NHS creating 'older people's plan'

The “huge pressures” in A&E reflect other problems in the health service because accident and emergency is the barometer for the whole system, Jeremy Hunt said.

He told delegates at the NHS Confederation conference in Liverpool that while immediate actions have been taken, officials must look at the underlying causes of the strains.

He said officials have been told that they have a year to develop and put into place a plan of action to help the “heaviest users of the NHS”.

The plan will compromise three elements: the current review of emergency and urgent care which is being undertaken by NHS England medical director Sir Bruce Keogh, the joining up of health and social care services, and making sure there are “good alternatives” to accident and emergency.

He said: “We have put in place some short-term measures which I think are going to make a difference - the ‘urgent care boards’ that NHS England has set up, giving hospitals a say in how money is actually spent to help prevent admissions.

“If we are really fundamentally going to look at these pressures, we are going to have to look at those underlying causes and address those as well.

“Which is why, together with NHS England, we are putting together a strategy focusing on the group of people who if we help, we can also do the most to relieve the pressure on A&E. And that is vulnerable older people, the people who are heaviest users of the NHS, people with multiple long-term conditions.

“We are putting together a vulnerable older people’s plan with three elements, and we would welcome your input to that plan, which we hope to conclude by the autumn and implement from April next year.

“The first is to look at what the emergency care proposition is and Sir Bruce Keogh is leading a review of that.

“Then we need to look at something else, that people in A&E constantly tell me is a problem, that hospital beds aren’t free.

“One hospital told me last week that two wards were full of people who actually could be discharged but they couldn’t because they couldn’t get into the social care system - the issue of integration of services. Looking at integration and making some real progress as to having joint commissioning of services.

“The third part of the review is making sure that we have good primary care alternatives to A&E where appropriate.”

NHS boss Sir David Nicholson said that the NHS’s interpretation of the Francis report into serious care failings at Mid Staffordshire Foundation Trust, combined with unseasonably bad weather, may have caused the poor performance in A&E waiting times earlier this year.