06.01.15
A&E waiting times in England worst since records began
The NHS in England has missed its four-hour A&E waiting time target, with performance dropping to its lowest level since the target was introduced a decade ago.
In type 1 A&Es, emergency departments based at hospitals in England, only 83.1% of arrivals were treated or admitted within the four-hour target in the week ending Sunday 21 December.
This is the lowest performance against the target since records began in 2004. It came in the week that emergency departments faced a new record high number of A&E patients – 289,530.
If all types of NHS facilities offering urgent and emergency care are included, such as walk-in centres and urgent care centres, the performance against the 95% target was 88.8% in the week before Christmas and 90.5% in Christmas week itself, according to official figures.
Across the three months from October to December 2014, 92.6% of all types of A&E patients were treated within the required four hours – the worst figure since the NHS began monitoring its performance against the standard.
A Department of Health spokesperson said: "We know the NHS is busier than ever before, which is why we've given the NHS a record £700m this winter for more doctors, nurses and beds. The NHS has ensured there are plans in every area to manage the extra demand.”
The rest of the UK is also missing waiting time targets. In Northern Ireland, the latest performance figures from November show only 80.5% of patients seen within four hours, while in Wales the figure is 83.8%.
Scotland has a stricter target of 98%, as England did under Labour but the Coalition reduced it to 95% in 2010, but the figures from September show that north of the border 93.8% of patients were seen within four hours.
Nigel Edwards, chief executive of the Nuffield Trust, said: "All the stops are being pulled out to meet waiting times targets at A&E departments, a focus that is quite explicitly being driven by the election. But the cracks are showing.
"There have been big spikes in the numbers of people needing to be admitted to hospital in an emergency for reasons that are not very clear. We may be reaching the point at which general practice, community services and social care can no longer contain the growing demand for their services."
Dr Cliff Mann, of the College of Emergency Medicine, warned hospitals were reaching a "tipping point". He told the BBC’s Today programme that part of the reason was the NHS non-emergency line 111 advising an increasing proportion of people to seek emergency care.
"My concern is the daily intolerable pressure is starting to have an effect on staff – they are more likely to become sick, become unable to work, burn out and choose to go into other professions. That means it is not a sustainable situation,” he said.
The failure to meet the targets is easily linked with the huge explosion in demand. In the last two weeks there were 849,800 attendances at A&E – up by nearly 70,000 from the 780,700 attendances in the same period last year.
In addition to contributing to the failure to meet waiting time targets, the increase demand has also led to several hospitals having to declare major incidents.
Gloucestershire Royal and Cheltenham General implemented the emergency measure for the second time in three weeks while hospitals in North Yorkshire, Surrey and Staffordshire have also declared a major incident.
Bryn Sage, CEO of Inhealthcare, believes that more money and increasing doctors’ overtime is not enough to solve the problem.
He said: “Whilst money has been put aside this winter to increase the amount of doctors working overtime, this has clearly not solved the problem – and it won’t in future. It is a band aid for a bullet wound. In order to make sure that our hospitals continue to function and everyone gets the best treatment, the NHS needs get to the heart of the problem and make sure the system itself works. Given the technology is already available, today’s news is clear evidence that the NHS simply cannot delay in the uptake.”
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