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A&E demand is 'out of control', warns chair of Care Quality Commission


Demand on NHS accident and emergency departments is “out of control” and “totally unsustainable”, the head of the health and social care regulator has warned.

David Prior, chair of the Care Quality Commission, said there should be widespread closures of hospital beds and investment in community care to tackle the increasing burden on emergency care.

Mr Prior said that far too many patients were arriving at hospital as emergency cases, a crisis which could be averted by earlier intervention through care in the community.

This has put such pressure on the health care system that it is at the brink of collapse, he said, meaning regulators cannot guarantee that there will never be another care disaster such as that in Mid Staffordshire, the Daily Telegraph said.

Speaking a conference hosted by health think tank the King’s Fund, Mr Prior said: “If we don’t start closing acute beds, the system is going to fall over.

“Emergency admissions through Accident and Emergency are out of control in large parts of the country… That is totally unsustainable.”

Mr Prior, who was brought in to lead the CQC in January after it faced criticism for failing to protect vulnerable patients, said that almost half of hospitals were now providing care which was either poor, or “not terribly” good.

He said the CQC had found 45 hospitals with problems dating back five years, and vowed that from now on regulators will take a “much clearer” approach in advising which hospitals should not be allowed to continue as they are.

“We will be outside the system and the politics - we will have a huge role in the reconfiguration debate because we are independent,” he said.

Mr Prior partly blamed the problem on a lack of market in health care, thus leaving patients with little choice but their local hospital, regardless of its quality.

He said: “The patient or resident is the weakest voice in the system. It is a classic market failure - the user doesn’t know nearly as much as the professionals, even with the internet.”

Mr Prior said it was unlikely the CQC could give a “cast-iron guarantee” that it would be able to prevent future healthcare scandals such as Mid Staffs.

He also criticised a decision by the previous government to allow family doctors to opt out of out-of-hours care, saying the decision had let patients down.

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Readers' comments (42)

  • the entire nhs is unsustainable, not just A&E departments - this has a knock-on effect, where do people think patients go?

    every ward I work on is so busy and understaffed, staff are at breaking point and no-one cares, it's relentless day in day out trying to do your best under the most stressful conditions.

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  • Cuts in LA funding, constant chasing our tales to prove delivery of targets, savings through QIPP, destroyed morale, lowering of basic care standards, lack of training......all compound the situation in general.
    When will this change? When will we be allowed to get back to basics and care for patients?
    Stop "measuring" and allow everyone to get on with the job of delivering and improving the NHS!!

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  • there seems to be a surprising amount reported in the press about weaknesses in the system since time immemorial. we can all make these observations but the question is what power do those in positions of authority have to effectuate any meaningful change to enhance the safety and quality of care to all of those entrusted to the healthcare system. when are we going to notice any improvements are being made?

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  • what did you all expect with the tories in charge of the nhs????

    in just 3 years they have destroyed it, privatised it and it will get a whole lot worse

    but eh this is probably part of their master it down then bring the private companies....i wonder if all them peers, lords etc who voted in this bill have any intrests in private medical companies...i just wonder..mmmm

    roll on the general election and get these eton toff boys out

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  • please stop blaming and insulting the tories. everybody has their weaknesses and just as many insults could be leveled at any other group. just get on and look at the principles of general management and their proven unsuitability to patient care and return to more appropriate clinical management models which actually impact on meeting healthcare needs and ensuring patient safety.

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  • michael stone

    I suspect that letting GPs avoid OOH responsibilities could have played a major part, here.

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  • The problem is multi-factorial.

    Lack of OOH GP services, increasing numbers of elderly chronically sick people and massive population increases associated with immigration.

    Couple these factors with the difficulties associated with the recruitment of A&E medical staff the assault on RGN staffing levels and the continuing reduction of acute beds it is not surprising that the service is in crisis.

    The responsibility for this dire state of affairs rests with "Management", The "Managers" are happy playing with spread sheets and are resolutely opposed to listening to health care professionals who have been warning of impending disaster for a long time.

    However in the wonderful NHS no "Senior" employees are accountable for the mess they create. Accountability is for the plebs - nurses !

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  • Anonymous | 9-May-2013 12:22 pm

    "please stop blaming and insulting the tories"

    Aw boo hoo! The top down, expensive, bitterly opposed by clinicians reorganisation of the NHS, which we were promised BY the Tories would NOT happen, is nothing to do with them, guv?!

    I think that Anonymous | 9-May-2013 12:12 pm shows admirable restraint.

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  • re-anon 12.22pm

    hi david cameron/hunt/lansley

    get real the tories have destroyed our nhs
    the quicker they go the better and then we can start to rebuild the service

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  • Yes, widespread closures of beds is just what we need...

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