Reviews by the College of Emergency Medicine and the Foundation Trust Network have warned that A&E demand is continuing to outstrip capacity.
Health Secretary Jeremy Hunt responded that better “joined-up thinking” between health and social care was necessary to reduce the demand.
A&E attendance figures have increased by 50% in the last 10 years, due to a number of factors: the ageing population, lack of out-of-hours GP services and, more recently, problems with the new 111 helpline.
The College of Emergency Medicine surveyed more than half of UK’s A&E units and concluded that a shortage of both middle-grade and senior doctors was weakening the service.
In addition, it said, as many as 30% of patients attending A&E could be treated in non-emergency settings, given better access and information.
The Foundation Trust Network (FTN) noted that some hospitals are losing millions of pounds each year due to current rules designed to reduce A&E admissions.
Where A&E admissions rise above the 2008–9 level, the hospital is only paid 30% of the normal fee for each admission.
Fining hospitals for having too many A&E patients was no way to improve services, the FTN said.
Its Chief Executive Chris Hopson argued: “Unless we can change the funding structure, the A&E system is going to fall over. We simply cannot carry on.” This winter was likely to see the collapse of the A&E system, he warned.
Health Secretary Jeremy Hunt commented that the underlying problem was “a lack of joined-up thinking between the health and social care systems which we’re sorting out”.