The organisation representing English hospitals has said the government’s NHS reorganisation is in part to blame for the failure to maintain low accident and emergency waiting times.

Foundation Trust Network chief executive Chris Hopson also described the government and regulators’ response to A&E performance problems as an “omnishambles”.

His comments to HSJ come as it has emerged that all hospital providers were today sent a letter by their regulators highlighting the widespread failure to meet the four-hour waiting target for at least 95 per cent of cases in recent weeks.

The letter says the “standard remains an essential component of the NHS providing safe and timely care for patients” (see attached) and warns that providers will be held to account for performance.

Mr Hopson said the government had, while reorganising NHS commissioning and oversight in the past three years, failed to address problems with health services which have led to the problems in A&E.

He said: “We all know everybody’s attention has been diverted to planning the [changes to] organisations, while the front line has been trying to pull the system together with duct tape, and generally doing a good job.

“This is the chickens coming home to roost in terms of the focus being on the wrong thing.”

Mr Hopson highlighted the combination of the Monitor and NHS TDA letter; NHS England’s publication of a framework for local reviews of emergency care; and HSJ’s coverage of internal NHS England discussion about an apparent Department of Health intention to release funds to help A&E.

He said he believed the organisations were not “aligned” in addressing the issue, and had not consulted providers enough.

He said: “When we were working on the Health Act, the key issue was we wanted the government and its bodies to co-operate effectively and create a single response, and support providers to do what they need to do.

“Jeremy Hunt has correctly said this [A&E performance] is the biggest operational problem facing the NHS and it is absolutely vital we get a single coordinated response.

“Yet here we have a day when we have apparently got Jeremy Hunt trying to solve a problem and identify a pot of money, [and] parts of NHS England appearing to resist that.

“And on the same day you’ve got Monitor and the TDA sending a finger pointing and blaming letter, saying ‘This is not good enough’.

“From the outside this looks like an omnishambles. They need to be aligned and working together to support the front line.”

A DH spokeswoman said:”Today’s action plan is a result of co-ordinated and intensive work by NHS England, the NHS TDA, Monitor and DH to help A&E departments meet demand and tackle waiting time pressures.

“Performance has improved in recent weeks to meet the national standard and we will continue to work closely together to build on this.”

HSJ understands the DH, NHS England, Monitor and the TDA have discussed and coordinated plans for responding to A&E problems, including the letter to providers.

The NHS England framework was published in association with Monitor and the TDA.

HSJ has highlighted that many trusts have failed to meet the four-hour A&E target in recent weeks. The situation has improved slightly improved in the final week of April but is still behind the 95 per cent target.