether they were voluntary or compulsory, temporary or permanent.

The MPs also highlighted differences in data they had been given about the scale of the problems, with vastly different impressions given of delayed discharges from hospital and the increases seen in attendances at A&E.

Committee chairman Stephen Dorrell said: "The system is 'flying blind' without adequate information about the nature of the demand being placed upon it."

He said all parts of the NHS - including social care, GPs, ambulance trusts and the 111 phone line - needed to have a plan place by the end of September to ensure they were ready for the winter peak.

"The committee is mindful of pressures which will build and is concerned that current plans lack sufficient urgency," he said.

Labour's shadow health secretary Andy Burnham said A&E departments were "routinely working below safe levels" because of inadequate staffing.

He said almost 5,000 nursing posts had been cut since the 2010 election and accused the government of taking "unacceptable risks with patient care".

"[David] Cameron must act on this report without delay if this coming winter is not to turn out even worse than the last," he said.

Patients Association chief executive Katherine Murphy said: "How much more evidence does the government and NHS England need before they take notice?

"The system is under increasing pressure and is coming apart at the seams. The time to act is now."

Find out more

Listen to File on 4's report into how hospital finances are adding to the A&E crisis.

NHS: Pricing Patients was broadcast Tuesday, 2 July on BBC Radio 4

An NHS England spokesman said it recognised there was work to be done and action plans would be in place by the autumn.

"The committee has raised some key issues," he added.

Dame Barbara Hakin, deputy chief executive of NHS England, said the organisation was "looking at a range of things that will take the pressure off our A&E departments", including supporting more patients at home and making sure people are discharged from hospital as soon as they are ready.

She said experts from across the health service were discussing how to improve care, especially for the growing number of elderly patients, in time for the winter.


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  • rate this

    Comment number 280.


    I had forgotten you claim to be an accountant I do apologize. Your alleged clients dodge between 70-120bn in UK tax every year, more than enough to properly fund the A+E and the NHS.


    Drunks are easy to deal with, especially the toff types, charge them the full cost of A+E treatment. There is nothing complicated or political about common sense.

  • rate this

    Comment number 279.

    i believe some of these changes were authorised on your 'watch' i too remember a time when you had a doctor (being taken to dr whitaker's at 4am because i had a boil on my arse) who was with you for the length of his career. re my first comment about economic reality. quality, quantity or cost. economic frailty dictates that free market capitalism favours the strong not the weak. x

  • rate this

    Comment number 278.

    If you spend 4 hours waiting in A&E and don't die then you didn't need to be there. Good rule of thumb.

  • rate this

    Comment number 277.

    Given that you can't even get basic antibiotic cream over the counter in this country for basic infected cuts and that everyone who looked at it here said "Oh, it looks fine" despite going into sepsis, I can't imagine the health care in this country is better than that of the Dark Ages. I had more hope for National Health - but you prefer killing people over making it actually work.

  • rate this

    Comment number 276.

    weareallwrong - GPs all offer the same surgery times give or take. You have to remember in this consumerist society that this is a free at the point of need service.

  • rate this

    Comment number 275.

    The Government's policy is clear; run the NHS into the ground so that it can be sold off to private companies looking to save the health service by making fat profits, closing wards and sacking nurses to be replaced by healthcare assistants.

    Sadly, our people are more interested in a baby's name than with the critical condition of the NHS.

  • rate this

    Comment number 274.

    I'm disappointed that there is no mention in Nick Triggle's article about the responsibility of patients to use A+E appropriately. They don't. There is much talk of entitlement without mention of responsibility, this needs to change!!

  • rate this

    Comment number 273.

    I agree with many of the comments here, Dave and his cronies are running the NHS into the ground, so that they can privatise and sell to a foreign company!

    Why does the BBC site have an American English spell checker?

  • rate this

    Comment number 272.

    What will happen in few years time when middle classes and employed are charged a small top up fee . . say £20 to see their doctor, £40 if urgent

    Will those folk be happy paying higher taxes to cover the unemployed who aren't paying the unnecessary and divisive charge ? Will they be happy with the inevitable situation of immigrants not having to pay under EU law ?

    Can't wait for this one !

  • rate this

    Comment number 271.

    All you labour idiots, all the public is interested in is good service when the english public need it, how they do it is up to the government. The problem with labour to interested in unions and union members than a good service.

  • rate this

    Comment number 270.

    Oxygen tents have a habit of causing explosions and other accidentals.
    It gets a person high and there is often abuse of O2.
    It is dangerous in case of fires - exploding cylinders - so are kept to a minimum number.

    If tissue heals too quickly it tends to leave a reddened area of skin.
    This is unsightly and patients would rather go the long route for aesthete purposes

  • rate this

    Comment number 269.

    Tory gross negligence in preparation for privatisation of OUR NHS.

    Never EVER trust the Tories.

  • rate this

    Comment number 268.


    Slippery slope. Are you prepared to be the person who decides which of us is 'worthy' of treatment or not? If so, then there should be a rule that says you must deliver your 'judgement' at the A&E centre and face-to-face with those you turn away. Good luck!

  • rate this

    Comment number 267.

    Just make your mind up is the NHS more important than EU Membership, Porn, Cigarette packaging, Packed Lunches, HS2, the Olympics or any other of this week's vital issues.

    Then Vote as your Conscience dictates.

    Or zone out and try to guess what Cambridge (the Royal Baby) is going to be called, and Vote for the same shower you always vote for.

  • rate this

    Comment number 266.

    Don't kid yourself that there is a shortage of GPS. I work in this field and 5 years ago the ratio was 7drs applying for GP speciality training compared to 1 who wanted to work in a hospital. This ratio is now far higher. I'm lucky if 1 from my 75 wants to work in hospital. That's what both Labour & the current lot have created. If GP does hospital work OOH you will pay dizzying locum rates.

  • rate this

    Comment number 265.

    Are these the same mp's that are voting for cuts, or a different lot of mps.

  • rate this

    Comment number 264.


    Those who have contributed nothing can go to the back of the queue and think about it"

    I totally agree"

    I knew if I was patient enough you'd begin to see that I'm right about such issues

    With my clients paying hundreds of thousands in tax/NIC and even my own lowly contribution of c£30k last year, you'll be pleased to hear we'd be right at the head of the queue

  • rate this

    Comment number 263.


    You should not be calling an Ambulance because it might be URGENT, an Ambulance should be called in an EMERGENCY.

  • rate this

    Comment number 262.

    Its Labours fault and the Unions.
    Its a terrible service now. Dont get ill !

  • rate this

    Comment number 261.

    BBC - "A&E crisis plans 'not good enough', MPs say"

    How ironic since it's MPs or rather the government which is reducing funding and generally running down the NHS ahead of privatisation.


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