NHS Bosses to Increase Funding For A&E Units

22 January 2014

NHS Bosses to Increase Funding For A&E Units

In the face of criticism that an estimated £500m a year of funding has been denied to accident and emergency (A&E) departments at hospitals, NHS bosses are relaxing a funding rule which will see A&E receive more money for treating patients as emergencies.

Mistreatment.com often hears from patients who have experienced a poor level of care when visiting A&E and the concerns of the funding rule seem to reinforce the fact that A&E is in need of more money to help clinicians, staff and of course the patients themselves.

A funding rule has meant that emergency departments have been deprived of important funding, receiving only some 30% of the cost of treating any patient admitted as an emergency over and above the number of patients treated in 2008-09. The other 70% was not provided to the hospitals and instead diverted to local NHS organisations in order to set up schemes to reduce avoidable trips to hospitals, except that it seems little in the way of clear evidence has been provided to show that all this money has been widely distributed across the NHS bar a few isolated hospitals.

Hospitals believe they deserve the funding because they have provided the treatment when other parts of the NHS – primary care trusts and now GP-led clinical commissioning groups (CCGs) – have failed to offer alternatives.

The 30% rule has received intense criticism from the FTN-which represents foundation trusts-as well as the College of Emergency Medicine (CEM) who are calling for its abandonment. Whilst NHS bosses have relaxed the system they are not scrapping it altogether despite reservations about the funding rule from both the National Audit Office and the Commons health select committee.

Monitor, the NHS regulator, sets the tariff rates and the health secretary Jeremy Hunt informed the CEM that "where there have been significant local increases in emergency admissions outside the control of providers [hospitals], commissioners [CCGs] will be required to agree a revised baseline before the marginal rate kicks in."

By relaxing the 30% rule hospitals will receive the full cost of treating more patients after they agree the details with their CCG. CEM President, Dr Cliff Mann, said "Hospitals have been severely hamstrung because of this unfair rule. It also contributes to hospitals being overfull because the only way to pay for an older lady admitted with pneumonia is to get the man in for his knee replacement, and there is only a finite amount of beds in hospitals."

The relaxation of the rule is simply not enough according to some quarters with a complete axing the only solution. The FTN said that the policy was “not fit for purpose” adding that "It does not meet the core purposes of funding emergency care appropriately, or supporting the shift of care to out of hospital settings. With the pressures on the system increasing year on year, we urgently need abolition of this policy to ensure we have a safe, effective, appropriately staffed and high-quality emergency care service in future years."

Mistreatment.com was created to listen to talk to people who feel that they had nobody at the NHS to listen to them when something went wrong. Members of the public who call through to us often want to raise an issue within NHS care so that somebody else is not affected the way their and their loved ones have been. Sometimes they call through to us to make a medical negligence claim because a financial settlement is needed to rebuild their life and to take care of their family. If you have experienced a form of medical mistreatment through emergency services, A&E or through surgery, for example, you can speak to the experts at Mistreatment.com