Video: A&E may reach 'breaking point' this winter The emergency care system has come under intense pressure, partly due to a rise in the number of people attending A&E with more than one million more people attending emergency departments compared to three years ago. A new survey of senior health service leaders carried out by the NHS Confederation said that misleading and ill-informed debate about the reasons behind A&E pressures is preventing the health service from addressing the actual causes. The NHS Confederation survey found that the majority of those questioned believe that the strain on the service is down to the rising number of frail older people with multiple long term problems followed by the difficulty in discharging or transferring patients into appropriate further care. The new 111 phone service has come under intense pressure but the poll found that 79% of those asked said they did not think it a big cause of the strain on A&E departments. The results also gave an up-to-date prediction from the A&E front line about how well the NHS will cope during the coming winter. Mr Farrar, the chief executive of the NHS Confederation, said: "A prolonged period of cold, a rapid increase in the acuity of patients presenting in A&Es or a lengthy norovirus season would be all it would take to bring many departments to breaking point."