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'Cohesive working needed to improve urgent care'

'Cohesive working needed to improve urgent care'

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The health sector is not working "cohesively" to improve local urgent and emergency care systems, the Public Accounts Committee has claimed. 

In a report into emergency hospital admissions, the committee called for the Department of Health to accept responsibility for the performance of urgent care. 

A statement from the committee states that the Department and NHS England "struggled to explain… who is ultimately responsible" for overseeing A&E services. 

Urgent care working groups, which have been established to create better integration, "have no powers" and are "overly reliant" on the good will of all those involved. 

The committee also blamed adverse financial incentives for the crisis. 

Margaret Hodge (pictured), chair of the Public Accounts Committee said, "Hospitals, GPs and community health services all have a role to play in reducing emergency admissions – but financial incentives to make this happen are not in place. Attempts to ensure patients are treated without coming to A&E are not working.

"While hospitals get no money if patients are readmitted within 30 days, there are no financial incentives for community and social care services to reduce emergency admissions. Without clear accountability and responsibility it is much more difficult to achieve the changes needed to improve the situation."

Chris Ham, chief executive at healthcare thinktank The King’s Fund said: "Reducing emergency admissions will become even more important when the Better Care Fund is introduced in 2015. The Fund is an opportunity to drive forward integrated care but will increase financial pressures on hospitals at a time when many are already running up deficits. 

"NHS England has estimated that a 15% reduction in emergency activity will be needed to pay for the Fund – this suggests that many hospitals could be tipped into financial crisis unless admissions can be significantly reduced."

Dr Paul Flynn, chair of the BMA Consultants Committee said: “As the report makes clear, consultants alone do not provide the solution to this problem. Greater funding, improved coordination of services across the NHS and clearer accountability are key if we are to get to grips with the crisis facing emergency medicine.”

The full report is available to view on the Committee of Public Accounts website

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