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Doctors demand end to A&E game-playing

Crisis needs serious debate on long-term solutions, not sticking-plaster policies and bail-outs

Louise Prime

Thursday, 26 March 2015

Politicians must avoid the mistakes of the past that have left accident and emergency departments across the country “bursting at the seams” as they attempt to tackle winter pressures, doctors’ leaders have demanded. Following new revelations of yet worse breaches of waiting time targets during one of A&E’s “worst winters on record”, the BMA has called for an open and honest public debate to find real solutions to the problem, with its No More Games campaign.

The BMA’s latest quarterly Omnibus Survey has revealed a huge increase in pressures on patient care. When they asked doctors “Has the hospital or practice where you normally work been directly impacted by any of the following in the last three months?”, they found:

  • increased waiting times for patients: 64.7% (18 percentage points higher than for the same period last year)
  • breaches in A&E targets: 47.4%
  • major service reconfiguration: 33.6%
  • black alert implemented (patients being turned away because the hospital reached capacity): 28.9% (22 percentage points higher than at the same time last year).

The BMA accused politicians of responding to the A&E crisis with a series of headline-grabbing initiatives and sticking plaster policies to simply bail out A&E departments, when what is really needed is development of a long-term, sustainable solution.

It pointed out that the £500m bailout the government announced in August 2013 wasn’t new money, but taken from the Department of Health’s ‘own efficiency savings’; it said that even David Cameron conceded that this was a short-term fix, and that more needed to be done to improve the NHS. Then as the government confirmed in November 2013 that it was injecting £250m for that winter, the health secretary said: “This is a serious, long-term problem, which needs fundamental changes to equip our A&Es for the future.” Finally, in November 2014 the government announced £300m worth of emergency funding for winter pressures, on top of £400m announced during the summer – but a recent report from the Royal College of Emergency Medicine found that less than one per cent of this money actually went to front line A&E services.

The BMA is demanding that all politicians stop playing games with A&E departments, and that ahead of winter 2015, and beyond, they commit to an open and honest public debate to find real solutions to the problem.

BMA Council chair Dr Mark Porter commented: “The pressure on A&E is increasing every year yet politicians have so far failed to take the decisive action needed to put in place a sustainable, long-term plan. The result is an NHS that lurches from one winter crisis to another, which aims to simply manage rather than prevent a crisis, to the detriment of patient care.

“Rather than annual emergency bailouts that are designed more to chase headlines than offer a lasting solution to the crisis, we need a long-term plan to equip hospitals with the funding, staff and resources they need to meet rising demand.

“It is also concerning that … only a small amount – one per cent – of the £700m announced by the Government for emergency care last year was actually spent on emergency department services. With a majority of hospitals in the red, this money is being used to plug other serious funding gaps and doesn’t make it anywhere near the frontline.”

He insisted: “Sticking plaster solutions won’t solve the long-term challenges faced by A&E. The time has come for the politicians to stop playing games with emergency care and commit to having an open and honest public debate about the future of the NHS.”

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