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.’