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NHS faces 'bleakest winter yet' as number waiting 12 hours in A&E for bed doubles

More than 50,000 patients waiting four hours or more in corridors and trolleys

Alex Matthews-King

Health Correspondent

Thursday 13 December 2018 17:02 GMT

Overcrowded A&E departments haven’t hit waiting time targets since 2015 but experts have warned they should not be abandoned to spare ministers’ blushes (Getty)

Twice as many patients spent 12 hours or more sitting in A&E trolleys waiting for a bed in November as in the same month last year, as experts warn of the ”the bleakest winter” in NHS history.

A&E performance figures show 54,000 people waited more than four hours for a bed after the hospital had decided they were sick enough to admit.

In this figure, 258 patients waited more than 12 hours for a bed, compared to just 107 waiting in November 2017.

The numbers released on Tuesday reveal the worst November A&E performance on record, with just 87.6 per cent of patients admitted, treated or sent home within four hours attending A&E.

Experts said this was a worrying symptom of unprecedented pressures in 2018, which lasted right through to summer, and which The Independent revealed has scuppered hospitals’ ability to prepare for winter.

In many cases the number of patients who waited more than 12 hours may also have been waiting to be seen at A&E before a decision to admit them.

The NHS is coping with steadily increasing demand, with 2.04 million attendances last month.

Improvements across social care mean many patients are sent home quickly after discharge, freeing up the equivalent of 742 beds across the NHS.

But experts warned there aren’t enough staff available to open up additional beds if more capacity is needed.

“This is deeply troubling,” Niall Dickson, chief executive of the NHS Confederation, said. ”Hospitals are now having to operate at unsafe levels – several are at full bed capacity and over a third are operating at 97 per cent or above bed occupancy.

“The cold, hard reality is that the NHS cannot keep pace with demand. These figures suggest we could be heading for one of the bleakest winters yet.”

Everyone the Government blames for the NHS crisis – except themselves

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1/6Everyone the Government blames for the NHS crisis – except themselves

Everyone the Government blames for the NHS crisis – except themselves

The elderly

“We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital.

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Everyone the Government blames for the NHS crisis – except themselves

Patients going to A&E instead of seeing their GPs

Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service.

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Everyone the Government blames for the NHS crisis – except themselves

Simon Stevens, head of NHS England

Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required.

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Everyone the Government blames for the NHS crisis – except themselves

Previous health policy, not funding

In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals.

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Everyone the Government blames for the NHS crisis – except themselves

Target to treat all A&E patients within four hours

Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame.

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Everyone the Government blames for the NHS crisis – except themselves

No one

Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in.

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Siva Anandaciva, chief analyst at the King’s Fund thinktank, said the number of long waits at A&E was “significantly higher than last year”.

“These figures show little slack in a system which is operating consistently in the red zone,” he added.

The figures for November come as the NHS is reviewing long-standing benchmarks like the four-hour target, and considering removing minor injuries which can safely wait.

But the Royal College of Emergency Medicine and others have criticised the plan, saying that they continue to help improve care and shouldn’t be revised for political convenience.

An NHS England spokesman said: “NHS staff continue to work hard to deal with increased demand across the board, seeing 1,000 more people within four hours in A&E every day in November compared to last year.

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“A growing proportion of people are getting same day emergency care which prevents the need for an overnight stay, and hospitals have freed up an additional 742 beds by working closely with councils to help more people return home with the right care in place.

“As the colder weather begins to set in it’s vital that the NHS and local authorities continue to work together to help people stay well and out of hospital wherever possible, and the public can also help the NHS staff by making sure they have their free NHS flu jab if eligible, and by using NHS 111 as their first port of call for non-emergencies.”

Shadow health secretary Jonathan Ashworth said: “While government remains paralysed by Brexit infighting, the NHS is struggling as a result of years of underfunding, cuts and staffing shortages.

“Rather than their self-interest, Tory ministers must start prioritising patients’ interests by outlining proposals for the NHS this winter.”

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