A&E cash linked to staff flu jabs

Hospitals in England will have to get most of their staff vaccinated against flu if they want access to the A&E bailout fund in the future.

The government has set aside £500m for the next two years to help deal with the growing pressures.

The 53 trusts most at risk this year have been told they will share £235m.

But to qualify for next year's slice trusts will have to get 75% of staff vaccinated as ministers attempt to tackle a long-running problem.

Currently less than half of health staff get the flu jab, putting themselves and patients at risk.

Chief Medical Officer Dame Sally Davies said she could not understand why they did not want to protect themselves and accused them of being "selfish" for not protecting their patients.

She also said two and three-year-olds would be getting the flu jab - via a nasal spray - this year as the roll out of the under fives vaccination programme begins.

The steps were announced as ministers set out their plans for tackling the growing pressures in A&E.

As well as the £500m pot, a series of longer term measures are also being taken after the NHS missed its four-hour waiting time target between January and March 2013.

It represented the worst performance for almost a decade.

24/7 service

This will start next year with care for vulnerable older patients with complex health problems.

From April 2014 they will get a named clinicians - most likely a GP - to coordinate their care across the hospital, community and social care system.

And by the end of the year a third of A&Es should have the technology in place to allow them to see the GP records of patients - only a handful currently do.

Next year will also see the start of "integrated care" pilots.

These will include schemes that shift care out of hospitals and into the community by helping these patients manage their increasingly complex conditions.

It will require joint working between social care, district nursing and GPs.

A total of £3.8bn has been set aside from 2015 to expand this out across the country.

That is also the target date for the redesign of the urgent and emergency care system.

NHS Medical Director Prof Sir Bruce Keogh is leading that review.

More detail is expected in autumn, but Sir Bruce said it was looking at issues such as seven-day working and an increased role for ambulances in treating and assessing patients.

Mr Hunt said: "In the long-term, I want a 24/7 service which recognises patients as individuals and looks out for them proactively."

But he said the support being put in place immediately meant the NHS should be able to keep to its four-hour waiting time requirement this winter.

He said it would be "tough", but "entirely possible".

But Shadow Health Secretary Andy Burnham told the House of Commons the plans were "half-baked".

"Too little, too late. Not good enough on an issue of huge importance."