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You can find the current article at its original source at http://www.guardian.co.uk/society/blog/2013/may/22/whats-causing-a-and-e-crisis

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What's causing the crisis in A&E? What's causing the crisis in A&E?
(4 months later)
Politicians, health professionals and patients seem to agree that NHS A&E services are under huge pressure. What they don't agree on are the reasons for this.Politicians, health professionals and patients seem to agree that NHS A&E services are under huge pressure. What they don't agree on are the reasons for this.
Jeremy Hunt, the health secretary, has said that the pressure on A&E is the "biggest operational challenge facing the NHS".Jeremy Hunt, the health secretary, has said that the pressure on A&E is the "biggest operational challenge facing the NHS".
His Labour shadow, Andy Burnham, has cited figures showing that the number of people waiting longer than four hours in emergency departments had risen from 340,000 in 2009/10 to 888,000 last year. And in 2012/13, 167 people waited for more than 12 hours to be admitted to hospital.His Labour shadow, Andy Burnham, has cited figures showing that the number of people waiting longer than four hours in emergency departments had risen from 340,000 in 2009/10 to 888,000 last year. And in 2012/13, 167 people waited for more than 12 hours to be admitted to hospital.
On Tuesday, Hunt blamed changes to GP contracts, which allowed family doctors to opt out of providing out-of-hours care.On Tuesday, Hunt blamed changes to GP contracts, which allowed family doctors to opt out of providing out-of-hours care.
Hunt told the Commons: "Last year's GP patient survey said that only 58% of patients know how to contact their local out-of-hours service, and said that 20% of patients find it difficult to contact their out-of-hours service, that 37% of patients feel that the service is too slow – problems that we are trying to address." He added that the changes to GP contracts "have had a huge and devastating impact".Hunt told the Commons: "Last year's GP patient survey said that only 58% of patients know how to contact their local out-of-hours service, and said that 20% of patients find it difficult to contact their out-of-hours service, that 37% of patients feel that the service is too slow – problems that we are trying to address." He added that the changes to GP contracts "have had a huge and devastating impact".
But Mike Farrar, the chief executive of the NHS Confederation, denied there was a link, pointing out that the contract changes had happened nearly a decade ago, in 2004. Farrar said: "In fact, for the vast majority of the last decade, A&E waiting time standards have been improving. It is in recent years where the pressures have started to bite, and there have not been any discernible structural changes to out-of-hours GP contracts during that time."But Mike Farrar, the chief executive of the NHS Confederation, denied there was a link, pointing out that the contract changes had happened nearly a decade ago, in 2004. Farrar said: "In fact, for the vast majority of the last decade, A&E waiting time standards have been improving. It is in recent years where the pressures have started to bite, and there have not been any discernible structural changes to out-of-hours GP contracts during that time."
Patrick Cadigan, registrar of the Royal College of Physicians, said: "The problem is that A&E is the recognisable brand, and that's where patients will go because they know they will see someone who is expert, often within four hours, and they will receive treatment."Patrick Cadigan, registrar of the Royal College of Physicians, said: "The problem is that A&E is the recognisable brand, and that's where patients will go because they know they will see someone who is expert, often within four hours, and they will receive treatment."
What are your experiences of A&E and out-of-hours care? And why do you think the pressure on A&E is so acute now? Please join the discussion in the comment thread here or contact us anonymously using the form below.What are your experiences of A&E and out-of-hours care? And why do you think the pressure on A&E is so acute now? Please join the discussion in the comment thread here or contact us anonymously using the form below.
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