TWO schemes designed to help end last winter's misery at North Staffordshire's accident unit are under threat in a funding row.

Both initiatives have helped cut the marathon queues of frail and elderly patients on trolleys, which blighted the University Hospital. But the NHS bodies which pay for them say they are costing too much.

Now community leaders fear the schemes may be cut – and the nightmare scenes which brought direct action from the Government could return this winter.

The Sentinel has learned the projects are being reviewed because the hospital is spending £20 million more than North Staffordshire's two primary care trusts agreed to give it to run its services this year.

The figure represents five per cent of the UHNS's budget. Hospital and PCT chief executives will meet on Friday to try to settle the dispute, with two directors from the West Midlands Strategic Health Authority acting as mediators.

One of the schemes was the opening in April of the new Ward 21. Its 22 beds are used either for emergency patients referred directly from GPs or to rescue elderly patients held up in the casualty department.

The other scheme was the creation of a separate primary care urgent care unit (PCUCU) within A&E staffed by GPs and nurse practitioners. Opened two years ago and extended more recently, its aim was to prevent people from needing to be admitted to a scarce hospital bed.

Since the schemes were established, delays have been slashed and 98 per cent of all patients are treated within four hours of arrival at the hospital. This is an official Government target.

But each patient sent to Ward 21 costs the PCTs £800 and their officials say the PCUCU – which sees 8,000 patients a year – is expensive yet "not delivering the level of service we require".

North Staffordshire PCT finance director Mark Day confirmed that £20 million was in dispute. He said: "The four-hour wait is currently being met, but at enormous cost."

Trust chief executive Tony Bruce, pictured, added: "Even though the target is being hit, it is still not spectacular for people to wait four hours. The A&E performance is better than it was, but not much better."

He said the future of the PCUCU was already under review and although there were no plans to "part company" with Ward 21 at present, its future would be part of the dispute resolution on Friday.

Hospital officials say the higher spending has been needed to treat the increasing number of patients who are referred.

And last night, health watchdogs in Stoke-on-Trent voiced fears of a repeat of last winter's A&E chaos if Ward 21 and the PCUCU were scrapped. Alby Walker, chairman of the city council health scrutiny committee, said: "We had been assured they both took pressure off A&E.

"Last winter almost everyone I spoke to had a horror story about the place. It is deeply worrying if we go back to that."

North Staffordshire GP leader Dr Paul Golik said: "There are now so many portals of entry for emergencies at the hospital each with their own criteria that it is a joke.

"We have to speak to three people for each patient referral so GPs will just refer straight to A&E and that defeats the object."