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Independents' Day

NHS England announces plan to tackle A&E waiting times

NHS England has told its local area teams to prepare a plan by the end of the month to tackle waiting times in A&E departments, including how primary care and other services can ease the rising pressure on emergency services.

NHS chiefs also said today that they will publish a plan over the next week about how they will support local commissioners and when they will intervene if a CCG is failing to control demand for urgent care services.

The move comes after a political row over waiting times at A&E departments, with Jeremy Hunt blaming ‘poor primary care provision’ for a rise in A&E attendances since the 2004 GP contract allowed GPs to opt out of out-of-hours care provision.

Earlier this month, the Labour Party published figures that showed the NHS had missed the national four-hour A&E wait target every week for six months.

At a board meeting today, NHS England interim chief operating officer Dame Barbara Hakin said she will ask local area teams to work with CCGs and local government to put together a full plan for how urgent care should be managed in their local area to reduce waiting times for patients in A&E, involving primary care as well as NHS 111 services.

She said: ‘I will be asking our area team directors to take responsibility for a plan for their local area… and to put together a full plan by the end of the month.’

‘They will take repsonsibility to make sure patients don’t wait an unreasonable time.’

NHS England chief executive Sir David Nicholson said NHS England will also launch two ‘interventions’ to ensure continued good care for patients locally next week.

One will be the ‘whole systems plans’ for urgent care, while the other will outline how NHS England will work to ‘develop and support’ CCGs as well as when it is approporate for NHS England to intervene to ensure patients receive good care locally.

He said : ‘We know there are real pressures on social care, primary care, hospitals… We have been working to support A&E services and in the last week we have seen some improvement to services but this is a whole systems issue.’

He said: ‘We will next week publish two interventions. The whole system plans that we expect to be put together… so that we can begin to see improvements. This is a very important intervention. We will also publish [a plan for] how to develop and support CCGs, and how to intervene when it is appropriate.’

The board meeting also saw NHS England approving its future plan for NHS 111, which will include an external review to learn lessons from the failings of the rollout as well as as an internal look at how the service should be taken forward including whether it has ‘got the scope right’ and if there is ‘a good balance’ between clinical and non-clinical call handling.

Dame Barbara said: ‘NHS 111 services have been undeniably unacceptable in some places but it is really important that we remember that in most places it has worked very well.’

She added: ‘Our ambition continues to be that over the next few months we will have 111 available everywhere.’

But the RCGP has called today for better support for NHS 111 to help it properly direct patients to the most appropriate form of care.

RCGP chair Dr Clare Gerada said: ‘It is extremely worrying that there is still so much uncertainty around the delivery and reliability of the advice provided by NHS 111 in some areas.

‘We are also concerned that patients are losing confidence in the new service before it is even fully up and running. We call on NHS England to provide more reassurance about its effectiveness and ability to deliver the necessary standards of care for all patients using the service, right across England.’


Readers' comments (9)

  • Well that didnt take long. I thought it would be a little further into the summer before the centre started issuing diktats to CCG's

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  • Harry Longman

    This plan is the wrong plan. Waiting times have gone up because demand has gone up. What they need to do is understand demand, not beat people up over waiting times.

    I've wasted so much time and train fares going to the DH to show them the evidence on the link between A&E and rapid access to your own GP. Sigh.

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  • I'm only visiting the UK, and today my wife used the NHS 111 number (an allergic reaction to an insect bite. Plenty of facial swelling, but no anaphylaxis, chlorphenamine maleate taken, but I feel she could use a script for prednisone). An hour on and she patiently awaits a return call. Amazing bureaucracy for this observer. One wonders if it's time to think outside the square and consider the structure and philosophical basis of the sacrosanct NHS. Are the days of a fully socialised health care gone? One would never want the inequity and imbalance of the system. But perhaps something closer to the half-way mark of either the Australian or New Zealand system (minimal fee for service, bulk billing) where GP access is direct and more efficient is worth considering?

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  • Why the hell can't people see that it is the 4 hour target that is fuelling the demand?

    A recent experience is as follows:

    Dad calls the practice at 11.30 about his kid who sounded like he had nothing more than allergic conjunctivitis. I returned the call at midday and offered an appointment for 4pm. Dad was not happy with the 4 hour wait and said he will go to the eye casualty. The A/E letter in his notes states he presented at 1.30pm and was seen at 2.20pm!

    You cannot have continuity of care and walk in centre mentality within the same practice. The great British Public need to decide what they want and then be prepared to pay for it.

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  • So much for assumed liberty then NHS England!

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  • Everything that needs to be said has already been said.Doesn't matter what topic it is the same few points are raised time after time again.Amongst them:


    It can't get more simple than that!!

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  • I retained 24 hour responsibility and have a low A+E attendance rate compared with national figures. I bet I will still have pay withheld unless I agree to work longer than 12 hours per day and every weekend. Patients turning up inappropriately at A+E should be refused treatment and advised it is use your out-of-hours service provider or wait until your surgery is next open.

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  • Shaba Nabi is entirely correct, an audit of people offered my surgeries " we will see you today if its urgent" revealed that the public want instant access.
    The fundamental dichotomy of GP service is the commissioners want "value for money" with a full working day of health promotion and chronic disease management plus unlimited I scheduled "instant access" from the same GP.
    the name is not Dr Who , GPs cannot be two places at the same time.
    A workforce expansion and perhaps federated working to staff an unscheduled medically led primary care rapid response team on a rota basis like the hospital acute medical and surgical take system might help.

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  • Nhsfatcat

    When you try your best but you don't succeed
    When you get what you want but not what you need
    When you feel so tired but you can't sleep
    Stuck in reverse

    And the tears come streaming down your face
    When you lose something you can't replace
    When you love someone but it goes to waste
    Could it be worse?

    Line 1- Fulfilling the expectation
    Line 2- Access targets/ 4 hour waits
    Line 3- NHS workers stress levels
    Line 4- Government thinking on GP contract and A+E
    Line 5- NHS workers frustration
    Line 6- The NHS
    Line 7- Collegues and their professionalism
    Line 8- You bet- The Health Act and it's outcome

    Prophecy by Coldplay? The song is called, ironically, FIx You, not what the government is trying to do to us, our collegues and the NHS

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