The fundamental challenge presently facing Accident & Emergency (A&E) services today is seeing more emergency patients, without letting waiting times increase and quality of patient care and safety fall.

The key waiting target is currently set at 95 per cent of A&E attendees being seen within four hours. The latest figures, ending on 5 May 2013, showed 47 of the 143 trusts with major accident and emergency departments hit the target for seeing 95 per cent or more within four hours. This was an improvement from April’s figures when only 18 of them hit the target.

Health Service Journal’s analysis shows that since the start of 2013 there have been 405,654 breaches of the four-hour target at A&E by serious casualty patients. In the same period in 2012 there were 269,821 and in 2011 there were 215,487. The number of serious casualty attendances has remained broadly the same.

Jeremy Hunt, Health Secretary, has described the pressure on A&E as the biggest operational challenge facing the NHS as two million more people are going through emergency wards every year. He says:

“The biggest pressure in the NHS is on A&E. The fundamental problem is that people are not finding it easy to see a doctor out of hours and are ending up in hospital. We also have an ageing population which means we have four million extra people going through A&E than we did in 2004.”

The causes of the problems in A&E departments are thought to be varied although health secretary Jeremy Hunt has claimed the refusal of GPs to do out of hours work was partly responsible for a rise in numbers attending hospital. A further increasing demand is our aging population, elderly patients with a combination of several disease processes requiring complex care attending the A&E departments and generally A&E being used by many patients for simple problems so the resources are diluted.