Demand for A&E departments continues to rise

A Public Accounts Committee report warned demand for accident and emergency treatment was still rising despite walk-in clinics and NHS Direct.

It said while most hospitals were meeting the four-hour A&E wait target there were still bottlenecks in the system, especially for the elderly.

But the government said patients now found A&E was "better than ever".

Some 34,700 people attend A&E departments every day - 3% higher than a year ago.

The government has opened 63 walk-in treatment centres and set up health advice service NHS Direct to try to ease the burden on services such as A&E.

Target focus

But the MPs said some hospitals were still struggling to cope.

While more than 95% of NHS trusts had been judged to be meeting the four-hour waiting target for treatment, just 70 trusts - fewer than half - were achieving it every week.

Delays for beds and diagnostic tests, and staff shortages were the most common causes of delays.

The MPs' report warned an undue focus on the target could mean less attention was paid to ensuring patients received the proper treatment.

This mirrored the findings of a survey by the British Medical Association earlier this month.

This report starkly illustrates the pressure A&E departments face as a result of Labour's obsession with targets Andrew Lansley, Shadow health secretary

Committee chairman Edward Leigh said the government's emphasis on providing innovative emergency care was to be welcomed but had had little impact.

"These new services are not taking the pressure off traditional A&E services, the demand for which continues to grow.

"There has been intense effort by NHS trusts to meet the four-hour target and patient waiting times in general have been reduced.

"But the picture is less rosy than it seems. Shortages of specialist staff mean that key patient groups, such as older people and people with mental health problems, are still waiting the longest."

'Progress'

A British Medical Association spokeswoman said A&E staff were "working flat-out to cope with more patients, increased expectations and constant government targets".

She said more doctors and nurses were needed to help cope with this workload.

Shadow Health Secretary Andrew Lansley said: "This report starkly illustrates the pressure A&E departments face as a result of Labour's obsession with targets."

And Liberal Democrat health spokesman Paul Burstow admitted improvements had been made, but added there was still a "huge amount" to be done to tackle staff shortages.

It was also important to ensure increases in services like NHS Direct "do not mean that A&E departments lose vital staff."

Health Minister Rosie Winterton said progress was being made, but the government was not complacent.

"Our drive to eliminate long waits in A&E has made the whole health and social care system work together in new and better ways resulting in faster access to treatment for patients.

"Patients tell us that A&E is now better than ever."

Nigel Edwards, of the NHS Confederation, said: "Emergency services as we know them are changing.

"There have been massive improvements in services in recent years, as demonstrated by the success in reducing waiting times for A&E services.

"At the same time, innovative models for delivering emergency care are being developed, for example co-locating primary care walk-in centres with A&E departments, or the use of emergency care networks.

"Practice is running ahead of policy in a number of places across the health service and the shape of A&E and urgent care is likely to change enormously in the next five years."