NHS winter pressures: Chair agrees with call for review
27 January 2017
Health Committee Chair, Dr Sarah Wollaston MP, has commented on NHS Providers' call for a review of how the NHS manages winter pressures.
Review of measures implemented
Dr Sarah Wollaston, Chair of the House of Commons Health Committee, said:
"The Health Committee undertook an inquiry into winter pressures in accident and emergency departments last autumn, focusing on the management, organisation and resourcing of emergency departments. We published our report (PDF 655KB) in November.
Bearing in mind the conclusions of our inquiry, and given the pressure that all parts of the NHS have to face, I agree with NHS Providers that a review of how the urgent and emergency care system has dealt with winter pressure is necessary. NHS England and NHS Improvement should review the measures that have been implemented and assess whether they helped to reduce demand and improve the flow of patients through hospital.
Four hour A&E target
Some hospitals have been in a better position to cope with the demands placed on them through improving their systems to stream patients and to identify those that are likely to require admission. The most efficient hospitals have a culture of regarding the four hour A&E target as a matter of patient safety as opposed to a bureaucratic necessity.
In our report examining Winter Pressure in Accident and Emergency Departments the Health Committee addressed most of the issues that NHS Providers wish to see reviewed. We made a range of recommendations which witnesses told us could be implemented to improve the performance of A&E departments, including increasing the capacity of social care.
The ongoing crisis in social care is undermining the ability of hospitals to respond to winter pressures. We also recognise the importance of community rehabilitation and intermediate care beds in helping to relieve the pressure on acute hospitals."
Cancellation of elective operations
NHS Providers has called for a review of the cancellation of elective operations as a means to free up capacity for patients admitted as emergencies during the winter period.
Commenting on this Dr Wollaston said:
"When we examined the measures being put in place to cope with winter pressures the Health Committee warned that cancelling elective operations meant delaying and denying patient care. Any review of measures designed to cope with winter pressures should analyse the impact of this measure and examine whether patients who had operations cancelled actually ended up seeking care in A&E departments."
Challenges facing the ambulance service
NHS Providers' call for a review highlighted the challenges facing the ambulance service, particularly in relation to handover delays outside A&E departments. This was a key feature of the Health Committee's November report. Dr Wollaston said:
"The Health Committee was extremely concerned about reports of ambulance crews being tied up for hours outside hospitals and the impact handover delays have on the ability of paramedics to respond to emergencies. Government targets mean ambulance providers are often forced to prioritise time over clinical need, which is not in the interests of patients.
National targets should be reviewed to allow more flexibility in the way emergencies are responded to, but acute trusts must also take responsibility for putting in place measures to make sure that ambulances are not tied up outside hospital. The variation between hospitals on this is unacceptable."
Further information
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