There is ‘no quick fix’ to A&E’s problems, Health Secretary Sajid Javid said, but he insisted there would be no more money for health services in England.

Mr Javid said he was ‘horrified’ to see video of a nurse at an A&E telling patients they could wait until 1pm to see a doctor.

But he told delegates at the NHS ConfedExpo conference in Liverpool that “the answer to all the challenges we face in health cannot always be more money”.

And the strain in the emergency services was “linked to the pandemic”, he added.

Meanwhile, NHS England chief executive Amanda Pritchard said emergency care was facing winter pressures in mid-summer.

And she said the issues facing social care are unlikely to be resolved until winter, which is traditionally very busy in A&E departments.

She also raised concerns about a reduction in the number of hospital beds, saying “we’re past the point where that efficiency is actually becoming inefficient.”

Ms Pritchard also said ‘budgets can never stretch so far’ when it comes to addressing concerns over capital funding in the health service, which covers upgrading buildings and systems computers.

On the pressures on emergency care, Mr Javid told delegates: ‘People have stayed away which is understandable at the height of the pandemic and many of these people are rightly showing up now in record numbers and this is showing up in A&E as well as primary care in other places.

“But the pandemic has also had an impact on social care, and it has had an impact on the capacity of the social care system, which means that many hospitals are struggling with delayed discharges and offering people the packages of care they need – this has an impact on the flow throughout the hospital.

“What can we do about it? And I honestly think we’re doing everything conceivably possible that we can do right now. There’s no quick fix for that.

He added: “Like most of us, I watched this recent video from Princess Alexandra Hospital at A&E and watched it with a mixture of emotions – of course there was horror at the thought that it could be me waiting in this A&E, it could be my children, your children.

On NHS finances, he added: “With the money, first of all, the funding for the NHS is okay, it’s increasing, it was increasing massively even before the pandemic, with the investment in the long-term plan.

“And because of the pandemic, record amounts of funding have been disbursed.

“The money that is collected through the levy, the vast, vast majority of that goes to the NHS and that’s true, because the first thing is that the NHS needs more resources.

“And that’s why he gets them over the next few years, gets the additional resources he needs, including for capital.

“My view on money more generally is that the answer to all the challenges we face in healthcare cannot always be more money. I think it is essential that we improve the productivity.

He added: “Rising health care spending to double the rate of economic growth over the next decade, as some are proposing, is neither sustainable, desirable nor necessary.

“I don’t want my children, anyone’s children, to grow up in a country where more than half of public spending goes to health care at the expense of everything from education to housing.

“It’s not a fair deal for Britons, especially young people.”

Ms Pritchard also spoke of the pressures A&E is facing, saying: “Frankly, the situation we are seeing in emergency services and ambulance services right now is as difficult as any winter before the pandemic.

“But demand isn’t the whole story. The unacceptable increase in 12-hour waits for A&E admission underscores that the problem is flow.

“You can draw the line from delayed dumps, to A&E congestion, to slower ambulance response times.

“It is difficult to see social care capacity being significantly expanded before winter so the NHS must do everything in its power to cope with this.”

She said the NHS is working on an urgent care strategy which will be published in the autumn.

Meanwhile, on the number of hospital beds, she added: ‘The NHS has long had one of the lowest beds among comparable healthcare systems and in many ways this reflects our efficiency and our efforts to provide better care in the community…we are past the point at which this efficiency becomes truly ineffective.

“So the point has come where we need to review how we properly size our capacity across the NHS.”

Regarding efficiency and productivity, she added: “At 2.2%, we have already set very ambitious efficiency targets.

“And because we are the NHS, we have an advantage over many other health systems in responding to this.

“We can act together by controlling the expenses of agencies and consultants.

“We can negotiate the best rates for the whole service when it comes to new and effective drugs, and access to independent hospitals for testing and treatment.

“And we can use our shopping data and power to find and save money on everyday items that services need and how we use our heritage.

“But we have to be realistic, so far we’ve absorbed the current inflation spike, but budgets can never stretch so far.”

Matthew Taylor, chief executive of the NHS Confederation, told the conference that the combination of the short-term impact of Covid, the medium-term impact of austerity and the long-term inability to s Tackling the social determinants of health had caused a ‘capacity gap’ in the NHS.

“That’s why for many of you, no, most of you, crisis management is a daily reality,” he said.

On financing, he added: “We need to learn the lessons of austerity and the ‘feast or famine’ approach to financing. We welcomed last year’s regulations for health and care.

“We can discuss with the Secretary of State and Treasury its adequacy given the impact of inflation, but we can certainly agree that it was only the first step towards financial sustainability.”

Meanwhile, Mr Javid and Ms Pritchard both said the current model of GP care ‘isn’t working’.

Mr Javid said he would present a primary care reform plan shortly.