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Government pledges extra cash for stricken A&E departments

£500 million over next two years to shore up services for winter pressures

Caroline White

Thursday, 08 August 2013

The government has pledged an extra £500 million over the next two years for 50 stricken emergency care departments in England in a bid to shore them up for the added pressures they will face over the winter months.

The cash boost comes in the wake of a Health Select Committee report, published two weeks ago, which warned that many services would be unable to cope with demand this winter unless urgent action was taken.

More than one million extra people pitched up in A&E departments last year compared to three years ago, and last year’s harsh winter put exceptional pressure on urgent and emergency care wards. Between January and March this year, many services missed their four hour waiting target.

But doctors say that the money is simply papering over the cracks of the current crisis facing emergency care.

The government is conducting a review of emergency and urgent care services, the public consultation for which closes this Sunday. But its findings are not expected until the autumn.

The extra money will go to A&E departments identified as being under the most pressure and be targeted at pinch points in local services.

NHS England, Monitor, and the NHS Trust Development Authority (NTDA) are working with the local NHS to work out which departments stand to benefit the most from the cash.

Announcing the cash boost today, Prime Minister David Cameron said that while A&E departments were performing well this summer, he wanted the NHS to take action now to prepare for the coming winter.

“The additional funding will go to hospitals where the pressure will be greatest, with a focus on practical measures that relieve pinch points in local services. By acting now, we can ensure doctors, nurses, and NHS staff have the support they need and patients are not left facing excessive waits for treatment,” he said.

Hospitals have been working on proposals to improve their services, in a bid to drive down unnecessary visits to A&E and curb longer stays in urgent and emergency wards.

Some of the local initiatives proposed include:

  • Minimising A&E attendances and hospital admissions from care homes by appointing hospital specialists in charge of joining up services for the elderly
  • Seven day social work; increased hours at walk-in centres; increased intermediate care beds and extension to pharmacy services
  • Consultant reviews of all ambulance arrivals in A&E so that a senior level decision is taken on what care is needed at the earliest opportunity

Speaking on BBC Radio 4’s Today Programme this morning, Clifford Mann, President of the College of Emergency Medicine, said there was a real concern that the money would be spent on social and integrated care, which although important, wouldn’t “make much difference to A&E.”

He said the money was just a short-term fix and would not solve the underlying cause of the problems: too few emergency care doctors.

But health secretary Jeremy Hunt insisted that the extra money would give patients confidence that they can access safe and reliable emergency care quickly.

“We will do whatever it takes to make sure the best A&E care is there for every patient when they need it, and we’re backing our hard-working NHS staff with the resources they need to deliver this,” he said.

The Department of Health and NHS England are working on plans to relieve pressure on A&E in the longer term, he said. A £3.8 billion fund has been agreed which will focus on joining up services, so that health and care services work more closely together.

In addition, the troubled NHS 111 will get a £15 million cash injection to increase capacity and prepare the service for potential winter pressures.

Dame Barbara Hakin, Chief Operating Officer and Deputy Chief Executive of NHS England welcomed the announcement.

“We will continue to work with our colleagues at Monitor, the NHS Trust Development Authority and the Association of Directors of Adult Social Services to ensure money is targeted at areas where we believe it can best be used to improve services for patients and provide equity of access,” she said.

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