The NHS has launched a plan to support its overloaded A&E services, with the formation of ‘urgent care boards’ able to invest in emergency care.
NHS England will work with the NHS Trust Development Authority and Monitor to address the problem of increasing A&E waiting times.
One priority is for hospitals to bring forward their planning for next winter to ensure that seasonal urgent care needs are under control.
The growing pressure on A&E services is due to increasing demand – four million more people in England are using these services than in 2004 – combined with the budget cuts of the ‘Nicholson challenge’.
Health Secretary Jeremy Hunt angered the BMA by blaming the increased A&E attendance figures on lack of GP access, but it is beyond doubt that many people use A&E to bypass primary care and referral barriers.
The NHS support plan therefore aims not only to help maintain A&E capacity, but to relieve the pressure on emergency care through GP and outpatient care.
At the same time, the increasing number of people attending A&E who require urgent hospital care points to a need to improve not just access to care, but the quality of care outside hospital.
While 90% of patients in A&E are seen within four hours, the average waiting time is increasing. The support plan notes: “Long waiting times in A&E not only deliver poor quality in terms of patient experience, they also compromise patient safety and reduce clinical effectiveness.”
The urgent care boards will bring together healthcare leaders from across the local NHS. By the end of May, these boards will ensure that local recovery and improvement plans are in place for each A&E department.
NHS England will ensure that extra money is made available: the urgent care boards will oversee the use of the fees paid for emergency admissions, and ensure that expenditure achieves specific improvements.
Professor Keith Willett, NHS England’s National Director for Acute Episodes of Care, commented: “When pressure builds across the health and social care system, the symptoms are usually found in the A&E department.”