Pressures facing A&E units across the country look set to continue, with the majority of trusts fearing next winter will be even worse.

A new survey by the Foundation Trust Network (FTN) shows that 62% of trusts expect the coming winter to be more severe than 2012-13, while 72% believe the accident and emergency system is at a tipping point.

The report, Emergency Care and Emergency Services 2013 - View from the frontline, paints a worrying picture of the dangers facing the system.

But where does the blame lie? Some 62% of trusts cite more demand as a factor, while 42% name an increase in more seriously ill patients coming through the doors. A total of 32% also point the finger at failures of primary and social care services.

Chris Hopson, chief executive of the FTN, called on each local health economy to plan effectively for the coming winter, or risk facing the consequences.

“In the short term, we need urgent action to ensure that the A&E system is able to function effectively this coming winter,” he said.

“While we welcome the recent focus on developing local plans, these must be fully supported financially, drawing on funding from NHS England’s commissioning risk pool, with funding levels agreed by the end of June 2013.”

Over 100 trusts responded to the survey, of which a large number saw revised roles of community and primary care as fundamental to reducing demand on the A&E system.

However, the majority lamented the lack of commissioner investment in out-of-hours, community and primary care services.

The general consensus was that until primary care is able to operate a 24/7 structure similar to that of A&E, little will or can change.