Bailout for A&E units only 'papering cracks' say doctors

David Cameron: "The money doesn't go with no strings attached"

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A £500m government bailout for struggling accident and emergency units in England is merely "papering the cracks", doctors have said.

The British Medical Association said it was a sign that austerity had failed.

Prime Minister David Cameron accepted it was a "short-term measure" and that more needed to be done to improve A&E.

The money - which will come from existing budgets - will be deployed in A&E units and linked community services, such as pharmacies.

It comes after MPs said "confusing" and "contradictory" information relating to NHS crisis plans raised questions about whether the service would be in a position to cope better next winter.

'Disingenuous and demoralising'

The problems in A&E units have stabilised in the past few months, but from January to March the NHS - which has an annual budget of more than £100bn in England - missed its four-hour waiting time target as long waits hit their highest level for nine years.

More than 300,000 patients waited longer than they should have - a 39% rise on the previous year.

A&E unit case study

Portsmouth's Queen Alexandra Hospital has tried to be proactive in dealing with demands in its A&E department.

Since last year it has set aside space in the unit to try and triage the elderly patients who arrive needing help.

The community assessment lounge - as it is known - is open from 9am to 9pm.

The aim of staff working there is to see if patients need alternative help rather than a hospital bed.

About half of the people they see manage to avoid admission, freeing up resources in A&E.

But - in a sign of how great the pressures have been - the hospital has still struggled.

Like many of the busiest units, it missed the four-hour target for much of the period.

At times, twice as many patients waited longer than they should.

A combination of the cold weather, staff shortages and an increasingly ageing population meant demand was high.

The prime minister told BBC Breakfast: "Compared with three years ago, a million extra people are visiting A&E."

"The money helps in the short term," he also said.

"But in the longer term what we've got to do is get our hospitals working better with GP surgeries and also get our hospitals working better with social care departments so that the frail elderly - who are often the ones who are going in and out of A&E - are better cared for in the community."

The Department of Health said the £500m would be sourced from its own efficiency savings programme.

It will be focused only on the minority of A&E units which have the worst problems.

Dr Clifford Mann, president of the College of Emergency Medicine, told BBC Radio 4's Today programme he had "real concerns" about how the money would be allocated.

"It seems disingenuous, and in many ways demoralising to those that managed to apparently perform satisfactorily, to understand or realise that they will benefit from this not at all," he said.

Labour's Lord Hunt cautiously welcomed the move, but warned the money could be too little too late

But the deputy chief executive of NHS England, Dame Barbara Hakin, defended the plans, saying the cash would benefit the hospitals facing most pressure this winter.

"Our good hospitals deliver a great service all the time but there are some that we know need some help to get them through this winter so that we can make the longer-term changes."

'Very welcome'

Earlier Dr Mann had cast doubt over the impact it would have, saying: "It is a short-term fix. It does not address the underlying cause - we have a shortage of doctors."

A spokesman for the British Medical Association (BMA) said it was right that the government was listening to the concerns of doctors and patients but added: "At a time when they are demanding cuts of £20bn across the NHS, this is nothing more than papering over the cracks.

Liberal Democrat MP Andrew George: "The question is where would it be spent?"

"It is recognition that their austerity programme has hospitals facing ever increasing demands with diminishing resources."

Labour's shadow health minister Jamie Reed said: "David Cameron's A&E crisis is a symptom of wider problems in the NHS and care system, which this announcement will not address."

Liberal Democrat MP Andrew George, a member of the Health Select Committee, said the money was "very welcome", but the government had to ensure it was "put to best use" and "distributed fairly".

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