80% of NHS finance directors who responded to a survey identified higher numbers of patients with severe illnesses and complex health needs as a key reason for the pressures on A&E units, while 70% cited delays in discharging patients from hospital. This contrasts with 27% who pointed to poor access to GPs and 20% to shortages of clinical staff as key factors.

The survey also highlights the huge effort made by the NHS to prepare for increased pressure on services during the winter. Over 70% of trusts increased their staff, while 80% of CCGs paid for extra resources in primary care.