Winter pressure in accident and emergency departments Contents

Contents

Summary

1 Winter pressure?

Evolving demand

Attendances & admissions

Seasonality

Performance

Impact on patients

2 Pressure & patient flow

Patient flow & performance

Early senior review of patients

National policy interventions

Practical improvement

Flow & delayed transfers of care

3 Maintaining patient flow this winter

Increasing bed capacity

Funding & staffing additional capacity

Community provision

A&E infrastructure

Supporting adult social care to maintain patient flow

Availability of adult social care

Cost of delayed transfers of care

Utilising primary care to reduce demand

Case-mix

Extended hours

Co-location of primary care with emergency departments

The ambulance service

Potential of paramedics

4 Further threats to the system

Staffing

Numbers

Recruitment

Reforming recruitment

New workforce in urgent & emergency care

Conclusion

Funding

Winter resilience funding

Tariffs

Management of the system

Performance management or improvement?

Reform of national oversight

Demand driven by alcohol consumption

5 Targets in urgent and emergency care

Four-hour waiting time standard

Ambulance service targets

Conclusions and recommendations

Annex: Visit to Luton & Bedford

Formal Minutes

Witnesses

Published written evidence

List of Reports from the Committee during the current Parliament





31 October 2016