6 things you need to know about the A&E crisis hitting NHS hospitals this winter

A surge in demand has left hospital bosses battling to cope, with several trusts forced to activate major incident plans.

Here are six key questions about the A&E crisis answered.

What has happened?

The government's target is 95 per cent of patients transferred, admitted or discharged within four hours of arriving at an A&E. But only 92.6 per cent were treated in this key four-hour window in the last quarter of 2014, the worst figures since the Coalition took power in 2010.

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In the last week before Christmas, 88.8 per cent of emergency patients were dealt with within the recommended four-hour window.

What is being blamed for the rise?

Several things. Firstly, more people are using A&E units. Between October and December there were 5,573,644 attendances (cases seeking treatment) at A&E departments across England. That was up more than 250,000 from 5,294,269 during the same period in 2013.

Unions also claim underinvestment and a fall in staff numbers are playing a part.

And problems are continuing into January?

Yes. More people go to hospitals in winter anyway, but several hospitals across the country have been forced to declare major incidents in recent days, because they were overwhelmed by the number of people attending.

People have been warned to stay away from affected hospitals, unless their cases are genuine emergencies.

What is a major incident?

The NHS says this can be declared when a hospital trust "is facing high levels of pressure". It allows it to divert resources from "partner" organisations like GP surgeries and other units to focus on treating the increased amount of people at A&E, prioritising the sickest. It can involve bringing in additional staff, diverting staff from other activities or postponing some routine procedures. The latter can mean some patients due to undergo non-urgent treatments face delays.

Why are people going to A&E if they are not emergency cases?

Charities including the Care and Support Alliance and Sense say cuts to local authority social care mean many people, including the elderly and disabled, are going to A&E for problems that should be treated elsewhere.

Barnsley Hospital in South Yorkshire recently surveyed almost 1,000 patients and just 22 per cent said they believed their condition was a real emergency. Most wanted reassurance about a pre-existing condition and others complained about difficulty in getting a local GP appointment.

There has also been criticism of the number and availability of GP appointments available in recent months, with people unable to get appointments quickly or at a time they can make heading to A&E instead.

But there are trivial cases slowing down the treatment times as well?

Yes. The NHS says that people are going to A&E for a variety of problems that could easily be treated by a GP, a pharmacist or in some cases without medical help.

Units across the West Midlands, Herefordshire and Staffordshire compiled a list of reasons for A&E visits over Christmas. They included a four-month-old verruca, a hangover, needing a replacement for an asthma inhaler, a finger wart, and people needing false fingernails and hair extensions removed.

There is also a myth that prescriptions obtained from A&E are free, bypassing the £8.05 cost from a pharmacy. In fact, hospitals will still charge you.

Have you needed to visit an A&E in East Lancashire recently? What was your experience like and how did you feel the hospital was coping? Add your comments below...