- 10 updates
NHS bosses have warned that last year's crisis in England's A&E departments might not be a one-off. They fear some casualty departments could be, "strained to breaking point" this winter.
ITV News Political Correspondent Simon Harris reports:
NHS leaders have warned that "myths and misinformation" about the reasons behind A&E pressures is preventing the health service from addressing the actual causes.
Mike Farrar, the chief executive of the NHS Confederation, said a survey of health managers on the pressures they are likely to face in winter reveals:
"Not only do we need some extra resources to help them plan now for winter but also to try and help the public understand that there a range of services outside of hospitals that they can access.
"Recent weeks have seen quite a political debate about NHS 111 and GP out-of-hours and we just want to make sure that people understand they are available, they are important resources and people can use those rather than go to A&E."
In July, ITV News spent 36 hours in the A&E department of at the Queen Elizabeth Hospital in Birmingham.
On the first day, 325 patients with a variety of complaints were treated in 24 hours and a total of 235 on the second.
Accident and emergency departments in England are understaffed on average by nearly 10%, a BBC survey suggests.
A Freedom of Information request by BBC 5 live revealed 101 out of 166 hospital trusts who responded had 1,260 vacant posts as of August 2013.
The largest proportion of vacancies were found in four trusts in London.
According to the BBC, the Department of Health said A&E staffing was an ongoing problem, but action was being taken.
The Department of Health has defended its A&E funding but said it will outline on Tuesday its plans to ensure departments can cope with "additional pressures" this winter.
A statement from the department said the NHS "on the whole" was "performing well" but added: "We know A&E departments are under pressure."
Health Secretary Jeremy Hunt has warned A&E units are unlikely to be able to avoid more long waits this winter despite a £500 million Government bailout that was designed to ease pressures.
Mr Hunt said he was determined to ensure hospitals met targets and was taking action to support front line services facing unprecedented patient numbers.
Prime Minister David Cameron last month announced a two-year funding boost, which includes £15 million for the troubled 111 phone service.
Two thirds of voters believe there is a crisis in A&E departments and patients are being put at risk, according to a survey by Survation, which found:
- 65% blamed Government cuts for any staff shortages and poor levels of care
- 75% said doctors and nurses were doing their best while being overworked
- 65% said consultants should be forced to work weekends and nights to ease the crisis
- 43% backed pay cuts for any who refuse
Professor Keith Willett, the doctor leading the emergency services reform, warned that up to 6.5 million people a year are wrongly going to A&E when they could be treated by GPs, paramedics or even chemists.
Nine out of 10 nurses working in A&E departments believe current pressures on emergency services are putting patients in danger, according to a new survey.
A poll of the Royal College of Nursing (RCN) members found 89% of staff thought the people they were meant to be caring for were being put at risk.
Some 85% said patient safety is being compromised by the strain on the departments.
More than three-quarters (79%) cited increased attendances at A&E as the reason for increased pressure.
And 74% blamed inappropriate attendances at A&E where patients could have been treated by primary care services or by calling NHS 111.
Misleading and ill-informed debate about the reasons behind A&E pressures is preventing the health service from addressing the actual causes, according to a survey of senior health service leaders.
The majority of those questioned by the NHS Confederation said the strain was down to the rising number of frail older people with multiple long term problems, followed by the difficulty in discharging or transferring patients into appropriate further care.
The new 111 phone service has come under intense pressure but the poll found that 79% of those asked said they did not think it a big cause of the strain on A&E departments.
Prolonged wintry conditions or another outbreak of norovirus will see A&E departments across the country reach "breaking point", NHS leaders have warned.
The emergency care system has come under intense and increasing pressure in recent years, with over a million more people attending emergency departments compared to 2010.
Labour has accused the Government of leaving A&E departments "on the brink of a serious crisis", a claim apparently supported by a series of separate surveys of leading medics, nurses and voters that suggested patients are at an increasing risk.