Exclusive: NHS crisis looms as A&Es miss waiting time targets


Health Correspondent

Accident and emergency departments in England have experienced an unprecedented “spring crisis”, missing a key performance target for five weeks in a row and leaving 20,000 patients waiting for four hours or more in the first week of June alone.

The performance of A&E departments, regarded as a barometer for the health of the entire NHS, typically improves in spring as the demand caused by cold weather affecting the elderly subsides.

But the seasonal pattern has been broken, with latest figures revealing that A&Es failed to hit their target of treating or admitting 95 per cent of patients in four hours, for the whole of May and the beginning of June.

Health experts called the target breaches “odd” and “worrying”. Senior health officials fear that the problem bodes ill for the NHS’s capacity to cope in summer – when attendances at A&E peak – and winter, when pressures become greatest because more frail elderly patients need admitting to hospital.

Richard Murray, director of policy at the King’s Fund think-tank and a former senior Department of Health official, told The Independent: “Performance is very seasonal in A&E: you have a bad winter, you have a good spring, that’s what happens every year. This time, rather than lifting up, [the number of patients seen within four hours] has been dipping back down again. If it was the economy and you were doing a seasonally adjusted forecast, this would be bad.”

The threat of a winter A&E crisis last year forced the Government to inject £400m into the sector. In the event, unusually low flu rates helped A&Es cope well. However, that is unlikely to happen again, and the prospect of long queues at A&Es in the winter before a general election will cause serious concern to the Conservative leadership, who know they are vulnerable on the NHS.

Even more damaging would be a summer crisis, which cannot be ruled out given previous annual increases in A&E attendances during the warmer months.

Figures released yesterday showed that there were 442,096 attendances at A&E in the first week of June. Of these, 94.3 per cent were seen in four hours. However, these figures include the performance of minor-injury units and single-specialty emergency departments, which typically perform better. When the performance of the major A&Es – known as Type 1 A&Es, which deal with the vast majority of the most ill patients – is analysed, the outlook is even more concerning. Only 91.6 per cent of patients were seen within four hours – the 48th week in a row that Type 1 A&Es have missed the 95 per cent standard.

Yesterday, health officials admitted the NHS was “undershooting the standard”. “We in the NHS are determined to address this quickly,” said Sarah Pinto-Duschinsky, the director of NHS operations and delivery. “Emergency admissions to hospital remain high as we come out of the winter, and we will redouble efforts to ensure our patients have speedy access to care.”

It is believed the pressures on the system are being driven by unseasonably high numbers of admissions to hospital wards from A&E. So far in 2014, nearly 80,000 more patients have been admitted to hospital from major A&Es than in the same period last year – a 4.9 per cent increase which represents a major spike in demand, above and beyond previous annual increases.

Mr Murray said the increase was “unusual” and had taken the NHS by surprise. “At the moment demand seems to be growing really pretty quickly,” he said. “If you look over April and May, the number of people being admitted into hospital through A&E is up really sharply, at a rate that is not sustainable.”

Renewed worries about A&E are just the latest sign that the NHS, which has been coping with ever-increasing demand without any major funding increase for five years, is reaching the limit of its ability to meet the high standard of care demanded by patients and the Government. The 62-day cancer waiting times target was missed for the first time last month, and another quality standard, the 18-week waiting time from GP referral,  was breached in both February and March, although performance recovered slightly in April.

Andy Burnham, Labour’s shadow Health Secretary, said: “These figures reveal A&E departments trapped in a downward spiral. Hospitals are operating above safe levels.”

Last night the Department of Health said it would provide £400m to help the NHS cope with pressure on winter beds – as well as another £250m to reduce the backlog of patients waiting over 18 weeks for treatment.

i100 In this video, the late actor Leonard Nimoy explains how he decided to use the gesture for his character
Robert De Niro has walked off the set of Edge of Darkness
news The Godfather Part II actor has an estimated wealth of over $200m
Arts and Entertainment
Fearne Cotton is leaving Radio 1 after a decade
radio The popular DJ is leaving for 'family and new adventures'
Robbie Savage will not face a driving ban
football'Mr Marmite' faced the possibility of a 28-day ban
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
Life and Style
Nearly half of all young people in middle and high income countries were putting themselves at risk of tinnitus and, in extreme cases, irreversible hearing loss
health Nearly half of all young people in middle and high income countries are at risk of tinnitus
It was only when he left his post Tony Blair's director of communications that Alastair Campbell has published books
people The most notorious spin doctor in UK politics has reinvented himself
Arts and Entertainment
arts + ents
Life and Style
Arts and Entertainment
James Franco and Zachary Quinto in ‘I Am Michael’
filmJustin Kelly's latest film tells the story of a man who 'healed' his homosexuality and turned to God
Arts and Entertainment
Public Service Broadcasting are going it alone
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Sauce Recruitment: Retail Planning Manager - Home Entertainment UK

    salary equal to £40K pro-rata: Sauce Recruitment: Are you available to start a...

    Ashdown Group: Front-End Developer - London - up to £40,000

    £35000 - £40000 per annum: Ashdown Group: Creative Front-End Developer - Claph...

    Recruitment Genius: Product Quality Assurance Technologist - Hardline & Electric

    £18000 - £24000 per annum: Recruitment Genius: The role in this successful eco...

    Ashdown Group: QA Tester - London - £30,000

    £28000 - £30000 per annum: Ashdown Group: QA Tester - London - £30,000 QA Tes...

    Day In a Page

    HIV pill: Scientists hail discovery of 'game-changer' that cuts the risk of infection among gay men by 86%

    Scientists hail daily pill that protects against HIV infection

    Breakthrough in battle against global scourge – but will the NHS pay for it?
    How we must adjust our lifestyles to nature: Welcome to the 'Anthropocene', the human epoch

    Time to play God

    Welcome to the 'Anthropocene', the human epoch where we may need to redefine nature itself
    MacGyver returns, but with a difference: Handyman hero of classic 1980s TV series to be recast as a woman

    MacGyver returns, but with a difference

    Handyman hero of classic 1980s TV series to be recast as a woman
    Tunnel renaissance: Why cities are hiding roads down in the ground

    Tunnel renaissance

    Why cities are hiding roads underground
    'Backstreet Boys - Show 'Em What You're Made Of': An affectionate look at five middle-aged men

    Boys to men

    The Backstreet Boys might be middle-aged, married and have dodgy knees, but a heartfelt documentary reveals they’re not going gently into pop’s good night
    Crufts 2015: Should foreign dogs be allowed to compete?

    Crufts 2015

    Should foreign dogs be allowed to compete?
    10 best projectors

    How to make your home cinema more cinematic: 10 best projectors

    Want to recreate the big-screen experience in your sitting room? IndyBest sizes up gadgets to form your film-watching
    Manchester City 1 Barcelona 2 player ratings: Luis Suarez? Lionel Messi? Joe Hart? Who was the star man?

    Manchester City vs Barcelona player ratings

    Luis Suarez? Lionel Messi? Joe Hart? Who was the star man at the Etihad?
    Arsenal vs Monaco: Monaco - the making of Gunners' manager Arsene Wenger

    Monaco: the making of Wenger

    Jack Pitt-Brooke speaks to former players and learns the Frenchman’s man-management has always been one of his best skills
    Cricket World Cup 2015: Chris Gayle - the West Indies' enigma lives up to his reputation

    Chris Gayle: The West Indies' enigma

    Some said the game's eternal rebel was washed up. As ever, he proved he writes the scripts by producing a blistering World Cup innings
    In Ukraine a dark world of hybrid warfare and murky loyalties prevails

    In Ukraine a dark world of hybrid warfare

    This war in the shadows has been going on since the fall of Mr Yanukovych
    'Birdman' and 'Bullets Over Broadway': Homage or plagiarism?

    Homage or plagiarism?

    'Birdman' shares much DNA with Woody Allen's 'Bullets Over Broadway'
    Broadchurch ends as damp squib not even David Tennant can revive

    A damp squib not even David Tennant can revive

    Broadchurch, Series 2 finale, review
    A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower: inside the mansion of Germany's 'Bishop of Bling'

    Inside the mansion of Germany's 'Bishop of Bling'

    A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower