‘Worse to come’ for casualty units next winter, poll claims

More than seven out of 10 trusts believe the accident and emergency system is at a “tipping point”, a poll for the Foundation Trust Network (FTN), representing more than 200 health trusts in England, finds today.

The survey of 100 FTN members showed six out of 10 expect the coming winter to be worse than the last. Most said increasing demand played a part in the pressures, with 42 per cent naming more seriously ill patients and 32 per cent blaming failures of primary and social care services.

Chris Hopson, FTN chief executive, said: “Our report is concrete evidence, highlighting the dangers facing the system unless each local health economy plans effectively for the coming winter.”

The warning comes after foundation trust regulator Monitor yesterday said there had been a sharp increase in casualty units failing the official Government target of seeing 95 per cent of patients within four hours.

It said 47 hospitals, 58 per cent of the total, had missed the target between January and March – up from 32 in the previous three months. At non-foundation trusts, 43 out of 61 A&E units missed the target (70 per cent).

Trusts blamed increases in the number and seriousness of A&E attendances, particularly among the elderly, discharge delays due to problems in community care and lack of capacity.

In some cases hospitals cancelled planned surgery to deal with increased A&E activity and high bed usage linked with emergency care led to problems with infection control. Extra contract and agency staff partly to deal with emergency care led to a £500m overspend on staff in 2012-13.

Stephen Hay, Monitor’s managing director of provider regulation, said: “We recognise that some of the causes and answers to this problem lie outside the control of individual organisations, particularly in primary care or social care.

“Trusts should therefore work with partners in their local health economy to tackle the issues affecting A&E but should use their own resources to fix those issues that are within the gift of hospitals in order to prevent further problems next winter.”