The Department of Health is planning to spend £500m propping up urgent care services in the most pressured health economies between now and the next general election.

HSJ revealed on Wednesday that the Treasury will release £250m this year to ease “winter pressures” on emergency departments in about 50 of the highest risk health economies in England. The DH expects to receive a further £250m the following year.

Downing Street formally announced the money this morning.

The money is likely to be allocated to the areas worst hit by winter pressures in 2012-13. It is intended to mitigate the most severe difficulties between now and the May 2015 general election.

As the cash comes from outside the existing NHS commissioning budget, it is not considered a reallocation of funds from more solvent health economies to those with performance challenges.

But the move is still likely to be controversial, and interpreted by some trusts as a reward for failure.

The final details about how the money is allocated will be decided this month. It is not yet clear how the cash will be allocated, for instance whether it will be funneled through clinical commissioning groups, or paid directly to acute trusts.

HSJ understands that the Department of Health, Monitor, the Trust Development Authority, urgent care boards and NHS England’s local area teams will dictate how the money is spent in each local area. For instance, the cash could be required to be spent on hiring more accident and emergency staff, be invested in infrastructure, or to be spent on preventative primary care or social care services.

Earlier this year HSJ reported that there was concern in NHS England over health secretary Jeremy Hunt’s plans to spend hundreds of millions of pounds extra on accident and emergency.

Leaked emails suggested the DH wanted to use a fund generated by the use of marginal rates of payment for repeat admissions to accident and emergency, but NHS England was concerned that only around £70m could be made available this way.

NHS Confederation chief executive Mike Farrar said the government must make sure the money was made available earlier than it had been last year so trusts could plan earlier for winter pressures, rather than wait until “the floodgates have opened”.

He said: “These payments will be useful in the short term, but we need the system working together to tackle the challenges we are facing if we are to get a longer-term solution.

“This money must be used to help divert work away from hospitals as well as to compensate trusts fairly for the extra work they are undertaking. This means that commissioners and all providers (including community and primary care services) should work together to get the best value possible out of this additional resource, not just transfer financial risk between each other.”

Prime minister David Cameron said: “The additional funding will go to hospitals where the pressure will be greatest, with a focus on practical measures that relieve pinch points in local services.

“By acting now, we can ensure doctors, nurse and NHS staff have the support they need and patients are not left facing excessive waits for treatment.”

In quarter four of 2012-13, the most challenged trusts on emergency performance were:

  • Stockport Foundation Trust
  • Weston Area Health Trust
  • University Hospital of North Staffordshire Trust
  • Royal United Hospital Bath Trust
  • Kettering General Hospital Foundation Trust
  • Barking, Havering and Redbridge University Hospitals Trust
  • The Queen Elizabeth Hospital, King’s Lynn, Foundation Trust
  • University Hospitals Coventry and Warwickshire Trust
  • University Hospitals of Leicester Trust
  • Heatherwood and Wexham Park Hospitals Foundation Trust
  • Tameside Hospital Foundation Trust
  • Heart of England Foundation Trust
  • Worcestershire Acute Hospitals Trust
  • Shrewsbury and Telford Hospital Trust
  • Northampton General Hospital Trust
  • University Hospital of South Manchester Foundation Trust
  • Milton Keynes Hospital Foundation Trust
  • Brighton and Sussex University Hospitals Trust
  • North West London Hospitals Trust
  • Wye Valley Trust
  • Maidstone and Tunbridge Wells Trust
  • Buckinghamshire Healthcare Trust
  • East Cheshire Trust
  • North Bristol Trust
  • Mid Staffordshire Foundation Trust
  • Portsmouth Hospitals Trust
  • Ashford and St Peter’s Hospitals Foundation Trust
  • Burton Hospitals Foundation Trust
  • Southend University Hospital Foundation Trust
  • Oxford University Hospitals Trust

These are the 30 trusts with the lowest scores against the four-hour A&E waiting target in quarter 4 of 2012-13.