PERFORMANCE: Clinical commissioning groups and hospital trusts across the West Midlands are drawing up plans to manage peaks accident and emergency demand after clinical leads at 18 emergency departments said they could not guarantee safe patient care.

In a joint letter to CCGs and trust chief executives last month, the clinical leads for A&E departments across the region described the situation in their departments as in a “state of crisis” and called for a whole health economy response.

Their letter warned: “The position is such that we can no longer guarantee the provision of safe and high quality medical and nursing care in our emergency departments.”

NHS England has since published a response to the letter, which says all CCGs and hospital trusts have been asked to develop specific plans for each A&E.

A spokesman for NHS England said in a statement that performance at West Midlands A&E departments had “greatly improved” in recent weeks.

But he added: “It is anticipated that we will continue to see peaks in demand at busy times and for this reason NHS England have asked their area teams to work with clinical commissioning groups and trusts to produce plans to manage peaks in demand more effectively and have robust plans in place to meet the needs of the service in the coming winter.”

Action plans will also be drawn up over a wider area than each trust, by urgent care board, which will bring together commissioners and providers and local authorities.

The statement from NHS England said: “NHS England will ensure local NHS and social care leaders come together to form urgent care boards to develop a system wide response to the issues facing local A&E departments.

“The boards will ensure local recovery and improvement plans are in place for each A&E on their patch.

“The plans will address all three stages of the emergency care process – before patients go to A&E, what happens while they are in hospital, and what happens after leaving hospital.”