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A&E hospital waiting times hit worst level since NHS records began, figures show

Just 84.4 per cent of patients treated, admitted or discharged within four hours despite milder flu and weather – lowest since 95 per cent target was set in 2004 

Alex Matthews-King
Health Correspondent
Thursday 14 February 2019 11:41 GMT
'We need to focus on prevention as much as we do on cure' Matt Hancock on the government's NHS long term plan

Waits at A&E departments in England have hit their worst levels since records began, official NHS statistics have shown.

Despite pressures from flu and bad weather so far this winter being significantly lower than in 2018, performance against the flagship four hour target in January hit its lowest level since its introduction in 2004.

NHS leaders said Thursday’s figures must be a wakeup call to the government that chronic underfunding in social care and a mounting staffing crisis is creating dangers for patients.

While more patients than ever are being seen at A&E departments, just 84.4 per cent were seen, admitted or sent home within four hours of arrival – well below the target of 95 per cent.

This is worse than the 84.6 per cent mark set in in March 2018 after the Beast from the East storm – the previous lowest figures on record.

While more than half a million patients were admitted to hospital from A&E last month, more than 80,000 waited over four hours for a bed to be found, and 600 patients had to wait over 12 hours.

“It’s a sad indictment of the state that our health service has been allowed to fall into that thousands of patients needing urgent medical help face the awful prospect of being left stranded in cramped corridors or on hospital trollies waiting for a hospital bed to become available,” Rachel Power, chief executive of the Patients Association, said.

Waits were even worse at major emergency departments, the 24-hour units in hospitals known as type one A&Es. Although the national four hour target also considers smaller minor injury units and walk-in centres, at type one units across England just 76.1 per cent of patients were seen within four hours.

The Royal College of Emergency Medicine (RCEM) said the pressures had been normalised by years of cuts to beds and staff, and A&Es are now in “chronic crisis”.

“These figures make clear the true scale of this crisis facing our systems,” RCEM president Dr Taj Hassan said.

“Despite a relatively mild winter, with lower rates of norovirus, nearly one in four people are waiting over four hours, and nearly a third of all attendances require admission; the need for more beds could not be clearer.”

These pressures create crowding and add to the risk of harm to patients, as well as deaths and disability, he added.

Last year The Independent revealed how a record heatwave and sustained funding squeeze had sapped the ability of hospitals to recover over summer.

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Despite milder conditions, pressure this winter is coming from the inexorable rise in patient numbers, with more than 2.11 million attendances in January – an increase of 85,000 on 2018.

This is being driven by the increasing elderly population, but also stems from a decade-long funding squeeze which means accessing social care services, GPs and other preventative services has been made harder.

While A&E is the most visible sign of stress, the statistics released on Thursday show performance is suffering in other areas too.

More than 164,000 patients waited over two weeks to see a consultant after being urgently referred by their GP because of suspected cancer in 2018, a 50 per cent rise on 2017, end of year data also released on Thursday shows. Around 4,600 patients waited more than the target of two months to start treatment after a referral, which was a 17 per cent increase.

Macmillan Cancer Support said this is creating “anxiety and even depression” for patients.

‘I understand the cuts but I feel let down,’ says Hannah who was eventually diagnosed with lymphoma (Hannah / Macmillan)

Hannah, 21, from Bradford was referred by her GP with suspected lymphoma in July, and should have seen a consultant within two weeks. In the end it took until November to get diagnosed, after she had chased her own referral, and she only began chemotherapy in December.

“I understand the cuts are having a big effect, but at the end of the day it’s people’s lives,” Hannah told The Independent.

“I feel let down and really quite disappointed. I understand the NHS is free but you can only be so grateful when you’ve been through a year like I’ve been through.”

The waiting list for NHS operations hit its highest level since 2007 last year, and the figures show just 86.6 per cent of patients started treatment within 18 weeks, against a target of 92 per cent.

Despite pressure to cut waits, there were 70,000 fewer consultant-led treatments last year than in 2017, and 200,000 fewer than in 2014, which the Royal College of Surgeons blamed on bed shortages and cancellations.

The recently published NHS 10-year plan sets out how new funding, in place from April, will be used to improve services, but does not address social care, staffing shortages and the future of NHS waiting time targets.

The Royal College of Nursing (RCN) said the figures were a wakeup call. “Speak to anybody at the coalface and they will tell you that it’s patients who are paying the price for the lack of staff and overcrowding at A&Es,” Patricia Marquis, RCN England director said.

An NHS England spokesperson said: “Despite real pressure, particularly over the past few weeks, thanks to NHS staff the health service has seen improved performance since the start of December compared to last winter, with thousands more people successfully treated in A&E within four hours than last year, significantly faster responses to life or death 999 ambulance calls, and unlike last year no national cancellations of routine surgery.”

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