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A&E could collapse without change, warn doctors and managers

A&E units could collapse in the not-so-distant future unless urgent changes are made to the way they are run, doctors and managers have warned.

Amid growing fears that the NHS will not be able to cope with rising demand, both the College of Emergency Medicine and Foundation Trust Network have put forward proposals to overhaul the system.

Funding, staffing and better non-emergency services have been all highlighted as key issues, with ministers and the NHS regulator recently admitting the problems were a cause for concern.

A&E attendances have risen by 50% in a decade, with growing pressure across the whole of the UK.

This winter, for example, the NHS in England started missing its four-hour waiting time target, while reports have even emerged of hospitals setting up temporary waiting areas in car parks and storerooms to cope with queues.

Ambulances have even been forced to wait to drop off patients due to excessive demand.

The College of Emergency Medicine said the scale of the challenge facing the NHS and A&E was the biggest for a decade.

Its review - based on feedback from more than half the A&E units in the UK - revealed a shortage in both middle-grade and senior doctors. At present, the average consultant headcount for an A&E is 7.4 - well short of the recommended 10 to 16.

The college suggests locating urgent care centres beside emergency departments to help cut unnecessary attendances. It believes between 15% and 30% of patients do not need A&E care and instead could be treated in non-emergency settings.

Meanwhile, the Foundation Trust Network highlighted the funding system in England that penalises A&E units seeing a rise in patients.

Hospitals are only paid 30% of the normal fee for an emergency admission when the numbers rise above the levels that were seen in 2008-9. But with the NHS failing to curb the rise in patients, this rule is costing some hospitals millions of pounds a year.

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Readers' comments (5)

  • Hospitals are only paid 30% of the normal fee for an emergency admission when the numbers rise above the levels that were seen in 2008-9. But with the NHS failing to curb the rise in patients, this rule is costing some hospitals millions of pounds a year.

    Isn't this a nonsensical strategy when individual A&E departments don't have much say in who turns up on their doorstep.

    Maybe charging GPs the extra 70%, if it was deemed patients could have been seen by their local practice, would reduce the burden.

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  • what is the point of going to one if there is no certainty you will get properly cared for. nhs hospitals should dangerous and hostile places.

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  • people go to A&E because they don't think there is an alternative, it should not take days to see a GP.

    does anyone know how many people are admitted to hospital who do not need acute or emergency care?

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  • It's completely nonsensical and part of the ill-thought-out pattern of deleterious NHS "reforms".

    Also the 2004 GP contract needs radical amendment - and soon!!

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  • hey, do politicians suffer from ADD?

    next on the list of their reforms is the fire service (today's newspapers). Heaven help us. I would have thought it wiser and best for them to leave it well alone but they have done their bit for the NHS and for the elderly and are now moving on as they have their agenda! Whilst their main focus is on global affairs and the EU they have to be seen to consider domestic affairs in their attempt to pacify the public who are not as gullible as they would like to imagine.

    Hopefully they will not assign the fire service another Tel 111 type arrangement with advice on the type of fire and what to do about it before giving any emergency assistance as their services are over used getting frightened pussies out of trees and kids off roof tops and they have no more money.

    it seems when the government leaves office they will be leaving most of their jobs and especially those on the vital services in he UK half done!

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