Fundamental mismatch between the demand for emergency services and the resources available

03 November 2016

The health committee has published a new report, Winter pressure in accident and emergency departments.

The report says that the declining level of performance in A&E is a marker of stress across the whole health and social care system, adding that performance standards are not just a 'canary in the mine' for system-wide pressures, they matter because long waits in A&E affect patient safety and patients' experience of care. 

Traditionally, waiting times in A&E increased in the winter, but that pattern no longer applies. For many hospitals demand pressures are high year-round, and hospitals are finding it increasingly difficult to maintain the flow of patients out of the emergency departments into wards and on to safe discharge.

The health committee calls on the government to ensure that sufficient funding is available to support the infrastructure required, and to review the real terms cuts to NHS capital budgets in the spending review.

NHS Providers welcomes the health committee's assessment of the scale of the challenge facing A&E departments.

Director of policy and strategy, Saffron Cordery, said:

“Emergency departments up and down the country are under significant pressure. They are struggling to cope with rising demand and to recruit and retain staff. There is now a fundamental mismatch between the demand for emergency services and the resources available, and until this is addressed even the most efficient hospitals will struggle to cope with this increasing pressure.

“Delayed transfers of care are having a big impact on emergency departments. We know that the lack of appropriate social care in many areas of the country is making it much harder for hospitals to discharge those patients that are medically fit to leave. Hospitals are already working hard to prepare for winter to make sure they provide the best possible care to patients. This includes working with partners in social care and other parts of the public sector. However there are wider issues that need to be tackled to deal with the current pressures. 

There is now a fundamental mismatch between the demand for emergency services and the resources available, and until this is addressed even the most efficient hospitals will struggle to cope with this increasing pressure

“High up this list is the need to address social care. We endorse the health committee’s recommendation that the government undertake an urgent review of the state of adult social care and its impact upon the NHS. We also share their view that the government should provide additional funding to increase adult social care capacity.”

In the health committee report, MPs highlight the need to address underfunding of adult social care to tackle avoidable admissions and delayed discharge from hospital. They point out that emergency departments do not exist in isolation and require investment in other services that can ease the pressures. They also emphasise the need for additional infrastructure to ensure major emergency departments are “fit for purpose”, and they call on the government to review cuts to NHS capital budgets."

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