Less than 1% of the £700m emergency care reached A&Es

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Nurses outside Chelsea & Westminster hospital during the last NHS pay strike on November 24th
Nurses outside Chelsea & Westminster hospital during the last NHS pay strike on November 24th

LESS than 1% of the £700m allocated by the government for emergency care in England this winter ended up directly in A&E departments, according to The Royal College of Emergency Medicine (RCEM).

The results of its research showed that the cash was not spent to improve emergency services, with some of it used to pay off trust debts.

In the Spring of 2014, four Medical Royal Colleges and many other organisations met to discuss how to make the urgent and emergency care system more resilient. Their report ‘Acute and emergency care – prescribing the remedy’ was published last June and was welcomed by the NHS Confederation and the Department of Health in England.

After the winter of 2014/15, in which there was unanimous recognition of unprecedented pressures, the Royal College of Emergency Medicine surveyed the doctors in charge of Emergency Departments in all four nations of the UK.

The Royal College of Emergency Medicine yesterday announced the results of this survey revealing just how much needs to be done to address the challenges facing Emergency Departments (A&Es).

The survey of clinical leaders in Emergency Medicine across the UK was responded to by 142 clinical leaders in January 2015. It therefore represents almost two thirds of the UK Emergency Departments.

The report says, ‘The findings of this survey have informed the follow-up report “Ignoring the Prescription”. This report highlights that although there are examples of full implementation of all of the original recommendations, the implementation is inconsistent and in most cases most systems have not implemented most of the recommendations.

‘In addition, we surveyed the department leads in England to ascertain what proportion of the £700 million allocated by the government was spent on staff or other resources in their emergency departments. The reported figure is a staggering one per cent!

‘The College concludes that a combination of failure to implement consensus recommendations coupled with the failure to invest allocated monies in front-line services has led to extraordinary winter pressures which were largely avoidable.

‘These results present a stark picture of what still needs to be done to implement the findings of the Prescribing the Remedy report issued last year. When the report was issued we knew that the solutions would take time to implement, but the scale of the gap is worrying.’

Dr Clifford Mann, President of the College said: ‘Throughout the past 18 months we have been working closely with the Department of Health on the challenges facing A&Es over the winter months. It is so disappointing that our survey shows that the significant investment the government made to tackle the winter pressures has not reached the A&Es it was supposed to help.

‘This report is an indictment of current decision-making and investment in acute and emergency care. Patients and frontline staff deserve better and will be incredulous at the failure to adopt best practice and squander money on admission avoidance schemes that have self-evidently failed. This report should act as a catalyst to ensure the same mistakes are not made in 2015.

‘In future it would make much more sense to release funding directly to hospitals for investment in A&Es. Rather than make this an annual winter crisis ritual, long-term funding should be targeted on A&Es which will enable Emergency Medicine Clinical Directors to make lasting improvements in patient care.’