Hospital Dr News

NHS misses key waiting times with A&E waits and delayed discharge crippling the system

The NHS has missed all the key waiting times targets, in the latest figures, performing particularly badly on the four-hour A&E wait.

NHS England blamed rising demand – overall attendances were up by more than 10% compared with the same time last year. There was also a sharp rise in emergency admissions and calls to NHS 111.

During January a total of 212,136 A&E patients were not treated within four hours, 17,392 did not have their x-ray, CT or MRI scan inside six weeks and 51,545 had to wait on a trolley for at least four hours before getting a hospital bed.

Only 83% of those who attended a hospital-based A&E unit in January were admitted, transferred or discharged within the required four hours – the worst performance ever on that measure. The NHS constitution stipulates that 95% of such patients should be treated within that time frame.

“A government which has the laudable aim of reducing hospital deaths by 11,000 must recognise overcrowded hospitals that are full of sick patients in overstretched medical units will contribute to avoidable deaths,” said Dr Mark Holland, president of the Society for Acute Medicine (SAM).

“The ability to deliver acute medical care is reaching crisis point and any other crisis affecting our society would be acknowledged and addressed. The volume of patients and disease severity is so much that we are now functioning at the edge of what is possible,” he added. “The NHS is running out of steam.”

The monthly performance publication also showed the NHS was struggling in other areas:

  • the target to see patients needing routine operations within 18 weeks was missed for the second month in a row;
  • the key cancer target for patients to start their treatment within 62 days of an urgent referral from GP was missed for the 20th time in 21 months;
  • twice as many people waited six weeks or longer for a diagnostic test than should have;
  • NHS 111 failed to hit its target to answer calls within 60 seconds;
  • ambulances missed their target to respond to the most critical calls in eight minutes – one in three patients waited longer – the eighth month in a row it has not been hit

Other parts of the UK are also struggling with Scotland, Wales and Northern Ireland also missing the A&E target.

Delays in discharging patients also continue to be a problem. In January there were nearly 160,000 days of delays – the second highest on record.

John Appleby, Chief Economist at The King’s Fund, said: “The figures underline the scale of the challenge for NHS trusts struggling to meet demand for services within current financial constraints. More than one in 10 patients are waiting longer than four hours in A&E, the worst performance for more than a decade. The number of patients waiting in emergency departments to be admitted to hospital has spiked to almost 52,000, the worst since ‘trolley waits’ started being recorded, and delays in discharging patients are at their highest level since February 2009.

“These are symptomatic of the perfect storm through which NHS trusts are trying to steer – with pressures on services across the board. Most trusts are operating with very high bed occupancy which makes it difficult to respond to unexpected fluctuations in admissions. This is compounded by delays in discharging patients, which prevents beds being freed up for new patients. Today’s figures suggest it will be a long winter for the NHS.”

North Middlesex University Hospital NHS Trust in London had the worst performance against the four-hour target – just 66.4% – though the University Hospital of South Manchester trust was not much better, recording a rate of 71.7%.




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