NHS England’s local area teams have been given less than a month to develop accident and emergency “recovery plans” for their patch, the organisation’s interim deputy chief executive has announced.

HSJ has highlighted serious problems with accident and emergency performance in recent weeks, with many more patients than normal waiting for more than four hours to be seen, and for more than 12 hours to be admitted.

Speaking at this morning’s NHS England board meeting interim director of operations and deputy chief executive Dame Barbara Hakin said she would be writing to the directors of its 27 local area teams this week to ask them to start work on recovery plans.

Dame Barbara said the plans should consider “the full range of things that can make a difference” and that directors should be working with partners in primary and social care to look at improving patient flow.

Areas should set up “urgent care boards” including all relevant organisations, she said, and plans should be “pulled together by the end of May”.

Urgent care boards have been recommended by Department of Health guidance since 2004 but a recent King’s Fund report on urgent and emergency care in the south of England found not all areas had them and where they did exist they varied in effectiveness.

NHS England will publish a framework for the development of recovery plans next week.

At the same board meeting NHS England chief executive Sir David Nicholson acknowledged accident and emergency services had been under “significant pressure” in the past few months.

Sir David said it was “hard to get to the bottom” of what was causing the pressures. He highlighted poor weather in March, which he said had been more typical of a January. However he said the problem was “not a number issue” as both emergency admissions and attendances had slightly reduced in the last quarter.

“The bottom line is this is a whole systems issue… We want our local area directors to be assured that everything that can be done is being done, not least of all to see that we are beginning to start to plan for what we know will be an increased pressure in the system as we move into winter.”