Planning for winter pressure in A&E departments
23 August 2016
Recent history has shown that during winter, although attendances decrease, admissions increase and measures of A&E performance deteriorate.
The committee will examine the issues from the perspective of a hospital trust which hosts a type 1 emergency department, with the aim of better understanding how some hospitals are able to ensure good performance by maintaining patient flow, while others struggle.
NHS Providers submitted written evidence to the committee, welcoming the focus on this topic area which as significant impact on how patients and the public experience emergency care.
The evidence highlights:
- Pressure on emergency departments is now year-round. Reasons include ongoing increases in patient demand, workforce shortages, the impact on the NHS of substantial social care cuts, dysfunctional funding and payment systems and a regulatory regime that blames individual NHS organisations for problems that are shared by the whole health and social care system.
- At the heart of A&E performance issues is the fundamental mismatch between the demand for emergency services and the funding made available for these services. Unless the imbalance is addressed, even the highest performing and forward-looking hospitals will be unable to cope with the increasing pressure on emergency care.
- The solution must involve: a new national strategy for urgent and emergency care that is focused on tackling the priority issues; national support for local areas to work together as a system to address issues driving up avoidable demand for A&E services; ensuring that frontline services receive the funds they need to maintain high levels of A&E performance for patients, including by ending the A&E financial penalties system, which does not benefit patients, the public or services.
The submission garnered extensive coverage in the Daily Telegraph, which highlighted NHS Providers' call for radical reform of the funding system to prevent services failing. The national tariff is unrealistic and ignores the fact that once patients are in hospital, their treatment needs to be paid for.
Siva Anandaciva, head of analysis, said:
"A&E departments up and down the country are being placed under increasing pressure each year. Demands for their services are increasing but hundreds of million of pounds in funding continues to be withheld from them.
"Ultimately, you get what you pay for and it is hard to see how we can maintain high levels of A&E performance for patients within the funding we have available."